Electronic Health Records

Policy & Regulation News

SGR Bill and Interoperability Requirements Move to Senate

By Kyle Murphy, PhD

- On Thursday, the House of Representatives voted overwhelmingly in favor of a bill to replace the Medicare sustainable growth rate (SGR) and with it recommendations for achieving widespread EHR interoperability.

The proposed bill aims to repeal the Medicare SGR and "strengthen Medicare access by improving physician payments and making other improvements" as well as to reauthorize the Children's Health Insurance Program (CHIP).

Representative Michael Burgess (R-TX) introduced the bill into the House of Representatives on March 25, only weeks after details of a discussion draft that he likewise authored emerged calling for significant changes to the Office of the National Coordinator for Health Information (ONC) and its approach to enabling nationwide health IT interoperability.

While many components of the discussion draft did not become part of the Medicare SGR repeal, others have, beginning with the definitions of interoperability:

(i) WIDESPREAD INTEROPERABILITY. — The term ‘‘widespread interoperability’’ means interoperability between certified EHR technology systems employed by meaningful EHR users under the Medicare and Medicaid EHR incentive programs and other clinicians and health care providers on a nationwide basis.

(ii) INTEROPERABILITY.—The term ‘‘interoperability’’ means the ability of two or more health information systems or components to exchange clinical and other information and to use the information that has been exchanged using common standards as to provide access to longitudinal information for health care providers in order to facilitate coordinated care and improved patient outcomes.

The bill would set Dec. 31, 2018, as the date for achieving this "national objective." If the Department of Health & Human Services (HHS) fails to achieve this objective, the proposed legislation calls on the federal agency to report to Congress the reasons the objective remains unachieved as well as recommendations for enabling widespread interoperability. The bill offers two recommendations as examples:

(i) to adjust payments for not being meaningful EHR users under the Medicare EHR incentive programs; and

(ii) for criteria for decertifying certified EHR technology products.

Beyond recommendations for promoting widespread interoperability, HR 2 also contains provisions dealing with the intentional blocking od health data exchange by eligible professionals and hospitals.

Lastly, in terms of interoperability, the legislation awaiting consideration by the Senate would require the HHS Secretary to assess and report on  the feasibility of establishing a mechanism to compare certified EHR technology products and offers two example of the form this mechanism might take:

(i) a website with aggregated results of surveys of meaningful EHR users on the functionality of certified EHR technology products to enable such users to directly compare the functionality and other features of such products; and

(ii) information from vendors of certified products that is made publicly available in a standardized format.

The Senate must now vote on the House bill.