Sorting through MU provider comments will be no easy task for CMS


I sure don't envy the Centers for Medicare & Medicaid Services this week (or over the next few weeks, for that matter). The comments on the proposed rules implementing Stage 2 of Meaningful Use are in, and from the looks of things, CMS is going to have its hands full evaluating the submissions and creating the final rule, hopefully sometime this summer.

Perhaps to no one's surprise, many comments from the provider community regarding the proposed rules consistently expressed concern that the second leg of the government's plan to push innovation use in healthcare is just too ambitious and unattainable. The objectives and thresholds, many providers said, are too high; Stage 1, others added, should be evaluated before Stage 2 is implemented.

For instance, The Federation of American Hospitals (FAH) noted that the "high cost of adoption in terms of both capital expenditure and workflow disruption, and limited capacity on the part of vendors resulted in a pace of adoption and attestation that was less than optimal for many providers." FAH recommended, as did many other provider representatives, a 90-day reporting period for the first year of Stage 2, rather than a full year and limits on the clinical quality measures.

The Cardiac Advocacy Alliance, meanwhile, warned that CMS "greatly overestimates the number of medical professionals that have or preparing to deploy [electronic health records] and the consistency of EHR use across specialties, sites of service, geography and vendors."

Additionally, the Medical Group Management Association (MGMA) requested that the rule align better with already existing HIPAA requirements.

A lot of this sounds reasonable. But some other provider comments are so self-serving that they undercut otherwise valid arguments. Case in point, the American Hospital Association suggested that the grace period for providing discharge summaries be increased from 36 hours to 30 days. Afterward, AHA was roundly criticized by others in the industry, like Healthcare Standards blogger Keith Boone. Commenting as a private citizen and patient advocate, Boone urged CMS to "ignore the AHA," adding that "Meaningful Use is not an entitlement program...it's about time hospitals are held to completing their documentation of the encounter in a timely fashion and making that information available to patients."   

Some of the other comments also didn't resonate well. The American Medical Association, for instance, wants to tone down the requirements so that "good faith" efforts to comply would count. So doctors should get the incentive money just for giving it the old college try? That doesn't seem fair to those who actually meet the requirements. And how would CMS even determine what a "good faith" attempt is?

Let's hope that CMS takes a reasoned approach and separates the wheat from the chaff. Many of the providers' comments make sense and should be taken into account. - Marla

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