The Medical Group Management Association, in a sharply worded, five-page letter to David Blumenthal, head of HHS' Office of the National Coordinator for Health Information Technology, warns of potential dire consequences if the government overreaches in setting up the health IT subsidy program created under the American Recovery and Reinvestment Act of 2009.
The letter, dated Nov. 22 and released publicly today, was signed by MGMA President and CEO William Jessee.
Jessee spoke of deep concerns that a possible “inappropriate definition of meaningful use” and “inefficient administration” of an IT subsidy program under the federal stimulus law could “result in the needless squandering of resources and significant disruption to the nation's healthcare system.”
To qualify for an estimated $34 billion in federal reimbursements to purchase, install and maintain electronic health-record systems, providers, including physician-led groups, must demonstrate that they not only have the systems up and running, but also that they're being used in a “meaningful manner,” and those so-called “meaningful use” criteria be stiffened over time.
The stimulus law, however, gives only a partial definition of the term “meaningful use.” A proposed rule from the CMS fleshing out the definition is expected before the end of the year, but an HHS federal policy advisory committee established under the law and reporting to the national coordinator has held a series of meetings on meaningful use and has issued a matrix of recommendations on what should be included as meaningful-use criteria.
Jessee's letter extensively addresses the upcoming meaningful-use criteria, but also calls for specific procedural measures in administration of the subsidy program, such as running a pilot program before the 2011 “payment year” arrives “to ensure that the process of demonstrating meaningful use is achievable and practical.”
The letter also recommends a “close monitoring of the EHR marketplace to ensure that appropriate and cost-efficient products are being offered to physicians,” noting that the stimulus law requires the ONC to support the development of a low-cost EHR if the market fails to produce a system to meet providers' needs.
“We urge HHS to aggressively scrutinize the EHR vendor sector, establishing toll-free telephone numbers and a Web site allowing physician practices and others to report problems, issues and unfair business practices,” Jesse wrote.