Yesterday was the first day of fall. The date is significant because, in a recent call, CMS reported that the final rule for Meaningful Use 2015 would be published by “early fall” – yet still no word from our friends at CMS. The last 90-day measurement period for this year starts in early October and if the rule were published today we don’t see a clear path for Meaningful Use 2015 to work like prior years. meaningful-use-timeline

Remember, per our original blog post on Meaningful Use 2015 as well as our recent post, the Meaningful Use 2015 proposed rule includes significant changes. Those changes consist of a shorter 90-day reporting period, as opposed to a full year in the original rule. Some of the proposed changes are vague and need the kind of clarification already anticipated, but overall the proposed changes are favorable to providers.

But what is taking so long?

CMS has received public comments for months, but they haven’t yet been able to publish the final rule for this year – with only a few more months left before 2016 begins. Has anyone ever heard of a program that establishes its rules after most of the year has passed – and not in advance?

If the final rule for this year were published today, vendors would have just about one week to get their systems in place to comply with the new rule. Not possible.

So what’s really going on with Meaningful Use for this year? No one actually knows because CMS is not allowed to comment on the final rule until it is published.

Here’s my theory:

ICD-10 starts on October 1 and CMS has subordinated Meaningful Use 2015 to ICD-10.

Can CMS really ask providers to adjust to a new Meaningful Use rule at the same time that they’re adjusting to the most transformative coding change in their career? Of course not. CMS knows that the distraction of issuing a Meaningful Use final rule right now could contribute to a greater rate of ICD-10 compliance failure. If ICD-10 gets off to a bad start, we could spiral into chaos at medical practices and access problems for Medicare patients. CMS just can’t take that risk.

Perhaps this delay was planned?

This year will be a different kind of Meaningful Use year. We agree with recent proposal made by MGMA:

… MGMA suggested CMS allow program participants to attest for 2015 during the last 90 days of the year or extend it into the first 90 days of 2016 (Heath, EHR Intelligence, 9/1).

In addition, MGMA recommended CMS use a 90-day reporting period for 2016, which would give those who attested for 2015 in the first 90 days of 2016 an additional three quarters to attest to the new measures (Health Data Management, 9/2).

Requiring program participants to exclusively use a measurement period that needs to finish by year-end is now impossible. Look for much more flexible measurement periods, ones that “leak” into 2016 for the 2015 Meaningful Use year.

These delays assure participants that it is unlikely that the measurement period for next year will be a full year and that the start of Meaningful Use Stage 3 will be delayed. In our last several blogs on Meaningful Use, we have commented that the program is in chaos and that decision-making is slow and indecisive. These continued delays reinforce our position.