Six US senators have reintroduced legislation to roll back some meaningful use requirements. The measure would mainly affect hospitals, which are still subject to the electronic health record (EHR) incentive program of the Centers for Medicare & Medicaid Services (CMS).
The new bill, cosponsored by Sens. John Thune (R-SD), Lamar Alexander (R-TN), Pat Roberts (R-KS), Mike Enzi (R-WY), Richard Burr (R-NC), and Bill Cassidy (R-LA), duplicates a measure introduced last year. A House bill that covers some of the same ground was introduced last summer and cleared two House committees on October 4.
The Senate legislation would remove the “all-or-nothing” approach of the meaningful use program, which requires eligible hospitals and eligible professionals to meet all requirements to avoid subsequent financial penalties. “This bill would create a new threshold that requires eligible hospitals to meet no more than 70% of the required metrics to satisfy meaningful use requirements,” the bill summary said.
No mention is made of physicians, who are exempted from meaningful use unless they participate in the Medicaid portion of the program, which will pay incentives through 2021. As of August, only 5626 eligible professionals (most of them doctors) were still participating in this program. Under current CMS rules, providers who are eligible for the Medicaid meaningful use program no longer face penalties if they don’t participate. But if they have sufficient Medicare patients or business to meet the threshold for participating in the Merit-Based Incentive Payment System (MIPS) and they’re not in a qualifying alternative payment model, they must participate in that program or face a penalty in 2019.
The Senate bill also addresses MIPS, but in a mysterious way. It would direct the Department of Health and Human Services (HHS) “to consider forthcoming recommendations from the GAO [Government Accountability Office] with respect to improving EHR requirements for physicians.” It is not clear how this provision would change the final rule with comment that CMS just released for the Quality Payment Program, which includes MIPS.
The bill would codify the 90-day reporting period for providers. CMS has administratively specified a 90-day reporting period for meaningful use, the bill summary noted. The agency could change that to calendar year reporting in the future unless Congress prohibits it.
The summary pointed out that current law requires HHS to make EHR standards more stringent over time, “which drives more providers to seek hardship exceptions as they struggle to remain in compliance.” The bill would eliminate that requirement. This would be a significant boon for hospitals that are now required to upgrade their EHRs from 2014 edition to 2015 edition certified products.
In addition, the bill would provide unspecified hardship relief for providers in 2019.
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