CMS releases Stage 2 rules

National coordinator for Health IT Farzad Mostashari, MD

 Proposal recommends delay to 2014

WASHINGTON–After some stops and starts, the Centers for Medicare & Medicaid Services (CMS) has at last released the proposed rules for Stage 2 of qualifying for the meaningful use of electronic health records incentives.

In a 455-page proposal, released on Feb. 23, CMS raised the performance bar, focused on interoperability and delayed the start of Stage 2 from 2013 to 2014.

As expected, the next stage of meaningful use builds on the criteria from Stage 1, pushing providers to actually exchange information in various transactions to drive continuous quality improvement.

On Feb. 22, at a keynote given at HIMSS12 in Las Vegas, National Coordinator for Health Information Technology Farzad Mostashari, MD, said federal regulators based the new proposal on thousands of recommendations from the industry. They also reflect the recommendations made by the federal advisory committees on policy and standards.

“We listened, and we learned from what you have been telling us,” Mostashari told HIMSS12 attendees. “We take seriously the need for flexibility. We have done whatever we can to increase flexibility and to reduce the burden.”

Though many organizations are still wading through the proposal, some early commenters came down on opposite sides of the fence. Health IT Now, a coalition of 62 patient, provider, employer and payer organizations said the rule didn’t go far enough. The group’s executive director, Joel White, called the proposal “a good start,” but said more needs to be done to ensure doctors have the right information when treating patients. “In the world of health IT, getting the right information at the right time about the right patient can literally mean life or death,” he said.

“We will work with our partners and encourage HHS to move aggressively to pursue information exchange that promotes better health, better outcomes and lower costs,” said White. “We can’t wait for this.”

The Healthcare Information and Management Systems Society (HIMSS) said it was pleased the proposed rule would provide at least 18 months before enactment of Stage 2, to give providers and vendors adequate time to meet the new requirements.

HIMSS has set up a website, Meaningful Use OneSource, where the group’s experts are expected to post “substantive analyses” of the proposed rule in the coming weeks.

Steven J. Stack, MD, chair-elect of the American Medical Association Board said HHS should conduct a full evaluation of Stage 1 before the proposal for Stage 2 is finalized. This should be done “to eliminate roadblocks and encourage greater physician participation,” Stack said.

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