Republican senators protest MU

Six Republican senators have published a report critical of progress in the Meaningful Use program and called for a halt to the program and re-examination of its strategies.

“We seek comments on whether it would be in the best interest of CMS, the Office of the National Coordinator for Health IT, vendors, providers, taxpayers and other stakeholders to hit ‘pause’ while re-examining the current procedures put in place to safeguard and ensure meaningful use of EHRs prior to forging ahead with Stage 2 and 3,” the senators wrote in the report entitled Reboot: Re-examining the Strategies Needed to Successfully Adopt Health IT.

“We are not alone in our concern on this issue. For example, the American Medical Association and other healthcare stakeholders have asked CMS and the Office of the National Coordinator for Health IT to hire an outside entity to evaluate the incentive program’s performance before quickly rushing into future stages. We are pleased CMS has effectively announced such a pause by delaying promulgating Stage 3 regulations and seeking to work with stakeholders. We seek comments on what steps CMS needs to take before implementing Stage 3.”

Signers of the report include Sens. Alexander Lamar (TN), John Thune (SD), Pat Roberts (KS), Richard Burr (NC), Tom Coburn (OK) and Michael Enzi (WY). They contend that “while promoting the use of health IT is a laudable goal, a growing body of objective analysis and empirical data suggests the program needs to be recalibrated to be effective.”

The senators' concerns include the following:

• Lack of a clear plan toward interoperability and concerns that incentive payments are being made without an adequate plan that ensures the sharing of information;
• Increased costs and concerns that rather than saving money, use of EHRs is accelerating the ordering of unnecessary care and increasing billings for the same procedures;
• Lack of oversight and inadequate mechanisms to prevent waste and fraud in the EHR incentive program;
• Lax security policies and procedures within CMS and ONC that may jeopardize patient data; and
• Worries of program sustainability if IT compliance and maintenance costs for providers are too burdensome after grant money and incentive payments run out just as Medicare reimbursements fall.

The senators put forth some questionable figures, however. For example, they cite a Government Accountability Office report of low hospital Meaningful Use participation levels during 2011, which was the first year of the program. The GAO report was selected because it was the most recent year data are available from outside the Department of Health and Human Services. Even with an increase in participation before 2015 when Medicare reimbursement penalties start for non-meaningful users, “one could project a scenario where more than a third of all hospitals are penalized,” according to the Senate report.

HHS data through 2012, after two years of Meaningful Use, show that 75 percent of hospitals have been paid for Meaningful Use (Medicare and/or Medicaid), with 55 percent having attested under the more rigorous Medicare criteria.

The 28-page report is available here.