CMS says 'meaningful use' Stage 2 will make optional measures mandatory

A lot of people were disappointed that the recently released standards for meaningful use of EMRs only covered Stage 1 of the program--2011-12--leaving them without much of a roadmap to plan for compliance in later years. But some clues about Stage 2, which begins in 2013, are evident in the new rule, a key HHS official says.

At the most recent meeting of the advisory HIT Policy Committee, Tony Trenkle, director of the CMS Office of e-Health Standards and Services, said that comments included in the Stage 1 rules indicate that items on the menu of 10 optional requirements will become part of the "core standards" in Stage 2, and that several administrative requirements included in a previous proposal but dropped from the final rule will be part of the next phase.

"We would also like to look at higher thresholds for other measures," Trenkle said, according to InformationWeek. "That is our intent, and it will be framed by feedback and recommendations that come from the Policy Committee."

For example, CMS lowered the e-prescribing requirement to 40 percent from the proposed level of 75 percent and said that eligible providers only needed to implement a single rule for clinical decision support in Stage 1, down from five rules in the proposal.

CMS has not offered much guidance about Stage 3 (2015-16), though, because the Medicare and Medicaid sides of the incentive program are much different starting in 2015. Medicare penalties for noncompliance begin in 2015 and bonus payments for EMRs end in 2016, while the Medicaid incentives could continue until 2021, and there are no penalties specified in the American Recovery and Reinvestment Act.

Meanwhile, as CMIO reports, CMS and the Office of the National Coordinator for Health Information Technology have started a series of audioconferences as a way of educating healthcare providers about meaningful use and EMR certification and helping providers enroll in the HHS program.

For greater detail:
- check out this InformationWeek story on Stage 2
- read this CMIO story about enrollment