Four Republican Senators–Tom Coburn (R-Okla.), Richard Burr (R-N.C.), Pat Roberts (R-Ks.), and John Thume (R-S.D.)–have sent a letter to HHS Secretary Kathleen Sebelius, asking that relevant staff from CMS and the Office of the National Coordinator (ONC) of Health Information Technology meet with the Senate Finance and Senate Health, Education, Labor, and Pensions Committees to address several concerns related to the final rule on adoption of electronic health records (EHRs) and the implementation of the Stage 2 of ONC’s “meaningful use” program. This letter follows on the heels of an October 4 letter from other Senators requesting that Sebelius suspend the distribution of EHR incentive payments until HHS promulgates universal interoperable standards.
“Meaningful Use” and Stage 2
The “meaningful use” program allows health care providers who demonstrate “meaningful use” of certified EHR systems to qualify for incentive payments from Medicare and Medicaid. Stage 2 meaningful use criteria expands upon the Stage 1 criteria to encourage the use of health IT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible, such as the electronic transmission of orders entered using computerized provider order entry and the electronic transmission of diagnostic test results.
Topics to Discuss
To date, more than $6.6 billion has been paid out in incentives to health care providers under the EHR incentive program. At the meeting, the senators wish to discuss: (1) Whether the use of taxpayer-subsidized EHRs actually increase the utilization of diagnostic tests rather than reduce them? (2) Have some health care providers received federal subsidies for EHR systems they already had in place prior to the adoption of federal standards and mandates? (3) Has the digitalization of records and broader adoption of EHRs increased providers’ billing of Medicare and thereby increased the overall costs of the program for taxpayers? (4) Since federal rulemaking has largely focused on stakeholders’ adoption and “meaningful use” of EHRs, what is the Administration’s strategy for meaningful interoperability, since they acknowledge current interoperability standards remain insufficient and incomplete?
According to the senators, a recent briefing from CMS did not provide sufficient time and opportunity to explore the full range of questions involving the EHR incentive final rule and related implementation issues. The senators request the meeting no later than October 26, 2012.