March was a significant month for Medicare and Medicaid providers who hope to gain bonuses starting in 2011 under the American Recovery and Reinvestment Act (ARRA).
The federal government closed the comment period March 15 on two rules providers will have to meet – meaningful use and the standards rule. On March 9 the Department of Health and Human Services published the proposed electronic health record certification rules – one for a temporary certification and one for permanent – with comment periods ending April 9 and May 10, respectively.
When they are finalized, these rules together will hold keys to qualifications for incentives. The final rules on meaningful use and standards are expected to come out in late spring.
Opinions both for and against the standards and meaningful use rules have been strong.
Two hundred and forty-nine members of the U.S. House of Representatives sent a letter March 17 to the Centers for Medicare and Medicaid Services calling for a revision of the meaningful use requirements for hospitals.
"The EHR rule goes against the intent of Congress to reward those hospitals that already have taken important steps toward implementing EHR systems and to provide incentives to encourage further development," they said. "It proposes an ambitious all-or-nothing approach in which hospitals would be required to adopt all 23 separate EHR objectives, or requirements, that very few hospitals have yet been able to accomplish."
The Markle Foundation, the Center for American Progress, and the Engelberg Center for Health Care Reform at Brookings joined with healthcare leaders from 56 diverse organizations, urging the federal government to make its goals more explicit. The goals could be something simple, like improving medication management or reducing readmissions to hospitals, "so that everyone – including the public – can play a role in contributing to these priorities," they said.
Mark McClellan, MD, director of the Engelberg Center said healthcare IT should prioritize key quality and outcome reporting requirements, while also streamlining the administrative overhead.
At a March 17 HIT Policy Committee meeting, Steve Posnack, a policy analyst with the Office of the National Coordinator for Health Information Technology said ONC received 700 comment letters on the standards interim rule, with about 300 of them relevant.
Tony Trenkle, director of the CMS Office of E-Health Standards and Services has so far read almost half of the 2,000 comment letters received. Most of the letters were well thought-out, and reflected the need for balance, "which we have to do to get this off the ground and meet the larger policy goals," Trenkle said.
Closing the comment period is the end of part one of March Madness, he said.
