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Meaningful Use in 2015

6 things to do before the years end

Presenter: Matt Anderson

Good News!
CMS has heard your call

Final rule announced

on October 6, 2015

These changes take

effect starting 2015
and continue through
2017.

Changes nally made to Meaningful Use

Stage 1 and 2.

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How is Modied Stage 2 different?

Previous Stages

Modied Stage 2

Full year reporting period

90 Continuous days reporting

period for 2015

Complicated framework of core and

menu measures

Core and menu measures replaced

with 10 objectives

Excessive data-entry measures in

reporting requirements

Eliminated redundant, duplicative, and

topped-out measures

High performance threshold for

Patient Engagement measures

Reduced performance threshold

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Stage 1 and Stage 2 Measures

Stage 1 Meaningful Use till 2014 (Core Measures)
1 CPOE for Medications
2 Drug Interaction Checks
3 Maintain Problem List
4 Eprescribing
5 Active Medication List
6 Medication Allergy List
7 Record Demographics
8 Record Vital signs
9 Record Smoking Status
10 Clinical Decision Support
11 Patient Electronic Access
12 Clinical Summaries
13 Protect Electronic Health Information

Menu Measures
1
2
3
4
5
6
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Drug Formulary Checks

Clinical Lab Test Results
Patient Lists
Patient Reminders
Patient Education
Medication Reconciliation
Transition of Care Summary

Public Health Menu Measures

Stage 2 Meaningful Use till 2014 (Core Measures)

1 CPOE for Medication, Lab, Radiology Orders
2 Eprescribing
3 Record Demographics
4 Record Vital Signs
5 Record Smoking Status
6 Clinical Decision Support
7 Patient Electronic Access
8 Clinical Summaries
9 Protect Electronic Health Information
10 Clinical Lab Test Results
11 Patient Lists
12 Patient Reminders
13 Patient Education
14 Medication Reconciliation
15 Summary of Care
16 Immunization Registries Data Submission
17 Secure Electronic Messaging

Menu Measures
1
2
3
4
5
6

Syndromic Surveillance Data Submission

Electronic Notes
Imaging Results
Family Health History
Report Cancer Cases
Report Specic Cases

8 Immunization Registries Data Submission

9 Syndromic Surveillance Data Submission

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Stage 1 and Stage 2 Measures

Stage 1 Meaningful Use till 2014 (Core Measures)
1 CPOE for Medications
2 Drug Interaction Checks
3 Maintain Problem List
4 Eprescribing
5 Active Medication List
6 Medication Allergy List
7 Record Demographics
8 Record Vital signs
9 Record Smoking Status
10 Clinical Decision Support
11 Patient Electronic Access
12 Clinical Summaries
13 Protect Electronic Health Information

Menu Measures
1
2
3
4
5
6
7

Drug Formulary Checks

Clinical Lab Test Results
Patient Lists
Patient Reminders
Patient Education
Medication Reconciliation
Transition of Care Summary

Public Health Menu Measures

Stage 2 Meaningful Use till 2014 (Core Measures)

1 CPOE for Medication, Lab, Radiology Orders
2 Eprescribing
3 Record Demographics
4 Record Vital Signs
5 Record Smoking Status
6 Clinical Decision Support
7 Patient Electronic Access
8 Clinical Summaries
9 Protect Electronic Health Information
10 Clinical Lab Test Results
11 Patient Lists
12 Patient Reminders
13 Patient Education
14 Medication Reconciliation
15 Summary of Care
16 Immunization Registries Data Submission
17 Secure Electronic Messaging

Menu Measures
1
2
3
4
5
6

Syndromic Surveillance Data Submission

Electronic Notes
Imaging Results
Family Health History
Report Cancer Cases
Report Specic Cases

8 Immunization Registries Data Submission

9 Syndromic Surveillance Data Submission

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Modied Meaningful Use 2015 -2017

Objective 1: Protect Patient Health Information
Protect patient health information created or maintained by the certied EHR technology through the implementation of appropriate
technical capabilities
Objective 2: Clinical Decision Support
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Implement clinical decision support interventions relevant to specialty or high clinical priority
Enable drug-drug and drug-allergy interactions
Objective 3: Computerized Provider Order Entry
Medication orders created by the EP should be recorded using computerized provider order entry
t Lab orders created by the EP should be recorded using computerized provider order entry
Radiology orders created by the EP should be recorded using computerized provider order entry
Objective 4: Electronic Prescribing
Prescriptions written by the EP should be transmitted electronically using certied EHR technology
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Objective 5: Health Information Exchange

When transitioning a patient to another setting of care, or referring the patient, providers should create a Summary of Care record and
electronically transmit it using certied EHR techonology

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Modied Meaningful Use 2015 -2017

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Objective 6: Patient Specic Education

Provide patients with specic education resources that are identied by certied EHR technology
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Objective 7: Medication Reconciliation

Perform Medication Reconciliation for patients transitioned into the care of the EP
Objective 8: Patient Electronic Access (VDT)

Reduced from 5% to 1 patient or more

Provide patients with timely access to view online, download, and transmit their health information
Health Information is viewed online, downloaded, or transmitted by patients
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Objective 9: Secure Messaging

Reduced from 5% to functionality fully enabled

Provide patients the capability to send and receive a secure electronic message with the EP
Objective 10: Public Health Reporting
Submit immunization data to an immunization registry
Submit syndromic surveillance data to a public health agency
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Providers scheduled to be in Stage 1 in 2015 may claim an exclusion for these measures

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Attestation periods for the Medicare

Incentive Program

Attestation
year

2011
Adoption

2012
Adoption

2013
Adoption

2014
Adoption

2015
Adoption

2015

Modied Stage 2
90 days

Modied Stage 2
90 days

Modied Stage 2
90 days

Modied Stage 2
90 days

2016

Modied Stage 2
Full year

Modied Stage 2
Full year

Modied Stage 2
Full year

Modied Stage 2
Full year

2017

Modied Stage 2 or
Stage 3 Full year

Modied Stage 2 or
Stage 3 Full year

Modied Stage 2 or
Stage 3 Full year

Modied Stage 2 or Modied Stage 2 or

Stage 3 Full year
Stage 3 Full year

2018

Stage 3 Full
year

Stage 3 Full
year

Stage 3 Full
year

Stage 3 Full
year

Modied Stage 2
90 days
Modied Stage 2
Full year

Stage 3 Full
year

2016
Adoption
_

Modied Stage 2
Full year
Modied Stage 2 or
Stage 3 Full year
Stage 3 Full
year

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Whats your plan for MU Attestation?

MU modified Stage 2 final rule came out a week into the last possible 90-day reporting
period, not leaving enough time for practices to create a game plan.
How to prepare for Meaningful Use in this short time-frame?

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6 things your practice must cover before

the years end!

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Task no 1

Choose the Reporting Period

The Final Rule from CMS states that all providers
will attest for a 90-day reporting period in 2015.
What stage or year you were previously in is
irrelevant.

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Task no 2

Perform A Security Risk

Analysis
Must be conducted at least once before
attesting for MU.
Identify and correct security defencies.
Once done, you can attest to CMS that you have
conducted this analysis.
A copy of the document must be maintained
in case there is an MU audit.

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Task no 3

Read the Exclusions

Objective
Objective 1: Protect Patient
Health Information
Objective 2: Clinical Decision
Support

Objective 3: Computerized Provider

Order Entry

Objective 4: Electronic
Prescribing

Exclusion
None

For Drug Interactions, any EP who writes fewer

than 100 medication orders during the EHR
reporting period.

Measure 1: Any EP who writes fewer than 100

medication orders during the EHR reporting
period.
Measure 2: Any EP who writes fewer than
100 laboratory orders during the EHR reporting
period.
Measure 3: Any EP who writes fewer than
100 radiology orders during the EHR reporting
period.

Any EP who writes fewer than 100

Prescriptions

Alternate Exclusion
None

Stage 1 EPs may use "Alternate Measure" which

has a reduced threshold of implementing one
clinical decision support rule, as opposed to ve
clinical decision support rules.
For Measure 1, Stage 1 EPs may use "Alternate
Measure" which has a reduced threshold of
30%, as opposed to 60%.
For Measures 2 and 3, Stage 1 EPs get an
exclusion since Stage 1 did not have an
equivalent core measure.

Stage 1 EPs may use "Alternate Measure"

which has a reduced threshold of 40%, as
opposed to 50%.

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Read the Exclusions

Objective

Exclusion

Alternate Exclusion

Objective 5: Health Information

Any EP who has fewer than 100

Stage 1 EPs get an exclusion since Stage

Exchange

transitions of care or referrals

1 did not have an equivalent core measure.

Any EP who has no ofce visits during the

EHR reporting period

Stage 1 EPs get an exclusion since Stage 1 did

not have an equivalent core measure.

Any EP who was not the recipient of any

transitions of care during the EHR reporting
period.

Stage 1 EPs get an exclusion since Stage 1 did

not have an equivalent core measure.

Any EP who:
a. Neither orders nor creates any of the
information listed for inclusion as part of the
measures; or
b. Conducts 50 percent or more of his or her
patient encounters in a county that does not
have 50 percent or more of its housing units
with 4Mbps broadband availability.

For Measures 2, Stage 1 EPs get an exclusion

since Stage 1 did not have an equivalent core
measure.

Objective 6: Patient Specic

Education

Objective 7: Medication
Reconciliation
Objective 8: Patient Electronic
Access (VDT)

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Read the Exclusions

Objective

Exclusion

Alternate Exclusion

Objective 9: Secure

Any EP who has no ofce visits during the EHR

Stage 1 EPs get an exclusion since

Messaging

reporting period, or any EP who conducts 50

Stage 1 did not have an equivalent

percent or more of his or her patient encounters

in a county that does not have 50 percent or

core measure.

more of its housing units with 4Mbps broadband

availability according to the latest information
available from the FCC on the rst day of the
EHR reporting period.

Objective 10: Public Health

Reporting

Measure Option 1 Immunization

Registry Reporting:
Does not administer any immunizations during
the EHR reporting period;
Operates in a jurisdiction for which no
immunization registry or immunization
information system is capable of accepting
Operates in a jurisdiction where no
immunization registry or immunization
information system has declared readiness to
receive immunization data from the EP at the
start of the EHR reporting period.

Stage 1 EPs need to meet 1 measure only

Stage 2 EPs only need to do Measure 1,
since they can claim an exclusion for
Measure 2 because Stage 2 did not
have an equivalent core measure.

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Read the Exclusions

Objective
Objective 10: Public Health
Reporting

Exclusion

Alternate Exclusion

Measure Option 2 Syndromic Surveillance

Reporting:
Is not in a category of providers from which
ambulatory syndromic surveillance data is
collected by their jurisdiction's syndromic
surveillance system;
Operates in a jurisdiction for which no public
health agency is capable of receiving electronic
syndromic surveillance data
Operates in a jurisdiction where no public
health agency has declared readiness to
receive syndromic surveillance data

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Task no 4

Read the Exclusions

Contact your Public Health Agency

Measures:
Immunization registry
Make sure you have an interface with your state registry. Contact
your vendor in case you dont.
Syndromic Surveillance Reporting
Your EHR should be capable to extract this report. Identify a Public
Health Agency near you to submit this report.
*Stage 1: Submit one of these measures
*Stage 2: Required to submit just Measure 1, since they can claim an exclusion for Measure 2, because Stage 2
did not have an equivalent core measure

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Task no 5

Create your Audit Folder

Required Documentation:

KPI Screenshot

CQM Screenshots

Public Health Registration/

Enrollment Request Email

Security Risk Analysis

Document

Medicaid Patient Volume

Report
(In case of Medicaid)

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Pre & Post-Payment Audits

CMS began pre-payment audits in 2013,
starting with attestations submitted during and after Jan 2013.

CMS, through its contractor, will also conduct post-payment

audits during the course of the EHR Incentive Programs.

Providers selected for both audits will have to present

supporting documentation to validate submitted attestation data.

EPs must keep their audit documentation with them for the
next 6 years post attestation.

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Task no 6
Hardship Exceptions to Avoid Medicare
Payment Adjustments

To be considered for an exception, an eligible professional or eligible hospital

must complete a Hardship Exception application along with proof of the
hardship.

If approved, the hardship exception is valid for 1 payment year only. A new
application must be submitted if the hardship continues for the following
payment year.

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Hardship Exceptions
Eligible professionals can apply for hardship exceptions in the following categories:

Infrastructure:

EPs must demonstrate that they are in an area without sufcient internet access or face insurmountable barriers to
obtaining infrastructure.
New Eligible Professionals:

Newly practicing EPs who would not have had time to become meaningful users can apply for a 2-year limited exception
to payment adjustments.
Unforeseen Circumstances:

Examples may include a natural disaster or other unforeseeable barrier.

Patient Interaction:

- Lack of face-to-face or telemedicine interaction with patient.

- Lack of follow-up need with patients.
Practice at Multiple Locations:

Lack of control over availability of CEHRT for more than 50% of patient encounters.

PECOS Specialties:

An EP that has a primary specialty listed in PECOS as anesthesiology, radiology or pathology 6 months prior to the
rst day of the payment adjustments that would otherwise apply.

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Task no 7
Registration Information (Bonus point)

Check your NPPES logins and make sure that they are working. (To reset the
password please call 1-800-465-3203)

Visit the Registration Tab to ensure your information is accurate, such as the
Payee selection and email address.

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CureMD Meaningful Use resources

Meaningful Use Resource Center

CureMD Meaningful Use Dashboard

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QA
&

Session

Need Help?

Request a demo to see how CureMD can

facilitate your practice for
Meaningful Use
Get in touch with our MU experts
at 718-213-4870
muconsulting@curemd.com

Thank you!
Look out for our email, containing the webinar
recording!
Meaningful Use in 2015
6 things to do before the years end

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