Senators Urge CMS to Modify “Meaningful Use” criteria

Special interest groups aren’t the only ones disputing the Center for Medicare & Medicaid Services’ (CMS) vision of “meaningful use” as defined in the government agency’s Electronic Health Record Incentive Program Proposed Rule (42 CFR parts 412), released in January. An AAPC article in EdgeBlast No. 146 reported on how 96 various specialty and state medical associations recently sent a letter to CMS stating their case for why Stage 1 of the electronic health record (EHR) incentive program is too aggressive. Since then, the offices of CMS and Health and Human Services (HHS) have been bombarded with letters from Congress.

Twenty-seven U.S. senators expressed several concerns they have with the proposed rule in a letter to CMS, dated March 2.

“Specifically,” senators say in the March 2 letter, “we are concerned about the proposed definition of meaningful use.” The senators go on to say they are also “deeply concerned about CMS’ proposed definition of a hospital-based physician.”

The senators, which include Sens. Al Franken (D-Minn.), Lamar Alexander (R-Tenn.), and Kirsten Gillibrand (D-N.Y.), say the proposed definition of requirements for hospitals to become qualified “meaningful users” of certified EHR technology is “too restrictive” and will penalize noncompliance more than it will reward implementation efforts. This, they say, “goes against the intent of Congress” to reward current and future efforts toward EHR implementation.

“The rule proposes an all-or-nothing approach in which hospitals would be required to adopt all 23 separate EHR objectives or requirements that very few hospitals have yet been able to accomplish,” the bipartisan group of senators maintain.

The senators ask CMS to consider:

  • Providing a longer transition for implementing all 23 objectives and rewarding ongoing efforts.
  • Granting critical access hospitals (CAHs) eligibility to receive Medicaid incentive payments for meeting meaningful use requirements.
  • Deferring automated quality reporting requirements until all measures to be collected through EHRs can be re-specified, tested, and implemented.
  • Modifying the scope of services the agency considers to be outpatient hospital services.
  • Giving direction to states to ensure incentive payments to providers are separate and distinct.

On this last point, senators say separate incentive payments will make it easier to track the investment being made into health information technology (HIT). The senators say, including incentive payments in existing reimbursements “could negatively affect current payments that providers receive.”

Following the letter, 249 members of the U.S. House of Representatives urged CMS to modify its proposed rule in a March 15 letter.

Two weeks later, another group of 37 U.S. senators sent HHS Secretary Kathleen Sebelius a remarkably similar letter.


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