What are they thinking?

Bernie Monegain

The October 4 letter four House leaders to Health and Human Services Secretary Kathleen Sebelius calling for a halt to the government's EHR Incentive Program seems to have come out of the blue.

Why now when the program is gaining momentum? Why now when every other industry has long ago made digital transactions of all kinds routine? Why now when healthcare is so long overdue for an overhaul, a move into the 21at Century.

The four congressmen, Ways and Means Committee Chairman Dave Camp (R-Mich.), Energy and Commerce Committee Chairman Fred Upton (R-Mich.), Ways and Means Health Subcommittee Chairman Wally Herger (R-Calif.), and Energy and Commerce Health Subcommittee Chairman Joe Pitts (R-Pa.), say it's because they are worried the government is squandering money by asking too little of providers. 

We have to wonder if they've talked with any providers? 

They also bring up recent reports that EHRs encourage "upcoding," potentially billing the government and insurance companies more for healthcare than they would have under the paper-based system. The question is are providers gaming the system, or are they "upcoding" to the correct code?

"We believe that the Stage 2 rules are, in some respects, weaker than the proposed Stage 1 regulations released in 2009," the House committee chairmen wrote. "The result will be a less efficient system that squanders taxpayer dollars and does little, if anything, to improve outcomes for Medicare."

"It is critical that your agency do everything possible to advance interoperability and meaningful use of HIT, not just in name only, the committee chairmen wrote in their letter. "More than four and a half years and two final Meaningful Use rules later, it is safe to say that we are no closer to interoperability in spite of the nearly $10 billion spent."

Two weeks later four Senators joined the chorus. Sens. Tom Coburn (R-Okla.), Richard Burr (R-N.C.), Pat Roberts (R-Kan.) and John Thume (R-S.D.) asked that CMS and ONC officials meet with Senate Finance and Senate Health, Education, Labor and Pensions Committees.

The meaningful use program was funded under the American Recovery and Reinvestment Act (ARRA) of 2009.  All eight lawmakers calling for scrutiny of meaningful use, voted "no" on ARRA.

While healthcare reform has been a political lightening rod, healthcare IT has enjoyed bipartisan support. We hope and expect that will continue. Perhaps the lawmakers inquiring into the details of meaningful use will take a page from the Bipartisan Policy Committee, where senators work across the aisle, so to speak.