Electronic Health Records

Adoption & Implementation News

Senators request EHR Incentive Programs, meaningful use meeting with HHS

By Kyle Murphy, PhD

Secretary Kathleen Sebelius has received another letter from Congress on the subject of meaningful use. This time is comes from the desks of Senators John Thune, Richard Burr, Tom Coburn, and Pat Roberts, who are requesting that “relevant staff” from the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) participate in a discussion of the final rule for Stage 2 Meaningful Use with members of the Senate Finance and Senate Health, Education, Labor, and Pensions Committees. The Department of Health & Human Services (HHS) has until Oct. 26 to furnish the Senators with pertinent knowledge of electronic health record (EHR) technology and the adoption of EHR systems by providers.

According to the letter, a previous briefing with Congress did not allow for enough discussion of EHR adoption. The Senators call attention to the missed opportunity “to fully cover the full range of questions regarding the final rule and related implementation.” In particular, the letter demands answers to four questions that recent reports and analyses have raised:

The first takes aim at the relationship between EHR use and testing: 

Does the use of taxpayer-subsidized electronic health records (EHRs), in some circumstances, actually increase the utilization of diagnostic tests rather than reduce them? What is the Administration’s strategy to address what may be an unintended consequence of federal policy — higher utilization of tests and higher spending across the health system?

The second considers the potential for meaningful use fraud:

Have some health care providers received federal subsidies for EHR systems they already had in place prior to the adoption of federal standards and mandates? If so what steps is the Administration taking to recoup any inappropriate payments and what additional program integrity measures have been adopted?

The third addresses higher Medicare costs associated with EHR adoption:

Has the digitization of records and broader adoption of EHRs increased providers’ billing of Medicare and thereby increased the overall costs of the program for taxpayers?

And the fourth takes issue with interoperability among EHR and health IT systems:

Since federal rule-making has largely focused on stakeholders’ adoption and “meaningful use” of EHRs, what is the Administration’s strategy for meaningful interoperability, since they acknowledge current interoperability standards remain insufficient and incomplete?

It should be noted that Senators’ figures for EHR Incentive Program payouts are $1 billion shy of current reports of payments recently exceeding $7 billion and quickly approaching $8 billion. The purpose of the next meeting is to inform decision-making about government spending on health IT. “Fully understanding the next steps for this significant federal investment and the decisions made in the final rule are a critical part of fulfilling our role in conducting oversight over this program and representing the concerns of our constituents as elected Members of Congress,” write the Congressmen.

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