Final IPPS rule adjusts Meaningful Use program requirements

The Centers for Medicare & Medicaid Services' final 2016 inpatient and long-term care hospital policy and payment rule (IPPS) modifies the Meaningful Use program to encourage electronic submission of clinical quality measures (CQMs) and to further align it with other rules and programs.

The final IPPS rule, released July 31 and scheduled to run in the Aug. 17 Federal Register, changes the reporting obligations and timelines to better align the Meaningful Use program with the Inpatient Quality Reporting program, which was created under independent statutory authorities. It uses payment adjustments depending not only on whether a hospital was a meaningful user, but also whether it submitted its quality reports. Reporting will be on a calendar year basis, to align with the Stage 3 proposed rule.

The final rule also modifies the CQM requirements. For instance, the proposed rule suggested the continuation of the requirement for hospitals to use the 2014 edition of certified electronic health record technology (CEHRT) when submitting electronic CQMs for 2016. However, based on comments received, CMS will allow hospitals to use either the 2014 or the 2015 edition of CEHRT.

In addition, while hospitals can report CQMs in 2016 by attestation or electronic submission, in order to encourage the latter, the rule reduces CQM reporting from at least 16 CQMs to at least four if a hospital submits electronically, and reduces the amount of data to be submitted. Hospitals electronically submitting also enjoy an extended submission deadline to allow them more time to "overcome the challenges associated with electronic reporting of CQMs."

The IPPS rule is not the only one that references EHRs. For instance, the skilled nursing facility (SNF) proposed rule had referenced the need for SNFs to use health information exchange. The final rule states that "[a]ll of the comments received on this topic supported the overall agency goal to accelerate HIE within SNFs, and among the post-acute care providers generally." CMS noted that one commenter asked it to consider the potential impact of regulations on data sharing; another suggested that incentives be provided.

CMS made no commitments, but said that it would share those comments with staff and other agencies to ensure that they would be taken into account.

The payment rules go into effect Oct. 1.

To learn more:
- read the hospital rule (.pdf)
- here's the SNF rule

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