EHR vendors make pitch for easing Stark rules
MAKING A CASE for market-driven interoperability, Athenahealth has asked the CMS to let physicians pay each other for exchanging patient data.
Healthcare lacks interoperability not because of technological problems but because of business limitations, according to the company.
Athenahealth’s novel suggestion was part of a slew of comments the industry submitted to the Office of Inspector General, which asked for ideas on how to alter Stark and anti-kickback fraud and abuse laws, which prohibit one provider from making certain referrals to another provider if the two have a financial relationship.
If the CMS made carve-outs to the laws, it could help establish a “true functioning market for the exchange of health information,” Greg Carey, Athenahealth’s director of government and regulatory affairs, wrote in a letter to the OIG.
Carey cited finance, insurance, and auto parts as industries that allow their players to pay for data. “It is our experience that information exchange occurs best when there is a business case and problem to solve,” Carey wrote.
Exchanging information is costly, according to the company. “There is a cost associated with building and maintaining the technical infrastructure,” Carey told Modern Healthcare. “Our proposal would allow for the recipient of valuable data to compensate for the real cost incurred in curating and sending that data electronically.”
But how that would look in prac- tice remains to be seen. “I’ve seen no evidence that providers are hesitant to share clinical data because of a kickback concern,” said Michael Burger, senior consultant for Point of Care Partners. Athenahealth’s strategy could even backfire, he said. “By placing a cost on sharing of clinical data, what if the doctor doesn’t want to pay? Perhaps they would go without the data,” he said. “Or they may just say, ‘fax it to me.’”
The real business problem, he added, is that health systems don’t want patients going to outside providers.
In its letter to the OIG, Cerner Corp. asked the CMS and OIG to write into the EHR Safe Harbor that providers in Advanced Alternative Payment Models be allowed to donate and receive “electronic health record items and services,” including population health management and care coordination tools.
Similarly, the College of Healthcare Information Management Executives asked the OIG to allow providers to donate cybersecurity tools, especially to
● smaller provider organizations.