Below are some excerpts from the published (Nov, 2017) MACRA Final rule -- See https://s3.amazonaws.com/public-inspection.federalregister.gov/2017-2406... for the complete 1600+ page document

Meaningful use, which CMS changed to "advancing care information" and rolled out under the Medicare Merit-based Incentive Payment System, will now be called "promoting interoperability."

While we continue to recommend that physicians and clinicians migrate to the implementation and use of EHR technology certified to the 2015 Edition so they may take advantage of improved functionalities, including care coordination and technical advancements such as application programming interfaces, or APIs, we recognize that some practices may have challenges in adopting new certified health IT. Therefore, we are finalizing that MIPS eligible clinicians may continue to use EHR technology certified to the 2014 Edition for the performance period in CY 2018.

Clinicians may also choose to use the 2015 Edition CEHRT or a combination of the two. Clinicians will earn a bonus for using only 2015 CEHRT in 2018.

For the 2018 performance period, MIPS eligible clinicians will have the option to report the Advancing Care Information Transition Objectives and Measures using 2014 Edition CEHRT, 2015 Edition CEHRT, or a combination of 2014 and 2015 Edition CEHRT, as long as the EHR technology they possess can support the objectives and measures to which they plan to attest. Similarly, MIPS eligible clinicians will have the option to attest to the Advancing Care Information Objectives and Measures using 2015 Edition CEHRT or a combination of 2014 and 2015 Edition CEHRT, as long as their EHR technology can support the objectives and measures to which they plan to attest.

As expected, the agency is allowing for the continued use of 2014-edition EHRs for MACRA year 2, though users of 2015-vintage EHRs will get a 10 percent formula bonus. The agency is also keeping the 90-day reporting period for meaningful use measures. Medicare is continuing to allow doctors in small practices to pool quality measurements in “virtual groups.”

Under the current policy as reflected in §414.1305, 2015 Edition CEHRT will be required in the performance period in 2019. We believe that there are many benefits for MIPS eligible clinicians and their patients implementing the 2015 Edition of CEHRT. These include enabling health information exchange through new and enhanced certification criteria