A proposed rule released today by the Centers for Medicare and Medicaid Services includes criteria that will allow ophthalmologists to continue to succeed in the Medicare Electronic Health Record Incentive Program. The rule defines the second stage of “meaningful-use” requirements of an EHR system that physicians must demonstrate to qualify for the Medicare incentive. Meaningful use is defined in stages, with each stage requiring more-advanced use of EHR technology. Physicians who successfully begin to participate in the EHR incentive program in 2012 are eligible to receive a total of $44,000 over five years.

Flexibility for Specialties
In response to months of advocacy by the Academy, CMS has proposed a set of criteria that is flexible to the needs of ophthalmologists. Specifically, the second stage of meaningful use requirements will include ophthalmology-relevant objectives advocated by the Academy related to in-office imaging results and reporting to specialty registries. More than 650 ophthalmologists have met the first stage of meaningful use requirements since the program began in 2011. Many qualified through CMS-granted exclusions from the requirements, which largely are focused on primary care. In stage two, CMS will continue to allow ophthalmologists to exclude themselves from requirements that are not applicable to their scope of practice, including recording patient vital signs and documenting a patient's advance directive.

Exemptions Offered from Future EHR Penalties
Congress requires CMS to penalize Medicare physicians who do not participate in the EHR incentive program beginning in 2015. Any physician who is not participating in meaningful use by Oct. 1, 2014 will be subject to the penalty. The proposed rule contains several exemptions to the EHR penalties, however, including:

• Availability of internet access or barriers to obtaining IT infrastructure;
• A time-limited exception for newly practicing physicians who would not otherwise be able to avoid payment adjustments; and
• Unforeseen circumstances such as natural disasters that would be handled on a case-by-case basis.

The proposed rule will be open for public comment for 60 days. Physicians are required to begin reporting on the second stage of meaningful use in 2014 or their third year of successful incentive-program participation, whichever comes later. The Academy continues to advocate for program criteria that enable ophthalmologists to qualify for the incentive and for adequate exemptions from the EHR penalties.

More information about the Medicare EHR Incentive Program is on the American Academy of Ophthalmic Executives' EHR Central.

For more information, contact the Academy's Governmental Affairs Office at 202.737.6662.