Healthcare Groups Ask HHS Chief Price for Regulatory Relief

Ken Terry

February 22, 2017

Sixteen healthcare associations, including the College of Healthcare Information Management Executives (CHIME) and America's Essential Hospitals, have asked Tom Price, MD, the newly appointed secretary of the Department of Health and Human Services (HHS), to delay "indefinitely" the implementation of stage 3 of the Meaningful Use Electronic Health Record (EHR) incentive program and the Advancing Care Information (ACI) section of the Merit-Based Incentive Payment System (MIPS).

In addition, the associations' letter to Dr Price, dated February 17, requested that "providers not be required to move to 2015 Edition CEHRT." This refers to the most recent requirements for Certified EHR Technology (CEHRT), which were approved in 2015 but which most EHR developers have yet to meet. According to the letter, just 56 EHRs have been certified under the government's 2015-edition criteria, compared to the 3724 EHRs that have been certified under the 2014 edition.

Most EHRs now in use are from the 2014 edition, according to Michael Lipinski, division director, federal policy and regulatory affairs, Office of the National Coordinator for Health Information Technology, also known as ONC. Lipinski mentioned this during a panel discussion at the annual HIMSS conference in Orlando, Florida, on Tuesday.

The Centers for Medicare & Medicaid Services requires all eligible clinicians to use 2015-edition EHRs in 2018 for stage 3 meaningful use and MIPS. Because so few EHRs have been certified in that framework so far, the letter to Dr Price said, "it is extremely unlikely that vendors will be able to deliver the systems in time for providers to test and deploy them by January 1, 2018. Without these systems, providers face rushed implementations, which may jeopardize patient safety, coupled with the potential for substantial financial penalties."

Those financial penalties would hit physicians who are in the Medicaid portion of the meaningful use program and doctors who are subject to MIPS if they don't meet the requirements of whichever program they're in. And they can't meet those criteria if they're not using 2015-edition software.

In addition, hospitals must still meet meaningful use requirements next year. The Medicare Access and CHIP Reauthorization Act (MACRA), which includes MIPS, does not apply to hospitals. In contrast, meaningful use will no longer apply to doctors who were previously eligible for the Medicare EHR Incentive program. But they will have to meet the ACI criteria, which are considerably trimmed down from those in the meaningful use program.

The signatories to the Dr Price letter include America's Essential Hospitals, the trade association for safety-net hospitals, and the CHIME, the association of hospital CIOs.

The American Hospital Association (AHA) was not represented, but AHA sent a letter to then President-elect Trump on November 30. That letter asked the incoming administration to cancel stage 3 of the meaningful use program "so that hospitals will not be forced to spend large sums of money upgrading their electronic health records (EHRs) solely for the purpose of meeting regulatory requirements."

The other associations' missive to Dr Price also said that their groups were concerned about being forced to make "considerable investments" to upgrade their EHRs to handle the new requirements. In addition, the letter pointed out, "Many providers today do not have the capability or the version of CEHRT to electronically report eCQMs [electronic clinical quality measures]." That reporting is required this year in stage 2 of meaningful use. Therefore, the signatories also asked Dr Price to make changes in hospital eCQM reporting as soon as possible.

Among the associations that signed the letter were the American Academy of Dermatology, the American Academy of Ophthalmology, the American Association of Neurological Surgeons, the American College of Cardiology, the American College of Surgeons, the American Society for Gastrointestinal Endoscopy, the American Society of Plastic Surgeons, America's Essential Hospitals, the Association of Black Cardiologists, CHIME, the Congress of Neurological Surgeons, the Infectious Diseases Society of America, the Medical Group Management Association, the North American Spine Society, the Premier Healthcare Alliance, and the Urgent Care Association of America.

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