Congress Includes EHR Interoperability Warning in SGR Fix Bill
By - Congress is taking a very hard look at EHR interoperability this spring by proposing several significant changes to the way the healthcare industry approaches the sharing of information between health IT systems. In addition to a discussion draft released earlier this month that suggests regulatory changes within the Department of Health and Human Services, a newly introduced bill to repeal and replace the Medicare sustainable growth rate (SGR) hopes to bring new rigor to the process of measuring EHR interoperability in accordance with Congressional goals.
Historically, the annual wrestling match over the SGR has left more than a few stakeholders bloodied and bruised. Each year since 1997, Congress has needed to make incremental adjustments for a flawed formula for determining the rate of Medicare reimbursements, leading to loud and frequent calls for a permanent fix that would prevent a cut of more than 25 percent in payment rates. In 2014, those calls almost succeeded, but instead of celebrating a permanent solution, providers were left scratching their heads at a surprise delay to ICD-10 implementation and yet another one-year patch to the SGR.
This year, one proposal to remedy the SGR problem includes no mention of ICD-10, but does put EHR interoperability in the spotlight. The bill requires HHS to establish interoperability metrics to measure the industry’s progress, delivering the goals to Congress by July 1, 2016.
“If the Secretary of Health and Human Services determines that the objective…has not been achieved by December 31, 2018, then the Secretary shall submit to Congress a report, by not later than December 31, 2019, that identifies barriers to such objective and recommends actions that the Federal Government can take to achieve such objective,” the bill adds.
“Such recommended actions may include recommendations to adjust payments for not being meaningful EHR users under the Medicare EHR Incentive Programs and for criteria for decertifying certified EHR technology products.”
This is not the first time Congress has raised the issue of decertifying EHR technology that does not actively promote health IT interoperability. In the $1.1 trillion 2015 omnibus appropriations bill passed at the end of 2014, Congress directed the ONC to “use its authority to certify only those products that clearly meet current meaningful use program standards and that do not block health information exchange.”
“ONC should take steps to decertify products that proactively block the sharing of information because those practices frustrate congressional intent, devalue taxpayer investments in CEHRT, and make CEHRT less valuable and more burdensome for eligible hospitals and eligible providers to use,” the bill added.
A number of stakeholders have questioned the purpose of spending billions of dollars in incentive payments for healthcare providers if the past six years since the creation of the EHR Incentive Programs have done so little to advance EHR interoperability, but Congress hopes to study the issue before coming to any damning conclusions.
The SGR fix bill asks HHS to collect input from meaningful use participants to help providers select and implement EHR technology that does make a positive impact on interoperability, and also requires HHS to deliver a report on suggested methods to alleviate blockages in health information exchange by the end of 2019, one year after Stage 3 meaningful use enters its prime.
Healthcare providers will be required to implement more robust and advanced EHR technology in pursuit of Stage 3, which may help to achieve some of the results Congress is looking for before its deadline passes.
