On June 15, the California Medical Association (CMA) submitted comments to the Centers for Medicare and Medicaid Services (CMS) on proposed rules modifying Stage 1 and Stage 2 Meaningful Use criteria of the federal electronic health records (EHR) incentive programs.

Under the federal EHR incentive programs, qualifying Medicare and Medi-Cal providers are eligible to receive incentive payments for adopting and demonstrating “Meaningful Use” of certified health information technology. The proposed rule aligns Stage 1 and Stage 2 Meaningful Use objectives and measures for 2015 through 2017 with proposed Stage 3 requirements by removing redundant, duplicative and topped-out measures and by reducing the reporting burden. It also proposes additional modifications to the EHR reporting period and timeline that will help physician practices.

“CMA, located in the hub of tech industry, encourages the widespread adoption of EHRs and the use of innovative technologies that facilitate and improve the provision of quality health care,” CMA President Luther F. Cobb, M.D., wrote in the letter to CMS. “California physicians, however, have found participating in the EHR incentive programs and achieving Meaningful Use to be difficult and frustrating due to EHR systems that are unable to keep up with the constantly changing requirements, complex criteria, high costs for EHR implementation and upgrades, inconsistencies in how EHRs report data, and lack of interoperability.”

In its letter, CMA supported the detailed comments submitted by the American Medical Association (AMA) and offered further comments that are of particular interest to California physicians. CMA commended CMS on the proposed modification to allow for a 90-day reporting period for all incentive program participants in 2015, while urging CMS to extend the proposal beyond 2015 and allow for a reporting period that is less than a full calendar year for all participants in 2016 and 2017.

Additionally, CMA supported CMS’s proposal to streamline the program requirements to provide a more flexible framework to reduce the burden on physicians. CMA also recommended changes to Meaningful Use measures requiring physicians to provide online access to health information for more than 50 percent of unique patients seen by the provider. CMA had been advocating to CMS to reduce the patient portal requirements that are beyond a physician’s control. The new regulation only requires one patient to access the online portal during the reporting period for a physician to receive credit.

CMA’s letter also stressed that physicians who face adjustments for not achieving Meaningful Use may be forced out of the Medicare program, and urged CMS to adopt less burdensome requirements and facilitate participation in the EHR incentive programs by adopting realistic modifications to Meaningful Use. The letter urged CMS to eliminate the “all-or-nothing” approach to meeting Meaningful Use, which penalizes physicians who are able to meet a majority of Meaningful Use requirements with the same payment adjustment penalties as those who do not participate in the EHR incentive program at all. CMA’s letter recommended a Meaningful Use program where incentives and penalties are proportional to the measures successfully completed.

For more information on AMA’s comments regarding the Modifications to Meaningful Use Stage 1 and Stage 2 in 2015 through 2017, click here.

For more information and resources, including CMA On-Call documents #4302 “Meaningful Use of Electronic Health Records” and #4305 “EHR Meaningful Use Stage 2,” as well as additional information on the EHR Federal Incentive Program and Meaningful Use, visit CMA’sHIT website. These documents, as well as the rest of CMA’s online health law library, are available free to members in CMA’s online resource library. Nonmembers can purchase documents for $2 per page.

Contact: Lishaun Francis, (916) 551-2554 or lfrancis@cmadocs.org.