2015 Meaningful Use Flexibility Rule Brings Much-Needed Relief

Yes, October is pretty late to be formalizing changes to meaningful use (MU) for the current year, but these changes provide some welcome relief to eligible providers (EPs) who are still finding their stride when it comes to MU. Here are the highlights of the adopted changes:

  • 90-day reporting period for all EPs in 2015. All EPs, regardless of previous MU participation may attest to a reduced period of 90 consecutive days for 2015. Although you can attest to any 90-period in CY 2015, the attestation system will be available only between January 4 and February 29, 2016. If you’ve been keeping up with your meaningful use throughout 2015, you can choose any 90-day reporting period. If you relaxed your meaningful use in 2015, your reporting period will likely be October 1–December 31.
  • 90-day reporting period for new participants in 2016. Any EP beginning participation in 2016 may report a reduced period of 90 consecutive days for 2016. All EPs continuing or resuming participation will be required to report a full year for 2016.
  • Streamlined measure and objective reporting. This streamlined reporting eliminates the need to report several redundant objectives and measures that have been widely adopted in the industry (and thus assumed you are fulfilling). While you might view this streamlined reporting as removing the low-hanging fruit, it removes a lot of the clutter that complicates reporting.
  • Aligning Stage 1 and Stage 2. CMS is overhauling the structure of the objectives by eliminating the Menu Set in favor of a streamlined Core Set. All providers, regardless of stage will attest to the same core set. For those EPs who were scheduled to attest to Stage 1, additional exclusions and alternative measures are available.

Highlights of the Changes

Most EPs will breathe a sigh of relief over these two modifications:

  • The Patient Electronic Access threshold is reduced from 5% of the patient population to at least one patient. This is a huge relief to those EPs who serve patient populations who are uncomfortable accessing their records online.
  • The Use Secure Messaging is changing from a percentage-based objective to a yes-no objective. This means that you can report that you have the functionality fully enabled even if none of your patients sent you a message.

In addition, the following measures have been removed because they were redundant or the industry has already widely adopted them as best practice:

  • Record Demographics
  • Record Vital Signs
  • Record Smoking Status
  • Clinical Summaries
  • Clinical Lab Test Results
  • Patient Lists
  • Preventive Care (Patient Reminders)
  • Summary of Care (measures 1 and 3)
  • Electronic Notes
  • Imaging Results
  • Family Health History

These are just the highlights of the meaningful use changes that go into effect for the 2015–17 reporting years. We’ll post the details and updated documentation within the next few days on eyefinity.com.

Upcoming Meaningful Use Hardship Exception Deadline

Summer’s here, and the July 4 holiday weekend is around the corner. Before packing your bags or lighting up the grill, take a moment to review the meaningful use hardship exception guidelines. The deadline to apply for a hardship exception and avoid a 2016 payment adjustment is July 1 at 11:59 pm ET.

You do not need to file a hardship exception if any one of these scenarios applies to you:

  • You successfully demonstrated meaningful use in 2014;
  • You’re a hospital-based provider; or
  • You’re a new eligible professional who didn’t file Medicare or Medicaid claims in 2014.

You can only file for a hardship and avoid the payment adjustment if you weren’t able to achieve and report meaningful use due to circumstances outside of your control. For example, if you used a vendor prior to coming to Eyefinity who was not able to get their EHR software certified in time, you might qualify for a hardship.

The timeline for hardship exceptions and payment adjustments can be confusing since the payment adjustments occur two years after the participation year.

If you failed to participate in this calendar year… File for a hardship exception by this date… To avoid a payment adjustment in this year…
2014 July 1, 2015 2016
2015 July 1, 2016 2017
2016 June 30, 2017 2018

To help you determine if a hardship exception is right for you, use the Hardship Exception Tool. For more information about filing a hardship exception, refer to CMS’ Payment Adjustments and Hardship Exceptions page.

CMS Extends Medicare EHR Attestation Deadline

announcementIn a surprise announcement this morning, CMS extended the 2014 attestation deadline for the EHR Incentive Program, popularly known as “meaningful use.” The submission deadline is now March 20, 2015, at 11:59pm (ET).

This extension gives providers a chance to breathe and a little more time to gather their meaningful use data from 2014 and attest. This is fantastic news for all participating providers who want to avoid Medicare payment adjustments in 2016. This is particularly good news to those who are attesting to meaningful use for the first time, since this is their last chance to receive any incentive money for meaningful use under Medicare.

CMS was careful to point out that this extension applies only to the Medicare EHR Incentive Program. This extension does not affect those providers who are participating under the Medicaid EHR Incentive Program. CMS also urged providers to attest as soon as possible despite the extension.

PQRS vs. CQMs—What’s the Difference and How Do I Report Them?

There’s a lot of confusion and frustration in the healthcare industry right now about the government quality programs, where they overlap (and where they still don’t), and how to report the correct information.

A (Brief) History

The Physician Quality Reporting System (PQRS) has been around since 2007. Traditionally providers voluntarily reported at least three measures by including level II CPT codes on their Medicare Part B claims, and they received an incentive payment from CMS.

Clinical Quality Measures (CQMs) were introduced in 2011 as part of the EHR Incentive Program, better known as meaningful use. This program required providers to manually enter a calculated percentage for six to nine measures to receive an incentive as part of meaningful use.

A Confluence of Program Changes

Recently, the Centers for Medicare and Medicaid Services (CMS) initiated plans to align the PQRS and the CQM measures to make reporting easier for providers. At the same time, CMS is laying the groundwork to discontinue the claims-based PQRS reporting that providers have become accustomed to. CMS’ goal is for providers to electronically submit a file that contains all of their yearly quality data to satisfy the requirements for both PQRS and CQMs. You may have heard of this file referred to as QRDA. Continue reading

Will the Implementation of ICD-10 Interfere with Meaningful Use?

No, but…Michael_Opsteegh

The implementation of ICD-10 does not affect your meaningful use (MU)  calculations. While the compliance date for ICD-10 is October 1—well into your meaningful use reporting year—you will not see any impact on your MU calculations.

It seems strange to think that such a disruptive change as ICD-10 wouldn’t impact your MU attestation. The transition from ICD-9 to ICD-10 applies only to diagnosis codes in offices and outpatient settings. The MU core and menu set measures do not require specific diagnosis codes. Therefore, ICD-10 will not impact your MU calculations.

The clinical quality measures (CQMs), however, are very dependent upon the proper diagnosis codes being in place. Eyefinity has you covered in this regard. Our 2014 Edition CQMs will accept your ICD-9 and your ICD-10 codes. Even when you switch midway through your reporting period, your calculations will reflect both code bases.

Here’s the but…

There’s one small detail that you may need to address one time. You’ll need to add any ICD-10 codes  to your clinical decision support rules to ensure that your diagnosis still trigger the correct clinical decision alerts (Stage 1, core measure 10; Stage 2 core measure 6).

What does 2015 hold for meaningful use?

Since the meaningful use program began, there has been an abundance of challenges to successfully demonstrate and attest.  According to CMS, only 4% of eligible professionals (EPs) have successfully attested to Stage 2, and beginning this month, 257,000 EPs will be assessed penalties as a result.

Progressively Tougher RequirementsPROOF_19922DR_fixit_blog
As the program currently stands, beginning this year, the meaningful use demonstration period is required to run for the full 365 days of the year, rather than 90 days as required in previous years. In an effort to mitigate the additional challenge and facilitate successful attestation, Representative Renee Ellmers introduced the Flexibility in Health IT Reporting Act (Flex-It) in 2014.

If passed, Flex-It will reduce the demonstration period in 2015 to 90 days, rather than the full year that is currently required for those attesting for either Stage 1 or Stage 2. Those in their first year of Stage 1 will attest to a three month period regardless of the outcome of the rule. In 2015, EHR solutions must be 2014 certified to qualify for meaningful use attestation.

Though the act was submitted, no decision was made in 2014. Not to be dissuaded, Rep. Ellmers has reintroduced the bill in January, and has the backing of legislators from both the Democrat and Republican parties.  Stay tuned, we’ll keep you posted on the status of the Flex-It Act, when its fate is decided, and all of the latest news on meaningful use.

Do you have questions about meaningful use? We’re here to help! Contact us at meaningfuluse@eyefinity.com.

Meaningful Use Hardship Exceptions Extended

Featured imageCMS has reopened the submission period for hardship exception applications, allowing eligible providers (EPs), like you, one last chance to avoid the 1% Medicare payment penalty in 2015. The new deadline is November 30 at 9:59 pm Pacific. You must complete the Hardship Exception Application and email it to ehrhardship@provider-resources.com.

Chasing Deadlines

October 1 was a frenzied rush as thousands of EPs attempted to attest to meaningful use to avoid the 1% Medicare penalty in 2015. The crushing volume strained the attestation system as well as the call centers of EHR vendors. Frustration increased when EPs attempted to attest to the 2011 Edition criteria under the recent delay because CMS’s attestation system had not been retrofitted to accommodate the revised rules.

Breathing a Collective Sigh of Relief

To alleviate the situation, CMS has decided to reopen the submission period for hardship exception applications after a three-month hiatus. EPs who were stuck in the snarl of October 1 will surely appreciate this extension.

Reading the Fine Print

This extension is not an outright postponement of Medicare penalties in 2015. To be eligible for a hardship exception, you must meet the following criteria:

  • You were unable to fully implement a 2014 Edition certified EHR because your certified software was not available soon enough for you to install, train, and use prior to July 1
  • You were unable to attest by October 1, 2014, using the flexibility options provided in the 2014 Flexibility Rule

Visit the Payment Adjustments and Hardship Exceptions webpage for more information about Medicare EHR Incentive Program payment adjustments.