For Medicare reporting (2010), one site jumped to 5.1.5 in Dec 2010. We subsequently isolated a bug that has to do with the Rx printer, which when I get a chance, I will write up what we learned about fixing it; it involves registry edits, so not for the weak of heart, or people flying without backups.
Most practices I have talked with is waiting for other Penguins to jump into version 6, then will pile in behind them if there aren't horror stories. [allusion for those who have seen Penguin behaviors on NatGeo or similar]