Over the past several months, NextGen Healthcare has been working hard to ensure that all clients participating in the EHR Incentive Programs (i.e., “meaningful use”) were prepared for the February 29 “active engagement” deadline for the public health reporting (Stage 2 objective #10). In addition to frequent communications through direct emails, our What’s Next newsletter, and our monthly health reform webinars, NextGen Healthcare launched the new Clinical Registry Service, giving clients access to numerous specialized registries utilizing a no-cost interface via NextGen Share®.
On February 25, just four days ahead of the active engagement deadline, the Centers for Medicare & Medicaid Services (CMS) released a set of new and updated FAQs related to the public health reporting objective. These FAQs reintroduce the “alternate exclusion” (previously valid for 2015 Meaningful Use reporting only) for the public health reporting measure #2 (syndromic reporting) and measure #3 (specialized registry reporting).
We know that our clients have been proactively working to ensure active engagement for this measure and have taken steps to register intent with one or more of the specialized registries, including but not limited to those available through NextGen Share.
Whether you met the February deadline for active engagement or not, you may be wondering if providers in your organization may claim the alternate exclusion.
What does CMS say?
According to FAQs #14397 and #14401, CMS has extended the 2015 alternate exclusions to 2016. Similar to what was said in 2015, CMS is once again stating that they “did not intend to inadvertently penalize providers for changes to their systems or reporting made necessary by the provisions of the 2015 EHR Incentive Programs Final Rule.”
FAQ #14401 outlines the following provisions for eligible professionals in 2016:
- May claim an Alternate Exclusion for Measure 2 and Measure 3 (Syndromic Surveillance and Specialized Registry Reporting).
- An Alternate Exclusion may only be claimed for up to two measures. The provider must either attest to or meet the exclusion requirements for the remaining measure described in 495.22 (e)(10)(i)(C).
What does NextGen Healthcare say?
NextGen Healthcare always errs on the side of caution when it comes to advising clients on regulatory requirements. While these FAQs seem to signal the intent of CMS to allow providers to claim exclusions for both measure #2 and measure #3, NextGen Healthcare urges clients to carefully review the FAQs linked to this message.
- We specifically note that FAQ 14401 says, CMS “will allow providers to claim an alternate exclusion for the Public Health Reporting measure(s) which might require the acquisition of additional technologies” (emphasis added); and a specific reference in FAQ 14397 regarding lack of software capabilities or a “significant cost to connect to the interface”. Given this language, we recommend limiting the use of the exclusion to specialties for which there is no available registry with applicable clinical measures, and/or situations where software upgrades or interfaces pose a challenge.
- If you missed the deadline and feel the conditions outlined in the FAQs apply to your organization, you would need to claim the exclusion in order to successfully attest for meaningful use 2016.
- If you registered before the deadline with one or more syndromic or specialized registries, NextGen Healthcare urges you to work on testing and production. Public Health Reporting will remain a meaningful use requirement going forward and there are benefits from reporting to and receiving feedback from clinical registries as part of your overall quality program. This same guidance applies if you already registered through NextGen Healthcare for one or more specialized registries hosted by CECity.
- Special note: CMS has indicated that it plans to allow providers to “double count” submissions to qualified QCDR registries that are both PQRS and specialized registries. This means that providers submitting to one of these registries could get credit for PQRS and Public Health Reporting measure #3.
For more information:
See these links to the new CMS FAQs:
https://questions.cms.gov/faq.php?faqId=14393&id=5005
https://questions.cms.gov/faq.php?faqId=14397&id=5005
https://questions.cms.gov/faq.php?faqId=14401&id=5005
See these links to the updated FAQs, covering steps providers must take to meet the exclusions for public health reporting and clarifying the requirements for a registry to qualify as a specialized registry:
https://questions.cms.gov/faq.php?faqId=13657&id=5005
https://questions.cms.gov/faq.php?faqId=14117&id=5005
https://questions.cms.gov/faq.php?faqId=13653&id=5005