The Senate Finance Committee began marking up a bill meant to adjust meaningful-use requirements for physicians using ambulatory surgery centers.
The Electronic Health Fairness Act is bipartisan legislation that would adjust meaningful-use requirements of the federal electronic health-record incentive payment program and protect providers who use ASCs from possible Medicare reimbursement penalties.
In 2015, physicians became eligible for a piece of the $30 billion EHR incentive pie if they performed at least half of their outpatient procedures in a setting with a certified EHR. Failure to meet the meaningful-use requirements could mean reduced future Medicare reimbursements of 1% up to 5%.
ASCs were excluded from qualification for EHR incentive payments. As a consequence, many of the EHRs used by physicians in ASCs have not been tested and certified for use in the program.
But in calculating the 50% meaningful-use requirement under the current rules, physicians who actively or exclusively use ASCs for surgery would have to count patient visits at ASCs when measuring the percentage of visits, even if they occurred at an ASC without a tested or certified EHR.
The incentive payment program rule as it stands today “really places a burden, and a disincentive, to use the ambulatory surgery center,” said Dr. Scott Ketover, president and CEO of Minnesota Gastroenterology, a multisite group practice with multiple endoscopy clinics.
Ketover says the meaningful-use rule could wind up financially penalizing patients and taxpayers as well.
“Physicians have started moving their patients away from the ASC to the hospital campus where the charges are often higher than the ASC,” he said.
According to the group Advancing Surgical Care, ASCs are paid 55% of the amount paid to hospital outpatient departments. They give an example of outpatient cataract surgery, where Medicare pays hospitals $1,670 while paying ASCs only $964.
The bill being considered by the Senate Finance Committee today “excludes ASC services from being counted toward the 50% meaningful-use eligibility threshold” until tested and certified EHRs are available for ASCs. The exclusion would end three years after the Office of the National Coordinator for Health Information Technology creates standards for EHRs in ASCs.
“This legislation takes off the burden on the part of the provider figuring out where to treat their patients,” Ketover said.
Ketover said his group practice is a 13-year user of an EHR from NextGen Healthcare Information Systems, Irvine, Calif., which has been modified for use at an ASC.
The EHR has been tested and certified, so the pending legislation would have no impact on his group, Ketover said, but “there are a lot of practices struggling with this.”