CMS proposes big changes to EHR meaningful use

On July 6, 2016, the Centers for Medicare & Medicaid Services (CMS) proposed significant changes to the Electronic Health Record (EHR) Incentive Program via the Hospital Outpatient Prospective Payment Proposed Rule, including a proposal to reduce the 2016 EHR reporting periods for returning Eligible Professional (EP), Eligible Hospital (EH) and Critical Access Hospital (CAH) participants from the full calendar year 2016 to any continuous 90 day period within calendar year 2016. First-time participants already have a 90-day reporting period option. In addition, CMS proposed the following changes to the meaningful use objectives and measures beginning in 2017:

• Elimination of Clinical Decision Support (CDS) and Computerized Provider Order Entry (CPOE) objectives and measures for 2017 and subsequent years in order to reduce reporting/administrative burden for EHs and CAHs. CMS noted that these measures appear to be “topped out.”
• For Modified Stage 2 reporting in 2017, reduction of the View, Download, and Transmit (VDT) measure requirement from more than 5 percent to at least one patient.
• For Stage 3 reporting in 2017 and 2018, reductions of the following thresholds:
  • For Patient Access measure, reduce threshold from more than 80 percent to more than 50 percent.
  • For Patient-Specific Education measure, reduce threshold from more than 35 percent to more than 10 percent.
  • For Secure Messaging measure, reduce threshold from more than 25 percent to more than 5 percent. 
  • For Patient Care Record Exchange measure, reduce threshold from more than 50 percent to more than 10 percent. 
  • For Request/Accept Patient Care Record measure, reduce threshold from more than 40 percent to more than 10 percent. 
  • For Clinical Information Reconciliation measure, reduce threshold from more than 80 percent to more than 50 percent.
  • For Public Health and Clinical Data Registry reporting, the requirement would be reduced from any combination of six measures to any combination of three measures. 
• For all EPs, EHs and CAHs that choose to report Clinical Quality Measures (CQMs) via the attestation process in 2016, proposal to reduce from a full year to a 90 day reporting period.
• For EPs, EHs and CAHs that are first-time participants in 2017, requirement that such participants attest to Modified Stage 2 objectives and measures by October 1, 2017, in order to avoid payment adjustment penalty.
• For EPs who are first-time participants in 2017 and are transitioning to the Merit-Based Incentive Payment System (MIPS) in 2017, proposal for a one-time significant hardship exception from the 2018 payment adjustment. 

Although these changes do not apply to EHs and CAHs that attest to meaningful use under their State’s Medicaid EHR Incentive program, CMS is inviting comments on whether these proposals should apply to Medicaid attestations as well. CMS is requesting comments on all of the proposed changes. The deadline for submitting comments is September 6, 2016. 

Bricker & Eckler will be monitoring the comment period and final rule and will be issuing additional information as it becomes available.