Meaningful Use in 2015
6 things to do before the year’s end
Presenter: Matt Anderson
Presentation

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Good News!
CMS has heard your call
These changes take
effect starting 2015
and continue through
2017.
Final rule announced
on October 6, 2015
Changes finally made to Meaningful Use
Stage 1 and 2.

How is ‘Modified Stage 2’ different?
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Previous Stages
Full year reporting period
Complicated framework of “core” and
“menu” measures
Excessive data-entry measures in
reporting requirements
High performance threshold for
Patient Engagement measures
90 Continuous days reporting
period for 2015
Core and menu measures replaced
with 10 objectives
Eliminated redundant, duplicative, and
topped-out measures
Reduced performance threshold
Modified Stage 2

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 Drug Formulary Checks
2 Clinical Lab Test Results
3 Patient Lists
4 Patient Reminders
5 Patient Education
6 Medication Reconciliation
7 Transition of Care Summary
Public Health Menu Measures
8 Immunization Registries Data Submission
9 Syndromic Surveillance Data Submission
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 Syndromic Surveillance Data Submission
2 Electronic Notes
3 Imaging Results
4 Family Health History
5 Report Cancer Cases
6 Report Specific Cases
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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 Drug Formulary Checks
2 Clinical Lab Test Results
3 Patient Lists
4 Patient Reminders
5 Patient Education
6 Medication Reconciliation
7 Transition of Care Summary
Public Health Menu Measures
8 Immunization Registries Data Submission
9 Syndromic Surveillance Data Submission
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 Syndromic Surveillance Data Submission
2 Electronic Notes
3 Imaging Results
4 Family Health History
5 Report Cancer Cases
6 Report Specific Cases
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Modified Meaningful Use 2015 -2017
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Objective 1: Protect Patient Health Information
Protect patient health information created or maintained by the certified EHR technology through the implementation of appropriate
technical capabilities
Objective 2: Clinical Decision Support
t
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
t
Medication orders created by the EP should be recorded using computerized provider order entry
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 certified EHR technology
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 certified EHR techonology
Stage 1
Exclusion

Modified Meaningful Use 2015 -2017
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Objective 6: Patient Specific Education
Provide patients with specific education resources that are identified by certified EHR technology
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
Objective 9: Secure Messaging
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
Providers scheduled to be in Stage 1 in 2015 may claim an exclusion for these measures
Reduced from 5% to functionality fully enabledStage 1
Exclusion
Stage 1
Exclusion
Stage 1
Exclusion
Stage 1
Exclusion

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Attestation periods for the Medicare
Incentive Program
Attestation
year
2015
2016
2017
2018
Modified Stage 2
90 days
Modified Stage 2
Full year
Modified Stage 2 or
Stage 3 Full year
Stage 3 Full
year
Modified Stage 2
90 days
Modified Stage 2
Full year
Modified Stage 2 or
Stage 3 Full year
Stage 3 Full
year
Modified Stage 2
90 days
Modified Stage 2
90 days
Modified Stage 2
90 days
_
Modified Stage 2
Full year
Modified Stage 2 or
Stage 3 Full year
Stage 3 Full
year
Modified Stage 2
Full year
Modified Stage 2 or
Stage 3 Full year
Stage 3 Full
year
Modified Stage 2
Full year
Modified Stage 2 or
Stage 3 Full year
Stage 3 Full
year
Modified Stage 2
Full year
Modified Stage 2 or
Stage 3 Full year
Stage 3 Full
year
2011
Adoption
2012
Adoption
2013
Adoption
2014
Adoption
2015
Adoption
2016
Adoption

Whats your plan for MU Attestation?
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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 year’s end!

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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.
Task no 1

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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.
Task no 2

Read the ExclusionsTask no 3
Objective Exclusion Alternate Exclusion
Objective 1: Protect Patient
Health Information
Objective 2: Clinical Decision
Support
Objective 3: Computerized Provider
Order Entry
Objective 4: Electronic
Prescribing
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
Stage 1 EPs may use "Alternate Measure"
which has a reduced threshold of 40%, as
opposed to 50%.
Stage 1 EPs may use "Alternate Measure" which
has a reduced threshold of implementing one
clinical decision support rule, as opposed to five
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.
None
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Read the Exclusions
Objective Exclusion Alternate Exclusion
Objective 5: Health Information
Exchange
Objective 6: Patient Specific
Education
Objective 7: Medication
Reconciliation
Objective 8: Patient Electronic
Access (VDT)
Any EP who has fewer than 100
transitions of care or referrals
Stage 1 EPs get an exclusion since Stage
1didnothaveanequivalentcoremeasure.
Any EP who has no office visits during the
EHR reporting period
Any EP who was not the recipient of any
transitions of care during the EHR reporting
period.
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.
Stage 1 EPs get an exclusion since Stage 1 did
not have an equivalent core measure.
Stage 1 EPs get an exclusion since Stage 1 did
not have an equivalent core measure.

Read the Exclusions
Objective Exclusion Alternate Exclusion
Objective 9: Secure
Messaging
Objective 10: Public Health
Reporting
Any EP who has no office visits during the EHR
reporting period, or any EP who 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 according to the latest information
available from the FCC on the first day of the
EHR reporting period.
Stage 1 EPs get an exclusion since
Stage 1 did not have an equivalent
core measure.
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.
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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.

Read the Exclusions
Objective Exclusion Alternate Exclusion
Objective 10: Public Health
Reporting
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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Read the Exclusions
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Make sure you have an interface with your state registry. Contact
your vendor in case you don’t.
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
Syndromic Surveillance Reporting
Contact your Public Health Agency
Measures:
Task no 4
Immunization registry

Create your Audit Folder
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Required Documentation:
KPI Screenshot CQM Screenshots Security Risk Analysis
Document
Public Health Registration/
Enrollment Request Email
Medicaid Patient Volume
Report
(In case of Medicaid)
Task no 5

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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To be considered for an exception, an eligible professional or eligible hospital
must complete a Hardship Exception application along with proof of the
hardship.
Hardship Exceptions to Avoid Medicare
Payment Adjustments
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.
Task no 6

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EPs must demonstrate that they are in an area without sufficient internet access or face insurmountable barriers to
obtaining infrastructure.
Infrastructure:
Newly practicing EPs who would not have had time to become meaningful users can apply for a 2-year limited exception
to payment adjustments.
New Eligible Professionals:
Examples may include a natural disaster or other unforeseeable barrier.
Unforeseen Circumstances:
- Lack of face-to-face or telemedicine interaction with patient.
- Lack of follow-up need with patients.
Patient Interaction:
Lack of control over availability of CEHRT for more than 50% of patient encounters.
Practice at Multiple Locations:
An EP that has a primary specialty listed in PECOS as anesthesiology, radiology or pathology 6 months prior to the
first day of the payment adjustments that would otherwise apply.
PECOS Specialties:
Hardship Exceptions
Eligible professionals can apply for hardship exceptions in the following categories:

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Check your NPPES logins and make sure that they are working. (To reset the
password please call 1-800-465-3203)
Registration Information (Bonus point)
Visit the Registration Tab to ensure your information is accurate, such as the
Payee selection and email address.
Task no 7

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CureMD Meaningful Use resources
CureMD Meaningful Use DashboardMeaningful Use Resource Center

Session
QA&

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
Need Help?

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recording!
Meaningful Use in 2015
6 things to do before the year’s end