Learn how the final rule update to 2014 meaningful use requirements provides additional options for your practice, but with certain limitations.

1. Meaningful Use Final Rule Updates
Wednesday, September 10, 2014
Disclaimer: Nothing that we are sharing is intended as legally binding or prescriptive advice. This
presentation is a synthesis of publically available information and best practices.

2. Meaningful Use - Overview
• Set of standards defined by the Centers for
Medicare & Medicaid Services (CMS)
• Financial incentives for using certified EHR
technology (CEHRT):
– In a meaningful manner
– For electronic exchange of health information
– Submit Clinical Quality Measures (CQM)
• Three stages
– Creating information
– Exchanging information
– Focusing on improved outcomes

3. Meaningful Use Stages
Data
capture
and sharing
Advanced
clinical
processes
Improved
outcomes
Stag
e 1
Stag
e 2
Stag
e 3

4. Meaningful Use Stages
* For Medicaid providers only

5. Medicare Reimbursement
MU
Stage
2011 2012 2013 2014 2015 2016
Year 1 $18,000 $18,000 $15,000 $12,000
Year 2 $12,000 $12,000 $12,000 $8,000
Year 3 $8,000 $8,000 $4,000 $4,000
Year 4 $4,000 $4,000 $2,000
Year 5 $2,000 $2,000

6. Medicaid Reimbursement
MU
Stage
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
AIU
(Year
1)
$21,25
0
$21,25
0
$21,250 $21,250 $21,250 $21,250 $21,250 $21,250 $21,250 $21,250 $21,250
MU1
(Year
2)
$8,50
0
$8,500 $8,500 $8,500 $8,500 $8,500 $8,500 $8,500 $8,500 $8,500
MU1
(Year
3)
$8,500 $8,500 $8,500 $8,500 $8,500 $8,500 $8,500 $8,500 $8,500
MU2
(Year
4)
$8,500 $8,500 $8,500 $8,500 $8,500 $8,500 $8,500 $8,500
MU 2
(Year
5)
$8,500 $8,500 $8,500 $8,500 $8,500 $8,500 $8,500
MU 2/3
(Year
6)
$8,500 $8,500 $8,500 $8,500 $8,500 $8,500

7. Meaningful Use Eligibility
• Doctors of medicine or osteopathy
• Doctors of dental surgery or dental
medicine
• Doctors of podiatry
• Doctors of optometry
• Chiropractors

8. MU1 vs MU2
MU1
• 13 Core
• 5/10 Menu
• Total: 18
MU2
• 17 Core
• 3/6 Menu
• Total: 20

9. MU1 2013 vs MU1 2014
• Patient Portal added as a Core Measure
• Other minor changes:
https://www.cms.gov/Regulations-and-
Guidance/Legislation/
EHRIncentivePrograms/ Downloads/
stage1changestipsheet.pdf

10. Penalties
Data Year Penalty Year Penalty Amount
2014 2015 -1%
2015 2016 -2%
Continues at
additional
-1% each year

11. Rule Updates
If you were
scheduled to
demonstrate:
Using 2011 Edition
CEHRT to do:
Using 2011 & 2014
Edition CEHRT to
do:
Using 2014 Edition
CEHRT to do:
Stage 1 in 2014 2013 Stage 1
objectives and
measures*
2013 Stage 1
objectives and
measures*
OR
2014 Stage 1
objectives and
measures*
2014 Stage 1
objectives and
measures
Stage 2 in 2014 2013 Stage 1
objectives and
measures*
2013 Stage 1
objectives and
measures*
OR
2014 Stage 1
objectives and
measures*
OR
Stage 2 objectives
and measures*
2014 Stage 1
objectives and
measures*
OR
Stage 2 objectives
and measures

12. To Use Any Of The Methodologies
with An Asterisk
You must attest that you could not fully
implement 2014 Edition CEHRT for the EHR
reporting period in 2014 due to
delays in 2014 Edition CEHRT availability.
This can be delays with the certification,
issues caused with defects, or delay in
ancillary products (like reports and HISPs).

13. Medicaid
Medicaid providers:
 Do not need to start attesting until 2016 to
receive full amount.
 Can do AIU the first year for first payment.
 Do not have a sequential year
requirement.
…. So ignore the next several slides.

14. Using the Correct MU Version
If you are on a 2011 certified system, you
MUST use 2013 MU 1 requirements.
If you are on a 2014 certified system, you
MUST use 2014 MU 1 requirements. This
means the patient portal is a core measure.

15. If this is your first year
attesting…
You need to attest by October 1, 2014 or
face penalty in 2015.
 Hardship exceptions for 2015 had to be
submitted July 1.
 Keep an eye out for 2016 hardship
exceptions.

16. If this is your second year
attesting…
You must attest for a quarter by end of year.
 If you are on a 2011 certified version, you
attest using MU1 2013 requirements.
 If you are on a 2014 certified version, you
attest using MU1 2014 requirements. This
requires a patient portal.

17. If this is your third or fourth year
attesting…
You must attest for a quarter by end of year.
You may either:
 If you are on a 2011 certified version, you
attest using MU1 2013 requirements.
 If you are on a 2014 certified version, you
attest using MU1 2014 requirements. This
requires a patient portal.
 Or attest using Stage 2.

18. Some Words of Caution
 Providers who are attesting for their fourth
or fifth year of Meaningful Use in 2015 will
have to attest for the full year (well, unless
CMS changes their mind again).
 For Medicaid providers, not all states will
have their attestation portals ready in time.
Contact your state for more details.

19. Q&A
Ben.quirk@quirkhealthcare.com