Practices buried under MU 'avalanche'

By Mike Miliard
11:57 AM
'2015 will be an extremely challenging year for medical practices on the IT and compliance side'

"I've never seen this level of frustration in our membership, as I have in the past six to eight months or so," says MGMA Senior Policy Advisor Robert Tennant. "It's not just meaningful use. But that is certainly one of the catalysts."

Indeed, a slew of recent edicts out of Washington – rules and revisions to rules, deadlines and extensions of deadlines – have proven to be a lot for even the most dedicated follower of health IT policy to keep track of – let alone a small physician practice trying to plan investments and strategies around federal timelines.

"It's an avalanche of regulations and requirements, mandates and other programs that are being thrust upon them," says Tennant. "Meaningful use has been one of the most challenging because it constantly changes. As soon as you think you've got a handle on what you need to do, the regulations require you to take different steps."

The Centers for Medicare & Medicare Services seems to understand this, announcing earlier this month that it would reopen the submission period for meaningful use hardship exception applications, with a new deadline of Nov. 30.

Perhaps it was the 44,000 providers who applied for hardship exceptions in the first go-round, keenly hoping to duck 2015 penalties. Or maybe it was the fact that fewer than 3,200 providers have managed to successfully attest to Stage 2 so far, according to the most recent set of numbers. But even CMS seems to understand on some level that practices are clamoring for relief.

"We've seen some flexibility from CMS over the last little while," Tennant concedes. But even that hardship exception deadline extension "only applies in the cases of the inability of the EP to fully implement 2014 software. So it was helpful, but it really doesn't address the underlying concern that EPs have not been successful moving to the 2014 requirements compared to the 2011."

Meanwhile the "flexibility" that MGMA and other groups – an alphabet soup including HIMSS, CHIME, AMA, AHA and AAFP – would really like to see has not materialized.

Those groups co-signed a Sept. 15 letter to CMS, imploring the agency to shorten the 2015 Stage 2 reporting period to 90 days, from its current full year, and to offer more latitude in how providers meet the troublesome view/download/transmit and transitions of care requirements.

The groups reiterated their concerns that "the pace and scope of change had outstripped our collective capacity to comply with meaningful use requirements," and warned that continued intransigence on the part of CMS could result in otherwise well-meaning providers "having to drop out of the program."

There could be relief coming from Capitol Hill, specifically the Flex-IT Act, filed in September by Republican North Carolina Rep. Renee Ellmers, which would mandate a 90-day reporting period.

"We're getting a lot of traction with a lot of key committees and leaders, especially in the House," says Tennant. But even if that bill should pass, he adds, "that alone is not going to solve all meaningful use issues for Stage 2."