MGMA-ACMPE Seeks Delay for Stage 2 MU Penalties

Lack of vendor readiness for the move to Stage 2 Meaningful Use means physicians will be unable to meet the requirements for EHR implementation and will be subject to fines starting in 2015, the Medical Group Management Association says.

The Medical Group Management Association has become the newest member in a grumbling chorus of prominent healthcare professional associations that want the federal government to modify components of Stage 2 Meaningful Use implementation.

MGMA-ACMPE President/CEO Susan Turney, MD, in a letter this week to Health and Human Services Secretary Kathleen Sebelius said that concern over "vendor readiness" for the move into Stage 2 Meaningful Use has left physicians in a lurch.

"It has become clear that the alignment between the more rigorous Stage 2 requirements and the ability of the vendor community to produce and deploy Stage 2 certified products has simply not occurred at the pace anticipated," Turney said in the letter.

"If the appropriate steps are not taken, we believe physicians that have made significant investments in (electronic health record) technology and successfully completed Stage 1 requirements will be unfairly subject to negative Medicare payment adjustments. Accordingly, HHS should immediately institute an indefinite moratorium on penalties for physicians that successfully completed Stage 1 meaningful use requirements."

A Lack of Vendor Readiness
Turney said vendors are lagging far behind on Stage 2 EHR systems. She said there are more than 2,200 products and almost 1,400 "complete EHRs" certified under the 2011 criteria for ambulatory eligible professionals. However, there are only 75 products and 21 complete EHRs certified for the Stage 2 criteria, which goes into effect for physicians on Jan. 1, 2014.

"This lack of vendor readiness has significant implications for (eligible professionals). Without the appropriate software upgrades and timely vendor support, EPs will be unable to meet the Stage 2 requirements and thus will be unfairly penalized starting in 2015," Turney said.

"Those EPs who invested considerable resources in their Stage 1 certified EHR, many of them in small or rural clinical settings, are now in danger of falling behind. To avoid the Medicare payment adjustments, EPs would be required to 'rip and replace' their existing EHR with one certified for the Stage 2 criteria. This is an unrealistic and unreasonable demand as the cost to the practice would be prohibitive and the disruption to organizational workflow and patient care would be significant."

AHA, AMA Also Want Delay
Last month the American Hospital Association and the American Medical Association sent a joint letter to Sebelius asking that the implementation date for Stage 2 be delayed. The two professional associations echoed MGMA's concerns about the lack of readiness on the part of EHR vendors as a primary reason for the needed delay.

Stage 2 implementation for hospitals takes effect on Oct. 1.

"Our members, and the vendors they work with, report growing concerns that the rapidly approaching start date for Stage 2 is on a trajectory that will not provide enough time or adequate flexibility for a safe and orderly transition unless certain changes are made," the AHA/AMA letter said.

The College of Healthcare Information Management Executives (CHIME) in May called for a one-year delay for implementation of Stage 2, noting that the delay "will give providers the opportunity to optimize their EHR technology and achieve the benefits of Stage 1 and Stage 2; it will give vendors the time needed to prepare, develop and deliver needed technology to correspond with Stage 3; and it will give policymakers time to assess and evaluate programmatic trends needed to craft thoughtful Stage 3 rules.

Last week, the Healthcare Information and Management Systems Society called for launching Stage 2 on schedule, but extending Year 1 of the Meaningful Use Stage 2 attestation through mid-2015 for hospitals and physicians. The society said the additional 18 months "encourages continued progress while simultaneously acknowledging short-term obstacles."

"Perfect Storm" of Regulatory Compliance Issues
On Aug. 7 the American Academy of Family Physicians asked Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner "not to delay the implementation of MU stage two, but to extend the timeframe for compliance with MU stage two requirements by 12 months."

AAFP Board Chair Glen Stream, MD, told Tavenner that "2014 brings a perfect storm of regulatory compliance issues for family physicians that, we fear, may derail health information technology adoption and substantially interfere with our shared progress toward achieving better care for patients, better health for communities and lower costs through improvements to the healthcare system."