Republican lawmakers continued their opposition to the meaningful use incentive program when six senators sent a letter and a detailed report to the Department of Health and Human Services (HHS) asking Secretary Kathleen Sebelius to address specific concerns and consider changes to the management of the program.
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In their report, the senators say there's a lack of progress toward interoperability in the meaningful use criteria, the possibility of increased costs through EHR use, insufficient oversight of the attestation process, risks to patient privacy and the uncertainty of maintaining the high costs of an EHR system once incentive payments run out.
"We have significant concerns with the implementation of the HITECH Act to date, including the lack of data to support the Administration's assertions that this taxpayer investment is being appropriately spent and actually achieving the goal of interoperable health IT," the letter states. It was signed by the authors of the report, Sens. Lamar Alexander (R-Tenn.), John Thune (R-S.D.), Pat Roberts (R-Kan.), Richard Burr (R-N.C.), Tom Coburn (R-Okla.) and Mike Enzi (R-Wyo.).
In addition to calling for stronger interoperability standards, the report recommends tightening oversight of the attestation process to prevent those who haven't met the meaningful use criteria from receiving incentive payments.
Reaction to the senators' letter was mixed. Fred Schulte, senior reporter for the Center for Public Integrity, who first reported the story, told SearchHealthIT there is some merit to the arguments. "People like the OIG [Office of the Inspector General] could learn from this report," he said.
Shulte pointed out that many of the issues raised in the report were previously discussed in his "Cracking the Code" series, which examined the ways in which EHRs may be contributing to higher Medicare claims.
But IT standards architect Keith Boone, who comments via social media platforms on health IT issues under the name Motorcycle Guy, sent a message on Twitter to SearchHealthIT objecting to the complaints in the report. In particular, the senators' insistence that meaningful use has done nothing to further interoperability standards is inaccurate, he said.
Boone pointed to the section of the stage 2 meaningful use rules that will require providers to send standardized electronic transition-of-care documents to other medical offices.
Republican lawmakers have been trying for several months to draw attention to what they see as flaws in the meaningful use program. In 2012 a group of four congressmen sent a letter to HHS officials stating they felt the stage 2 rules were weaker than the stage 1 rules and that this could waste taxpayers' investment in health IT. Two weeks later, four senators sent a similar letter to HHS asking administration officials for a meeting to discuss these concerns.