Bills seek to expand meaningful use, allow non-certified EMRs; Orthopedists call standards inappropriate

Once again, members of Congress, unsatisfied with the scope of "meaningful use," are seeking to expand eligibility for federal EMR subsidy payments, while more criticisms of the final CMS rule are emerging.

To nobody's surprise, the two senators from Rhode Island, Sheldon Whitehouse and Jack Reed, both Democrats, have introduced a Senate version of the legislation to open up incentives to mental health, behavioral health and substance-abuse treatment facilities professionals. Currently, psychiatrists, who are physicians, can qualify for meaningful use, but psychiatric hospitals, clinical social workers and substance-abuse programs are excluded.

The bill, the Health Information Technology Extension for Behavioral Health Services Act of 2010 (H.R. 5040), is a companion to a House proposal introduced by Reps. Patrick Kennedy (D-R.I.) and Tim Murphy (R-Pa.) in April, but, unlike the House version, it would not create a new grant program for mental health, InformationWeek reports.

A more radical proposal comes from Rep. Michael C. Burgess (R-Texas). The Ensuring Equality for Early EHR Adoption Act of 2010 (H.R. 6005) would allow providers to qualify for meaningful use in 2011 and 2012 even if their EMRs were not certified. They would have to have certified products by 2013 to continue to receive incentive payments.

The legislation has the strong support of the American Hospital Association. "[E]ven the early adopters this program was designed to recognize--those hospitals already using EHRs--will need to upgrade or replace existing systems with certified products in order to be eligible for incentives. Moreover, the certification process is not yet up and running, so no certified products are available to any provider at this time," AHA Executive VP Rick Pollack writes in a letter to Burgess. "Your bill would help to alleviate this situation by providing for the temporary treatment of certain EHR products as certified for purposes of EHR payment incentives."

Meanwhile, the American Academy of Orthopaedic Surgeons effectively declared the final rule on meaningful use inappropriate for its membership. "Orthopaedic surgeons will have great difficulty in meeting the current 25 meaningful use standards. Orthopaedics would derive greater benefits from standards promulgated by our medical specialty society rather than a set of generic requirements that mostly do not apply to musculoskeletal patient care," Dr. Thomas C. Barber, leader of the AAOS EMR Project Team, says in an article published in AAOS Now, an academy newsletter.

To learn more:
- read this InformationWeek story about the Whitehouse-Reed bill
- view the text of H.R. 5040
- check out this DOTmed News story about Burgess' legislation
- see the text of that bill
- read Pollack's letter to Burgess (.pdf)
- take a look at this article in AAOS Now

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