Physicians, Health IT Experts Call for Delay of Stage 2 Rules

September 7, 2013

A chorus of healthcare voices is rising, urging CMS to delay the beginning of the Stage 2 requirements of the EHR Incentive Program.

Designed to spur widespread EHR implementation, CMS' EHR Incentive Program offers annual payouts to physicians and practices that incorporate EHR systems before 2015. According to CMS, over 269,000 Medicare eligible professionals (EPs) and more than 131,000 Medicaid EPs have already registered for the program, and these individuals will continue to receive payments if they can prove meaningful use  within the given time allotments. Many physicians, however, believe they will be unable to meet the Stage 2 requirements of meaningful use by the current deadline, and they’ve requested an extension.

The U.S. Senate Committee on Finance (CMF) met on July 17 and July 24, 2013, to evaluate the state of the meaningful use portion of the program to make sure it’s working effectively. During the first meeting, U.S. Senator Orrin Hatch (R-Utah) asked the CMF to pause and reassess the timing and requirements of meaningful use. John Glaser, Ph.D., CEO of Siemens' health services business unit, offered an alternative during the second meeting. He asserted that the EHR Incentive Program is reaching an inflection point and the Stage 2 requirements are too stringent. Glaser went on to suggest that the deadline for Stage 2 be delayed until October 1, 2015. He added that the program’s other stages should be extended to span three years each as well.

Since those hearings, other influential medical groups have stepped forward to echo Glaser’s sentiments regarding Stage 2. On August 7, 2013, the American Academy of Family Physicians (AAFP) wrote a letter to the CMF asking that the Stage 2 timeline be extended by one year. AAFP Board Chair Glen Stream expressed concern about the timeframe for physician compliance and regulatory expectations.

As an alternative, AAFP proposed creating three cohorts for physicians based on whether the qualifying physician would be attesting to meaningful use in 2014 as the first, second, or third/fourth payment year, and then staggering payouts by cohort. Stream noted that lessons learned during implementation for the first cohort could be used to improve experiences for the next two groups. By retooling the schedule, vendors would still be required to release 2014 certified product versions by the beginning of the year, but physicians would have more time to manage the logistics of converting to a new system.

On August 15, 2013, the Healthcare Information and Management Systems Society (HIMSS) sent its own letter to the CMF requesting that Stage 2 be launched as planned but with an extended attestation period. The HIMSS Board of Directors mentioned that many eligible professionals are citing timeline and certification challenges while preparing for Stage 2. The organization’s suggestion is to extend the attestation period to June 2015 for eligible medical professionals, which would give them 18 months to wait for any necessary upgrades that would enable them to confirm Stage 2 implementation.

The CMF has not yet made a statement regarding whether or not it will approve an extension to the deadline, so more medical groups will likely come forward to voice their thoughts. Still, there is a good reason to be optimistic since HHS already issued one extension to the Stage 2 requirements back in 2011.