While the HHS Office for the National Coordinator for Health Information Technology (ONC) released two Final rules with implications for various electronic health record (EHR) issues in October, the end of the year is seeing significant developments and debate in this area. The ONC itself even released a clarification to one of the Final rules early in December. Later this week, a vote on a bill that would allow physicians in ambulatory surgical centers (ASCs) to participate in the EHR incentive program is set for a vote in Congress.
Final rules, clarification
The rule released by the ONC finalized the 2015 Edition Health Information Technology (Health IT) Certification Criteria (2015 Edition) and the 2015 Edition Base EHR definition. It also modified the ONC Health IT Certification Program to make it more accessible to varying types of health IT in various health care settings (Final rule, 80 FR 62602, October 16, 2015; see Final rule out for Health IT certification, Base EHR definition, Health Law Daily, October 16, 2015). On the same day, CMS issued a Final rule that specified the requirements that eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) must meet in order to qualify for EHR incentive payments and avoid penalties under Stage 3 of the Medicare EHR Incentive Program (Final rule, 80 FR 62762, October 16, 2015; see CMS sets Stage 3 EHR incentive program date for January 2018, Health Law Daily, October 16, 2015). The ONC issued a clarification to certain changes made to the Health IT Certification Program earlier in December (Final rule, 80 FR 76868, December 11, 2015; see ONC clarifies Health IT certification requirements and Base EHR definition, Health Law Daily, December 11, 2015).
In a letter to CMS Acting Administrator Andrew Slavitt, the American Hospital Association (AHA) urged CMS to revise the EHR framework. Specifically, the letter focused on three recommendations to modify the program:
(1) revise the program framework to reflect the experience of the program to date;
(2) provide increased flexibility in program requirements; and
(3) adopt certain program requirements “supported by mature interoperability standards and infrastructure only.”
The Electronic Fairness Act of 2015, H.R. 887, if passed, would protect physicians practicing in ASCs from potential penalties under the meaningful use program until the time an EHR technology system is available to those facilities. It also would authorize HHS to move forward to certify such an EHR system. A vote on the bill is expected on Wednesday, December 16, 2015.In connection with its first recommendation, the AHA letter asked CMS to allow for a reporting period of 90 days in the first year of Stage 3 and any subsequent stage. Further, the AHA asked for the same reporting period “whenever there are changes to the definition of certified EHR, including a new edition of technology or new functionality.” AHA also asked Slavitt to “eliminate the all or nothing approach in meaningful use,” and allow an attestation by EPs, EHs, and CAHs that it met 70 percent of the requirements to be designated as having met meaningful use.