Congress Putting Pressure on HHS to Tighten EHR Meaningful Use Standards

Several Republican Senators and House Members recently have increased pressure on Kathleen Sebelius, Secretary of the Department of Health and Human Services (HHS) expressing several concerns over several issues related to the adoption of EHRs through the Centers for Medicare & Medicaid Services (CMS) and the Office for the National Coordinator for Health IT (ONC)’s meaningful use program. 

In early October, House Republicans sent a letter to Sebelius asserting that the Stage 2 rules fail to achieve comprehensive interoperability, and leave our healthcare system in silos.  The letter was penned by Ways and Means Committee Chairman Dave Camp (R-MI), Energy and Commerce Committee Chairman Fred Upton (R-MI), Ways and Means Health Subcommittee Chairman Wally Herger (R-CA), and Energy and Commerce Health Subcommittee Chairman Joe Pitts (R-PA). 

“More than four and a half years and two final Meaningful Use rules later, it is safe to say that we are no closer to interoperability in spite of the nearly $10 billion spent.,” the letter’s authors say.  “With the bar for Meaningful Use set so low and with a focus instead on trying to pad participation rates, these challenges are predictable.  Incentive payments, particularly those funded by the Medicare trust funds and taxpayers, should be given to providers who are truly ‘meaningful users’ of EHR.” 

Camp and others want HHS to increase what is expected of meaningful users.  They say requiring a summary of transfer document 10 percent of the time is “insufficient.”  Electronic prescribing only 50 percent of the time, they say is “woefully inadequate.”   The letter also mentions the recent New York Times investigative report on coding, and how many providers may be using EHRs to abuse Medicare reimbursements.  “Hospitals and physicians who are deemed Stage 1 ‘meaningful users’ are not required to know with certainty whether their systems are capable of exchanging information,” they wrote.  

The Senate letter, written by senators, Tom Coburn (R-Okla.), Richard Burr (R-N.C.), Pat Roberts (R-Ks.), and John Thume (R-S.D.), asked the relevant staff from CMS and ONC to meet with Senate Finance and Senate Health, Education, Labor, and Pensions (HELP) Committees, noting a recent briefing by the government agencies did not give “enough time and opportunity” to cover the final rule. 

Some of the questions they asked in the letter came out of various recent media reports. This included asking if EHRs increase or reduce diagnostic tests, inappropriate EHR payments to providers, increased billing of Medicare due to EHRs, and meaningful interoperability. The senators say because Stage 2 of meaningful use directly affects the direction of health information technology in the country, they need a better understanding of these issues to conduct a proper oversight.  The Senators asked to meet no later than October 26, 2012.  

We previously wrote that the HHS Office of Inspector General (OIG) is also investigating EHRs closely, so it is likely that Congress will continue pressing HHS and ONC for more information, particularly given the amount of money being spent on implementing EHRS, the potential for abuse, and the tremendous dependence many of the provisions of the ACA have on EHRs.