The American Hospital Association sent a letter Tuesday asking CMS and the Office of the National Coordinator for Health IT to quickly finalize a proposed rule that extends the meaningful use timeline so that providers can take advantage of the added flexibility, EHR Intelligence reports (Murphy, EHR Intelligence, 6/18).

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

Details of Proposed Rule

The proposed rule would change:

• The meaningful use timeline;
• The definition of certified EHR technology; and
• Requirements for the reporting of clinical quality measures.

Specifically, the proposed rule would provide additional flexibility by allowing eligible professionals, eligible hospitals and critical access hospitals to use the 2011 Edition certified EHR technology or a combination of 2011 and 2014 Edition certified EHR technology for the 2014 EHR reporting period.

Providers would be able to attest to meaningful use under the 2013 reporting year definition and use the clinical quality measures from 2013.

In addition, providers scheduled to begin attesting to Stage 2 in 2014 who have run into vendor problems could use 2014 Edition certified EHR technology to meet the 2014 Stage 1 objectives.

The proposed rule also would formalize the agencies' plan to extend Stage 2 through 2016 and push back of the start of Stage 3 until 2017 (iHealthBeat, 5/21).

Letter Details

In the letter, AHA Senior Vice President Linda Fishman praised the additional flexibility but wrote that the last-minute nature of the proposed rule means that "hospitals are essentially asked to act on faith that the agencies will finalize these proposals as written -- while risking that they may not -- without the benefit of a later reporting period to conform to more stringent final rules."

According to EHR Intelligence, the proposed rule has not removed the timing requirements on eligible hospitals that only have through July 1 to participate in the last reporting period for the fiscal year that ends in September (EHR Intelligence, 6/18).

Fishman asked the agencies not to make any changes to the proposed flexibility when they finalize the rule, noting that "a final rule that narrows the proposed flexibility could unfairly cause significant financial and operational harm to hospitals."

In addition, AHA listed several other suggestions as to how the agencies could improve the meaningful use program, including:

• Simplifying and clarifying how the finalized rule would be implemented;
• Increasing flexibility for how hospitals report electronic clinical quality measures;
• Shortening the meaningful use reporting period for 2015;
• Learning from Stage 2 before selecting a start date for Stage 3 (AHA News, 6/17); and
• Confirming that the proposed changes to the regulatory text support the intended flexibility (EHR Intelligence, 6/18).