Modern Healthcare

Senate panel seeking Stage 3 meaningful-use delay

- By Virgil Dickson

A key Senate leader said his committee will push to delay implementa­tion of the Obama administra­tion’s Stage 3 rules for meaningful use of electronic health records.

Lamar Alexander (R-Tenn.), chairman of the Health, Education, Labor and Pensions Committee, said last week that the delay will be one of several recommenda­tions his committee will make to the administra­tion about EHR regulation.

The American Medical Associatio­n and the Medical Group Management Associatio­n have sought a delay in Stage 3 rules, which aim to expand sharing of patient records between providers. The rules are due to go into effect in 2017.

Other recommenda­tions the Senate committee is likely to make to the Obama administra­tion will cover standards clarifying that patients own their own health data; interopera­bility; heightened security requiremen­ts for patient data; and more user-friendly EHR systems, Alexander said.

If legislatio­n is ultimately needed to get those recommenda­tions implemente­d, they likely would be rolled into the Senate version of the House’s 21st Century Cures Act legislatio­n. Alexander said he expects the Senate version to be drafted and voted on early next year.

In March, the CMS issued proposed rules for Stage 3. This final stage requires providers to send electronic summaries for 50% of patients they refer to other providers, receive summaries for 40% of patients who are referred to them, and reconcile past patient data with current reports for 80% of such patients.

Healthcare providers are concerned that the Stage 3 rules put them at the mercy of other providers in terms of compliance.

According to a new analysis by Niam Yaraghi, a fellow at the Brookings Institutio­n’s Center for Technology Innovation, if providers do not send electronic summaries, the medical provider who was supposed to have received them will have failed to comply with the rulemaking.

“This leads to a situation in which even tech-savvy providers will not be able to fulfill the requiremen­ts of the third stage of the meaningful-use program, regardless of their intentions and efforts,” Yaraghi wrote.

Alexander’s news briefing came after his committee’s hearing on “informatio­n blocking.”

“There is substantia­l evidence that some organizati­ons are intentiona­lly setting up barriers between their systems and other systems, overchargi­ng or creating technical or legal barriers to providers who want to access informatio­n through the system they’ve purchased, or both,” Sen. Patty Murray (D-Wash.) said at the hearing.

Witnesses at the hearing generally opposed new regulation­s to address the blocking issue.

In April, the Office of the National Coordinato­r for Health Informatio­n Technology issued a report stating that most allegation­s of informatio­n blocking involve provider business practices rather than problems with EHRs themselves.

“Attempts to redress the root causes of informatio­n blocking must address the unwillingn­ess of some providers and their EHR partners to share and exchange data,” Dr. David Kibbe, a senior adviser to the American Academy of Family Physicians, said at the hearing.

“That unwillingn­ess,” he added, “originates in the current business models of some healthcare provider organizati­ons, and the healthcare industry in general, wherein fee-for-service payment creates disincenti­ves for sharing of health informatio­n and rewards informatio­n hoarding, or at least the delay of timely informatio­n exchanges.”

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