CMS Releases Stage 3 Proposed Rules

Tuesday, April 14, 2015

The Centers for Medicare and Medicaid Services (CMS) has released the proposed rule for Stage 3 of Meaningful Use under the Health Information Technology for Economic and Clinical Health (HITECH) Act.

Program Structure & Timing

If approved, the proposed rule for Stage 3 will be considered the final MU stage and begin in 2017 and include measures to earn incentives or avoid payment penalties. One of the major proposals for Stage 3 is for CMS to establish a single set of objectives and measures, tailored to eligible providers, eligible hospitals, and critical access hospitals (CAHs). This will be optional for providers in 2017 and required by 2018, regardless of a provider's prior participation in the Electronic Health Record (EHR) Incentive Program.

  • All participants will:
    • use a single stage of meaningful use in 2018
    • be required to attest based on a full year of data for a single set of meaningful use objectives and measures to demonstrate Stage 3 (optional in 2017, required in 2018)
  • For CAHs ONLY: Change the relationship between EHR reporting period year and payment adjustment year.
  • All first-time MU participating providers would report under a full calendar year timeline beginning in 2017
    • Limited exception: First-time MU participants under Medicaid Incentive Program
  • Proposing changes to EHR reporting period beginning with the EHR reporting period in 2017
    • Limited exception: First-time MU participants under Medicaid Incentive Program
    • For incentive payments for the 2017 payment year, the EHR reporting period would be the full 2017 calendar year.
      • Proposal means that EHs and CAHs will have a reporting gap for objectives and measures (3 months)
        • May still have to report on CQMs over this timeframe

Thumbnail of Proposed ObjectivesClinical Quality Measures

  • Reporting options that included paper-based workflows, chart abstraction, or other manual actions would be removed
    • Transition to an electronic format utilizing EHR functionality for Stage 3
      • Encourages electronic submission in 2017
      • Requires the electronic submission in 2018

Objectives & Measures

Stage 3 focuses heavily on interoperability and patient engagement.

  • Removes Core/Menu structure
  • Removes “Topped Out” measures (i.e. objective to record demographics)
  • Proposes that paper-based formats would not be required or allowed
  • Proposes set of eight objectives that all providers must successfully attest to or meet exclusion criteria.

Tags: Quality Services

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