Citing the crush of an increasing workload and dwindling government funding, the Office of the National Coordinator has proposed a health IT user fee that would be imposed on health IT vendors who certify their products through the ONC Health IT Certification Program.
The HIMSS EHR Association opposes ONC's proposal.
"EHR developers are already devoting extensive resources to successful implementation of the EHR Meaningful Use Incentive Program and other healthcare delivery reform efforts, including the significant fees associated with EHR product certification," the group said in a statement.
"The fee would be a separate and dedicated resource that ONC would put right back into the administration of the certification program; to maintain, upgrade, and develop new electronic testing tools; develop new standards; and to ultimately improve the certification experience by making it faster and more efficient for the health IT developers that go through the certification process," ONC spokesman Peter Ashkenaz told Healthcare IT News. "The President’s budget proposes that the fee would need to be equitable. If Congress supports this proposal, ONC will work with industry to ensure the proposed fee creates the most value through a notice and comment rulemaking process."
The ONC further explains the reasoning for the fees – totaling as much as $1 million – in an appendix of the agency’s proposed 2014 budget.
The work to date has been funded with money from ARRA, the American Recovery and Reinvestment and Act, but the funding is set to expire at the end of 2013.
The health IT industry relies on ONC to administer a timely and reliable testing infrastructure and certification process for health IT products, the ONC writes. “Since the establishment of ONC’s Health IT Certification Program, the number of health IT vendors and the volume of health IT products submitted for certification has steadily increased. This workload is expected to increase in the coming years as ONC’s responsibilities associated with administering the Certification Program expand.”
The user fee would provide ONC with the resources necessary to pay for the program, the ONC notes, including administration; development of implementation guides and other technical assistance for incorporating standards and specifications into products; developemnt of health IT testing tools; and development of consensus standards, specifications and policy documents related to health IT certification criteria.
"Rather than the proposed user fee approach, we suggest that the Department of Health and Human Services evaluates whether all requirements in the meaningful use program and the associated certification activities are valuable and consistent with available federal and industry resources, and then streamline where appropriate," the EHR Association wrote in its statement.
The EHR Association's complete statement is on the next page.
EHR Association Position Statement
EHR User Fee as Proposed in President Obama’s FY 14 Budget
The EHR Association does not support the user fee for electronic health records (EHR) included in the President’s proposed 2014 budget. EHR developers are already devoting extensive resources to successful implementation of the EHR Meaningful Use Incentive Program and other healthcare delivery reform efforts, including the significant fees associated with EHR product certification. Adding costs to the healthcare system at a time when providers already feel significant effects from several new legislative and regulatory programs, including payment cuts, is not an approach consistent with the government's larger goals of fostering broad health information technology adoption to support healthcare delivery system reform.
Rather than the proposed user fee approach, we suggest that the Department of Health and Human Services evaluates whether all requirements in the meaningful use program and the associated certification activities are valuable and consistent with available federal and industry resources, and then streamline where appropriate. This is especially important as the industry considers the scope and depth of meaningful use Stage 3 as balanced against the infrastructure and tactical work that would be required for successful deployment.
At the same time, we encourage Members of Congress to ensure that they are appropriating sufficient funds to the Office of the National Coordinator to enable execution of the critical programs they have been asked to roll out. The adoption of standards-based, interoperable health information technology benefits many stakeholders, including providers, payers and most importantly, patients and their families.
