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In Program Year 2019, providers must attest to Stage 3 Meaningful Use (MU). The EHR reporting period may be any continuous 90-day period between January 1, 2019 and December 31, 2019. Note the distinction between MU reporting period (which is based on data from the current calendar year) and the patient volume reporting period (which is based on 90-days of data from the prior calendar year.)

To meet Stage 3 MU requirements, Eligible Professionals (EPs) must attest to a single set of objectives and measures. For EPs, there are 8 objectives outlined in the Stage 3 Specification Sheets Adobe Acrobat Reader Symbol. There are no alternate exclusions or specifications available.

In Program Year 2019, EPs attest to 6 (of 50) electronic Clinical Quality Measures (eCQMs). The eCQM reporting period is 365-days in calendar year 2019 (January 1, 2019 through December 31, 2019). At least one of the eCQMs selected must be an outcome measure (if any are relevant). If no outcome measures are relevant, EPs must select at least one high priority measure (if any are relevant). If no high-priority measures are relevant, EPs may report on any six relevant eCQMs. The list of available eCQMs, identifying those that qualify as outcome or high-priority, is available to download in a Zip file. To meet Stage 3 requirements, EPs must have 2015 Edition certified EHR technology (CEHRT) to attest in Program Year 2019, however, it does not need to be implemented by January 1, 2019. As long as 2015 Edition functionality is deployed, and in place, by the first day of the 90-day EHR reporting period, the EHR can be pending certification. However, it must be certified to the 2015 Edition criteria by the last day of the 90-day EHR reporting period in order for the EP to meet Stage 3 objectives. For 2015 Edition CEHRT, the CMS EHR Certification ID (obtained through the Certified Health IT Product List website and uploaded during the attestation process) will display '15E' in the third through fifth digits.

If the EP practices in more than one site/location that has CEHRT, the Meaningful Use numerators and denominators need to include the patient records from all CEHRTs and any records maintained on paper or non-certified EHR. For further guidance on calculating numerators and denominators from multiple locations, refer to the Guide for Practicing in Multiple Locations (2018) Adobe Acrobat Reader Symbol.

There are changes to the measure calculations policy which specify that actions included in the numerator must occur within the EHR reporting period if that period is a full calendar year, or, if it is less than a full calendar year, within the calendar year in which the EHR reporting period occurs. Specific measures affected are identified in the Additional Information section of the specification sheets.

Flexibility within Objectives and Measures
Stage 3 includes flexibility within certain objectives to allow providers to choose the measures most relevant to their patient population or practice. The Stage 3 objectives with flexible measure options include:

  • Coordination of Care through Patient Engagement – Providers must attest to all three measures and meet the thresholds for at least two measures to meet the objective.
  • Health Information Exchange – Providers must attest to all three measures and meet the thresholds for at least two measures to meet the objective.
  • Public Health Reporting – Eligible professionals must report on two measures.

EPs must upload EHR screenshots and other supporting documentation with Protected Health Information redacted (i.e., HIPAA protected information) at the time of attestation in order for a payment request to be processed. In addition, screenshots must be dated from within the EHR U reporting period.

Rules

  • EPs that work at multiple practice locations: at least 50 percent of their total patient encounters must take place at a location(s) where certified EHR technology is available. (These EPs would base all MU measures only on those encounters that occurred at locations with CEHRT.) For the purpose of calculating the 50 percent threshold, all encounters (and not just Medicaid and/or Needy Individual encounters) should be considered in this calculation.
  • Measure results do not round up. For example, a numerator of 199 and a denominator of 1,000 is 19%.
  • Measures that require a result greater than a given percentage must be more than that given percentage to pass. For example, in a measure requiring a result of greater than 80%, a result of 80.1% will pass, but a result of 80.0% will not pass.
  • There are two types of percentage-based denominators reported for MU measures. The first is when the denominator equals all patients seen or admitted during the EHR reporting period. In this instance, the denominator is all patients regardless of whether their records are maintained using CEHRT. The second is based on actions or subsets of patients seen or admitted during the EHR reporting period. In this instance, the denominator only includes patients, or actions taken on behalf of those patients, whose records are maintained using CEHRT.

 

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