WASHINGTON – Hospitals are up in arms about what they consider unfair treatment in the meaningful use rule that will prevent them from earning millions of dollars in incentives. But it appears Congress might come to their rescue.
Rep. Zack Space (D-Ohio) introduced the Electronic Health Record Incentives for Multi-Campus Hospitals (H. R. 6072) on July 30 that would allow each hospital in a multi-campus organization to qualify separately for meaningful use incentives.
According to the final meaningful use rule, the hospital EHR incentive payment formula incorporates both a $2 million base amount and a $200 per discharge amount for the 1,150th through 23,000th discharge. The bill would allow health systems to choose whether they want to receive base payments for each campus and one per-discharge sum, or one base payment for the entire organization with additional per-discharge amounts for each campus.
Sen. Charles Schumer (D-N.Y.) introduced a matching Senate bill (S. 3708) on Aug. 5. Both bills have been referred to committees for consideration, but little action will likely be taken on them until Congress returns from recess on Sept. 13.
American Hospital Association Vice President Rick Pollack applauded the bills.
"Providing these payments to only one hospital in a multi-hospital system would not accurately account for the implementation and training costs of EHRs across different institutions; nor would it accurately reflect differences in clinical services provided at different sites," he said.
Premier alliance leaders said more than 50 Premier alliance hospital systems representing more than 100 inpatient facilities are affected by what they call a "methodological error" in the meaningful use rule, unless Congress can change things.
Tony Trenkle, director of the Office of E-Health Standards and Services at the Centers for Medicare and Medicaid Services (CMS) said CMS carefully reviewed comments and met with interested stakeholders, including the two largest hospital associations – the American Hospital Association and the Federation of American Hospitals – to hear their concerns when the rule was proposed.
"Taking this input as well as the legislative language of the Recovery Act into account, we came to the conclusion in our final rule that we should define "subsection (d) hospital" in alignment with how we have defined that term in other situations," Tenkle told a congressional panel.
Trenkle said "other situations" include the Medicare Disproportionate Share payment program.
Because the government could get sued for treating hospitals one way, as in the DSH program, and another way in the EHR incentives program, Trenkle said, CMS would need a law from Congress to change how hospitals are defined for reimbursement purposes.
