GE Healthcare Camden Group Insights Blog

MACRA Final Rule Released Revealing Changes

Posted by Matthew Smith on Oct 17, 2016 10:09:29 AM

This past Friday morning, October 15, 2016, the Department of Health and Human Services released its final rule (with a comment period) on the Quality Payment Program ("QPP"), a part of the Medicare Access and CHIP Reauthorization Act of 2015 ("MACRA").

The QPP has two tracks: the Merit-Based Incentive Payment System ("MIPS") and the Advanced Alternative Payment Model ("APM").

Compared with the proposed rule, the main changes in the final rule include:

  • support for small and independent practices
  • expansion of APM opportunities
  • flexible 2017 reporting options
  • a focus on a unified program that supports clinician-driven quality. 

CMS launched a new Quality Payment Program website where the final rule, along with educational material, can be found. This website will be a great resource for eligible clinicians as they rollout QPP activities in 2017. 

For More Information:

Learn more about the details of the final rule in GE Healthcare Camden Group's webinar: "Chart Your Course for MACRA Success" this Thursday, October 20th. To register for this complimentary webinar, please click the button below.

Webinar, MACRA

Topics: CMS, Final Rule, MACRA, MIPS, QPP, APM

CMS Releases Final Rule for Participants in EHR Incentive Programs

Posted by Matthew Smith on Sep 2, 2014 2:16:00 PM

EHR Incentive Program, Meaningful UseOn Friday, August 29, CMS released a final rule that allows providers participating in the EHR Incentive Programs to use the 2011 Edition of certified electronic health record technology (CEHRT) for calendar and fiscal year 2014. 

The rule grants flexibility to providers who are unable to fully implement 2014 Edition CEHRT for an EHR reporting period in 2014 due to delays in 2014 CEHRT availability. Providers may now use EHRs that have been certified under the 2011 Edition, a combination of the 2011 and 2014 Editions, or the 2014 Edition for 2014 participation.

Under the modified attestation schedule, providers that were not able to fully implement 2014 Edition certified EHR technology in time to successfully attest to meaningful use due to vendor delays will be able to use 2011 Edition CEHRT or a combination of 2011 and 2014 Edition to attest to either stage 1 or stage 2. Providers will also be able to attest to meaningful use under the 2013 reporting year definition and use 2013's clinical quality measures.

The College of Healthcare Information Management Executives has supported giving providers more options for attesting in what has been a challenging year for CIOs. However, the organization was disappointed the rule will still require a full year of attestation in 2015.

"Roughly 50 percent of eligible hospitals and critical access hospitals were scheduled to meet stage 2 requirements this year and nearly 85 percent of EHs and CAHs will be required to meet stage 2 requirements in 2015,” said CHIME CEO Russ Branzell in a statement. “Most hospitals that take advantage of new pathways made possible through this final rule will not be in a position to meet stage 2 requirements beginning Oct. 1, 2014. This means that penalties avoided in 2014 will come in 2015, and millions of dollars will be lost due to misguided government timelines.”

Beginning in 2015, all eligible providers will be required to report using 2014 Edition CEHRT.

2014 Participation Options

Under the rule, providers are able to use 2011 Edition CEHRT, and have the option to attest to the 2013 Stage 1 meaningful use objectives and the 2013 definition CQMs.

2011 CEHRT

Providers scheduled to meet Stage 1 or Stage 2:

Combination of 2011 & 2014 CEHRT

Providers scheduled to meet Stage 1:

Providers scheduled to meet Stage 2:

  • 2013 Stage 1 objectives and 2013 CQMs; or
  • 2014 Stage 1 objectives and 2014 CQMs; or
  • 2014 Stage 2 objectives and 2014 CQMs

2014 CEHRT

Providers scheduled to meet Stage 1:

  • 2014 Stage 1 objectives and 2014 CQMs

Providers scheduled to meet Stage 2:

  • 2014 Stage 1 objectives and 2014 CQMs; or
  • 2014 Stage 2 objectives and 2014 CQMs

CEHRT Flexibility Resources

To help the public understand the final rule’s changes to 2014 participation, CMS has developed the following resources:

  • CEHRT Interactive Decision Tool – providers answer a few questions about their current stage of meaningful use and Edition of EHR certification, and the tool displays the corresponding 2014 options.
  • 2014 CEHRT Flexibility Chart – chart provides a visual overview of CEHRT participation options for 2014.
  • 2014 CEHRT Rule Quick Guide – guide provides corresponding resources based on the option a provider chooses to participate in the EHR Incentive Programs in 2014.

Extending Stage 2

The rule also finalizes CMS and ONC’s recommended timeline to extend Stage 2 through 2016. The earliest a provider can participate in Stage 3 of meaningful use is now 2017.

For More Information

Visit the CMS Newsroom to read the press release about the final rule. For more EHR Incentive Programs resources, visit the CMS EHR website.


Topics: EHR, EMR, Meaningful Use, Electronic Health Records, CMS, HIT, Health IT, Provider, Final Rule

CMS Subtly Sets Oct. 1, 2015 Conversion Date for ICD-10

Posted by Matthew Smith on May 2, 2014 9:12:00 AM

ICD-10, CMSIn a nearly 1,700-page proposed rule on fiscal year 2015 inpatient payment policies released Wednesday, CMS appears to have quietly set Oct. 1, 2015, as the new ICD-10 implementation deadline, Health Data Management reports (Goedert, Health Data Management, 5/1). 

HHS “expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning Oct. 1, 2015,” the CMS statement said. “The rule will also require HIPAA-covered entities to continue to use ICD-9-CM through Sept. 30, 2015.”


U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.

Earlier this month, President Obama signed into law legislation (HR 4302) that pushes back the ICD-10 compliance date until at least October 2015 (iHealthBeat, 4/25). 

Health care stakeholders have been pushing the agency to provide more clarity on the new deadline.

For example, a coalition of health care organizations last month sent a letter to CMS Administrator Marilyn Tavenner urging the agency to clarify the ICD-10 implementation deadline as soon as possible.

The group -- which includes the American Health Information Management Association, America's Health Insurance Plans and the College of Healthcare Information Management Executives -- urged the agency not to extend the compliance date beyond October 2015 and to announce Oct. 1, 2015, as the official deadline.

They wrote that coalition members "have already expended an enormous amount of time, effort and resources in preparing for the transition to ICD-10 in accordance with the original timeline given by HHS." They added, "Continued uncertainty relative to the ICD-10 implementation date will add significant demands on limited resources and will measurably increase the overall cost of completing the transition" (iHealthBeat, 4/17).

Details of Proposed Rule

The proposed rule includes a request for comment on the ICD-10 strategy. It states, "The ICD-10-CM/PCS transition is scheduled to take place on Oct. 1, 2015. After that date, we will collect non-electronic health record-based quality measure data coded only in ICD-10-CM/PCS."

CMS is seeking feedback on how "if at all, [it] should adjust performance scoring under the Hospital [Value-Based Purchasing Program] to accommodate quality data coded under ICD-10-CM/PCS, or otherwise ensure fair and accurate comparisons under the Hospital VBP Program once the transition date has passed" (Health Data Management, 5/1).

Note: The request for comment on the ICD-10 deadline can be found on pages 648-650 of the proposed rule.

Topics: CMS, ICD-10, Final Rule

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