The government receives a lot of criticism for what it does and does not do. Some of that criticism is unfounded.
But sometimes it's justifiable.
Just look at the proposed rule modifying the Meaningful Use program for 2015-2017. The rule, issued in April, was intended to soften some of the harsher requirements of the prior rule, which had been criticized by stakeholders as being too burdensome to meet. The new proposed rule would shorten the 2015 reporting requirement from 365 days to 90 days, reduce the patient engagement obligation, and clarify some measures.
But we still don't have the final rule, and the last possible 90-day reporting period is only a month away. In July a group of stakeholders urged the Department of Health and Human Services to issue the final rule so that they'd know how to proceed, especially since final rules never look exactly like their proposed counterparts.
This week, the Medical Group Management Association reiterated this request, warning that without its immediate release, the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT are dooming providers--and the program--to failure.
"Without having a definitive set of program measures, and sufficient time to incorporate them into EHR software and practice workflow, medical groups simply cannot responsibly transition to the modified Stage 2 requirements without a massive drop-off in participation" MGMA's statement warns.
Of course, we want government agencies to promulgate rules carefully and not haphazardly. They need to make sense. After all, people have to comply with them.
But mistakes have already been made with the rules implementing the Meaningful Use program. This is not the first time that CMS/ONC has backed off, issuing a flexibility rule last year to change the program. And look what happened to the voluntary 2015 edition of the certification criteria rule; it died on the vine. People are already saying that the proposed rule implementing Stage 3 needs to be changed.
While it's commendable that CMS/ONC is listening to stakeholders and willing to modify rules that turn out to be unworkable, it's not good that the rules continue to change. And it's worse when the changes aren't communicated in a timely manner. How can providers, vendors and others comply when guidance isn't forthcoming?
It also points to a bigger issue: How much faltering and how many misfires can be allowed with the Meaningful Use program itself? The health IT committees and work groups exert a lot of time and effort on recommendations and rule drafting. Why are so many of them missing the mark?
Granted, the problem isn't isolated to the Meaningful Use program. The healthcare industry is also lacking guidance in related areas, such as the accounting of disclosures for electronic patient protected health information. That proposed rule also has yet to be finalized.
And it would be helpful to have guidance from the Federal Trade Commission (FTC) regarding when it will investigate breaches of patient information and when it will defer to HHS' Office for Civil Rights (OCR), which has to its credit issued extensive compliance guidance. Just ask LabMD, still fighting the FTC after some of its patient information ended up on the internet. Or will hapless entities be investigated by two different agencies for the same breach? Do the FTC and OCR even have the same compliance requirements?
The healthcare industry is highly regulated. That's hard enough. But it's even worse when the industry isn't given the tools to attempt to navigate muddy and constantly changing waters.