The federal government's proposed moves to roll back some of its antikickback regulations won't help spur the use of health information technology as intended, according to members of the health IT community.
A public comment period for the CMS' proposed changes was scheduled to end today, and some groups, including the American Hospital Association, were ready to criticize the government's plan with comments before the deadline had passed.
"Hospitals will not feel confident that they can donate IT items and services without risk of prosecution," wrote AHA Executive Vice President Richard Pollack, in a Dec. 5 letter to HHS Inspector General Daniel Levinson. "The (inspector general's office) failure to provide an antikickback safe harbor imperils an important opportunity to increase physician use of EHRs and thereby significantly improve quality of care for patients. ... Without these changes, hospitals will not have the needed flexibility to work constructively with physicians to realize the promise of IT for improving quality of care."
Similarly, Scott Wallace, president and chief executive officer of the National Alliance for Health Information Technology, offered harsh criticism of the proposals in a Dec. 8 letter to the CMS. He wrote that the objective to combat Medicare fraud must be weighed against the potential "to save thousands of lives" by having interoperable electronic health-records systems in place to improve the quality of medical care.
"To focus solely on the potential for fraud and abuse is to see only half the picture," Wallace wrote, adding that, as proposed, the regulations do not advance the objective of interoperability. Another NAHIT executive, Bill Head, vice president of policy and government affairs, also said that the proposals would create awkward situations that he doesn't think "physicians will find all that enticing."
For example, the proposals would allow software to be donated to physicians for the purpose of electronic prescribing, but other applications that vendors bundle with e-prescribing systems would have to be stripped from the software, Head said.
Also, he said that a proposed requirement to have physicians certify that items and services they're receiving are not technically or functionally equivalent to items and services they already possess will make physicians wary of linking up with hospitals.
"Physicians are going to have to hire legal counsel to figure out 'Is my system the same?' or if a system that performs 20 functions is all that different than one that performs 26," Head said.
CMS spokeswoman Barbara Cebuhar said concerns that hospitals have about safe harbors for software donations will be duly noted. "We'll be analyzing the comments and expect that we will address those concerns in the final rule," she said.
At least one organization is supportive of the proposals. Tom Leary, director of federal affairs for the Healthcare Information and Management Systems Society, said that a HIMSS work group has suggested that the organization's board support the proposals as well as other government efforts to reduce barriers to health IT adoption.