Advocacy News

January 19, 2016



Meaningful Use Exemption Information, 2016 Continuing As-Is

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OHRP: Notice of Proposed Rule Making on the Common Rule

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CMS Issues an Emergency Update to the 2016 Medicare Physician Fee Schedule

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Meaningful Use Exemption Information, 2016 Continuing As-Is

Last month, President Barack Obama signed into law S. 2425, the Patient Access and Medicare Protection Act, which includes a provision addressing relief from Electronic Health Records (EHRs) and the meaningful use (MU) program. Importantly, the legislation requires that the Centers for Medicare and Medicaid Services (CMS) provide a blanket hardship exemption from 2015 meaningful use penalties to all providers who ask for it. The penalties would have been assessed in 2017.

According to a recent CMS blog post, the exemption “will allow groups of health care providers to apply for a hardship exception instead of each doctor applying individually,” and this “should make the process much simpler for physicians and their practice managers in the future.” CMS stated today they will be releasing guidance on this new process “soon.” Please visit for updates.

In the same blog post, CMS outlined several things they ask physicians and other clinicians to keep in mind as they work through a transition from the staged meaningful use phase to the new program as it will look under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA):

1. The current law requires that we continue to measure the meaningful use of ONC Certified Health Information Technology under the existing set of standards. While MACRA provides an opportunity to adjust payment incentives associated with EHR incentives in concert with the principles we outlined here, it does not eliminate it, nor will it instantly eliminate all the tensions of the current system. But we will continue to listen and learn and make improvements based on what happens on the front line.

2. The MACRA legislation only addresses Medicare physician and clinician payment adjustments. The EHR incentive programs for Medicaid and Medicare hospitals have a different set of statutory requirements. We will continue to explore ways to align with principles we outlined above as much as possible for hospitals and the Medicaid program.

3. The approach to meaningful use under MACRA won’t happen overnight. Our goal in communicating our principles now is to give everyone time to plan for what’s next and to continue to give us input. We encourage you to look for the MACRA regulations this year; in the meantime, our existing regulations – including meaningful use Stage 3 – are still in effect.

The post – which stressed both that meaningful use Stage 3 is still in effect and that MACRA will continue to require that physicians be measured on their meaningful use of certified EHR technology for purposes of determining their Medicare payments – comes after acting CMS Administrator Andy Slavitt stated that in 2016, meaningful use “as it has existed—with MACRA—will now be effectively over and replaced with something better.” Additionally, Slavitt stated that CMS will be sharing details and inviting comment this spring, but that the work will be guided by several critical principles:

1. Rewarding providers for the outcomes technology helps them achieve with their patients.

2. Allowing providers the flexibility to customize health IT to their individual practice needs. Technology must be user-centered and support physicians.

3. Leveling the technology playing field to promote innovation, including for start-ups and new entrants, by unlocking electronic health information through open APIs – technology tools that underpin many consumer applications. This way, new apps, analytic tools and plug-ins can be easily connected to so that data can be securely accessed and directed where and when it is needed in order to support patient care.

4. Prioritizing interoperability by implementing federally recognized, national interoperability standards and focusing on real-world uses of technology, like ensuring continuity of care during referrals or finding ways for patients to engage in their own care. We will not tolerate business models that prevent or inhibit the data from flowing around the needs of the patient.

Slavitt delivered his remarks right around the same time CMS released data on eligible providers who face payment adjustments in 2016 for failing to demonstrate meaningful use in 2014. According to CMS, 209,000 eligible professionals will see a 2 percent payment adjustment this year.