Medical Societies Seek 'Meaningful' Relief From Congress

Ken Terry

November 04, 2015

An American Medical Association–led coalition of 111 medical societies asked Congress yesterday to force the government to refocus stage 3 of the meaningful use electronic health records (EHR) incentive program. Although the associations' letters to the leaders of the House and the Senate did not call for stage 3 to be eliminated, they demanded that legislation be enacted to prevent what the societies view as the failure of stage 2 from being repeated in the third stage.

"Stakeholders have urged the Administration to take a different path to achieving the vision originally laid out by Congress in the HITECH Act," the identical letters said. "We believe that the success of the program hinges on a laser-like focus on promoting interoperability and allowing innovation to flourish as vendors respond to the demands of physicians and hospitals rather than the current system where vendors must meet the ill-informed check-the-box requirements of the current program."

Medical associations have been expressing their dismay over the stage 3 criteria since they were proposed last March. On September 17, the AMA and 41 other medical societies asked the administration to pause the formulation of stage 3 regulations. That coalition noted that the passage of the Medicare Access and Chip Reauthorization Act (MACRA) had changed the playing field.

"Given the vital role of the Meaningful Use program in the reformed payment systems introduced by MACRA, proceeding with the proposed Stage 3 rules threatens to impede the health care delivery innovations Congress sought to promote when it passed the law," an AMA news release stated.

Nevertheless, the Centers for Medicare and Medicaid Services (CMS) proceeded with its rule making and issued a final rule on stage 3 requirements, changes in stage 1 and 2 rules, and EHR certification criteria in early October. So now that that's a done deal, the physician sector is turning to Congress for relief.

Dismal Performance

In its plea to congressional leaders, the AMA-led coalition stressed the poor track record of meaningful use stage 2. According to the associations, only 12% of physicians have successfully attested to date in stage 2, which began Jan. 1, 2014. Of course, not all physicians are eligible to enter stage 2; some haven't been in stage 1 long enough, don't have 2014 certified EHRs, or never participated in the program. But according to the latest figures from the CMS, 57,726 eligible professionals had attested in stage 2 through September. That's 19% of those who attested in stage 1.

The coalition attributed this dismal performance partly to the continuing difficulty of exchanging data between providers, which is a stage 2 requirement. In fact, the letters said, the meaningful use program has "created new barriers to easily exchanging data and information across care settings."

Another flaw that the coalition cited in both the stage 2 and the stage 3 rules is the "excessive documentation requirements," including a heavy focus on measure thresholds.

Although the letters did not mention the penalties for failing to meet the program requirements, physicians who do not attest to meaningful use face reductions in their Medicare payments. The penalties increase from 1% this year to 3% in 2017.

All eligible professionals must begin stage 3 in 2018, although they have the option to attest in that stage a year earlier.


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