The Centers for Medicare and Medicaid Services has issued a 752-page final rule covering three components of the electronic health records meaningful use program. The rule finalizes modifications to Stages 1 and 2; the 2015 edition of electronic health records certification criteria; and Stage 3 of meaningful use.

Since publication of proposed rules last spring, the Medicare Access and CHIP Reauthorization was enacted, which will create a new Merit-Based Incentive Payment System (MIPS). Consequently, this final rule includes a 60-day comment period for certain provisions of the payment system that could affect meaningful use. For instance, the existing Medicare payment adjustment for eligible professionals will end in calendar year 2018 and be incorporated under MIPS starting in calendar year 2019, according to the rule.

“It is our intent to issue a notice of proposed rulemaking for MIPS by mid-2016,” CMS says. “This final rule with comment period synchronizes reporting under the EHR Incentive Programs to end the separate Stages of meaningful use, which we believe will prepare Medicare EPs for the transition to MIPS.”

Under the modifications to Stages 1 and 2, eligible professionals have 10 meaningful use objectives, down from 18 previously. The objectives include reporting to public health agencies, which has been problematic over the course of meaningful use. Hospitals have 9 objectives including public health reporting, down from 20 previously. The objectives for eligible professionals and hospitals have been modified to align with Stage 3. Clinical quality measures reporting for eligible professionals and hospitals remain as previously finalized.

“In addition, the final rule adopts flexible reporting periods that are aligned with other programs to reduce burden, including moving from fiscal year to calendar year reporting for all providers beginning in 2015, and offering a 90-day reporting period in 2015 for all providers, for new participants in 2016 and 2017, and for any provider moving to Stage 3 in 2017,” according to the rule.

Under the final rule, providers in the meaningful use program have an option to participate in Stage 3 in 2017, but moving to Stage 3 is mandatory in 2018 as it will incorporate portions of prior stages into its requirements.

In Stage 3, there are 8 objectives for eligible professionals and hospitals and more than 60 percent of measures require interoperability. Public health reporting gives flexibility in the measures to report.

Further, Stage 3 will include the use of application programming interfaces (APIs) “that enable the development of new functionalities to build bridges across systems and provide increased data access,” according to the rule. “This will help patients have unprecedented access to their own health records, empowering individuals to make key health decisions.” Providers choosing to do Stage 3 in 2017 will have a 90-day reporting period. The Stage 3 provisions finalized in the rule have a 60-day comment period. The entire rule is available here.

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