This document provides an overview of the Meaningful Use program and regulations. It discusses the stages of Meaningful Use which focus on data capture, sharing, and advanced clinical processes. It also outlines the financial incentives available through Medicare and Medicaid for eligible providers that successfully meet Meaningful Use objectives. The document reviews eligibility, objectives and measures for Stages 1 and 2 of Meaningful Use, and penalties for providers that do not successfully demonstrate Meaningful Use. It provides guidance on determining which version of Meaningful Use objectives a provider must attest to based on their EHR certification year.

1. Regulation Recap - Meaningful Use
Wednesday, November 19, 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. Quick Introduction
Jonathan Everett
I have been around the Healthcare
IT arena for over 12 years
Vice President of Business
Development for Quirk Healthcare
Reside in Portland, OR – it rules

3. 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)

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

5. Meaningful Use Stages
* For Medicaid providers only

6. 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

7. Medicaid Reimbursement
MU
Stage
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
AIU
(Year 1)
$21,250 $21,250 $21,250 $21,250 $21,250 $21,250 $21,250 $21,250 $21,250 $21,250 $21,250
MU1
(Year 2)
$8,500 $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

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

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

10. 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

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

12. 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

13. 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).

14. 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.

15. 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.

16. If this is your first year attesting…
You need to attest by October 1, 2014 or face
penalty in 2015.
 Hardship exceptions for 2015 have to be
submitted by November 30th.
 Keep an eye out for 2016 hardship exceptions.

17. 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.

18. 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.

19. 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.

20. Q&A
Jonathan.everett@quirkhealthcare.com