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MU proposed rule provides 'relief,' but raises new concerns, questions

Some industry leaders say changes hurt patient access to information
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The Centers for Medicare & Medicaid Services has finally issued its promised reprieve of some of the harsher provisions of the Meaningful Use program, releasing its proposed rule that shortens the attestation period in 2015 from 365 to 90 days and reduces reporting and other burdens.

The rule, revealed April 10 and slated to be published in the Federal Register Wednesday, changes Stages 1 and 2 of the Meaningful Use program for 2015 through 2017 so that they align with CMS' proposed vision of Stage 3 beginning in 2017.

It softens some of the measures and objectives currently required, such as reducing the patient access obligation from 5 percent to one patient, and reduces reporting requirements to ease provider burdens, support interoperability and improve outcomes, according to CMS.

Patient advocates cry foul    

Some in the industry, including former National Coordinator Farzad Mostashari, M.D. were unhappy with the changes to patient engagement requirements. Mostashari, in his closing keynote at a patient engagement preconference symposium at the Healthcare Information and Management Systems Society (HIMSS) annual conference in Chicago, brought up the prososed rule and turned to Twitter in a cry for action.

"I support patients rights to get their own health records--electronic, affordable, NOW," he wrote on the social media site Monday. He also implemented the hashtag #DataIndependenceDay, which caught on among industry professionals. 

Patient rights advocate Regina Holliday also used the hashtag, tweeting from the conference: "I am in the house, I brought my megaphone. Let's rumble #DataIndependenceDay #HIMSS15." 

Meaningful Use "milestones" too much?

"The analysis conducted during the planning process for Stage 3 also allowed insight into the progress toward program milestones and provider performance on the objectives and measures. This analysis allowed us to identify an approach to be responsive to stakeholder concerns about program complexity and revisit the consideration that the stage of meaningful use and EHR reporting periods should align where possible," the proposed rule states.

The proposed rule had been anticipated since January, when CMS indicated that it would follow "multiple tracks" to update the program and "be responsive to stakeholder input." CMS had come under fire in recent months as providers struggled to meet Stage 2 of the program.

Although comments are not due until mid-June, the American Hospital Association has already voiced its concerns about the proposed rule. While it provides "much needed relief" and gives hospitals ore time to transition to Stage 2 and meet CMS' timetables, "the inclusion of numerous additional program changes at this late date risks causing confusion and added burden for hospitals on top of the elements proposed in the Stage 3 rule," Linda Fishman, the AHA's senior vice president for public policy analysis and development, said in a statement.

The rule, perhaps unsurprisingly, does not address concerns about the utility of the program itself--an issue that has also been raised in recent months. It also does not address how CMS would reconcile Meaningful Use should the Medicare Access and CHIP Reauthorization Act become law and significantly modify the program for physicians. That act has passed in the House and is up for debate in the Senate this week.

To learn more:
- read the proposed rule
- here's the AHA statement

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