Last week, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) finalized new rules for the Electronic Health Records (EHR) meaningful use program.  In response to significant public criticism of the program, the final rulemaking offers some additional flexibility for complying with the program’s requirements.

The new rules build on two proposed rules issued earlier this year: Electronic Health Record Incentive Program Stage 3, 80 Fed. Reg. 16731 (March 30, 2015), and Electronic Health Record Incentive Program—Modifications to Meaningful Use in 2015 through 2017, 80 Fed. Reg. 20346 (April 9, 2015).

According to CMS and ONC, the final rules are designed to simplify program requirements, introduce “flexibility within certain objectives,” and “focus on interoperability.”  For example, the final rules establish that Stage 3 compliance will be optional, not mandatory, for 2017.  Stage 3 will not become mandatory until 2018. In addition, the agencies shortened the 2017 reporting period for some providers.  Under the proposed rules, the 2017 reporting period for providers would have been a full year, with an exception for providers in the Medicaid EHR Incentive Program.  In the final rule, the exception to full-year reporting is expanded to cover all providers attesting to Stage 3 compliance.  Providers attesting to Stage 3 compliance in 2017 will only be subject to a 90-day reporting period.

CMS and ONC also use this rulemaking to solicit comments on the implementation of the EHR provisions in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). As CMS and ONC explain, MACRA “altered the EHR Incentive Programs such that the existing Medicare payment adjustment for [Eligible Professionals] under 1848(a)(7)(A) of the Act will end in CY 2018 and be incorporated under [the Merit-Based Incentive Payment System] beginning in CY 2019.” CMS and ONC intend to issue a notice of proposed rulemaking implementing MACRA by mid-2016. In preparation for that proposed rulemaking, the agencies solicit comments for 60 days on how they should transition to MIPS.