As predicted, the rule modifying meaningful use in 2014—now referred to as “The Flexibility Rule”—was finalized basically as proposed. Pleas for future flexibility, however, were rejected. (For a review of the details, read EMR Straight Talk’s Kudos to CMS for MU 2014 Proposed Rule).The good news is that for 2014, many providers can report Stage 1 again instead of Stage 2, and some providers can report using 2011-certified EHR technology instead of 2014 CEHRT.
Providers who exercise any of the flexible options will have to attest to the following statement: “EP was unable to fully implement 2014 Edition CEHRT for a full EHR reporting period in 2014 due to delays in 2014 CEHRT availability,” and they should be prepared to support their decision if they are audited pre- or post-attestation. Potential justifications include—for example—certification delays or implementation backlogs, software problems once the EHR was implemented or upgraded, delayed installation of required integrations/interfaces, insufficient time to make necessary workflow revisions, etc. Provider inaction or delay, financial constraints, inadequate staffing, and the contention that Stage 2 is just too darn hard—while certainly understandable—are not considered legitimate justifications under the rule.
Many of the comments submitted on the Proposed Rule had asked (“pleaded” would be a more accurate word) for flexibility beyond that which was offered. The biggest “ask” in this regard was for quarterly reporting again in 2015, as it is in 2014, rather than full calendar year reporting. CMS rejected that request outright. Undeterred by that response, numerous healthcare professional organizations subsequently submitted their recommendations on the future of meaningful use directly to the Secretary of HHS and the head of ONC—the two organizations responsible for the program. In addition, “The Flex-IT Act” (recently introduced by representatives Renee Ellmers and James Matheson) attempts to mandate a return to 3-month reporting.
While it may be tempting to dream that the bill will become law or that CMS will relent, the only safe assumption at this time is that the 2015 meaningful use reporting period will begin on January 1. Therefore, any physicians who want to pursue meaningful use incentives in 2015 will need to have a 2014-certified EHR in place by January 1 (if they are not already using one), and physicians who will be at Stage 2 next year should devote the next 2 months to preparing to support the increased requirements—installing required interfaces and integrations, implementing Direct, and developing new workflows as needed.