May 4, 2010
A coalition of 53 medical organizations signed a letter sent Monday to U.S. Department of Health and Human Services secretary Kathleen Sebelius urging the government to extend its proposed meaningful use deadlines two years, from 2015 to 2017.
In the letter, the organizations said they "fully support the purpose of the American Recovery and Reinvestment Act of 2009 to encourage the adoption and use of e-health records and infuse stimulus dollars into the health care sector." However, the coalition -- representing tens of thousands of clinicians and other health-related professionals -- expressed concern about healthcare providers having enough time to meet all approximately two dozen proposed meaningful use requirements. The coalition "wants to ensure that the provisions of the statute are implemented in a manner that will remove barriers to and promote the widespread adoption of health information technology," according to the letter. However, "these requirements are asking for too much, too soon." The letter noted that the "coalition of groups from across the health care spectrum" each submitted to HHS their own specific comments about the proposed meaningful use rules prior to the public comments deadline in March. However, as a group they share "several common views" on the proposals. Among the complaints from the coalition is the proposed requirement for the use of "advanced functions" such as computerized physician order entry, clinical decision support, and medication reconciliation. These activities "generally happen at the end of multi-year transitions to e-health records," and "the proposed phase-in-period for this aggressive set of requirements is unrealistic," the letter said. "If finalized, it would likely result in even those providers with advanced HIT systems not meeting the requirement in fiscal year 2011." Instead, the group is urging the Centers for Medicare & Medicaid Services "to extend the transition to meaningful use to 2017, consistent with ARRA." An American Hospital Association spokesman in an interview with InformationWeek said the coalition is urging CMS to consider making meaningful use incentives available to healthcare providers until 2017, and delay by two years when penalties kick in for non-compliance. "This approach would provide a more realistic adoption curve without changing the payment and penalty schedule established in law," said the letter. Under the ARRA, providers can receive incentive payments through 2016, although under current HHS proposals healthcare providers are eligible for higher bonus amounts in earlier years. And, while the proposed penalties for those who do not meet the meaningful use criteria begin in 2015, they are phased in over three years, with the maximum penalty imposed in 2017. HHS is currently reviewing industry and other feedback related to the proposed meaningful use regulations, which is scheduled to be finalized and published in "late spring," said a CMS spokesman in an email to InformationWeek. "CMS received numerous comments from provider organizations. We are reviewing and giving careful consideration to all comments, including those recommending adjustments to the stages of meaningful use timeline," he said. "The disposition of all comments will be addressed in the final rule," he said. The coalition's letter to HHS also lists several other requests and concerns. Those include urging CMS "to require providers to implement a percentage or limited number of the meaningful use objectives and offer providers greater flexibility in choosing which requirements to implement." The letter says that the "long term goal" should remain for healthcare providers to fully implement EHRs, but that "it's critical that individual providers be able to take a different path to reach that goal." Also, the coalition is asking CMS to shorten from 10 years to 5 years the amount of time healthcare providers will need to retain electronic "evidence" of meeting meaningful use incentive requirements. The group is also requesting that CMS drop two proposed objectives or measures related to administrative systems, including electronically checking insurance eligibility of patients with public and private payers, and submitting claims electronically to those payers. The group is urging CMS to "focus on clinical objectives."
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