Burwell in the hot seat in Senate hearing on MU, ICD-10

The Senate continued its examination of health IT issues during a Senate Appropriations subcommittee hearing that put Health and Human Services Secretary Sylvia Burwell in the hot seat, fielding questions about Meaningful Use and the ICD-10 transition.

Senator Lamar Alexander (R-Tenn.), in the hearing on the HHS fiscal 2016 budget request, noted that despite the $28 billion spent on EHRs, half of doctors are choosing not to participate in Meaningful Use. Alexander, who is chairman of the Senate Health, Education, Labor, and Pensions Committee, told Burwell that he and ranking member Senator Patty Murray (D-Wash.) have formed a bipartisan working group to identify five or six EHR problems “that we can address administratively—in other words, you could do it—or legislatively if we have to.”

Alexander asked Burwell if she would commit to making EHRs a priority “in the year and nine months” left in the Obama administration. HHS has staff “ready to go and we are committed to do that," she said. "We are looking forward to putting the list [of EHR issues] together and looking forward to getting it done. We’ll look at our administrative things and we want to work with you all on what we need legislatively as well.”     

Meanwhile, Senator James Lankford (R-Okla.) expressed concerns about the impact the transition to ICD-10 will have on small physician practices. Unpaid Medicare claims could cause significant cash flow disruptions, he said.

Only a very small group isn’t ready, Burwell said, and HHS will work with those providers to prevent problems with their transition. “We have been doing testing and communication with large players and small players. Most of the large players have been ready and are ready.”

Surveys indicate that a very high percentage of people are ready, she said, but for those who aren’t, “we are still in the process of providing the technical assistance and we will go in to try and do the training.”

That wasn’t good enough for Senator Bill Cassidy (R-La.), MD, who said small practices are the most vulnerable. He recommended that CMS delay the penalty phase for two years to give providers time to adjust. “Unless we are sympathetic,” the senator predicted that small physician offices will go out of business.    

“CMS estimates that in the early stages of implementation denial rates will rise by 100 to 200 percent, and that days in accounts receivable will grow from 20 to 40 percent,” Cassidy said.