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27 Senators Tell CMS to Relax, Postpone Meaningful Use Rules

Cheryl Clark, for HealthLeaders Media, March 30, 2010

Very few hospitals are able to satisfy the 23 electronic health record objectives or requirements necessary for federal incentives payments, says a bipartisan coalition of 27 U.S. senators, which wants CMS to allow a slower, more gradual implementation process and relax or change many other EHR mandates.

"We urge you to consider a longer transition that recognizes a practical, incremental approach to EHR adoption that rewards the efforts already underway in America's hospitals," wrote the senators, who include Orrin Hatch, R-Utah, Amy Klobuchar, D-MN, Barbara Boxer, D-CA, and Lamar Alexander, R-TN.

The letter was addressed to Charlene Frizzera, acting CMS administrator.

The group also objected to what it calls the "inappropriate exclusion of most physicians working in outpatient centers" from being eligible to receive EHR stimulus incentives.

"We are deeply concerned about the CMS' proposed definition of a hospital-based physician," they wrote, adding that it is "quite broad and inappropriately excludes" physicians practicing in outpatient centers and clinics from being eligible because their offices or clinics are located in facilities owned by the hospital system.

And, the senators wrote, the EHR rules allow "punitive treatment" of some hospitals that have multiple campuses, but one federal provider number.

"If the Medicare provider number is used to define a hospital, a healthcare system with multiple hospital sites [but a single Medicare provider number] would receive one incentive payment for the entire healthcare system. This disadvantages and penalizes hospital systems with only one provider number relative to hospital systems with multiple provider numbers," they wrote.

They added that they are concerned that the CMS proposed rule is "too restrictive and could result in many hospitals, particularly rural and safety-net providers, being financially penalized for an inability to comply."

"We urge you to modify your proposed definition of requirements for hospitals to become qualified as ‘meaningful users' of certified EHR technology," the senators added.

Another concern is that critical access hospitals, about 1,300 facilities with 25 acute care beds or less, are now excluded from being eligible for incentive payments even if they adopt qualifying meaningful use systems.

"CMS' exclusion of CAHs for the Medicaid incentive program is contrary to the statute and inappropriate."

The Senators asked also that CMS postpone quality reporting requirements for EHR because the current goals are "not yet possible to meet."


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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