The process has been repeated time and again: Regulators issue proposed rulemaking, stakeholders comment, a final version manifests. So what, this time, has the industry concerned in the case of two pieces of meaningful use?

Timing. And there’s precious little of it left before hospitals and vendors find themselves in a real bind.

Both healthcare providers and electronic health record vendors, in fact, are anxiously waiting for the Centers for Medicare & Medicaid Services to release final rule changes to meaningful use regulations for 2015 through 2016, expected before Labor Day – in addition to final rules for meaningful use Stage 3 for 2017 and beyond, widely anticipated to drop before year’s end.


Indeed, this time crunch is as big of a deal as it looks. Here’s why: In the 2015/2016 proposed rule, all hospitals and eligible providers would be able to attest to 90 consecutive days of meaningful use for 2015 only, instead of an entire year.

If CMS makes the 90-day attestation period available in the final rule, the latest date that providers could begin recording meaningful use data would be Oct. 1.

That means until CMS delivers the rules EHR vendors cannot update their systems accordingly and, in turn, hospitals are left waiting on those upgrades before they can start the next phase of meaningful use.

What’s more, an exact date when the rules will come out is anyone’s guess, said Jason Fortin, senior advisor at consultancy Impact Advisors. So he’s playing it safe by checking the Federal Register three times a day.

GE Healthcare vice president Mark Segal – he's also chair and vice chair emeritus of the HIMSS EHR Association – said changes to the measures themselves from what was proposed in April will likely be minimal.

Even still, two sticking points both Segal and Fortin would like to see clarification on include measures for population health management and patient electronic access.

Leslie Krigstein, interim vice president of public policy at the College of Healthcare Information Management Executives said CHIME is pleased that CMS listened to the industry’s concerns and included changes in the proposed rule for 2015/16 that would allow the 90-day reporting period and some other flexibility – but noted that if the final rule isn’t released soon, these added proposals won’t have the intended effect.

"We are urging and pleading with CMS to get the modification rules out there," she said.

Krigstein added that if all else fails, CIOs could still make things work if  CMS would release just the 2015 portion of the rule by August and followed with the 2016 portion later.


"In reality, 2016 is going to come with more changes and with a year-long reporting period,” she added, understanding that these might take more time before they can be released.

As a backdrop to all the waiting, some members of Congress are using the time to propose ways of blocking meaningful use into the future.  The American Medical Association added heat to that fire with a late July town hall meeting to voice complaints about electronic health records and meaningful use, attended and endorsed by House Budget Committee Chair Tom Price, MD (R-Ga).  

GE’s Segal said the added scrutiny from Congress is probably not making things any easier for CMS when it comes to getting these two critical rules released.

Diana Manos is a Washington, D.C.-based freelance writer with specialties in healthcare, technology, politics and policy.