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HITECH Act incentives still confuse some providers

New legislation aims to clarify who is eligible for HITECH Act incentives, but doctors say the law still doesn't go far enough to fund and promote EHR implementation.

For providers confused about whether they qualify for HITECH Act stimulus incentives, pending legislation may clarify things. Some say, however, that the act's language doesn't go far enough to help doctors and the law should be expanded to include more physicians.

The American Workers, State, and Business Relief Act of 2010, or H.R. 4213, extends Medicare payment rates to physicians and unemployment benefits to patients. Passed by both the Senate and House of Representatives, the bill also includes language that spells out which doctors qualify for HITECH Act incentives for adopting and using electronic health record (EHR) technology under the stimulus law.

The HITECH Act's language did not make it clear that outpatient physicians are eligible for incentives, according to the American Academy of Family Physicians (AAFP). What is clear, though, is that inpatient physicians employed by hospitals are not eligible. "The assumption is that the hospitals are already going to provide EHR connectivity," said Dr. Lori Heim, president of the AAFP's board of directors.

Still, eligibility is not as big an issue as the confusion still surrounding meaningful use requirements, Heim said. "I think everyone is trying to figure out meaningful use and how they'll qualify based on that."

The Centers for Medicare & Medicaid Services is reviewing the public comments it received on the proposed meaningful use rule, and hopes to release a final rule early this summer. Among the concerns from the AAFP and other provider associations is worry that the all-or-nothing approach to, and strict timeline for EHR implementation will hurt the initiative.

"Folks are realizing they have to move ahead," Heim said. But moving ahead depends on how the meaningful use criteria are constructed, she added: "It ought to be incremental."

Doctors are adopting EHR technology at an increasing rate, according to a survey of 180,000 physicians' offices. Most of the growth, however, is in larger practices, while smaller doctors' offices are unsure about what they should buy to comply with federal requirements, the survey said.

Legislation would expand eligibility for HITECH Act incentives

Still, although the issue for some doctors is which EHR system to buy, for others it's getting to participate in stimulus payments at all. Additional legislation, separate from H.R. 4213, has been introduced to expand HITECH Act incentives to behavioral health providers. The HITECH Extension for Behavioral Health Services Act of 2010, or H.R. 5025, seeks to extend incentives to practitioners in behavioral and mental health and substance abuse services and facilities.

Folks are realizing they have to move ahead.

Dr. Lori Heim, president of the board of directors, American Academy of Family Physicians

Mental health is a key area of health care, and providers shouldn't be excluded from receiving assistance in adopting health IT, said Sigurd Ackerman, a physician who is president and medical director of Silver Hill Hospital. The New Canaan, Conn.-based facility is integrating its electronic systems into a full EHR system from Medsphere Systems Corp.

Because of its low population of Medicare beneficiaries, Silver Hill itself would not qualify for many of the HITECH Act incentives, but mental health facilities in general need help getting started with health IT, Ackerman said. Training staff and helping medical teams adjust to the cultural changes that come with EHR implementation can be costly, however, and providers need a boost with those challenges, he added: "It's as important to the effectiveness of the system as the system itself."

Let us know what you think about the story; email Jean DerGurahian, News Writer.

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