The Centers for Medicare and Medicaid Services released its final stage 2 meaningful use rules Thursday, saying that providers have one year more to sign up than originally planned.

The rules were based on nearly 6,100 responses the agency received since floating the proposed second stage rules in March, around the time of HIMSS' annual meeting.

Providers demonstrating meaningful use in 2011 or 2012 won't have to meet it until 2014, not 2013 as originally set out by CMS, according to the 672-page rule. This gives vendors "needed time" to develop certified EHRs, CMS said in the rule. There's also a special three-month HER reporting period in 2014, rather than a full year, for providers attesting to stage 1 or 2 that year, to give them time to put in place the new EHRs that vendors will be developing.

Under stage 2, to qualify for Medicare incentive payments, eligible professionals must meet 17 core objectives and half of the six so-called menu objectives. Eligible hospitals must meet 16 core objectives and half of the 6 menu objectives.

In Stage 1, providers and hospitals had to meet 15 core objectives and half of the 10 menu objectives.

Providers also have to meet nine out of 64 clinical quality measures, and eligible hospitals 16 out of 29 CQMs.

For the final rule, CMS has scaled back some other requirements, due to provider feedback. For instance, in one of the core objectives, CMS was originally asking that more than 60 percent of radiology, lab or medication orders be made through a computerized order entry. In the final rule, that was revised down to at least 60 percent of medication orders, 30 percent of lab orders and 30 percent of radiology orders.

CMS also tweaked a menu objective that originally would have required 40 percent of all imaging scans and tests with at least one image ordered by the EP or hospital to be accessible via the EHR. In the final rule, CMS knocked it down to 10 percent, as respondents worried that hospitals or doctors contracting with multiple imaging providers could have a hard time meeting the target.

For two new core measures, one for hospitals, requiring giving patients online access to health information, and another for providers, requiring secure electronic messaging with patients, CMS also reduced the threshold from 10 percent to 5 percent of patients, because of provider concerns. Also, some providers can get waivers if they have limited broadband access. "CMS believes that the patient utilization thresholds are achievable and that the ability to access clinical information electronically promotes patient engagement," the agency said on its fact sheet.

CMS estimates its EHR incentives program will cost the federal government $15.4 billion from 2014 through 2019, a figure that includes savings realized by Medicare from cuts providers face for failing to achieve meaningful use by 2015.

To read the final rule, go here: http://tinyurl.com/bm5juyh

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