The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced a proposed rule, on May 20, 2014, that would allow providers more flexibility in how they use electronic health record (EHR) systems to meet meaningful use requirements and would formally extend the reporting requirements for Stage 2 of the Medicare and Medicaid EHR Incentive Programs.

Under the revised timeline, eligible professionals and hospitals will have greater flexibility in demonstrating meaningful use in the 2014 reporting year. The proposed rule allows providers to use either 2011 Edition certified EHR technology (CEHRT) or a combination of 2011 and 2014 Editions CEHRT for their EHR reporting period in 2014 for in Medicare and Medicaid EHR incentive programs. However, in 2015 all eligible hospitals and professionals would still be required to report using 2014 Edition CEHRT. Additionally, the proposed rule includes a provision that would formalize CMS and ONC's previously stated intention to extend Stage 2 through 2016 and begin Stage 3 in 2017.

According to the agencies, the proposed rule comes in response to providers' feedback about needing more flexibility in the program requirements and acknowledges that many software vendors have had difficulty upgrading their EHR products, receiving certification and upgrading customers' systems in time to attest to the meaningful use program. The goal of the proposed rule is "two-fold;" first, the proposed rule allows CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement and the interoperability and health information exchange requirements in Stage 2, and second, the proposed rule allows CMS and ONC to use data collected during Stage 2 participation to inform policy decisions for Stage 3.

In the fall of 2014, it is expected that CMS will release a notice of proposed rulemaking (NPRM) for Stage 3, and that the corresponding ONC NPRM for the 2017 Edition of the ONC Standards and Certification Criteria will be released, which will outline further details for this proposed new timeline. The final rule with all requirements for Stage 3 would follow in the first half of 2015.

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