The original Flexibility in Health IT Reporting Act of 2015 (Flex-IT), introduced by Congresswoman Renee Ellmers (R-N.C.) in September 2014, aimed to shorten the meaningful use reporting period from one year to 90 days. In late July, Rep. Ellmers introduced the Further Flexibility in HIT Reporting and Advancing Interoperability Act, or Flex-IT 2, stating the “legislation is key to supplying healthcare providers with flexibility and certainty.” The new bill expands on the old proposal with further goals for improvement.
The Meaningful Use program began as a result of the Health Information Technology for Economic and Clinical Health (HITECH) Act back in 2009. The intention was to encourage adoption of electronic health records (EHR) among providers. Now, six years later, there are mixed feelings about the program.
The program offers incentive payments to those providers who demonstrate “meaningful use” of their EHR software, based on certain objectives predefined by the Centers for Medicare and Medicaid Services (CMS). Providers must attest to these objectives at each stage and then report to CMS. Stages 1 and 2 emphasized electronic data capture and advanced clinical processes. Stage 3, while still a long ways away, will focus on interoperability and improving outcomes.
CMS proposed a Stage 3 rule in April, which would require all eligible providers (EPs) and hospitals to attest to Stage 3 in 2018. A final rule has not yet surfaced, but many providers are against it.
Flex-IT 2 proposes five main objectives as part of its mission to reform the Meaningful Use program for providers:
- Delay Stage 3 final rules until 2017
- Streamline reporting requirements (Meaningful Use, Physician Quality Reporting System, Hospital Inpatient Quality Reporting)
- Reduce reporting period for everyone to 90 days
- Improve interoperability between EHR systems
- Expand hardship exceptions
The American Medical Association (AMA) and the College of Health Information Management Executives (CHIME) are both in favor of the Flex-IT 2 bill. The AMA issued a release declaring “strong support” of the legislation. Officials believe the “bill addresses many of the fundamental shortcomings in government regulations that have made many EHR systems very difficult to use.”
The CEO and President of CHIME together released a joint statement sharing similar sentiments. “While CHIME remains committed to the success of Meaningful Use…we believe significant changes are needed to address increased dissatisfaction with EHRs and growing provider dissatisfaction with the program.”
Congresswoman Ellmers asserts on her website that a mere 19% of providers have managed to attest to Stage 2 of MU, feeling that it is a “clear sign that physicians, hospitals, and healthcare providers are challenged in meeting CMS’ onerous requirements.”
Many are in agreement that MU is too ambitious. In September 2014, several physician organizations sent a joint letter to the Department of Health and Human Services (HHS) expressing their support of the Flex-IT Act of 2015 and their dissatisfaction with the Meaningful Use program’s current requirements.
If the Flex-IT 2 bill passes, it will serve to reinforce the Meaningful Use program, which has long been viewed as a burden on healthcare providers with its hard and fast rules. As it stands now, MU faces a great deal of opposition from the provider community. Providers feel that the program has not been beneficial to them, and has even, in some cases, hindered their ability to perform their duties. Unless the program is amended, it will continue to be heavily opposed.
Of course, there are those who believe there is no use in delaying the next stage. The Senate Health Education Labor and Pensions (HELP) committee has been holding hearings this summer to identify problems with the EHR incentive program and develop potential solutions. In one such hearing, Allscripts CEO Paul Black stated that Stage 3 should continue as scheduled, as there is still time left for providers to adjust.
In an effort to placate providers, CMS proposed a rule in April 2015 that would shorten the reporting period and allow the much needed flexibility for providers as they aim to attest to Stage 2. However, no final rule has been released as of yet. Since the fiscal year will end September 30th, the rule will be relevant for the current period. On August 6th, eight hospital organizations sent a letter to HHS secretary Sylvia Matthews Burwell, stating that a final rule is “past due” and “failure to release a final rule in the immediate future would create significant hardships for hospitals and physicians.”
Author: Apoorva Anupindi