About 100 healthcare CIOs were up before dawn Thursday to meet with and question the government's own meaningful-use guru at the College of Healthcare Information Management Executives' fall CIO forum in San Antonio.

Travis Broome, program manager for meaningful use at the CMS, spent most of the hourlong meeting, which started at 7:30 a.m., answering questions about attestation, payment and timing issues regarding the Medicare and Medicaid electronic health-record incentive programs created by the American Recovery and Reinvestment Act of 2009.

There has been no change in the timeline for release of a proposed rule on Stage 2 meaningful-use criteria, according to Broome. “Our regulations for that will come out in January,” he said. With a public comment period and subsequent revisions, it's been estimated that a final rule on Stage 2 criteria won't be ready until summer 2012.

Under the existing federal rule for the Medicare program, the effective date for the Stage 2 meaningful-use criteria is Oct. 1, 2012, for those hospitals that attest they were meaningful users for at least 90 days during the first year of the program, federal fiscal 2010, which ended last month. The tight time frame between the release of the Stage 2 criteria and their effective date was a key reason the Health IT Policy Committee recommended earlier this year that the CMS delay the start of Stage 2 for fiscal 2010 meaningful users.

Broome posted a slide with a statement by Dr. Farzad Mostashari, head of the Office of the National Coordinator for Health Information Technology, saying that “we agree with the logic of delaying the start of Stage 2 of meaningful use for a period of one year for those first attesting to meaning use of in 2011. We also agree that it makes sense to maintain the current expectations for those first attesting to meaningful use in 2012, so that all providers attesting to meaningful use in 2011 or 2012 would attest to Stage 2 in 2014. That would give all providers adequate time to move up the escalator for a robust set of Stage 2 meaningful-use expectations.”

And while Mostashari's opinion will no doubt be given considerable weight, it's not the final word, since the CMS, not ONC, will write the Stage 2 rules.

“We're certainly evaluating pushing it back,” Broome said, but that's as far as he would go. Thus, there is only the inference, but no official statement affirming, that the compliance date for Stage 2 criteria will be delayed.

Broome also spoke about recent reports of software glitches seen by ambulatory-care providers leading to inaccurate reporting of Stage 1 meaningful-use data. Asked whether the CMS has a plan in place for dealing with inaccurate data from those and other systems, Broome said, “We really don't have a set policy for it yet. The ones we dealt with so far, we've basically been able to fix the attestation.”

“Anybody who finds themselves in that situation, contact CMS,” Broome said. “Right now, we're basically dealing with that on a case-by-case basis.”

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