37 Senators Write Kathleen Sebelius Criticizing “All-or-Nothing” Meaningful Use Criteria, Gaps in Incentive Payments

A group of 37 Senate Democrats, including Senator Max Baucus (D-MT) and Senator Tom Harkin (D-IA), have signed a letter to HHS Secretary Kathleen Sebelius commending her “work to advance the adoption and meaningful use of health information technology (HIT) by health care providers” but criticizing the “all-or-nothing” approach to awarding incentive payments for health IT adoption.

The Senators advocate an approach “that allows providers to defer a limited set of criteria under Stage 1 of meaningful use while preserving a floor of mandatory functional use requirements, as recommended by the HIT Policy Committee.”  They write that the deferment would be temporary, and that “all criteria should be met over the course of the incentive payment program.”

“While we believe that the general implementation framework outlined in the proposed rule should be preserved,” the senators write, “starting with a phased, flexible approach to meaningful use would be a constructive change.”

Additionally, the senators write that outpatient physicians that practice near hospitals were excluded from incentive payment eligibility, “despite legislative intent.”  According to the letter, “A technical correction to ameliorate this oversight has been included in the American Workers, State, and Business Relief Act which recently passed the Senate,” but they urge that Secretary Sebelius use “administrative flexibility” to close the gap, irrespective of the bill’s legislative future in the House of Representatives.

A final concern of the senators is the use of Medicare provider numbers to distinguish hospitals for the purposes of requesting incentive payments, one that they write could cause “unintended inequities.” The letter reads, “A single provider number can sometimes encompass multiple campuses for a hospital system.  Therefore, a hospital system with multiple provider numbers will be eligible for more incentive payments than would be a hospital system of equal size with a single provider number.”

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