Love for CMS 5010 Compliance Deadline Roll-Back Not Universal

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In authorizing a second deadline extension for compliance with its 5010 EHR standards this week, CMS is extending the timetable for providers and payers by another 90 days.

A high-profile request from the Medical Group Management Association (MGMA) may have featured prominently in this decision. In February 2012, the group insisted that postponement was the only way to alleviate payment disruptions that would result from systems being put online prematurely.

In a statement, MGMA President and CEO Susan L. Turney claimed that without an extension, “many practices [would] face significant cash flow disruptions, operational difficulties, a reduced ability to treat patients, staff layoffs, or even the prospect of closing their practices.”

But for businesses that spent time and money getting into compliance with the regulations on schedule, the roll-back is one in a pattern of disappointments.

Scott Cubellis, CEO of Affiliated Professional Services, Inc. (APS), a computerized medical billing service provider located in Wareham, MA, expressed his frustrations with trying to hit a moving target.

“We’ve met every deadline [CMS has] ever given us,” Cubellis said. “We spent one solid year planning for this and working on this, and putting the resources on it. We tested with every provider. We turned it on in January and we had not one issue.”

Cubellis, who estimates that APS has spent $50,000 to become 5010-compliant, says there’s no benefit to meeting the original deadline if it keeps getting pushed back. He agrees that state payers like Medi-Cal—which announced in October 2011 that it wouldn’t be able to meet the January 2012 deadline—simply have a larger infrastructure to maintain, but for a comparatively smaller company like his, the grace period erodes any competitive advantage his investment would have yielded.

“Every time we think we’re in a position where we think we can show we’re a company that can bring about the changes that are being asked of us, [deadlines are] extended,” he says. “Now everybody’s kind of the same again. A billing company that’s not ready to submit the 5010 can submit under the old format. We take these mandates seriously, [and] it puts us at a disadvantage,” he says.

Furthermore, Cubellis says, the delays in enforcement of policy mandates are counterproductive to the overall national goals of CMS to lower costs and improve efficiencies because they delay patient data from reaching analysts.

“The more information they have, the better ability they have to be able to analyze and look at utilization and, I assume, make some changes in reimbursement,” he says. “CMS wanted it. If it was that important, why do they keep delaying it?”