CMS updates EHR incentive programs, clinical quality measure reporting rules

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 - CMS

CMS has proposed rules in updating the reporting of clinical quality measures (CQMs) and Medicare and Medicaid EHR incentive programs. CMS has also released a request for information regarding the newly proposed rules.

“The proposed rule aims to relieve regulatory burdens for providers, supports the patient-doctor relationship in health care and promotes transparency, flexibility and innovation in the delivery of care,” stated the CMS in a press release.

Regarding the changes to CQMs:

  • The 2017 reporting period for eligible hospitals and critical access hospitals (CAHs), that have showed meaningful use in any year before 2017 or for the first time in 2017, would be two self-selected quarters of CQM data in 2017. For eligible hospitals and CAHs only participating in the EHR Incentive Program or also participating in the hospital IQR Program, reporting would occur on at least six self-selected CQMs.
  • The 2018 reporting period for eligible hospitals and CAHs, that have showed meaningful use in any year before 2017 or for the first time in 2017, would be the first three quarters of 2018. For Medicare EHR Incentive Program only, the submission period for reporting would be the two months following the end of the year. For eligible hospitals and CAHs only participating in the EHR Incentive Program or also participating in the hospital IQR Program, the reporting would occur on at least six self-selected CQMs.
  • The CQM reporting period for Eligible Professionals (EPs) in the EHR Incentive Program in 2017 has been modified to a minimum of a continuous 90-day period during the year. Additionally, specific available CQMs to EPs in the EHR Incentive Program will be aligned with professionals in the Merit-based Incentive Payment System (MIPS).

Regarding changes for Medicare and Medicaid EHR Incentive Programs:

  • The 2018 EHR reporting period for new and returning participants to CMS or their state Medicaid agency will be modified from a full year to any continuous 90-day period during the year. According to the 21st Century Cures Act, CMS proposed to add a new exception to Medicare payment adjustments to EPs, eligible hospitals and CAHs that have shown compliance with the requirements to being meaningful Her users.
  • CMS proposed a policy to provide no payment adjustments will occur for eligible professionals who brand their ambulatory surgical center services as “substantially all." Additionally, CMS propose to exempt EP-based ambulatory surgical centers from 2017 and 2018 Medicare payment adjustments if they state “substantially all” of their professional services in an ambulatory surgical center.