Electronic Health Records

Policy & Regulation News

Congress Considering Changes to Meaningful Use Requirements

By Kyle Murphy, PhD

- A bill to relax meaningful use requirements for ambulatory surgery centers has passed the Senate and now awaits a vote by the House of Representatives.

Congress considers bills that would change meaningful use requirements

The Electronic Health Fairness Act of 2015 (S 1347) is sponsored by Senator Johnny Isakson (R-GA) was first introduced on May 15 and has seen little activity until July 30 when it was referred to the Senate Committee on Finance where it received an amendment.

The act aims to amend current law for eligible meaningful use providers and potential Medicare payment adjustments (i.e., penalties) to be levied against eligible professionals and hospitals failing to demonstrate meaningful use prior in the 2014 reporting program year.

The proposed bill contains four Congressional findings that provide a proper overview of the meaningful use challenged faced by ambulatory surgical centers around patient encounters:

(1) Ambulatory surgery centers were not covered under the provisions of the HITECH Act of 2009, which created certification standards and incentives for adopting electronic health record (EHR) technology in the physician office and hospital settings.

(2) The Centers for Medicare & Medicaid Services (CMS) defines a meaningful EHR user as an eligible professional having 50 percent or more of the professional’s outpatient encounters at practices or locations equipped with certified EHR technology.

(3) Physicians with patient encounters in an ambulatory surgical center are at a disadvantage when attempting to meet meaningful use requirements because there currently is not certified EHR technology for such centers.

(4) Until such time as EHR technology is certified specifically for use in the ambulatory surgical centers, patient encounters that occur in such a center should not be used when calculating whether an eligible professional meets meaningful use requirements, unless an eligible professional elects to include those encounters.

Accordingly, the bill proposes an amendment specifically regarding the treatment of patient encounters at ambulatory surigical centers:

“(i) IN GENERAL.—Subject to clause (ii), for a payment year after 2015, any patient encounter of an eligible professional occurring at an ambulatory surgical center (described in section 1833(i)(1)(A)) shall not be treated as a patient encounter in determining whether an eligible professional qualifies as a meaningful EHR user. Notwithstanding any other provision of law, the Secretary may implement this clause by program instruction or otherwise.

“(ii) SUNSET.—Clause (i) shall no longer apply as of the first payment year that begins more than 3 years after the date the Secretary determines, through notice and comment rulemaking, that certified EHR technology is applicable to the ambulatory surgical center setting.”

An identical bill (HR 887) has lingered in the House of Representatives since February 11, with only minor activity having occurred in the months since.

The Senate's passing of Electronic Health Fairness Act of 2015 follows shortly after the House of Representatives first received a new bill to modify the timeline for the EHR Incentive Programs sponsored by Representative Renee Ellmers (R-NC) — Further Flexibility in HIT Reporting and Advancing Interoperability Act (Flex-IT 2 Act).

This bill already enjoys the support of both the College of Healthcare Information Management Executives (CHIME) and American Medical Association (AMA) and has five goals:

  • delay Stage 3 until 2017 or until 75 percent of healthcare facilities are able to meet the standards in Stage 2
  • standardize the list of requirements for Stage 3 to make them less repetitive
  • create a 90-day reporting period every year
  • bolster EHR interoperability
  • allow for more hardship exemptions

While Congress weighs these changes to the EHR Incentive Programs, a group of hospitals is urging the Department of Health & Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) to hurry up with the finalization of modifications to meaningful use requirements between 2015 and 2017 so that eligible providers are not adversely affected.

 

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