Medicare

Republicans attack new HIT ‘meaningful use’ rules

“Our approach to meaningful
use must be both ambitious and achievable,” Blumenthal said. “The speed of
ascent must be calibrated to reflect both the capacities of providers who face
a multitude of real-world challenges and the maturity of the technology itself.”

The debate swirls around HHS’s final
rules
governing providers as they adopt mandated HIT systems,
including e-prescribing and electronic health records. To ensure that providers
are actually using those tools to improve healthcare services, Congress
required the agency to establish benchmarks for providers hoping to take
advantage of federal incentive payments for HIT adoption.

Bowing to provider complaints
that benchmarks proposed in December were too stringent, HHS scaled back the
requirements in its final rule.

For instance, while the
proposed rule would have required doctors to e-prescribe 75 percent of their
drug orders to meet incentive requirements, the final rule lowered that
threshold to 40 percent. 

Also, CMS’s proposed rule had
required physicians to meet 25 “meaningful use” objectives, with hospitals
asked to meet 23 markers. The final rule splits those objectives into a group
of core measures — 15 for doctors and 14 for hospitals — and offers a menu of
10 additional measures, from which providers can choose five to report.

Under that incentive system,
doctors are eligible for up to $44,000 through Medicare and $63,750 through
Medicaid. 

Herger, though, says the new
requirements are too lenient. Among the optional items that providers can
choose not to report, Herger noted, are harmful drug interactions and the
results for clinical lab tests. 

“So each of the practices
that experts have told this subcommittee are vital to improving patient safety
and eliminating waste, are optional,” Herger said. The lesser requirements, he
warned, could lead to “a lower standard and lower compliance rates.”

Democrats, though, have a
different take. Rep. Pete Stark (D-Calif.), chairman of the health subpanel,
said HHS “took a responsible position in the final rule.” 

“The standards are
aggressive, but set realistic goals,” Stark said in his opening remarks.

Many provider groups have
applauded HHS’s move to ease the requirements for incentive payments. But those
same groups are also criticizing the agency’s decision to exclude individual
hospitals operating under multi-campus university systems. 

The Premier healthcare alliance, a national provider network, warned Tuesday
that a failure to change the rules to include those facilities “could
financially handicap their ability to implement EHRs in a timely manner.”

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