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AMA, AHA raise concerns over MU2


With the starting date for stage 2 of the meaningful use program fast approaching, two major provider groups are asking for more flexibility in the program's requirements

As the starting date for Stage 2 of the Meaningful Use (MU2) program draws near, two major provider organizations are asking the government to loosen the requirements to qualify for the program.

            In a joint letter to U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, the American Medical Association and the American Hospital Association called for a “realignment” of the MU requirements “to ensure a safe, orderly transition to Stage 2.”

            The associations want HHS to:

  • Allow providers who have qualified for Stage 1 MU to be able to qualify for Stage 2 using either 2011 or 2014 MU-certified editions of electronic health records (EHRs). Allowing use of both editions, they say, would help alleviate the shortage of 2014-certified editions that meet the MU2 requirements. As of mid-July, only 11 EHRs were 2014 certified, compared with 313 that were 2011 certified. (A spokesman for the Health Information Management Systems Society (HIMSS) said, “HIMSS is working with our HIMSS Analytics team and healthcare community partners to assess overall readiness for Meaningful Use Stage 2. It is imperative that we keep focused on ensuring [that] health IT supports care coordination and healthcare transformation in the U.S.”)

  • Establish a 90-day reporting period for the first year of each new stage of MU, similar to what was done for Stage 1. “This change will allow upgrades [to EHR systems] to be spread out over time, rather than being clustered on certain dates,” the associations say.

  •  Offer more flexibility to providers in meeting Stage 2 requirements so as to ameliorate the “all or nothing” problem. Under the current rules, they note, failure to meet any part of an MU objective, or missing a threshold by even a small amount, is considered failure to meet the requirements.  

  • Extend each stage of MU to at least 3 years for all providers. Doing so would recognize that “vendors need time to develop usable and safe upgrades, and providers need time to implement systems and optimize their use,” the associations say.


The associations say greater flexibility in implementing MU2 would especially benefit smaller medical practices and those serving rural communities. They cite studies published in the journal Health Affairs that found higher rates of EHR adoption among “physicians in practices with 11 or more physicians, in practices owned by a hospital or academic medical center, and in counties where less than 15% of the population was in poverty.”

An additional concern about MU2 was raised last year by four powerful Republican members of the Ways and Means Committee in the U.S. Congress. The representatives wrote to Sebelius to express "serious concern" that MU2's standards for interoperability-the ability of different EHR systems to communicate with one another-are weaker than those under MU1. The MU2 rules "fail to achieve comprehensive interoperability in a timely manner, leaving our healthcare system trapped in information silos," the authors said, and   urged Sebelius to suspend incentive payments and delay penalties until HHS develops universal interoperability standards

      The MU2 implementation date for hospitals is October 1, which is the start of the federal government’s 2014 fiscal year. The implementation date for physicians is January 1, 2014.  


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