MU Stage 3 and EHR certification proposed rules issued

The Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) and the Office for the National Coordinator for Health IT (ONC) have published the proposed rule for Meaningful Use (MU) Stage 3, making the program more flexible for providers by establishing a single reporting period for all providers based on the calendar year and allowing providers the option to start Stage 3 in either 2017 or 2018. An additional proposed rule was issued that will improve the way electronic health information is shared.

“Together, these proposed rules will give providers additional flexibility, make the program simpler, and drive interoperability among electronic health records, and increase the focus on patient outcomes to improve care,” according to an announcement from the agencies.

“The flow of information is fundamental to achieving a health system that delivers better care, smarter spending, and healthier people. The steps we are taking today will help to create more transparency on cost and quality information, bring electronic health information to inform care and decision making, and support population health,” said HHS Secretary Sylvia M. Burwell.

The MU Stage 3 proposed rule issued by CMS specifies new criteria that eligible professionals, eligible hospitals, and critical access hospitals must meet to qualify for Medicaid EHR incentive payments. The rule also proposes criteria that providers must meet to avoid Medicare payment adjustments (Medicaid has no payment adjustments) based on program performance beginning in payment year 2018. The rule gives more flexibility and simplifies requirements for providers by focusing on advanced use of EHRs and eliminating requirements that are no longer relevant.

The Stage 3 rule allows for more flexible measures under health information exchange, consumer engagement, and public health reporting. The overall number of objectives is reduced to eight to focus on the advanced use of EHRs. Measures that are redundant or already widely adopted are removed and clinical quality measure reporting is better aligned with other programs.

The draft interoperability roadmap outlines a three-year interoperability agenda for 2015 to 2017 and the proposed rule aims to support that agenda by simplifying provider and consumer electronic access to health information.

The 2015 Edition Health IT Certification Criteria proposed rule builds on past editions of adopted health IT certification criteria, and includes new and updated IT functionality and provisions that support care improvement, cost reduction and patient safety across the health system.

“This Stage 3 proposed rule does three things: it helps simplify the Meaningful Use program, advances the use of health IT toward our vision for improving health delivery, and further aligns the program with other quality and value programs,” said Patrick Conway, MD, MSc, CMS acting principal deputy administrator and chief medical officer. “And, in an effort to make reporting easier for healthcare providers, we will be proposing a new Meaningful Use reporting deadline soon.”

“ONC’s proposed rule will be an integral component in the shared nationwide effort to achieve an interoperable health system,” said Karen DeSalvo, MD, MPH, MSc, national coordinator for health IT. “The certification criteria we have proposed in the 2015 Edition will help achieve that vision through provisions that consider the range of health IT users and uses across the care continuum, including those focused on interoperable standards, data portability, improved transparency, privacy and security capabilities and increased oversight through ONC’s Health IT Certification Program.”

As announced earlier this year, CMS is considering additional MU changes through separate rulemaking.

The Stage 3 proposed rule will be published in the Federal Register on March 30 but a pre-publication draft PDF may be viewed. The comment period ends on May 29. The 2015 Edition proposed rule also is scheduled to be published on March 30 and a pre-publication draft PDF may be viewed. That comment period also ends on May 29.