Senate Committee Chairmen Urge HHS to Delay Final Stage 3 Rule

Two Senate committee chairmen are joining 116 members of the House of Representatives in urging Health and Human Services Secretary Sylvia Burwell to delay rulemaking for the final stage of the Meaningful Use program.

The Senators are urging HHS to “pause” the process of finalizing the Stage 3 rules until Jan. 1, 2017.

In their letter, Sens. Lamar Alexander (R-Tenn.), chairman of the Senate Committee on Health, Education, Labor, and Pensions, and John Thune (R-S.D.), chairman of the Senate Committee on Commerce, Science, and Transportation, argued that the government, physicians, and hospitals need time to do Stage 3 “right” and that it should be phased in “at a rate that reflects how successfully the program is being implemented.”

While all hospitals and most physicians have met the requirements for Stage 1 Meaningful Use, the senators warned that Stage 2 requirements are “so complex” that only about 12 percent of eligible physicians and 40 percent of eligible hospitals have been able to comply. “Pausing the Stage 3 rules will also enable the department to ensure its final rules align with the new payment models created by the Medicare Access and CHIP Reauthorization Act, which created the Merit-Based Incentive Payment System,” they wrote.  

Also See: Lawmakers Pressure OMB, HHS for Delay in Stage 3

Last night, the American Medical Association and Massachusetts Medical Society held a Meaningful Use town hall meeting in Waltham, Mass., to discuss the problems with the federal government’s regulations and their impact on practices and patient care. AMA and 41 medical societies sent a letter earlier this month to Burwell and Office of Management and Budget Director Shaun Donovan urging them to postpone finalizing Stage 3. 

“Our goal tonight is to hear from practicing physicians about issues of concern regarding the upcoming governmental documentation requirements known as Meaningful Use 3,” Henry Dorkin, M.D., vice president of MMS, told the meeting. “There is wide concern that, as currently structured and proposed, aspects of the electronic health record and accompanying Meaningful Use regulations actually impair good healthcare delivery. Many feel that direct patient contact time, as well as time to spend reading the medical literature, is being reduced by more and more requirements for keyboard entry of information deemed of questionable value to either the patient or the doctor.”

While the Meaningful Use program has driven high rates of EHR adoption among physicians, AMA President Steven Stack, M.D., said “it has been less successful in spurring the kinds of innovation, interoperability, and efficacy” needed to help doctors be more efficient and to provide better coordinated patient care.

“The reason the meeting tonight is particularly timely is that the federal government has two open rules on Meaningful Use—one is a corrective action for Stage 1 and 2, and the other one promulgates the rules for Stage 3,” Stack told the audience.

In their letter to Burwell, Alexander and Thune asked that the modified rule proposed for Stage 2 should be adopted immediately by HHS to give physicians and hospitals time to adapt to these “huge” changes. “If the department does not delay making final the Stage 3 rules and instead proceeds before it can measure the impact of the modified Stage 2 rule, it will be a missed opportunity to build support among providers,” the senators argued. “The modified Stage 2 rule will enable more providers to comply with the government’s requirements.”

Alexander has previously said that he hopes to persuade HHS to make the changes to the Meaningful Use program “administratively” but will weigh legislative options if necessary.