The Senate is moving to lift restrictions so that some hospital-based physicians can receive subsidies for the purchase of electronic health-record systems.
A draft of a multibillion-dollar jobs bill pending before the Senate contains an amendment that would remove those bans. The American Recovery and Reinvestment Act of 2009 bans some hospital-based doctors from receiving Medicare and Medicaid subsidies for EHRs under the "meaningful use" guidelines for such technology, according to an American Hospital Association spokesman.
"We're definitely supportive" of the amendments, said Don May, vice president for policy at the AHA.
The intent of the amendment is to relax restrictions to the EHR subsidy programs for hospital-affiliated outpatient practices made even more stringent by a CMS rule issued in late December 2009, May said.
Many hospital-affiliated clinics use an ambulatory EHR that is “completely different” than the hospital's own EHR system, but many doctors are unsure whether they qualify for federal subsidies for their systems, May said. "Everyone thought the intent of Congress was to allow this to happen, but the way CMS interpreted it was much more strict.”
Currently the stimulus law says a hospital-based professional "such as a pathologist, anesthesiologist or emergency physician, who furnishes substantially all of such services in a hospital setting" is not eligible for EHR subsidies under the ARRA program if they furnish "substantially all of such services in a hospital setting (whether inpatient or outpatient) and through the use of the facilities and equipment, including qualified electronic health records, of the hospital.”
The language in the draft of the jobs bill would amend that exclusionary provision to read: "substantially all of such services in a hospital inpatient or emergency room setting and through the use of the facilities and equipment, including qualified electronic health records, of the hospital."
By dropping the word "outpatient," the amendment appears to remove a number of hospital-based "outpatient" physicians from the exclusion for hospital-based physicians, an exclusion that otherwise would bar them from receiving EHR subsidy payments under the stimulus law.
The legislative package, designed to move quickly through the Senate and possibly the House, also carries along with it a number of healthcare provisions that otherwise would have been dealt with as part of broader reform bills.
The bill could be introduced Thursday.
Senate Majority Leader Harry Reid (D-Nev.) said that early signs indicate that the bill could garner some Republican support.
“I don't know of any sticking points at this stage,” he said. “I think we're in pretty good shape.”