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The Flex-IT 2 Act: More posturing than promise


The Flex-IT 2 Act, recently proposed in Congress, is seen as an example of the resistance toward adopting Meaningful Use standards.

Much like "meaningful use" itself, the Flex-IT 2 Act may work better in theory than in reality.

The bill, proposed by U. S. Rep. Renee Ellmers (R-N.C.) in July, likely won’t make it through Congress, but it’s seen as significant for doctors as it sends a message to the Centers for Medicare & Medicaid Services (CMS) to slow the pace of adopting meaningful use (MU) standards for electronic health records (EHRs), say those involved with the legislation.

Key provisions of the proposed bill include delaying MU stage 3 rulemaking until at least 2017 and instituting a 90-day reporting period for each year’s compliance regardless of the stage involved. CMS is scheduled to finalize Stage 3 rules by year's end.

Related:CMS releases Stage 3 Meaningful Use rules

Only about 10% of the members of the American Academy of Family Physicians (AAFP) have met stage 2 requirements, according to AAFP president, Robert Wergin, MD.

Complying with meaningful use requirements to date has hindered many doctors’ abilities to see patients, he contends. In his own rural Nebraska practice, Wergin estimates he’s seeing 10% to 15% fewer patients now than four years ago, when he started meeting MU requirements, because of the administrative burden those requirements have imposed.

Bill a 'conversation starter'

Ellmers’ bill has 17 co-sponsors, a number that could get CMS’s attention and lead it to reconsider its Stage 3 timetable, those close to the debate say. "This is the first piece [of legislation] that takes a comprehensive look at meaningful use," says Leslie Krigstein,  vice president of Congressional Affairs with the College of Healthcare Information Management Executives, a health IT organization that supports the legislation. The chances of the bill passing are slim, she confirms, but "using it as a conversation starter is likely just as valuable."

A Congressional battle to defund Planned Parenthood is putting all other healthcare-related measures on the back burner, says a spokesperson for Ellmers' office. But even without the Planned Parenthood fight, it’s doubtful Congress could agree on the Flex-IT 2 Act, given the highly charged political atmosphere in Washington today, notes Krigstein. No hearings for the bill had been set as of mid-September.


NEXT: Fate of stage 3


Fate of stage 3

"The goal of the legislation is to add flexibility to the meaningful use program in the areas that have been the source of continued frustrations for clinicians," Krigstein  says. The 90-day reporting area in particular is one doctors would like to see as part of Stage 3.

In January CMS announced it was considering a 90-day reporting period for 2015. Proponents of the Ellmers bill hope that will be extended into future years as well.

Related:MU2: Mission Impossible

EHR vendors have raised doubts about Flex-IT 2 or any effort to slow the pace of EHR adoption. "Generally we would suggest that delaying the release of the final regulatory language around meaningful use stage 3 would not necessarily get us to the place where we are all collectively trying to go," says Leigh Burchell, vice president of government affairs, with EHR vendor Allscripts.

Burchell adds that it would be more useful for doctors and software vendors to first see what requirements CMS proposes for Stage 3 before seeking to delay anything, Knowing the CMS plan would offer a useful guide for all parties to begin their Stage 3 planning, she says.

Even at the current pace, which has included a delay in CMS issuing final rules for Stage 3, it’s unlikely that Stage 3 would start much before 2018, Burchell cautions. That’s enough time for software providers to have their products ready, she says.

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Jennifer N. Lee, MD, FAAFP
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