In response to strong lobbying activity and numerous comments from physicians, the Final Rule on Meaningful Use (Stage 1) included a provision for physicians to exclude certain measures that are outside the scope of their practice. This was primarily an accommodation made to enable specialists to participate in the EHR incentives program without substantially changing their practices—although some primary care physicians may find exclusions applicable to them as well.
For a physician to exclude a measure:
- The measure must be explicitly identified as “excludable” in the Final Rule—not all measures contain such a provision. (6 core and 7 menu measures are potentially excludable, but for some there will be very few providers who would meet the criteria.)
- The physician must meet the defined criteria for exclusion of that particular measure.
- The physician must attest that he/she meets these criteria.
Excluding a measure is the equivalent of meeting that measure. Therefore, if a physician excludes one (or more) of the menu measures, he/she only has to satisfy 4 of the remaining 9 menu measures (or 3 of the 8, etc.) The excluded measure does not have to be replaced by another measure.
In the next Meaningful Use Monday posts, I will address each of the measures individually and will identify the eligibility criteria where exclusions exist. I’ll start with Reporting on Clinical Quality Measures (one of the 15 Core meaningful use measures) because while not technically excludable, there is an accommodation available for the many specialists who find none of the measures relevant.
Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.