Senators Object To Meaningful Use Rules For E-Health Records

Strict requirements for EHR use could kill funding incentives for doctors, hospitals, senators say.
In a rare show of bipartisanship on healthcare, 27 senators have expressed opposition to proposed federal "meaningful use" rules that hospitals and healthcare providers must comply with in order to be reimbursed for implementing electronic health records.

Mandated under the American Recovery and Reinvestment Act, the rules will determine whether a healthcare provider qualifies for the more than $20 billion in stimulus funds that the federal government plans to start paying out next year to healthcare providers who demonstrate meaningful use of EHR systems.

The Centers for Medicare and Medicaid Services (CMS) published the Meaningful Use Notice of Proposed Rulemaking late last year and is analyzing comments from healthcare providers and other interested parties.

In a letter to Charlene Frizzera, CMS's acting administrator, the senators cited concerns with the proposed definition of "meaningful use." They also criticized the inappropriate exclusion of most physicians working in outpatient centers and restrictions that would make hospitals that have multiple campuses eligible for only one reimbursement as measures that will financially penalize many hospitals and doctors.

"The rule proposes an all-or-nothing approach in which hospitals would be required to adopt all 23 separate EHR objectives or requirements that very few hospitals have yet been able to accomplish," the letter said. "We urge you to consider a longer transition that recognizes a practical, incremental approach to EHR adoption that rewards the efforts already underway in America's hospitals."

Senators signing the letter included Orrin Hatch (Rep.-Utah), Susan Collins (Rep.-Maine), Amy Klobuchar (Dem.-Minn.) and Patrick Leahy (Dem.-Vt.).

The letter also recommends that critical access hospitals be considered healthcare providers eligible for payments if they meet the definition of meaningful use. Additionally the senators asked CMS to broaden the scope of services it considers to be outpatient hospital services for the purpose of including them under the EHR incentives program.

"Regardless of how the ambulatory care sites are licensed or established, the care and services furnished in these settings are similar to services furnished by private physician offices in other communities that are able to attract private physicians and clearly eligible under the statute to receive HIT incentive payments," the letter states.

The senators also appealed to CMS to provide flexibility in the early years of the program, as a way to support hospitals' and physicians' efforts to adopt medical records.

"Electronic reporting of quality measures through EHRs is a highly valued goal that is not yet possible to meet. Therefore, we urge CMS to defer the automated quality reporting requirement until all measures to be collected through EHRs can be re-specified, tested, and implemented," the letter said.

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