Lawmakers Send Letters to Federal Officials About Health IT Efforts

March 7, 2014 in News

This week, lawmakers sent four separate letters to federal officials asking for more information regarding the meaningful use program.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.

House GOP Letters to CMS, OIG

Lawmakers on the House Energy and Commerce Committee sent separate letters to CMS Administrator Marilyn Tavenner and HHS Inspector General Daniel Levinson seeking information about how the agencies screen providers claiming to attest to meaningful use before administering federal funds, EHR Intelligence reports.

The letters come after Joe White, former CFO of the now defunct Shelby Regional Medical Center in Texas, was indicted for allegedly defrauding the federal government of nearly $800,000 in meaningful use payments (Murphy, EHR Intelligence, 3/3).

The letters were signed by:

  • Fred Upton (R-Mich.), chair of the committee;
  • Joe Barton (R-Texas), chair emeritus of the committee; and
  • Michael Burgess (R-Texas), vice chair of the committee (Durben Hirsch, FierceEMR, 3/4).

In the letter to CMS, the lawmakers asked Tavenner to provide details on:

  • Actions CMS has taken to use other federal databases, such as the General Systems Administration database, to screen providers;
  • CMS’ authority for stopping payments to a provider or recipient being investigated for fraud;
  • The number of Medicare provider revocations that have occurred since Jan. 1, 2004; and
  • The status of CMS’ efforts to use predictive modeling.

The letter also asked:

  • If CMS is working with FDA on lists for debarment and disqualification;
  • If the Zone Program Integrity Contractors has been successful in improving provider screening over the past year; and
  • How CMS guarantees that it is alerted to credible allegations of fraud.

In the letter to the HHS Office of Inspector General, the lawmakers asked Levinson about recommendations on how CMS could improve the screening process, including specific actions OIG has taken to review the current process.

Tavenner and Levinson were asked to respond by March 12 (Pedulli, Clinical Innovation Technology, 3/6).

They also were also asked to attend a congressional briefing on the issue this month (EHR Intelligence, 3/3).

Senate GOP Letter to CMS

Meanwhile, six Republican senators on Thursday sent a letter to Tavenner asking for more details on the “hardship exemptions” the agency will grant for providers that need more time to meet meaningful use Stage 2 requirements (Senate HELP release, 3/6).

At the Healthcare Information and Management Systems Society’s annual conference last week, Tavenner announced that the agency would offer more flexibility in hardship exemptions for Stage 2 of the meaningful use program (iHealthBeat, 2/28).

However, few details have been released on how the exemptions will be administered.

The letter was signed by:

  • Lamar Alexander (R-Tenn.);
  • Richard Burr (R-N.C.);
  • Tom Coburn (R-Okla.);
  • Mike Enzi (R-Wyo.);
  • Pat Roberts (R-Kan.); and
  • John Thune (R-S.D.).

In September, 16 Republican senators sent a letter to HHS Secretary Kathleen Sebelius requesting a one-year extension of Stage 2 of the meaningful use program.

In the new letter, the senators said they were “disappointed” with the agency’s decision not to delay Stage 2 and “the lack of clarity about how the exemptions will be administered.”

Specifically, the letter called for details on:

  • How the current categories for exemptions will be expanded;
  • The documentation needed to obtain an exemption;
  • Timing for review; and
  • The appeals process (Senate HELP release, 3/6).

Calif. Lawmakers’ Letter to CMS, ONC

In related news, 24 California lawmakers in a letter to Tavenner and National Coordinator for Health IT Karen DeSalvo expressed support for using Stage 3 of the meaningful use program to reduce health disparities, Government Health IT reports (Manos, Government Health IT, 3/7)

They wrote, “Health disparities are a pervasive and costly problem,” adding, “Through the development of the Stage 3 meaningful use criteria, [the Office of the National Coordinator for Health IT] has an immediate opportunity not only to make an extraordinary difference for the millions of patients, families and caregivers experiencing health disparities, but to improve the quality, safety and efficiency of America’s health care system as a whole” (Murphy, EHR Intelligence, 3/7).

Specifically, the letter recommends that CMS:

  • Develop more comprehensive and inclusive data collection standards to track disability status, sexual orientation and gender identity variables;
  • Require that data collected by EHRs can be stratified by disparity in order to facilitate health care improvements; and
  • Ensure that EHRs have the functionality to improve health literacy and communication; and
  • Ensure that patients can access their health data on smartphone devices (Walsh, Clinical Innovation Technology, 3/6).
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