CMS to Recast 'Meaningful Use' Data Reporting Rules

Kerry Dooley Young

April 25, 2018

The Trump administration intends to use the annual update of the Medicare payment rule to rebrand and streamline electronic data reporting requirements, abandoning the much derided "meaningful use" name.

The Centers for Medicare & Medicaid Services (CMS) said it will rename the meaningful use program "promoting interoperability." Physicians and other healthcare professionals had long joked that the program should have been called "meaningless abuse," a view CMS appears to address in its planned revisions of reporting requirements.

CMS intends to make these changes through Medicare's fiscal 2019 hospital inpatient prospective payment system (IPPS) rule. It released the draft version on Tuesday.

CMS said in a statement that it also intends to remove 18 previously adopted data measures that it considers no longer relevant or in which the burden of data collection outweighs the measure's ability to improve quality of care. CMS also said it will "de-duplicate" another 21 measures to simplify and streamline measures across programs. These changes are meant to hone in on the data that matter most for patient care, said CMS Administrator Seema Verma in a teleconference with reporters.

"This will enable providers to focus on tracking and reporting measures that matter the most," Verma said.

List of Prices

CMS also intends to use this payment rule to compel hospitals to put lists of their standard charges on the Internet and to address the high cost of a new kind of genetically engineered cancer drug.

Current law requires hospitals to make public a list of their standard charges. CMS said it intends to update guidelines to specifically require hospitals to make public a list of their standard charges via the Internet. The agency also is seeking feedback through a request for information about providing greater transparency for patients as to what costs they will face after hospital stays.

"CMS is concerned that challenges continue to exist for patients due to insufficient price transparency, including patients being surprised by out-of-network bills for physicians, such as anesthesiologists and radiologists, who provide services at in-network hospitals, and patients being surprised by facility fees and physician fees for emergency room visits," the agency said.

In addition, the fiscal 2019 IPPS rule will touch on the cost of an expensive new approach to cancer treatment, chimeric antigen receptor (CAR) T-cell therapy, CMS said. In CAR T-cell therapy, a patient's own immune-system T cells are genetically engineered in a laboratory and are used to assist in the attack on certain cancerous cells, CMS said. The agency said it is inviting public comments on approaches for payment for this targeted therapy, "including in the context of the pending Kymriah (Novartis) and Yescarta (Kite Pharma) technology add-on payment applications, and the most appropriate way to establish payment for FY [fiscal year] 2019 under any alternative approaches."

CMS also said an expected rate increase, together with other proposed changes to payment policies in the fiscal 2019 proposal, will increase IPPS operating payments by approximately 2.1%. Proposed changes in uncompensated care payments, capital payments, and changes to the low-volume hospital payments will increase IPPS payments by an additional 1.3%, resulting in a total increase in IPPS payments of 3.4%.

CMS also said that total Medicare spending on inpatient hospital services, including capital, may increase by about $4 billion in fiscal year 2019.

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