Rethinking Meaningful Use in 2014 – CMS Releases Final Rule

 In Articles, Meaningful Use

If you have had difficulties implementing a 2014-certified EHR system to meet Meaningful Use in 2014, you may have some new options according to a final rule published by CMS this week. All providers must still attest to Meaningful Use for a calendar quarter in 2014 in order to earn a bonus and avoid a 2% penalty on Medicare payments in 2016. However, providers may now be able to attest to an earlier version of MU criteria.

These alternatives are only available if you have been unable to fully implement the 2014-certified version due to delays in the availability of 2014-certified software. The attestation system is being updated to include this statement as a mechanism that allows you to use an earlier version of the MU criteria. If you are audited, it will be up to the auditor to determine whether you had sufficient cause to make this claim. CMS states that each provider’s situation is different, but does indicate that financial constraints will not be sufficient justification. The final rule does state that a provider would qualify to use the 2014 Stage 1 MU criteria if he is unable to meet the Electronic Summary of Care criteria because he does not have enough trading partners with capability to accept the SOC document.

Providers may not pick and choose between individual criteria, instead they must meet the full set of criteria for the MU version they select, including applicable Clinical Quality Measures.

For providers that were scheduled to attest to Stage 2 criteria in 2014, there are three choices:

  1. Attest to Stage 2 criteria using a 2014-certified EHR system (as scheduled)
  2. Attest to the 2014 version of Stage 1 criteria using a 2014-certified EHR system
  3. Attest to the 2013 version of Stage 1 criteria using a 2011-certified system

For providers that were scheduled to attest to Stage 1 criteria in 2014, there are two choices:

  1. Attest to the 2014 version of Stage 1 criteria using a 2014-certified EHR system (as scheduled)
  2. Attest to the 2013 version of Stage 1 criteria using a 2011-certified EHR system

If you have a modular EHR system and some modules have been certified at the 2014 levels while others have only 2011 certification, you may use this system to attest to Stage 2 criteria or select between the 2013 or 2014 versions of Stage 1 criteria.

Please note, that these alternatives exist only for 2014 and do not impact your future course in the MU program.  This means that if you were scheduled to meet Stage 2 criteria in 2014, regardless of what path you choose, you are required to attest to Stage 2 for the full calendar year in 2015.

Our recommendation is for all practices to work diligently to attest as scheduled and to rely on these alternatives only if you find it impossible to meet the measures for the final reporting period of October-December 2014.  If needed, you will want to carefully document the effort made to implement a 2014-certified system, highlighting vendor delays or problems as a major cause.  As always this documentation should be saved for at least six years following attestation.

To find the detailed list of criteria for each version and stage, click here.

The final rule was published in the Federal Register on September 4 and is available at the Federal Register website.

Download the MSOC Printable Summary for 2014 Meaningful Use Measures.

For assistance with meeting requirements for Meaningful Use, PQRS or the new Value-Based Modifier Program, contact Jeanne Chamberlin at 919-442-2422 or j.chamberlin@msochealth.com.

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