Healthcare Law Blog

Changes to Deadlines for Stage Two – Meaningful Use in the Medicare and Medicaid EHR Incentive Programs

Under the Health Information Technology for Economic and Clinical Health (“HITECH”) Act, health care professionals and hospitals may qualify for incentive payments when they adopt and meaningfully use certified electronic health records (“EHR") under a three stage process.

Specifically, they provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (“CAHs”) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology through a three stage process. Eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program.

Now that Stage 1 is underway, CMS’s recently published a final rule (September 4, 2012) that specifies EHR Incentive Programs Stage 2 criteria for eligible professionals (“EPs”), eligible hospitals, and CAHs. One of the core objectives is that all providers must achieve meaningful use under the Stage 1 criteria before moving to Stage 2. “Meaningful use” consists of transferring data to EHRs and being able to share information, including electronic copies and visit summaries for patients and means providers need to show they are using certified EHR technology in ways that can be measured significantly in quality and in quantity.

Deadlines for Stage 2- meaningful use requirements are fast approaching.   In the Stage 1 meaningful use regulations, CMS had established a timeline that required providers to progress to Stage 2 criteria after two program years under the Stage 1 criteria. This original timeline would have required Medicare providers who first demonstrated meaningful use in 2011 to meet the Stage 2 criteria in 2013. However, this deadline has been delayed. The earliest that the Stage 2 criteria will be effective is in fiscal year 2014 for eligible hospitals and CAHs, or calendar year 2014 for EPs.

To avoid penalties starting in 2015 for not being a meaningful user, providers will need to ensure they can attest to the proper length of time of meaningful use. The time requirements vary for types of providers and by the amount of time the program has been implemented. For example, eligible hospitals first achieving meaningful use in 2014 must attest no later than July 1, 2014 (because their payment years use the federal fiscal year) to avoid the 2015 payment adjustment. This means they must begin their 90-day reporting period by April 1, 2014. However, if an EP demonstrates meaningful use in 2014 for the first time, the EP must attest to meaningful use no later than Oct. 1, 2014 to avoid the Medicare penalty. Because the initial reporting must cover a 90-day period, the absolute latest for EPs to begin meaningful use is July 1, 2014 to avoid a penalty.

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This article does not constitute legal advice.