HHS Issues Proposed Rule for Stage 3 of EHR Incentive Program

By Jessica Russell

On March 30, 2015, the Department of Health and Human Services (“HHS”) published its proposed rule for Stage 3 the Electronic Health Record Incentive Program (the “EHR Program”). The EHR Program is a three stage program that provides incentive payments to eligible professionals and eligible hospitals and critical access hospitals (“CAHs”) (collectively, “eligible providers”) that attain “meaningful use” of an EHR by meeting the specific criteria of their respective stage in the EHR Program. Currently, providers are in Stage 1 or Stage 2, depending on when they began their participation in the EHR Program.

While some providers have elected not to implement an EHR due to the high costs, administrative burdens, and dissatisfaction with the structure of the program, starting this year Medicare providers that have failed to obtain meaningful use of an EHR are subject to penalties.

With HHS’s newly proposed rule, HHS attempts to address many of the issues that have plagued providers since the EHR Program’s inception, including the burden of reporting to multiple quality reporting programs, the number of EHR Program requirements, the timing of EHR meaningful use reporting periods, and the numerous stages of participation. HHS has stated its goal in Stage 3 is to broadly increase “simplicity and flexibility in the program while driving interoperability and a focus on patient outcomes in the meaningful use program.” Overall, HHS’s proposed rule aims to have all participating providers in Stage 3 and subject to the same meaningful use and EHR Program standards by 2018.

In order to streamline and simplify the EHR Program, HHS intends to establish a single set of objectives and measures for the definition of meaningful use (tailored to eligible professionals or eligible hospitals and CAHs). In 2017, all eligible providers would have the option to attest to these objectives and measures in lieu of the requirements of their current stage in the EHR Program. However, as of 2018, all eligible providers would be required to attest to Stage 3 meaningful use, regardless of their current stage in the program.

In addition, HHS intends to expand the reporting period by requiring eligible providers to attest to a full year of data to demonstrate meaningful use in Stage 3. Certain Medicaid eligible professionals and eligible hospitals demonstrating meaningful use for the first time would be exempt from this requirement and only subject to a 90 day continuous reporting period for that year to meet meaningful use standards.

HHS has also suggested solutions to minimize the burden of reporting Clinical Quality Measures (“CQMs”), which are measures that must be reported by eligible providers in order to qualify for the incentive payments and avoid penalties. Specifically, reporting under the EHR Program would be aligned in a single reporting mechanism with Hospital Inpatient Quality Reporting (IQR) and the Physician Quality Reporting System (PQRS). To effectuate further efficiency and integration, HHS proposes to require eligible providers to report CQMs electronically in 2018.

HHS is accepting public comments on this proposal rule until May 29, 2015.