MU Stage 2 Proposed Rules Released

Senior editor Cheryl Clark provided additional reporting.

The long-anticipated proposed rules for meaningful use Stage 2 were released late Thursday by the Department of Health and Human Services.

In a press conference at the annual conference for the Healthcare Information and Management Systems Society, (HIMSS) Farzad Mostashari, head of the Office of the National Coordinator for Health IT, characterized the proposed rules as "reducing the regulatory burden" for providers. He noted that the proposed rules are consistent with recommendations by the Health IT Policy and Health IT Standards committees.

"It's our expectation that the vast majority of providers and nearly every hospital will become meaningful users."

Mostashari highlighted these aspects of the proposed rule:

• It continues the core and menu objectives. He said the Department of Health and Human Services considered eliminating the menu objectives but decided it was important to provide that flexibility of meeting both core and menu objectives.
• Regardless of when they start, everyone would have two years in Stage 1, two years in Stage 2, and two years in Stage 3
• A 90-day reporting period would be retained for the first year
• It allows medical groups to report quality measures as a group instead of on an individual basis. In a practice with 20 doctors, for example, there would be no need to individually slice out which provider had which quality measure. Mostashari said that's more in line with the principle of team and accountable group care.
• HHS is seeking comments on whether group reporting should be extended to functional measures such as prescribing measures.
• By default, vendors would enable encryption on end user devices

When asked how future events such as a Supreme Court ruling and the results of upcoming elections might put elements of health IT at risk, Mostashari said at HIMSS that he has heard no discussions that suggest problems.

He noted that health IT has broad bipartisan support. "I think that everyone recognizes that…we need to have better information to move toward whatever model reform takes."

When asked to put meaningful use in perspective with regard to healthcare reform efforts, Mostashari noted that providers now care about how they do on quality and patient satisfaction measures, and how well they coordinate care.

"There are such a number of payment changes happening. It's almost as if Medicare unplugged a dam and there's just an explosion of new initiatives. It's really, really good because it provides, finally, a business case for the coordination of care that we need and frankly which health IT enables."

He added that making meaningful use of meaningful use "is absolutely where to start."

The 455-page document released by HHS also includes these points:

• Stage 1 of meaningful would be extended to fiscal year 2014 and eligible providers would have two full years to participate in Stage 2
• There would be two new menu objectives: Electronic reporting to registries and viewing images through electronic health records
• Eligible providers must meet 17 core objectives and three of five menu objectives
• Hospitals must meet 16 core objectives and two of four menu objectives
• Hospitals and physicians would have to use CPOE for more than 60% of medication, laboratory and radiology orders
• Providers would be required to enable patients to view, download, and transmit their medical records online
• Specialists could qualify for meaningful use by using EHRs that are certified to meet the needs of their specialties
• Stage 2 regulations would require the alignment of clinical quality measures and reporting across accountable care organizations and patient-centered medical homes

The HHS fact sheet may be viewed here. Comments will be accepted for 60 days after the proposed rules are in published in the Federal Register. The final rule is scheduled for release this summer.

Senior editor Cheryl Clark provided additional reporting.