Wednesday, October 31, 2012

Changes to Deadlines for Stage Two: Meaningful Use in the
Medicare and Medicaid EHR Incentive Programs


Under the Health Information Technology for Economic and Clinical Health (“HITECH”) Act, incentive payments may be provided to eligible professionals, eligible hospitals and critical access hospitals (“CAHs”) provided they adopt, implement, upgrade or demonstrate meaningful use of certified electronic health records (“EHR") under a three-stage process. Eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program.

Now that Stage 1 is under way, CMS recently has published a final rule (September 4, 2012) that specifies EHR Incentive Programs Stage 2 criteria for eligible professionals (“EPs”), eligible hospitals, and CAHs. One of the core objectives is that all providers achieve meaningful use under the Stage 1 criteria before moving to Stage 2. “Meaningful use” consists of transferring data to EHRs and being able to share information, including electronic copies and visit summaries for patients, and requires that providers show they are using certified EHR technology in ways that can be measured significantly in quality and in quantity.

Deadlines for Stage 2 meaningful use requirements are fast approaching.   In the Stage 1 meaningful use regulations, CMS established a timeline that required providers to proceed to Stage 2 criteria after two program years under the Stage 1 criteria. This original timeline would have required Medicare providers who first demonstrated meaningful use in 2011 to meet the Stage 2 criteria in 2013. However, this deadline has been delayed. The earliest that the Stage 2 criteria will be effective is in fiscal year 2014 for eligible hospitals and CAHs, or calendar year 2014 for EPs.

To avoid penalties for not being a meaningful user, providers starting in 2015 will have to ensure they can attest to the proper length of time of meaningful use. The time requirements vary for types of providers and by the amount of time the program has been implemented. For example, eligible hospitals first achieving meaningful use in 2014 must attest no later than July 1, 2014 (because their payment years use the federal fiscal year) to avoid the 2015 payment adjustment. This means they must begin their 90-day reporting period by April 1, 2014. However, if an EP demonstrates meaningful use in 2014 for the first time, the EP must attest to meaningful use no later than October 1, 2014 to avoid the Medicare penalty. Because the initial reporting must cover a 90-day period, the absolute latest for EPs to begin meaningful use to avoid a penalty is July 1, 2014.

Gina Riddell
griddell@mmlk.com
McBrayer, McGinnis, Leslie & Kirkland, PLLC
Lexington, Kentucky


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