Industry Groups Pressure Feds to Delay Stage 3 EHR Rule

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Support continues to grow among industry groups for delaying Stage 3 of the federal government’s electronic health records Meaningful Use program.

The American Medical Association and 41 medical societies have sent letters to the Department of Health and Human Services and Office of Management and Budget urging the Obama administration to pause Stage 3. The groups want Meaningful Use re-evaluated following “pivotal changes to Medicare” enacted by the Medicare Access and Chip Reauthorization Act (MACRA), such as the Merit-Based Payment System (MIPS) and Alternative Payment Models (APMs).

According to the groups, the proposed Stage 3 rule was developed prior to and without consideration of the changes to Medicare, even though the Meaningful Use program “will play a vital role in both the new MIPS payment system and the development of alternative payment models.”  

The letters to HHS and OMB were sent the day after Sen. Lamar Alexander’s Sept. 16 call for a delay in the finalization of the Stage 3 rule until January 1, 2017. Both the AMA and College of Healthcare Information Management Executives immediately issued separate statements strongly agreeing with the senator’s concerns about the timing of the final Meaningful Use stage.

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

In letters to HHS Secretary Sylvia Burwell and OMB Director Shaun Donovan, the 42 physician groups—including AMA—said they were “extremely concerned with the current direction of the Meaningful Use program,” namely that 80 percent of physicians are using EHRs but less than 10 percent have successfully participated in Stage 2. They also complained that due to inflexible Meaningful Use regulations and certification requirements, EHR vendors have “created software products that are frequently unusable, administratively burdensome, and in many instances do not promote clinically relevant patient care.”

Further, the physician community is “extremely dismayed” by “reports that the Final Stage 2 Modifications Rule and the Final MU Stage 3 Rule have been combined” and that the rule is currently being reviewed by OMB. “If the administration finalizes the proposed MU Stage 3 regulation now, vendors will create software that will lock-in problematic technology, which physicians and patients will be living with for years to come,” warn the groups. “Pausing Stage 3 will not stop or delay progress with EHRs. Rather, we believe it will help move the program forward and drive innovation and adoption.”

However, the HIMSS EHR Association (EHRA)—which represents health IT vendors—has urged the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for HIT to release the Stage 3 and 2015 edition certification final rules as soon as possible to give providers and developers as much time as possible to develop, test, and implement new functionality and adjust workflows and external data sharing relationships.

In its response to the proposed rules last spring, EHRA noted that short timeframes for development and implementation had negative impacts on providers and developers.  The association also emphasized that although it appreciated CMS pushing out the mandatory start of Stage 3 from 2017 to 2018, such timing was still very tight given the proposed scope of Meaningful Use and EHR certification.

“Whether 2018 will work as the mandatory starting point for Stage 3 really depends on the scope and complexity of what is finalized for Meaningful Use and certification, when the final rules and associated guidance ultimately emerge, and also when CMS releases the Final Rule on modifications to Meaningful Use for 2015-2017,” says Leigh Burchell, EHRA chair and vice president of policy and government affairs for Allscripts. “The delayed release of that rule, about which we raised concerns in a recent coalition letter, poses threats to provider success with Stage 2 this year.”

Likewise, the 42 physician groups urged HHS and OMB to proceed with finalizing the Modifications Rule as well as with integral pieces of the proposed 2015 Edition EHR Certification Rule as soon as possible.

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