A recent survey indicates that steps by the federal government to make it easier for hospitals to pay for physicians information technology has not boosted IT use, though industry officials are anticipating help on the matter from the Internal Revenue Service.
Nearly two out of three chief information officers in the survey indicated that federal actions taken last year giving hospitals a safe harbor from the federal anti-kickback law and exceptions to the Stark laws barring remuneration for referrals have not prompted hospitals to fund or extend their healthcare IT systems to physicians.
Last August, HHS inspector generals office released a long-awaited safe harbor from anti-kickback statutes for IT investments. Simultaneously, the CMS published similar Stark exceptions.
But in a February Web survey of members of the College of Healthcare Information Management Executives, 62% of the 117 who participated indicated they have no plans to take advantage of the new Stark exception and anti-kickback safe harbor laws, according to a CHIME news release. The other 38% indicated they do plan to avail themselves of the leeway granted by the rule changes.
The relaxation of the rules was taken in hopes that it would boost clinical IT adoption by office-based physicians, where the adoption of full-function electronic medical-records systems remains in the 10% to 20% range, according to several surveys.
In a section on the CHIME survey reserved for written comments, respondents indicated one concern was with the change of party control in Congress and whether the exceptions might be altered or reversed, according to Anne Wizauer, spokeswoman for the group.
In addition, a major concern is the IRS possibly questioning 501(c)(3) status, Wizauer said, referring to the section of the tax code that gives many hospitals tax-exempt status. The IRS requires donations from tax-exempt hospitals to primarily serve a public benefit, not a private interest.
But Melinda Hatton, general counsel for the American Hospital Association, said she is hopeful the IRS will soon rule favorably on the IT assistance program. In November 2006, the AHA sent a letter to the IRS asking for guidance on the matter, and AHA staffers have discussed it with IRS officials since.
Our impression is the IRS staff has been very supportive of that issue, and we really expect there to be some guidance coming out in the foreseeable future that will be supportive of the regulations, Hatton said. We hope that issue will be taken off the table.
One possible way of handling the problem is for individual hospitals to ask for specific rulings on their programs, but Hatton said, I think the IRS would really like to deal with this as a policy issue, so a broader approach from the tax agency is more likely.