On February 25, the Centers for Medicare and Medicaid Services (CMS) announced an extension to the attestation deadline for Medicare EHR Incentive Program reporting periods that occurred in calendar year (CY) 2014. Participants now have until March 20, 2015 to complete the online attestation process for their CY 2014 meaningful use (MU) compliance.
CMS recommended attesting during non-peak hours (evenings and weekends) well in advance of the deadline. For help, contact the CMS’ EHR Information Center at 1-888-734-6433, Monday-Friday, 8:30AM-7:30PM (ET).
Deadlines in the Medicaid version of the program are not necessarily impacted by this extension.
The PQRS submission deadlines for the “EHR Direct/Data Submission Vendor” and “qualified clinical data registries/QRDA III” reporting options have likewise been extended until March 20.
The negative payment adjustments for nonparticipation in the Medicare EHR Incentive Program (“Meaningful Use” or MU) will increase to -2% off covered professional services in calendar year (CY) 2016. Physicians who are eligible for the Medicare version of the program will have two ways to avoid the 2016 penalties:
Option 1: Compliance
- Prior MU participants must have been a Meaningful EHR User in 2014 to avoid the 2016 penalties. If the prior MU participant was not MU-compliant in 2014, he/she must use Option 2 below.
- Those who have never participated in MU must begin participating by July 1, 2015 and complete the attestation process by October 1, 2015 (at the latest) to avoid 2016 penalties. If the first-time participant does not meet the attestation deadline, he/she must use Option 2 below.
Option 2: Significant hardship exception
Regardless of whether or not a physician was MU compliant in the past, he/she can obtain one of several “significant hardship exceptions” to avoid 2016 penalties. CMS can grant these to physicians on an annual basis for up to 5 total years. The various available significant hardship exceptions are as follows:
- Lacking broadband/infrastructure: The physician was located in an area without sufficient Internet access to comply for any 90-day period of time from the beginning of 2014 to July 1, 2015. Moreover, the physician must have faced insurmountable barriers to obtaining the internet connectivity. A manual application is required by July 1, 2015.
- Newly practicing: The physician has been practicing for less than 2 years. This will be automatically given. No manual application is required.
- Extreme and uncontrollable circumstances: a) A previous MU participant faced extreme and uncontrollable circumstances in 2014. Or, b) a physician who has never participated in MU faced extreme and uncontrollable circumstances in 2015. A manual application is required by July 1, 2015.
- Inability to influence availability of certified EHR technology (CEHRT): The physician practiced at multiple locations, and lacked control over the availability of CEHRT at one or more locations where he/she had more than 50% of his/her patient encounters. A manual application is required by July 1, 2015.
- Lack of face-to-face/telemedicine interaction with patients AND lack of need for follow-up: The physician can demonstrate difficulty in meeting MU on the basis of lack of face-to-face or telemedicine interaction with patients and lack of need for follow up with patients. A manual application is required by July 1, 2015.
- Primary specialty listing in PECOS: The physician has a primary specialty listed in PECOS as radiology, anesthesiology, or pathology by July 1, 2015. For radiology, the primary specialty listing must be “diagnostic radiology” (30), “nuclear medicine” (36), or “interventional radiology” (94). No manual application is required.
The above information is subject to change. For more information about the significant hardship exceptions, please see CMS’ website.
On February 6, the American College of Radiology (ACR) submitted comments regarding the HHS Office of the National Coordinator for HIT’s (ONC) draft 2015-2020 update of the “Federal Health IT Strategic Plan.”
As background, Congress directed ONC in the Recovery Act of 2009 to periodically update a strategic plan on health IT goals for federal agencies. ONC’s broad policy document, which was originally created (pre-mandate) in 2008 and later updated in 2011, describes non-binding, high-level objectives for all agencies that fund related research, regulate IT solutions, or deliver health care services.
The ACR’s comments generally supported the goals, objectives, and strategies in the plan and offered insights into relevant informatics initiatives in the College and elsewhere in the radiology community. The ACR identified the following two objectives as being especially critical for federal government agency involvement and leadership:
- Objective 2A: Enable individuals, providers, and public health entities to securely send, receive, find, and use electronic health information.
- Objective 5B: Accelerate the development and commercialization of innovative technologies and solutions.
Moving forward, the ONC will use public comments and input from other sources, such as their own federal advisory committees, to refine and finalize the updated strategic plan.
The HHS Office of the National Coordinator for HIT (ONC) released its draft National Interoperability Roadmap and associated Standards Advisory today for public comment. The Roadmap builds upon ONC’s past efforts to obtain stakeholder feedback on advancing interoperability and health information exchange. The Standards Advisory is a compilation of current standards ONC identified that could facilitate implementation of the Roadmap.
Public comments are due on the Roadmap by April 3, 2015, and the Standards Advisory by May 1, 2015. Any and all members of the American College of Radiology interested in providing feedback for potential inclusion in ACR’s future comments should please email Michael Peters, ACR Director of Regulatory and Legislative Affairs, at firstname.lastname@example.org.
For additional background information, please visit healthit.gov.
Today, the Centers for Medicare and Medicaid Services (CMS) announced its intent to propose additional regulatory changes via a separate rulemaking from the imminent “Stage 3” EHR Incentive Program (“meaningful use”) rulemaking. The proposals would potentially include allowing a 90-day EHR reporting period in 2015 as well as other revisions to reduce complexity and lessen providers’ reporting burdens.
CMS’ “Stage 3 MU” and the HHS Office of the National Coordinator for HIT’s “2015 Edition EHR Certification Criteria” rulemakings have been under formal regulatory review for about one month. They were likely drafted months before both agencies realized that participation in the physician version of the program was going to be much lower than acceptable based on the small number of additional new participants in 2014 (and not even factoring in all the anticipated drop-offs from previous years). So, this second CMS MU rulemaking in 2015 will be another bite at the regulatory apple.
Timing-wise, we should expect to see the agencies’ Stage 3/2015 Edition proposed rules released for public comment within the next couple of months. Then, likely before those final rules are promulgated later this year, we should see this second CMS rulemaking published for comment around spring/early-summer (and presumably finalized before the end of the year).
Beyond the mechanics and expected timing of the various MU-related rulemakings in the pipeline, today’s announcement was also CMS’ way of signaling to the public that a 90-day EHR reporting period in 2015 is in the works. If all goes well with the rulemaking process, prior MU participants who could not begin their CY 2015 EHR reporting periods on January 1 should get another chance to comply this year. Although the agency had several opportunities to include a shortened 2015 EHR reporting period in various rulemakings in 2014, this “announcement of intent” is better late than never.
A s part of last month’s FY 2015 Consolidated and Further Continuing Appropriations Act efforts, Congress directed the HHS Office of the National Coordinator for HIT (ONC) to decertify products that “proactively block the sharing of information” and to report back to Congress on the extent of the problem, including an estimate of the number of vendors, hospitals, or providers who “block information.” An example of “blocking information” could be when a hospital or EHR vendor prohibits, discourages, or excessively charges for appropriate and secure exchange between referring providers’ systems and those of unaffiliated radiology practices.
The American College of Radiology (ACR) is working with the American Medical Association and other physician groups to collect information to help HHS and Congress understand the scope of the issue. Please contact Michael Peters, ACR Director of Regulatory and Legislative Affairs, at email@example.com by February 4 if you have information about any of the following items:
- Fees charged by EHR vendors, or others, to connect radiologists with ordering providers who use the vendors’ products.
- Interface costs to connect radiologists’ systems with those of referring providers.
- Contractual limits on which parties EHR vendors or providers will exchange information with.
- Contract language that explicitly states EHR vendors own data.
- Interface costs to connect with health information exchange (HIE) networks.
- Monthly or per-transaction costs associated with the use of health information service providers.
- Any other charges/fees (not identified above) required to exchange data.
The American College of Radiology (ACR) recently released “ACR’s Pocket Guide to Meaningful Use (MU) in 2015,” a three-page overview of Medicare EHR Incentive Program requirements for radiologists. This free educational resource will be enhanced over time with new information and links to additional materials.
The 2015 version is the third iteration of this educational tool. The continued goal of the “Pocket Guide” series is to translate the vast, enormously complex regulatory framework of the Medicare EHR Incentive Program for eligible professionals into the shortest and most basic of summaries. Approximately 9 out of 10 questions I get from ACR members regarding Meaningful Use can be answered with this simple document and/or using the links provided within.
Note: Physicians interested in the State/Medicaid version of the program have additional fundamentals to learn beyond those discussed in this Medicare EP-specific resource.