D.C. Report: MU Workgroup Mulls Stage 2 Delay and its Implications

Medicare Meaningful Use Incentive Payments See Light of Day; eRx Incentives to Be Revisited. In an announcement made last Thursday, the Centers for Medicare & Medicaid Services (CMS) said that $75 million in Electronic Health Records (EHR) Incentive Payments had been made to providers who signed up in the first two weeks of the program (attestation began April 18, 2011). According to CMS’s latest tabulations, $158.3 million has been awarded in 2011 to eligible professionals and eligible hospitals for demonstrating meaningful use of certified EHRs under Medicare and Medicaid incentive programs. And more than 42,600 EPs and EHs had registered for the program through April 30. Also announced by CMS Thursday was a notice of proposed rulemaking for the e-prescribing (eRx) Incentive Program that would “better align” the eRx and EHR incentive programs, as well as possibly expand the “significant hardship exemption categories.” CHIME’s Policy Steering Committee is currently debating the rule’s relevance for possible comment. For more on the proposed rule change, read this fact sheet.

ACO Rule and Multi-Campus Focus of Congressional Attention. Seven Republican Senators in a letter this week urged HHS Secretary Sebelius to withdraw the Accountable Care Organization rules based on concerns expressed by various leading healthcare institutions such as Intermountain, Cleveland Clinic, Mayo, and national organizations including CHIME. “Incentives and accountability are misaligned,” said the letter, [and] “Detailed requirements are complex and return on investment is uncertain.” Acknowledging that the model of an ACO still holds promise, the letter requested the Secretary to “re-engage with experienced stakeholders to craft a new rule that fulfills the promise of ACOs.” The group of Senators includes Tom Coburn (R-OK), Jon Kyl (R-AZ), Mike Crapo (R-ID), Mike Enzi (R-WY), John Cornyn (R-TX), Pat Roberts (R-KS), and Richard Burr (R-NC).

As authorized by the HITECH Act, meaningful use payments are based on provider number not physical campuses, which pose a problem for hospital systems with multiple hospital campuses under the same provider number. While making the investment for system-wide changes as envisioned by HITECH, these healthcare institutions will see a significant reduction in incentive payments. To remedy this problem, a bi-partisan group of House members (Burgess R-TX-26, Engel D-NY-17, Brady R-TX-8 and Rangel D-NY-15) have proposed the “Provide Fairness in Health IT Payments.” In a letter to other House members, they are seeking to expand the list of co-sponsors. Similar legislation was introduced in the 111th Congress but failed to gain traction. The obvious revenue impact is likely to impede action this year, as well given ongoing budgetary constraints.