Electronic Health Records

Policy & Regulation News

Revised 21st Century Cures Act Targets Effective EHR Use

House Republicans have introduced a revised version of the 21st Century Cures Act that integrates support for better EHR use, which will go to a vote Wednesday.

By Sara Heath

The Friday following Thanksgiving, Republican members of Congress put forward an amended version of the 21st Century Cures Act, which contains several provisions regarding EHR use and adoption.*

*Editor's note: President Barack Obama signed the bill into law on December 13.

Notably, the legislation refers to EHR use as a part of its efforts toward assisting providers in improving patient quality care. The legislation details strategies to reduce provider reporting burden, health IT certification, and meaningful use hardship exemptions.

According to the law, the Secretary of Health and Human Services must “establish a goal with respect to the reduction of regulatory or administrative burdens (such as documentation requirements) relating to the use of electronic health records,” and subsequently create a strategy to achieve such a goal.

Overall, the strategies should prioritize incentive payments which facilitate the adoption and meaningful use of EHRs, the requirements included under the Quality Payment Program, and the Hospital Value-based Purchasing Program.

The strategy, as well as recommendations to reduce provider reporting burden, should be developed no later than one year after the Act’s passage.

The revised bill also includes language regarding health IT certification, stating that ONC should maintain a set of requirements for EHR vendors and health technology developers to follow. Specifically, the law touches on the subject of information blocking, an issue the government has long been tackling.

Certification rules must include language that ensure a health IT developer “provides assurances satisfactory to the Secretary that such developer or entity, unless for legitimate purposes specified by the Secretary, will not take any action described in clause (i) or any other action that may inhibit the appropriate exchange, access, and use of electronic health information.”

Additionally, the rules should include ramifications for developers that do engage in intentional information blocking.

The bill also discusses meaningful use, stating that no later than six months after the Act is passed, the HHS Secretary must submit to ONC meaningful use attestation statistics.

“Such statistics shall include attestation information delineated by State, including, to the extent practicable, the number of providers who did not meet the minimum criteria necessary to attest for the Medicare and Medicaid EHR Meaningful Use Incentive programs for a calendar year, and shall be made publicly available on the Internet website of the Secretary on at least a quarterly basis,” the law says.

The revised legislation likewise contains language allowing for hardship exemptions, stating that they must be made reasonably available for both eligible professionals and eligible hospitals.

The Secretary shall exempt an eligible professional from the application of the payment adjustment under subparagraph (A) with respect to a year, subject to annual renewal, if the Secretary determines that compliance with the requirement for being a meaningful EHR user is not possible because the certified EHR technology used by such professional has been decertified under a program kept or recognized pursuant to section 3001(c)(5) of the Public Health Service Act.

In addition to supporting EHR adoption and use, the bill provides significant funding for the National Institutes of Health and the FDA, both of which are actively working on the Precision Medicine Initiative and Cancer Moonshot.

In supporting better health IT and EHR use, the bill helps drive both of those initiatives by making more accessible and usable electronic health data.

The revised 21st Century Cures Act is set for a House vote on Wednesday, November 30.

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