The Centers for Medicare & Medicaid Services has published the final rule outlining the requirements for Stage 2 of the Meaningful Use incentive program, adopting many, but not all of the provisions they proposed in March.
CMS's 672-page rule delays the Stage 2 requirements to 2014, giving providers more time to meet the Stage 2 criteria. No provider will have to follow the Stage 2 requirements before then. Stage 2 originally was slated to begin in 2013. Other changes to the rule include:
- There will be 20 measures for eligible professionals and 19 for eligible hospitals and critical access hospitals;
- There are two new core objectives: one on the use of secure electronic messaging to communicate with patients, and another requiring hospitals to automatically track medications from order to administration using assistive technology with electronic medication administration records (eMAR);
- Several proposed measurement thresholds--such as for patient engagement and electronic exchange summary of care documents--have been reduced from those suggested in the proposed rule. Specifically for the former, both eligible providers and hospitals now will need "more than 5 percent" of unique patients to view, online, download or transmit their information to a third party (the proposed threshold was 10 percent);
- Batch reporting for medical groups and the process for implementing penalties for not meeting Meaningful Use have both have been finalized;
- An outpatient lab reporting requirement has been added;
- Eligibility of the Medicaid incentive program has been expanded to 12 children's hospitals that originally didn't meet the eligibility requirements.
CMS received 6,100 comments on the proposed rule.
The Office of the National Coordinator for Health IT's Standards and Certification criteria, which weighs in at 474 pages, adopts the certification criteria to support the changes in the program. It also updates the certification program to make it easier and more efficient, and changed the name of the permanent certification program to "ONC HIT Certification Program."
"Certified EHR technology used in a meaningful way is one piece of a broader health information technology infrastructure needed to reform the health care system and improve health care quality, efficiency, and patient safety," CMS said in a fact sheet explaining the rules.
ONC already is working on Stage 3 of the program, which won't be implemented until 2016 at the earliest.