Proposed MACRA rule relaxes EHR requirements for physician practices

A hotly anticipated physician payment rule released by the Centers for Medicare and Medicaid Services would make it optional for physician practices to adopt upgraded EHR systems.

Proposed updates to the Quality Payment Program (QPP) for 2018 would allow physicians participating in the Merit-based Incentive Payment System (MIPS) to continue using the 2014 Edition Certified EHRs. Although adopting the 2015 Edition is “encouraged” by CMS, it is not a requirement for participation in 2018.

RELATED: CMS releases updated proposed rule for MACRA, eases burden on small and rural practices

“While we continue to recommend that physicians and clinicians migrate to the implementation and use of EHR technology certified to the 2015 Edition so they may take advantage of improved functionalities, including care coordination and technical advancements such as application programming interfaces, or APIs, we recognize that some practices may have challenges in adopting new certified health IT,” the rule states.

Physician practices that do upgrade their EHR systems to align with 2015 requirements will be awarded bonus points in their scoring methodology.

In a statement, American Medical Informatics Association (AMIA) President and CEO Douglas B. Fridsma, MD said he was pleased with the flexibility of the proposed rule.

"Specifically, the proposal to reward those clinicians who demonstrate more advanced use of health IT to support patient care through 2015 Edition CEHRT will improve interoperability for providers and provide patients with better access to their data," he said. "Meanwhile, clinicians who need additional time to upgrade or adopt 2015 Edition CEHRT will benefit from another 90-day reporting period, and the option to use legacy versions of CEHRT in 2018."

RELATED: Doc groups upbeat about proposed 2018 MACRA changes

Overall, the 1,058-page proposed rule (PDF) provides a regulatory reprieve for physicians participating in QPP, a program implemented under the Medicare Access and CHIP Reauthorization Act (MACRA). In an announcement, CMS Administrator Seema Verma said the agency “heard the concerns” about onerous technology and quality measurement requirements.

“By proposing this rule, we aim to improve Medicare by helping doctors and clinicians concentrate on caring for their patients rather than filling out paperwork,” she said.

RELATED: Provider groups call on CMS to delay electronic health record certification requirements

Provider groups, including the American Medical Association (AMA), urged CMS to delay 2015 EHR certification requirements one year, arguing that a limited number of vendors had upgraded their systems. HIMSS followed suit, calling for a six-month delay. According to the Office of the National Coordinator for Health IT, 74 products are currently certified under the 2015 Edition.  

Although the proposed rule offers some reprieve for physician practices, under the current Meaningful Use regulations, hospitals are still on the hook to upgrade their systems by January 2018.