D.C. Report: Meaningful Use Stage 2, ICD-10 Compliance Delay Finalized

April 9, 2013
Christmas came August 23rd this year for those of us health IT policy wonks. And our presents were so complex we were still trying to figure out how to make it work the next day. I am, of course, talking about Meaningful Use Stage 2 (also trending on Twitter as #MUS2). Stage 2 final regulations were issued by CMS and ONC this Thursday at 2:30pm ET and CHIME Advocacy HQ has been in a frenzy since.

Final Rule for Meaningful Use Stage 2 Drops Christmas came August 23rd this year for those of us health IT policy wonks.  And our presents were so complex we were still trying to figure out how to make it work the next day.  I am, of course, talking about Meaningful Use Stage 2 (also trending on Twitter as #MUS2).  Stage 2 final regulations were issued by CMS and ONC this Thursday at 2:30pm ET and CHIME Advocacy HQ has been in a frenzy since.  Thanks to some quick analysis by the Advocacy team, we can safely say that over 70 percent of CHIME’s recommendations, spanning over 55 pages, were ultimately adopted by CMS and ONC.  Key recommendations incorporated into CMS and ONC final rules include:

  • Those providers attesting to Stage 2 for the first time should have a 90-day reporting period, not a 365-day reporting period as proposed.
  • Added more menu options for providers to meet, assuaging fears that many EPs and EHs would get tripped up on menu items
  • Removed the organizational and vendor limitations on the “Transitions of Care” measure/objective
  • Decreased percentage of patients who must “view, download or transmit” their health information.
  • Generally soften thresholds on several measures
  • Reduced total number of required CQMs and allowed flexibility to report in National Quality Strategy “domains”

Of course with just about all of these concessions, CMS and ONC made stipulations; added more nuance to the requirements and generally only gave up what was absolutely necessary.  For instance, the 90-day reporting period is only for 2014, not for Stage 2; anyone who attests to Stage 2 in 2015 will have to report with data on a 365-day reporting basis.  And although CMS decreased the percentage of patients who must view their health information, providers are still on the hook for 5 percent of their patients actively seeking their information.

CHIME will continue to delve into this sizable and weighty effort, including the technical specifications and certification criteria.  So be on the lookout for more information as it becomes available.

Savvy CHIME members can click here to see the rules and they can also find CHIME’s Concordance Analysis to see how our recommendations matched up with CMS and ONC final rules.  Others will have to go here for CMS rule and here for the ONC rule.

Coming To A Provider Near You in October 2014: ICD-10 And just when those of us in Washington thought the excitement and fury over government regulations had reached its apex, CMS dropped another final regulation on Friday: the final regulation on ICD-10 compliance.  From the official CHIME perspective, this one came out 100 percent as hoped.  CMS issued a final rule, based on its proposed rule, calling for a one year delay to ICD-10 compliance.  In a statement released Friday afternoon, CHIME President and CEO Richard A. Correll said the organization “is pleased that CMS understood the importance of finalizing its proposed one year delay for compliance to ICD-10.”  In public comments filed last April, CHIME urged CMS to keep its proposed one year delay because a longer delay would seriously disrupt ongoing efforts to convert to ICD-10.  And, as HHS itself recognizes, a longer delay would significantly increase the costs of converting to ICD-10.  “Overall CHIME applauds the efforts of HHS to quickly and decisively signal a commitment to ICD-10 conversion and we urge the Department to develop a clear path forward, with benchmarks, so that healthcare industry stakeholders can make the conversion in 2014,” the statement concluded.

White House Announces 18 Innovation Fellows – HIT Nabs 3 Spots US CTO Todd Park announced 18 Presidential Innovation Fellows yesterday during a special event streamed online. Three of the 18 Innovation Fellows will help the Blue Button for America Project according to a White House press release. The fellows are top problem solvers/innovators from academia, nonprofits, and the private sector that will assist the government in achieving various goals over the next six months. The three HIT fellows are:

·         Henry Wei, MD – Practicing doctor and informatics expert, New York, NY

·         Ryan Panchadsaram – Founder of Pipette, San Francisco, CA

·         Matt McCall – Information systems expert, Baltimore, MD

Blue Button gives people access to their personal health records – it allows patients to download their health information electronically and transfer their information to other providers. The Blue Button for America Project specifically aims to create awareness of tools and apps to help patients gain access to their electronic health information to help them improve their healthcare. This program also hopes to create demand for such products outside of the VA. This health information includes, but is not limited to: lab results, medication lists and drug allergies, and claims and treatment data.

The 18 fellows were chosen from a pool of over 700 candidates for five projects. The other projects are: MyGov, Open Data Initiatives, RFP-EZ, and the 20% Initiative. Read more about these programs here.

House Members Join Chorus of Stakeholders Seeking Specifics on ACA Implementation
In a letter sent to CMS Acting Administrator Marilyn Tavenner this week, House Energy and Commerce Republicans pushed for answers first raised by state Medicaid directors and Republican governors about specific health reform details.  Committee Chairman Fred Upton (R-MI) and health subcommittee Chairman Joe Pitts (R-PA) said CMS needs to specify when certain regulations related to health insurance exchanges and Medicaid will be issued and when final regulations will be completed.  “Basic requirements, such as essential health benefits and actuarial value, have not even been outlined in a proposed rule,” the Representatives said.  “As you know, it has been nearly two and a half years since the president signed his health care plan into law and today, there are 500 days until the major provisions in the law are fully implemented.  While it seems [the] Center for Medicare and Medicaid Services intends to delay any major announcements until after November, states do not have the luxury of procrastination.”  Representatives Upton and Pitts point out that states must submit exchange applications by November 16 – “less than 100 days away” – but recent verbal guidance from CMS officials have said states are free to apply after that date.

The prominent House members request that CMS respond to letters from the Republican governors and state Medicaid officials by no later than September 3, 2012.  And they request that an outline of all outstanding exchange and Medicaid-related regulations (with associated timelines for completion) be submitted to the Committee by the same date.

The AHA has also sought further clarification on ACA Medicaid expansion.  A copy of their letter can be found here.

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