Doctors who want to earn Medicare and Medicaid incentives for the meaningful use of electronic health records will not have to meet so-called stage 2 requirements until 2014, under final federal regulations that were released on Aug. 23.
More than 120,000 eligible health care professionals and more than 3,300 hospitals have qualified to receive such incentive payments under stage 1 of meaningful use, which requires physicians to certify that EHRs can capture and report data, among other issues, according to the Health and Human Services department.
Under stage 2, users must show that they can exchange data with other providers and that they can give patients secure online access to their health information.
Original federal proposals required providers to meet stage 2 requirements next year. The delay was hailed by at least one group of physicians.
"MGMA is pleased that the Centers for Medicare and Medicaid Services responded to our concerns regarding several of the proposed stage 2 meaningful use requirements," said Dr. Susan Turney, president and CEO of MGMA-ACMPE, the merged entity of the Medical Group Management Association (MGMA) and the American College of Medical Practice Executives (ACMPE), in a statement."Extending the start for stage 2 until 2014 was a necessary step to permit medical groups sufficient time to implement new software," she added.
Dr. Turney also said that MGMA-ACMPE members applauded some other changes to the proposal, including "lowering the thresholds for achieving certain measures such as mandatory online access and electronic exchange of summary of care documents."
Other important provisions in the final rule exempt certain physicians from the penalties that will be assessed come 2015 on those providers who do not adopt EHRs.
Physicians or hospitals will be exempt from the 1% reduction in Medicare reimbursement if they can show that the following apply to them:
• They lack Internet access, or face barriers to obtaining health information technology infrastructure.
• They are newly practicing.
• They have to contend with unforeseen circumstances, such as natural disasters.
The rule also makes exceptions for physicians who have limited interaction with patients, who practice at multiple locations, or who have no control over the availability of EHRs at locations that make up more than half of their patient encounters.
"These exclusions will allow physicians to achieve meaningful use with fewer hurdles," said Dr. Turney.
Kathleen Sebelius
The American Medical Association took a more cautious approach, at least in an initial statement by board chair Steven J. Stack. "In a comment letter submitted by the AMA and 100 state and specialty medical societies in May, recommendations were outlined to eliminate physician roadblocks and encourage greater physician participation," said Dr. Stack. "We will carefully review the final rule and hope to see the changes we advocated for to promote widespread adoption and meaningful use of EHRs by physicians."
The rule also further clarifies certification criteria for EHRs, and modifies the certification program to "cut red tape and make the certification process more efficient," according to an HHS statement. All EHRs that have been certified under the 2011 rules can be used until 2014.
"The changes we’re announcing today will lead to more coordination of patient care, reduced medical errors, elimination of duplicate screenings and tests and greater patient engagement in their own care," said HHS Secretary Kathleen Sebelius in the statement.