Medicare Compliance & Reimbursement

Adoption of the 2014 Edition Certified EHR Technology (CEHRT) could hold the key to ending MU woes.

Meaningful use of the electronic health records (EHR) system seems to have become a source of tension for many providers. As you hurry to comply with meeting the Stage 1 and Stage 2 deadline, a proposal by the Centers for Medicare & Medicaid Services (CMS) could give you some respite.

On May 23, the Office of the National Coordinator for Health Information Technology (ONC) and CMS issued a proposed rule to modify the meaningful use Stage 1 and Stage 2 timeline for the EHR Incentive Programs. Here is what your practice needs to know:

Enjoy a Stage 2 Deadline Extension

The proposed rule extends the deadline for providers to meet the Stage 2 criteria for making meaningful use of EHRs, explained Orlando, FL-based partner Robert Slavkin in a May 27 posting for Akerman LLP’s Health Law Rx Blog. “Under Stage 2, providers not only transmit patient records electronically when making referrals, but they also must be capable of sending charts to a physician with a different EHR system.”

Stage 2 also requires providers to ensure that patients use EHRs by requiring that at least 5 percent of patients send a message to their physicians using a portal within the EHR system and that 5 percent access their health information online, Slavkin noted.

Why? Many providers have been unable to timely acquire, adopt, or fully implement the 2014 Edition Certified EHR Technology (CEHRT), which CMS requires for successfully demonstrating meaningful use for Stage 1 and Stage 2 in 2014, according to a May 27 analysis from the law firm Ropes & Gray, LLP.

Choose From 3 Compliance Options

“As such, CMS proposes allowing eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) that have not been able to fully implement 2014 Edition CEHRT for the 2014 reporting year to use the 2011 Edition CEHRT, or a combination of the 2011 and 2014 Edition CEHRT, for the meaningful use reporting periods in 2014,” Ropes & Gray reported.

If you use the 2011 Edition only, you must meet the meaningful use objectives and measures for Stage 1 that were applicable for the 2013 payment year, regardless of your current stage of meaningful use, Ropes & Gray explained. If you’re using a combination of the 2011 and 2014 Editions, you could choose to meet the 2013 Stage 1 or the 2014 Stage 1 objectives and measures. Or if you are scheduled to begin Stage 2 in 2014, you could choose to meet the Stage 2 objectives and measures.

If you choose the third option — using the 2014 Edition CEHRT only — you could attest to the 2014 Stage 1 objectives and measures for the 2014 meaningful use reporting period, even if you’re unable to fully implement all the functions of your 2014 Edition required for Stage 2.

But to take advantage of the delays, you must attest that you were unable to upgrade or fully implement to the 2014 Edition CEHRT because of issues related to availability, wrote attorney Elana Zana in a May 21 blog posting for the Seattle-based law firm Ogden Murphy Wallace Attorneys.

The proposed rule also makes a formal announcement of CMS’s previously announced plans to extend Stage 2 through 2016 and begin Stage 3 in 2017, after provider complaints about the original deadlines, Slavkin said. But even with this extension, beginning in 2015, you will still need to report to CMS using the new technology.

Delay Won’t Forgive Noncompliance

Despite the reprieve on Stage 2, you’re still facing penalties for noncompliance. “Beginning in 2015, lack of EHR compliance means penalties for providers in the form of reduced reimbursements,” Slavkin warned. “For the first year, Medicare reimbursements will be reduced by 1 percent for providers that don’t meet EHR standards. That penalty jumps to 2 percent the following year and 3 percent every year afterward.”

Bottom line: “While this extension of time to allow compliance with Stage 2 is welcome news, implementation and compliance are still a priority that must stay on all providers’ radar screens,” Slavkin stressed.

Read more: To read the proposed rule, go to www.gpo.gov/fdsys/pkg/FR-2014-05-23/pdf/2014-11944.pdf.