The American Medical Association appreciates a proposed rule easing some requirements of the electronic health records meaningful use program, but the rule offers too little relief and comes too late.

That’s the message in a July 21 letter AMA sent to the Centers for Medicare and Medicaid Services. In particular, despite offering several different ways to attest to Stage 2 this year, the rule retains the “all-or-nothing” approach to meaningful use. The association asks that CMS implement a 75 percent pass rate for attestation and enable physicians meeting at least half of MU requirements to avoid a financial penalty. AMA warns that a majority of physicians won’t move to Stage 2 absent more modifications to the current meaningful use timetable, and CMS should rigorously study the timetable before proposing future stages.

The association also contends that the relief in the proposed rule to enable attestation using version 2011 criteria or a combination of old and new software provides limited relief. “While we appreciate that the rule allows physicians who were scheduled to move to Stage 2 to stay in Stage 1 another year, we are concerned that this proposal is aimed at helping the earliest adopters--those physicians and hospitals that are the most experienced and advanced with respect to the MU program.” A one-year exception for these providers brings little relief to the vast majority of other physicians still struggling.

AMA also expresses disappointment that the rule does not align reporting for meaningful use and the Physician Quality Reporting System. “Instead, physicians are forced to report twice to avoid penalties.” Further, with a final rule not expected before September and CMS on July 1 closing the period during which physicians could file a hardship extension and not face penalties for failing to attest this year, AMA asks that CMS extend the deadline until 30 days after the final rule is published. The association reminds regulators that they extended the hardship deadline for the 2011 e-prescribing program when publication of new rules complicated application deadlines.

Finally, AMA seeks to rein in meaningful use auditors by suggesting that acceptance by CMS of attestation from providers that they are not able to fully implement updated technology “will be sufficient to avoid later attempts to review or recoup any MU payments.” Full text of the letter is here.


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