CMS: Meaningful Use Stage 1 changes explained

Meaningful Use (MU) Stage 2 has been the talk of the healthcare community since the Centers for Medicare & Medicaid Services’ (CMS) Aug. 23 final rule was released, but the rule also contains changes to Stage 1 that providers who have yet to attest should know about.

Robert Anthony, a health specialist in the Office of E-Health Standards and Services at CMS, discussed Stage 1 changes and Stage 2 details during an Aug. 30 webinar hosted by Physicians Practice.

Eligibility
Hospital-based eligible providers (EPs) have been defined as those who do 90 percent or more of their clinical work in an inpatient or emergency department setting. This barred a number of providers who frequently billed inpatient or emergency department settings without the benefit of a hospital EHR system from receiving financial incentives.

EPs who are able to demonstrate that they have funded the implementation and maintenance of EHRs without reimbursement from an eligible hospital will now be able to receive incentive payments as non-hospital-based EPs. Determinations will be made through an application process.

2014
Stage 2 was initially planned to begin in 2013, but the final rule delayed the start until 2014.

Beginning in 2014, EPs in both Stage 1 and Stage 2 will be eligible for incentives only if they attest using certified EHR technology, as outlined in a separate final rule published by the Office for the National Coordinator of Health IT.

CMS will allow a one-year only 90-day reporting period in 2014 for Stage 2 to provide time for certified EHR implementation. Providers attesting to Stage 2 in all subsequent years will be required to report for full years.  

Those who attested to Stage 1 MU in 2011 will be allowed a third year at Stage 1 because of the delay. Those who attest or have attested to Stage 1 in later years will proceed as originally planned, with a 90-day reporting period in their first year and a year-long reporting period in their second year before moving on to Stage 2 in their third year.

Stage 1 Changes
EPs can continue to claim exclusions for menu objectives, but they will no longer count toward the number of menu objectives needed to attest.

Clinical quality measures (CQMs) are no longer a core objective of MU beginning in 2014, but providers are still required to report on CQMs to demonstrate MU.

Several Stage 1 measure revisions will go into effect beginning in 2014:

• The denominator for the computerized provider order entry measure will change from “unique patient with at least one medication list” to “number of orders during the EHR reporting period.”
• Age limits for the vital signs measure will change from two years old for blood pressure, height and weight to  three years old for blood pressure and no age limit for height and weight.
• The objective for the online access will change to “provide patients with the ability to view online, download and transmit their health information.
• The health information exchange testing requirement will be removed beginning in 2013.