Issue link: https://viewer.e-digitaledition.com/i/334922
A YEAR ANTICIPATED AS one fraught with challenges for meaningful users attempting to adopt new stage 2 rules for EHR, 2014 has not disappointed. As it turns out, however, the greatest challenge has come from announcements of changes by the rule makers themselves. This was to be the year of new stage 2 measures and an industrywide requirement to upgrade to 2014-certified EHR software. And it still is … maybe. That's the problem. Based on a recent announcement by the Centers for Medicare & Medicaid Services (CMS), no one knows for sure. In May, CMS released an announcement stating possible changes to the meaningful use rules that would give greater flexibility to eligible professionals in 2014. The most important aspect of the announcement, however, is that the "flexibility changes" are only a possibility and are not definite. The May 23 CMS announcement is considered a notice of proposed rulemak- ing (NPRM). An NPRM allows 60 days for public commentary. Once completed, there will be another period of time for the final ruling to be announced. Based on knowledgeable sources, the estimated time frame for a final determination is sometime this fall. The proposed flexibility rule is most likely a response to delays in the availability of 2014-certified EHR software. The original goal was for vendors to have their products certified at the 2014 level by Jan. 1, but the entire process of certification, which includes an interactive period between the EHR companies and the government's certification agency, became seriously delayed, stretching out delivery to practices well into 2014. The rule proposes changes that may allow some medical organizations — those that otherwise would not because of the delays — to reach meaningful use this year. There are three scenarios it addresses: practices that have 1) only a 2011 EHR version, 2) a combination of 2011- and 2014-certified versions, or 3) a complete 2014-certified system. In each of these scenarios, there is relief offered regard- ing the software version required in 2014 and the meaningful use rules that can be applied. In each case, practices will have to attest to their respective scenario. According to the proposed rule, in 2014 medical practices in stages 1 and 2 that only have 2011-certified software at the beginning of their reporting period must use the 2013 stage 1 meaningful use rules. This would eliminate the need to implement a patient portal, for example, which is a con- siderable task. Practices with a combination of 2011- and 2014-certified software would have the option of using the 2014 stage 1 or the 2014 stage 2 meaningful use measures. In this case, both would require the use of a portal, although those meeting the 2014 stage 1 measures would need to meet only a portion of the patient access requirement. Finally, practices with 2014-certified software at the beginning of their reporting period that are in stage 2 can make a case that because they received their 2014 certi- fied product so late in the year, they were unable to fully implement it. If accepted, they would be able to abide by the 2014 By John Netti Changing Rules Creates Uncertainty +++++++++++++++++++++++ + +++ + +++ +++++++++++++++++++++++ MEANINGFUL USE Meaningful Use