Final regulations for the second stage of the Meaningful
Use incentive program for electronic health records (EHRs), as expected,
call on hospitals, physicians, and other "eligible providers" to
increase interoperability of health information, adopt more standardized
data formats, and generally make their EHR systems more capable than in
the current Stage 1.
Federal officials in late August released the final Stage 2 rule for Meaningful Use and accompanying final rule on certification of EHR technology.
The 2009 American Recovery and Reinvestment Act, which authorized the
$27 billion program, requires providers to use certified EHRs in order
to earn bonus payments from Medicare, Medicaid or both for Meaningful
Use.
Stage 2 will begin in 2014, a year later than
ARRA originally called for, or two years after a provider first achieves
Stage 1 requirements. Providers can start earning Stage 1 incentive
payments as late as 2017, although Medicare will impose penalties for
not achieving Meaningful Use by 2015.
For 2014 only, all providers regardless of their stage of
meaningful use are only required to demonstrate meaningful use for a
3-month EHR reporting period. For Medicare providers, this 3-month
reporting period is fixed to the quarter of either the fiscal (for
eligible hospitals and CAHs) or calendar (for EPs) year in order to
align with existing CMS quality measurement programs, such as the
Physician Quality Reporting System (PQRS) and Hospital Inpatient Quality
Reporting (IQR). The 3-month reporting period is not fixed for Medicaid
EPs and hospitals that are only eligible to receive Medicaid EHR
incentives, where providers do not have the same alignment needs. CMS is
permitting this one-time 3-month reporting period in 2014 only so that
all providers who must upgrade to 2014 Certified EHR Technology will
have adequate time to implement their new Certified EHR systems.
Core and Menu Objectives
Stage 2 uses a core and menu
structure for objectives that providers must to achieve in order to
demonstrate meaningful use. Core objectives are objectives that all
providers must meet. There is also a predetermined number of menu
objectives that providers must select from a list and meet in order to
demonstrate meaningful use.
To demonstrate meaningful use under Stage 2 criteria—
- EPs must meet 17 core objectives and 3 menu objectives that they
select from a total list of 6, or a total of 20 core objectives.
- Eligible hospitals and CAHs must meet 16 core objectives and 3 menu
objectives that they select from a total list of 6, or a total of 19
core objectives.
A third and
final stage of Meaningful Use (stage 3) is scheduled to begin in 2016.
To date, CMS has paid out $6.6 billion in incentive money to about 3,600
hospitals and more than 128,000 individuals.
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