Lawmakers Pressure OMB, HHS for Delay in Stage 3

Seeking to delay the final rule of Stage 3 of the Meaningful Use program, some 116 members of Congress are asking the heads of the Office of the Management and Budget and the Department of Health and Human Services to hold off on the release of the rule.


Seeking to delay the final rule of Stage 3 of the Meaningful Use program, some 116 members of Congress are asking the heads of the Office of the Management and Budget and the Department of Health and Human Services to hold off on the release of the rule.

The lawmakers, led by Reps. Renee Ellmers (R-N.C.), Tom Price (R-Ga.) and David Scott (D-Ga.), sent a letter to the agencies--joining a rising chorus of industry groups--asking for lead federal agencies to hold off on rules for the next stage of the Meaningful Use program, which directs efforts to implement electronic health records systems.

The letter from Congress to OMB Director Shaun Donovan and HHS Secretary Sylvia Burwell asks for the delay to “refocus the program to better serve patients and the providers who care for them.”

Legislators call the deadlines imposed by the EHR Incentives Program arbitrary and assert that a delay in the final rules for Stage 3 and the 2015 Edition Certification “is necessary for the proper evaluation and optimization of implemented technology to ensure the technology can ensure better quality care for all patients.”

Additional time will give policymakers more time to understand the impact of “problematic policies of Stage 2,” the lawmakers contend.

A reboot of the Meaningful Use program will enable agencies to focus on capabilities that are rising in importance to a reforming healthcare system, they suggest. “We should incentivize technology that enables interoperability and improved health outcomes rather that incentivizing technology that counts how many times a provider performs an activity…taking the time to get it right now will surely pay dividends in the future.”

The letter shows increasing congressional support for a delay in Stage 3 of the Meaningful Use program. Within the last two weeks, Senate health committee chairman Sen. Lamar (R-Tenn.) said he wants to see a delay in the finalization of the Stage 3 rule, threatening to use legislative options if the administration does not choose to change timelines in the program.

Also See: Alexander Pushes Legislation if CMS Won’t Delay Stage 3 on Its Own

Ellmers said the letter was prompted by growing industry concern about the capacity to meet requirements to comply with the MU program, and the threat of penalties if certain thresholds are not met.

“There is a clear consensus among healthcare providers – they are concerned with how they will meet existing mandates of the Meaningful Use program,” she said. “Many are frustrated by the continued onslaught of regulatory changes, and most are desperate for relief.”

Moving too quickly into Stage 3 increases the likelihood that the program will fail to meet important goals, according to Ellmers. “It’s time that we focus on interoperability…to ensure that these products work for our nation’s providers,” she added. “If the administration dives into Stage 3 prematurely, we only stand to aggravate providers and vendors, who have already experienced ample challenges in meeting attestation deadlines.”

The College of Healthcare Information Management Executives was quick to detail support for the congressional letter, pointing to lagging attestations for Stage 2 by the nation’s hospitals as a reason to slow down on the next stage of the program.

“Many hospitals and physician practices are still struggling to meet requirements under Stage 2,” said Chuck Christian, chair of the Ann Arbor, Mich.-based organization, which represents IT executives in healthcare organizations. CMS data show that “only 1,826 hospitals successfully attested to Stage 2 in 2014, just 38 percent of hospitals that registered for the program. By comparison, 4,379 hospitals successfully attested for Stage 1 during the past five years.”

CHIME said its staff has had a “high-level briefing with administrative officials last week,” at which it described how a delay would give stakeholders “time to address challenges to continued success of the Meaningful Use program.” Because of the sensitive nature of these discussions, CHIME declined to identify with whom its staff met.

“It’s important to point out that CHIME isn’t calling for a permanent delay in Stage 3,” said Matthew Weinstock, director of communications and public relations for CHIME. “Rather, put it off so that everyone, including CMS, OMB and the industry, can assess where we are (with the program) and then make any adjustments to Stage 3 to ensure that we are putting in place technology that will truly advance patient care.”

CHIME joins a chorus of other industry groups, including the American Medical Association, Medical Group Management Association and American Hospital Association, putting pressure on the administration to stall the start of Stage 3. These organizations, meanwhile, have increasingly called for OMB to release a modification rule that brings some relief for providers to meet Stage 2 requirements.

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