Health IT, Policy

Bill would shorten Meaningful Use reporting period, delay Stage 3

Rep. Renee Elmers (R-N.C.) on Thursday introduced legislation that would prevent the Centers for Medicare and Medicaid Services from even writing the final Stage 3 Meaningful Use rules until at least 2017. It also would permanently shorten the annual attestation period to 90 days, rather than the full year, and institute a “linear scale” next year for compliance to replace the current all-or-nothing nature of the EHR incentive program.

 

The latest congressional attack on Meaningful Use comes not from the Senate Health, Education, Labor and Pensions Committee, but from the House of Representatives.

Rep. Renee Elmers (R-N.C.) on Thursday introduced legislation that would prevent the Centers for Medicare and Medicaid Services from even writing the final Stage 3 Meaningful Use rules until at least 2017. It also would permanently shorten the annual attestation period to 90 days, rather than the full year, and institute a “linear scale” next year for compliance to replace the current all-or-nothing nature of the EHR incentive program.

CMS proposed Stage 3 regulations in March, and expects to finalize them before the end of 2015. The third and final state would begin no earlier than 2017.

The Stage 3 rulemaking delay that Ellmers wants could last beyond 2017. The Further Flexibility in HIT Reporting and Advancing Interoperability Act (H.R. 3309), a.k.a. the Flex-IT 2 Act, would block CMS from finalizing Stage 3 rules until the Medicare agency finishes Merit-based Incentive Payment System (MIPS) rules, as called for in the “Doc Fix” legislation that passed in April.

CMS also could go forward with Stage 3 after at least 75 percent of eligible hospitals and individual providers meet Stage 2. As of January, just 19 percent of doctors and other individuals and 48 percent of hospitals had done so, according to Centers for Disease Control and Prevention statistics that Ellmers cited. (CMS numbers are higher because that agency bases success on the percentage of providers that have registered their intention to attest to Meaningful Use, a much lower denominator.)

“Today’s legislation is key to supplying healthcare providers with flexibility and certainty, as they struggle yet again to meet the Centers for Medicare & Medicaid Services’ (CMS) stringent requirements pertaining to Meaningful Use. This legislation supplies relief by delaying Stage 3 rulemaking until at least 2017 in order to give providers time to breathe and a reprieve from the unfair penalties,” Ellmers, a nurse, said in a written statement.

She called the low attestation rates “a clear sign that physicians, hospitals and healthcare providers are challenged in meeting CMS’ onerous requirements.”

Said Ellmers, “Given this basic fact, I’m uncertain why CMS would continue to push forward with a Stage 3 rule. From my conversations with doctors back home, it is clear they are eager for relief.”

At least one provider-side organization, the College of Healthcare Information Management Executives, representing hospital CIOs, expressed strong support for the bill.

“While CHIME remains committed to the success of Meaningful Use, and to making sure improved patient care is its lasting legacy, we believe significant changes are needed to address increased dissatisfaction with EHRs and growing provider dissatisfaction with the program,” CHIME CEO Russell Branzell and Board Chair Charles E. Christian said in a joint statement. “The introduction of the Flex-IT 2 Act serves to strengthen accountability and effectiveness of an e-enabled healthcare system and ensure long-term vitality of Meaningful Use.”

The “2” designation is because another Ellmers-sponsored bill, H.R. 270, is called the Flex-IT Act. That piece of legislation, which Ellmers introduced in January after a previous version died in the last Congress, calls for a three-month Meaningful Use reporting period, rather than the full year, in 2015.

The first Flex-IT Act, which remains in committee, could become unnecessary, as CMS has already proposed making that change through the regulatory process. A final CMS decision on Stage 2 modifications should be published this summer.

Photo:  Flickr user Will Palmer