CMS Stage 3 MU Rule Synposis
Senators propose EHR Regulatory Relief Act to eradicate ‘all or nothing’ meaningful use
Six U.S. Senators have proposed a new bill that would ease reporting requirements, institute a 90-day reporting period and extend hardship exceptions for healthcare providers that cannot attest to the EHR reimbursement incentive program.
“Regulatory flexibility is necessary to help hospitals and medical providers focus on transitioning into the new, patient-focused payment policies created by Congress by the Medicare Access and CHIP Reauthorization Act of 2015 instead of the ‘check-the-box’ meaningful use program,” Senators John Thune (R-SD), Lamar Alexander (R-TN), Richard Burr (R-NC), Mike Enzi (R-WY), Pat Roberts (R-KS), and Bill Cassidy (R-LA) wrote in a bill summary.
Specifically in the EHR Regulatory Relief Act, the Senators recommended codifying the previously proposed 90-day reporting period for eligible hospitals and providers to attest for 2016 the way they did last year, removing the burdensome “100 percent-is-passing” approach to meaningful use, retuning the threshold for providers to meet certain criteria from 75 percent to 70 percent of the metrics and, lastly, extending the existing hardship exceptions for 2016 and 2017 to accommodate providers that cannot attest because of insufficient web connectivity, natural disasters, vendor certification issues and so forth.
“Feedback from the hospital and physician community resoundingly indicates that the burdens of compliance with the meaningful use requirements are negatively affecting hospitals and medical providers,” the Senators wrote.
The same Senators penned legislation to reboot the meaningful use program.
ONC certifies first open API for Stage 3 meaningful use interoperability requirements
The Office of the National Coordinator has awarded its first Stage 3 meaningful use certification for interoperability requirements using the FHIR (Fast Healthcare Interoperability Resources) standard to Carefluence, for its open application programming interface platform, the company announced on July 12.
Carefluence OpenAPI is a plug-and-play software platform compliant with the FHIR standard, which provides insights on datasets to support health information exchange across disparate EHR systems. As a result, any EHR vendor will be able to license Carefluence OpenAPI and offer it to customers, with the knowledge it’s compliant with meaningful use.
“The Carefluence OpenAPI is a living example of a complete FHIR implementation to interconnect any healthcare system, doctor patient or medical device,” Carefluence CTO Aditya Ayyagari said in a statement. “It normalizes all incoming requests and data as appropriate FHIR resources, bringing simplicity and flexibility to the Carefluence platform.”
CMS regulations for open API implementation state the ONC is required to measure the success of each healthcare system in achieving widespread interoperability and every provider with a certified EHR must provide and open API.
Drummond Group, which is authorized by ONC to determine compliance of software to meet interoperability requirements of meaningful use, determined Carefluence OpenAPI platform is able to be deployed along with existing EHRs and can provide open access to EHRS.
“ONC-ACB certification marks a significant moment for Carefluence in furthering the cause of interoperability in healthcare, while taking a progressive step in the direction towards better patient care through enabling technology for data sharing,” Carefluence COO Lloyd Williams added.
Carefluence adopted the FHIR standard in 2014, and its integration software can map with existing data exchange protocols, like HL7, with its secure access management tool using OAuth 20, an authorization framework that allows applications limited access to patient data through user accounts.
The company’s Health IT module is 2015-Edition compliant and is certified in accordance with the Secretary of the U.S. Department of Health and Human Service’s certification criteria, which doesn’t reflect an endorsement by the HHS.
President Obama signed into law the Medicare Access and CHIP Reauthorization Act (MACRA) on April 16, 2015. It passed with a 392 to 37 vote in the House of Representatives, and a 92 to 8 vote in the Senate. That bipartisanship indicates the legislative support for MACRA and the significance of the bill in U.S. healthcare reform.
MACRA replaces the current Medicare reimbursement schedule with a new pay-for-performance program that’s focused on quality, value, and accountability. The Centers for Medicare and Medicaid Services (CMS) stated that MACRA enacts a new payment framework that rewards health care providers for giving better care instead of more service.
MACRA combines parts of the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VBM), and the Medicare Electronic Health Record (EHR) incentive program into one single program called the Merit-based Incentive Payment System, or “MIPS”.
The Merit-Based Incentive Payment System (MIPS) is the name of a new program that will determine Medicare payment adjustments. Using a composite performance score, eligible professionals (EPs) may receive a payment bonus, a payment penalty, or no payment adjustment.
The Composite Performance Score is based on four performance categories:
- Resource use
- Clinical practice improvement activities
- Meaningful use of certified electronic health records (EHR) technology
Performance for MIPS will start on January 1, 2017 and will annually measure eligible providers in four performance categories to derive a “MIPS score” (0 to 100). The MIPS score can significantly impact a provider’s Medicare reimbursement in each payment year from -9% to +27% by 2022. The four performance categories are weighted:
- 50% for quality (PQRS/VBM)
- 25% for Meaningful Use
- 15% for clinical practice improvement
- 10% for resource use
The points provided for each category will shift over time to place an increasing focus on more resource use.
The best way to get ready for MACRA and MIPS is to satisfy Meaningful Use Stage 2 requirements and continue to work on achieving PQRS requirements. CMS has stated that providers already attesting to Meaningful Use and PQRS will likely have no net new requirements.
The MIPS proposed rule is expected in the summer of 2016 and the final rule is expected in November. The final rule will determine how points are earned within each component.
We’ll keep you informed if there are any changes that you need to incorporate into your day-to-day use of your EHR. If you’re a Practice Fusion provider, you’ll receive additional communication from our team to help your practice succeed with this new program.