The Centers for Medicare & Medicaid Services (“CMS”) finalized a rule on August 29th which should give providers some breathing room in complying with meaningful use requirements for the Electronic Health Record (“EHR”) Incentive Program (the “Final Rule”).  The EHR Incentive Program was developed by CMS to motivate health care providers to use and implement EHR systems.  Under the EHR Incentive Program, hospitals and healthcare professionals can qualify for incentive payments from CMS for “meaningful use” of certified EHR technology (“CEHRT”).  However, both the definition of “meaningful use” and the technologies which qualify as CEHRT are moving targets under the EHR Incentive Program and vary by “Stage.”  The EHR Incentive Program consists of Stages 1, 2 and 3 which represent set time periods during which providers must implement CEHRT to receive payments.  Each Stage has progressively more robust meaningful use objectives and clinical quality measures.  As a result, providers must continually update their EHR technology and quality assurance programs to receive payments under each Stage.

With the Final Rule, CMS has modified its requirements for CEHRT in order to enable “more providers to participate and meet meaningful use objectives like drug interaction and drug allergy checks, providing clinical summaries to patients, electronic prescribing, reporting on key public health data and reporting on quality measures.”^[1] CMS cited public comments and feedback from stakeholders as its motivation for the Final Rule.

Key changes include:

• Providers may be able to use previous editions of CEHRT to meet 2014 reporting requirements under the EHR Incentive Program.

• Stage 2 of the EHR Incentive Program has been extended for a full year through October 1, 2016 (institutional providers) or January 1, 2017 (non-institutional providers).   As a result, Stage 3 of the program has been delayed until such dates.

• CMS has modified reporting requirements for clinical quality measures based on which CEHRT a provider chooses.

The relief provided by the changes above is significant, but the Final Rule did not provide details on 2014 reporting when combinations of CEHRT are used nor did the Final Rule change the reporting requirements for 2015.

The Final Rule is likely to have a positive impact for a great number of providers who have struggled with meeting the stringent EHR deadlines set by CMS.  Providers who find themselves unable to comply with CMS’s original schedule should carefully explore the flexibility measures the Final Rule provides.

Despite the benefits to numerous providers, the Final Rule has also caused consternation among a few stakeholders.  Early adopters of EHR technology may feel that the Final Rule penalizes providers who were on track per the original implementation schedule set by CMS.^[2]  Furthermore, such providers could face difficulty fulfilling interoperability measures for the EHR Incentive Program since some late adopters have not necessarily adopted Stage 2 technology.  Those providers who were on track to comply should conduct an assessment of how the Final Rule may impact their business and prepare to adapt their approach to the new requirements.

_{[1] Centers for Medicare and Medicaid Services, “New CMS rule allows flexibility in certified EHR technology for 2014.” CMS Press Release, August 29, 2014.}

_{[2] Darius Tahir, “CMS finalizes EHR meaningful-use rule, adds some flexibility.” Modern Healthcare – Healthcare Business News, August 29, 2014.}