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Meaningful Use Stage 3 Final Rules Elicit Mixed Reactions

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   October 07, 2015

The American Medical Association applauds CMS for allowing a hardship exemption for physicians who are unable to attest in 2015, but calls the final rule, as a whole, "deeply disappointing." The American College of Cardiology says that the program requirements "[remain] difficult to implement."

Despite pleas within the past week from more than 100 members of Congress and various healthcare stakeholders for stage 3 rules to be postponed, the Department of Health and Human Services, with the release Tuesday of twin rules totaling 1302 pages, signaled what it intends to publish in the Federal Register on October 16.

Many healthcare providers have yet to successfully achieve stage 2.

HHS says it is providing a simpler, more flexible set of stage 2 regulations for 2015 through 2017 as the meaningful use regulation era gives way to CMS's transition to value-based compensation.

"We have a shared goal of electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people," said Patrick Conway MD, CMS deputy administrator for innovation and quality and chief medical officer, in a statement.

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"We eliminated unnecessary requirements, simplified and increased flexibility for those that remain, and focused on interoperability, information exchange, and patient engagement. By 2018, these rules move us beyond the staged approach of 'meaningful use' and focus on broader delivery system reform."

After CMS's March and April notice of proposed rule-making (NPRM) regarding stage 3 and adjustments to stage 2, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which will sunset the meaningful use "payment adjustments," in essence, penalties for noncompliance, at the end of 2018. Instead, Congress has called for the establishment of a Merit-Based Incentive Payment System (MIPS), of which the meaningful use program will form one component.

Due to this interim Congressional action, CMS in its final stage 3 rule said it would allow for an additional 60-day comment period, starting upon enactment of the stage 3 rule, regarding the transition from meaningful use to MIPS. Afterward, CMS may modify its final rules and lay the groundwork for an NPRM in mid-2016 detailing the implementation of MIPS.

Industry Reaction
Initial reaction to the final rule was mixed. Providers applauded the relaxation of 2015 requirements, and some applauded the retirement of some process measures that currently must be satisfied in order for providers to successfully attest they have met meaningful use's requirements.

But concerns remain about the complexity of the existing program, issues such as lack of interoperability among EHRs, and what providers still say is too hasty a timetable for adoption of stage 3-certified EHR software.

"Today's release of the meaningful use rules is a mixed bag for hospitals and health systems and the patients they serve," said Rick Pollack, president and CEO of the American Hospital Association, in a statement.

"We are pleased that CMS released the long-awaited modifications rule, which will allow hospitals a 90-day reporting period in 2015 along with other flexibilities in response to AHA concerns. Hospitals will finally have the clarity they need to take steps to ensure they meet the revised requirements.

Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.

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