Upcoming Meaningful Use Stage 2 rules include some proposed changes to Stage 1, an official from the Centers of Medicare and Medicaid Services said during a Town Hall session at HIMSS12 in Las Vegas on Tuesday.

That disclosure by CMS official Elizabeth Holland was the second big surprise for attendees of a packed seminar on Tuesday morning originally headlined as "Stage 2 Meaningful Use."

The first surprise of the session was Holland's admission that Stage 2 details weren't ready for disclosure at that day's event as many had expected.

So, instead of talking about the anticipated Stage 2 rule, CMS officials talked mostly about Stage 1. That included the revelation that "Stage 1 won't necessarily be the same" once Stage 2 criteria comes out, said Holland.

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While Holland would not elaborate on what might change in the Stage 1 requirements, those proposed changes won't impact organizations that have already complied to Stage 1, said Holland.

"Any stage 1 changes to be approved will come into effect 2013," she said, adding that there will be "tweaks to other parts of the program, too."

Many HIMSS 12 attendees came into a seminar dubbed "Stage 2" anticipating details around the proposal for the next stage of Meaningful Use. What many didn't expect was the news that changes to Stage 1 would be included Stage 2.

"Yes, I expected to hear about Stage 2, but I guess we'll have to wait a little," said attendee Charles Scudelari, chief operating officer of Pueblo Radiology Medical Group, a physicians group in Santa Barbara, Calif. Scudelari's organization isn't yet Stage 1 compliant, but he was hoping a sneak peek into what'll be expected for Stage 2.

Still, while Scudelari was surprised at the disclosure of upcoming, unspecified changes to Stage 1 criteria, he didn't expect those changes to impact work that's already underway at his group.

As for Stage 1 Meaningful Use, 191,604 eligible providers have registered to participate in the HITECH Act program so far, said Holland. As of Jan. 13, $1.6 billion in incentive money has been paid out to Medicare providers and $1.4 billion to Medicaid providers.

It is possible that Stage 2 rules could be ready for public disclosure on Wednesday at HIMSS12 during other CMS and Office of National Coordinator for Health IT related seminars. "But I'm not a betting person," said Holland.

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