HHS removes health IT hurdle

Originally posted at 1:42 p.m. and updated at 4:43 p.m.

(Updated) The Health and Human Services today announced final rules that should advance the use of electronic health records and electronic prescribing by creating exceptions to fraud-and-abuse laws.

The creation of exceptions to the Stark anti-fraud and anti-kickback laws, which govern physician self-referral of Medicare patients, are designed to let hospitals help physicians acquire health IT. Under the exemptions, hospitals may provide hardware, software and training to physicians who refer patients to them, which currently is illegal.

The final rules will be published in the Federal Register Aug. 8. It becomes effective in 60 days.

By removing barriers, the regulation changes will help physicians get health IT systems in place faster, according to HHS secretary Mike Leavitt.

"Hospitals desire to have more adoption by small- and medium-sized physicians simply to assure that their systems are populated with the data necessary to serve patients. And there are many small- to medium-sized providers who have been waiting to let the systems mature before buying," Leavitt told reporters in a teleconference.

Hospitals know that efficiency requires investment and there is substantial evidence that health IT will produce those savings when integrated into a system that allows physicians and hospitals to exchange patient data.

"This is going to take time to materialize, but it will take longer and be more expensive if we don't begin with the building blocks of interoperability as opposed to having to migrate there later," Leavitt said.

HHS is accelerating use of e-health records and other health IT to reduce medical mistakes and costs, as well as improve the quality of care. Under the Stark rule changes, health IT systems must ultimately be able to exchange health information.

Leavitt hopes that lawmakers also will consider the HHS rule as a roadmap for their deliberations on reconciling two health IT bills and balance the competing influences of rapid adoption and interoperability. The difference centers on language that in Senate bill S. 1418, the Wired for Health Care Quality Act, requires interoperability. The House-passed H.R. 4157, the Better Health Information System Act, does not.

'And because statute trumps rule, the absence of it [interoperability] would be significant,' Leavitt said.

The final rules announced today by HHS' Centers for Medicare and Medicaid Services and the Office of the Inspector General create new exceptions and safe harbors under the physician self-referral law, which prohibits a physician from referring Medicare patients for certain health services to hospitals with which the physician has a financial relationship.

'These final rules will improve care by giving doctors and other health care providers needed support for interoperable health records that enable them to increase quality and improve efficiency,' said CMS administrator Mark McClellan.

The OIG rule establishes two new safe harbors under the federal anti-kickback statute. Arrangements involving the provision of items and services that meet the requirements of the safe harbors are exempt from enforcement action under the federal anti-kickback statute related to e-prescribing, as well as electronic health records systems.

The rules finalize an exception and safe harbor for the provision of e-health records information that is more expansive than that first proposed last year. The Medicare Prescription Drug, Improvement and Modernization Act, however, mandated exceptions and safe harbors for e-prescribing.

About the Author

Mary Mosquera is a reporter for Federal Computer Week.

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