Congress to CMS: Modify meaningful use requirements

In a letter to Charlene M. Frizzera, acting administrator for the Centers of Medicare & Medicaid Services (CMS), 235 members of the U.S. House of Representatives urged CMS to modify its proposed definition and requirements for hospitals to qualify for the meaningful use of health IT incentive payments.

In addition, CMS should identify hospitals in a multi-campus hospital setting as discrete facilities of service so that individual sites of hospitals are eligible to separately qualify for the payment incentives relating to the meaningful use of health IT, according to the letter.

For multi-campus hospitals, CMS inappropriately limits the number of hospitals that are eligible to receive incentives and participate in the program, the members of Congress stated. “In many facilities, a single provider number can include multiple campuses of a hospital system,” the letter stated. “If the Medicare provider number is used to define a hospital, a healthcare system with multiple sites (but a Medicare provider number) would receive one incentive payment for the entire healthcare system.”

“The regulation’s narrow definition of an eligible provider would preclude individual campuses of multi-campus hospitals and many physicians that CMS considers ‘hospital-based’ from even participating in the incentive program,” concluded the letter.

According to the members of Congress, CMS' proposed rule regarding incentives for meaningful use of EHRs is too much too soon for the vast majority of America’s hospitals and does not take into account the progress hospitals already have made toward the goal of universal EHR adoption.

Members of Congress strongly urged the modification of meaningful use requirements to:

• Require a narrow base of objectives in 2011 to qualify as a meaningful use of EHRs and increase the requirements over time until all required objectives are operational by 2017;
• Extend the transition to 2017 so that it mirrors the transition established for Medicare payment penalties for non-meaningful users of EHRs;
• Grandfather certification requirements for existing systems in use for 24 months to ensure that the current delay in the Department of Health and Human Services’ development of a certification process and time needed to become certified does not prevent a hospital from being considered a meaningful user;
• Include quality reporting of measures that have been fully tested and validated for EHR reporting and for which CMS has an ability to accept in EHR form; and
• Exclude non-clinical objectives such as electronic insurance verification and claims submission that are unrelated to patient care and rely on voluntary payer participation.

The signing participants also stated that states should not be allowed to make it harder to qualify for Medicaid EHR incentive payments and that Medicaid incentives should be considered separate and apart from other Medicaid program payments for services.