Washington Debrief: Flex-IT Bill Makes Series of Meaningful Use Program Changes

By Leslie Kriegstein, Interim Vice President of Public Policy, CHIME for Healthcare Informatics

Congressional Affairs

Flex-IT Bill Makes Series of Meaningful Use Program Changes

Key Takeaway: Congresswoman Renee Ellmers (R-NC-02) introduced legislation last week that makes a series of substantial improvements to the Meaningful Use Program, including a delay in the release Stage 3 rules.

Why It Matters: Conversations regarding reforming the Meaningful Use Program on Capitol Hill elevated last week with the introduction of a bill in the House that would not only delay Stage 3 rulemaking, but a series of substantive program changes as requested by many in the provider community.

The Flexibility in Health IT Reporting and Advancing Interoperability Act of 2015 or “Flex-IT 2” (H.R. 3309) was introduced by Congresswoman Ellmers last Wednesday. Key provisions of the legislation include:

1. Delay in Stage 3 Rulemaking – The legislation directs the Centers for Medicare & Medicaid Services (CMS) to wait until at least 2017 to publish a final rule on requirements for Stage 3 meaningful use, currently set for release this fall.
2. Annual 90-day Reporting Period – The program’s reporting period would be shortened to 90 days annually.
3. Quality Measure Reporting Harmonization – The bill would align the program’s reporting requirements with those of the CMS’s Physician Quality Reporting System (PQRS) and the Hospital Inpatient Quality Reporting Program (IQR).
4. Expansion of Hardship Exemptions – Providers who recently changed electronic health record systems would be added to the list of those eligible to qualify for a hardship exemption as well as anesthesiologists, radiologists, pathologists and hospitalists, who may not interact directly with patients as dictated by the Meaningful Use Program.
5. Elimination of the All-or-Nothing Construct – The legislation directs the secretary to remove the pass-fail nature of the program to accommodate the needs of different needs of the diverse healthcare provider landscape.

Earlier this year, Representative Ellmers introduced the Flex-IT Act of 2015 to shorten the Meaningful Use Program’s reporting period in 2015 from a full year to three months.

In statement accompanying the bill’s release, CHIME President and CEO Russell P. Branzell said, “While CHIME remains committed to the success of meaningful use, and to making sure improved patient care is its lasting legacy, we believe significant changes are needed to address increased dissatisfaction with EHRs and growing provider dissatisfaction with the program.” He added, “The introduction of the Flex-IT 2 Act serves to strengthen accountability and effectiveness of an e-enabled health care system and ensure long-term vitality of meaningful use.”

To offer your support for the legislation, and to encourage your member of Congress to cosponsor the Flex-IT 2 Act, use CHIME’s Congressional Advocacy Portal today.

Federal Affairs

CHIME Joins Industry Call to Expedite the Meaningful Use Modifications Rule

Key Takeaway: Last week CHIME joined 17 industry stakeholders to request the Centers for Medicare and Medicaid Services (CMS) publish the final Meaningful Use Modifications Rule for 2015 through 2017 expeditiously.

Why It Matters: CMS has yet to finalize the rule that proposed a 90-day reporting period in 2015, in addition to a number of substantive changes to the challenging patient engagement and secure messaging measures.

In May, CHIME submitted comments to CMS on the proposed changes to the program in which the organization commended CMS for leading a series of changes to the program, specifically highlighting the provision to shorten the EHR reporting period in 2015 from 365 days to 90 days.

But as stated in the stakeholder letter, with each passing day participation in the Meaningful Use Program in 2015 becomes more of a challenge for the nation’s providers. “Overall, the Department’s efforts to simplify and focus meaningful use in the 2015-2017 Modifications Rule are welcomed by the community—and will be a key contributor to the ongoing success of the EHR Incentive Program.  However, providers and technology developers need to have the certainty now that comes with a Final Rule in order to be able to meet the reporting deadlines for 2015 and continue participation in the program,” said the stakeholder group, which included provider and vendor representatives.

Citing the end of the fiscal year nearing, the letter states, “If providers do not receive the Final Rule shortly, it will be very difficult to make workflow adjustments in a timely manner to meet programmatic deadlines and facilitate Meaningful Use tracking and reporting.”

CMS Releases Additional Guidance on ICD-10 Flexibility for Providers

Key Takeaway: Last week, the Centers for Medicare and Medicaid Services (CMS) provided more clarification related to its joint announcement with the American Medical Association (AMA) regarding ICD-10 flexibilities.

Why It Matters: The flexibility announced jointly by the AMA and CMS on July 6 only pertains to those eligible for payment under Medicare’s Physician Fee Schedule, says CMS. The agency released additional guidance last week addressing some industry concerns resulting from the initial announcement.

One item that had been a source of confusion was CMS’ definition of “family of codes. The Q&A guidance offered an explanation, according to CMS, “Family of codes” is the same as the ICD-10 three-character category. Codes within a category are clinically related and provide differences in capturing specific information on the type of condition.”

The Q&A document clearly states that ICD-10 implementation is set to proceed on October 1, 2015