Feds may extend an olive branch now that they're listening to EHR coding issues
There have been several articles written this week about talking points made by healthcare industry speakers at last Friday's "listening session" hosted by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator. At the session, representatives from several organizations--including the American Medical Association, the American Health Information Management Association and the American Hospital Association--were very vocal in outlining problems with electronic health record systems that can lead to enhanced coding. In particular, they expressed frustration with the allegations that providers are committing wide-spread billing fraud, and called for a code of ethics and national guidelines.
Interestingly, though, what CMS and ONC said is getting considerably less press.
Robert Tagalicod, CMS' director of e-Health Standards and Services, told those in attendance that the coding and EHR issue was "clearly important" to the U.S. Department of Health & Human Services, since it gets to the "core" of transforming healthcare delivery and payments.
Jonathan Blum, Deputy Administrator and Director for CMS' Center for Medicare, went even further, saying that CMS intends to study coding patterns with EHRs, comparing them to those with paper records, and would consider coding guidelines and payment policies to address the shift to EHR use. The industry may get some sorely needed help here.
Although Blum said that he would not make a commitment on policy change, he did state that CMS was "very interested in learning and listening." Policy change is not being dismissed out of hand.
He added that there are "a variety of things we can do together" to balance the tension between EHRs and coding. It's a spirit of cooperation.
This hardly is the first time that healthcare technology has evolved ahead of the rules, and the healthcare legal industry has to scramble to catch up. Look at telemedicine and physician licensure problems, or fertility treatments and child/embryo custody issues.
It's often easy to criticize the government. This time, however, I was rather impressed. This is a promising development. Maybe mainstream media and others won't be so quick to assume that thousands of nefarious providers are gaming the system at the expense of the hapless government and poor taxpayers.
It sounds like CMS and ONC aren't merely hearing what stakeholders have to say; they're paying attention.