In response to significant input from multiple stakeholders, expert testimony, and countless hours of review, analysis and deliberation, the Department of Health & Human Services (HHS) announced its intention to delay the start of stage 2 meaningful use for the Medicare and Medicaid electronic health record (EHR) incentive programs for a period of one year for those first attesting to meaningful use in 2011. The Centers for Medicare & Medicaid Services (CMS) intends to propose such a delay in the stage 2 meaningful use notice of proposed rule making (NPRM), which is scheduled to be published in February 2012.

Why did CMS make this decision?

Input from the vendor community and the provider community makes clear that the current schedule for compliance with stage 2 meaningful use objectives in 2013 poses a challenge for those who are attesting to meaningful use in 2011.

The current timetable would require EHR vendors to design, develop, and release new functionality, and for providers to upgrade, implement, and begin using the new functionality as early as October 2012.

What are the benefits to the proposed delay?

CMS believes that a proposed delay will be beneficial for several reasons:

• CMS hopes that this will give vendors added time to develop certified EHR technologies for stage 2, as well as give providers additional time to implement new software and meet the new requirements of stage 2.

• CMS also intends to propose maintaining the current expectation for those first attesting to meaningful use in 2012, so that all providers attesting to meaningful use in 2011 or 2012 will begin stage 2 in 2014.

• CMS believes this provides an added incentive for providers to attest to meaningful use in 2011 and rewards early participants.

Under the Medicare and Medicaid EHR incentive programs, providers who attest early receive greater incentives. And now those providers who first attest in 2011 are eligible for three payment years for meeting the stage 1 criteria, while those first attesting in 2012 can only have two payment years under stage 1 criteria.

Are Medicaid program participants affected?

Because Medicaid providers can receive an incentive payment for adopting, implementing, or upgrading to certified EHR technology in their first year of Medicaid EHR incentive program participation, Medicaid providers will still be able to attest to stage 1 meaningful use for the next two years (first for a 90-day period, then for a 365-day period).

Therefore, most Medicaid providers do not attest to stage 2 requirements until 2014 at the earliest.