Feds Want to Extend Stark Law Exception

The Obama administration has proposed two rules to extend protections that allow hospitals to donate electronic health record technology to physicians who refer patients to their facility, The Hill's "RegWatch" reports (Goad, "RegWatch," The Hill, 4/8).

Background

The Stark Law bans payments that are aimed at encouraging referrals to hospitals. In addition, the federal anti-kickback law prohibits payments that are designed to influence care for Medicare beneficiaries.

However, in an effort to encourage physicians to adopt costly EHR systems:

• CMS established an exception to the Stark Law allowing hospitals to donate EHR software to physicians; and
• HHS' Office of Inspector General established a "safe harbor" provision to protect such EHR donations from anti-kickback enforcement, provided that the physicians cover 15% of the cost of the EHR technology.

The exceptions to the Stark and anti-kickback laws are scheduled to expire at the end of 2013 (iHealthBeat, 3/29).

Details of Proposed Rules

The Obama administration's proposal includes:

• A proposed rule from CMS that would extend the Stark Law exception for EHR donations to the end of 2016; and
• A proposed rule from OIG that would extend the safe harbor protections for EHR donations to the end of 2016 (Durben Hirsch, FierceEMR, 4/9).

 

In addition to extending the EHR donation protections, the new proposed rules would remove an electronic prescribing requirement from the original rules and adjust language regarding the types of EHR systems that qualify for exceptions (Conn, Modern Healthcare, 4/9).

OIG in its proposed rule said, "We expect these proposed changes to continue to facilitate the adoption of electronic health recor[d] technology" ("RegWatch," The Hill, 4/8).

CMS in its proposed rule said that it is considering extending protections for EHR donations to Dec. 31, 2021, to align with the end of the Medicaid portion of the meaningful use program.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicaid and Medicare incentive payments.

Publication, Public Comments

The two proposed rules are scheduled to be published in the Federal Register on Wednesday.

Federal officials will accept public comment on the proposed rules for 60 days after their publication (Murphy, EHR Intelligence, 4/9).

Read more: http://www.ihealthbeat.org/articles/2013/4/9/federal-officials-seek-to-extend-protections-for-ehr-donations.aspx#ixzz2PzgTjelu

Survey says EHR adoption faster than expected

Erin McCann

Family physicians are adopting electronic health records (EHRs) at a much faster rate than previous data suggested, reaching a nearly 70 percent adoption rate nationwide, new study findings reveal. 

The study, published in the January/February issue of the Annals of Family Medicine, shows EHR adoption by family physicians has doubled since 2005, with researchers estimating that the adoption rate will exceed 80 percent by 2013.  

Findings also reveal a higher percentage of EHR adoption among physicians in comparison to a July 2012 study conducted by the CDC's Center for National Health Statistics, which reported that 55 percent of office-based physicians had adopted EHRs.

EHR adoption rates among family physicians, however, have also been shown to be higher than other office-based specialities. One November study, for example, reported that pediatricians had some of the lowest adoption rates of EHR systems, with a paltry 41 percent indicating they had EHRs.   

[Related: 7 ways meaningful use grew deeper roots in 2012]

Researchers also point to geographical differences in EHR adoption rates. Georgia, Massachusetts, Minnesota, New Hampshire, Oregon and Utah, for example, had significantly higher adoption rates in comparison to states with much lower numbers such as Florida, Illinois, Michigan and Ohio.   

According to study co-author Andrew Bazemore, MD, director of the Robert Graham Center for Policy Studies in Primary Care, report findings offer "some encouragement that we have passed a critical threshold," HealthDay reported.   

Utah family physicians had the highest EHR adoption rates in the country, pegged at nearly 95 percent statewide, according to the study, but Bazemore said, "More work is needed, including better information from all of the states."  

North Dakota ranked lowest among the 50 states, with an overall EHR adoption rate of only 47 percent. 

The study was conducted by researchers at the Association of American Medical Colleges, Georgetown University Medical Center, National Center for Health Statistics, University of Colorado Denver, The Robert Graham Center for Policy Studies in Family Medicine and Primary Care and Medstar Franklin Square Hospital.

NFL Moves to EHRs

The National Football League (NFL) will make the switch from paper to electronic health records, contracting with ambulatory vendor eClinicalWorks to serve 32 teams nationwide.

"The health and safety of our players continues to be our number one priority," Brian McCarthy, NFL's vice president of communications, tells Healthcare IT News. "We want to provide team medical staff with the latest technology that will help with their care and treatment of players in real time at the team facility, in the locker room [and] on the sidelines. This solution will help medical staff with secure real-time information to make decisions that will benefit the player."

“The NFL prides itself in staying ahead of current healthcare developments,” said Anthony Yates, MD, president of the NFL Physicians Society, in a statement.

Yates, a physician at UPMC and team doctor for the Pittsburgh Steelers, is also a member of member of the EMRCommittee for the National Football League.

“We are always looking for innovative ways to enhance the organization," he said. "Electronic health records are the next logical step, and we look forward to partnering with eClinicalWorks on this initiative."

The NFL is implementing EHRs across the organization to streamline processes between locations and coordinate care, officials say. All 32 teams will have access to the EHR system, which will be accessible at stadiums during games, on the sidelines and at the training facilities.

Girish Kumar Navani, CEO and co-founder of Westborough, Mass.-based eClinicalWorks, says this implementation has some similarities to certain other ambulatory EHR deployments.

"It’s not very different in capabilities from an orthopedics and physical therapy clinic," he says. "eClinicalWorks has had orthopedic and physical therapy components within the EHR, so this will be the same system as we traditionally implement, with a few added features."

Still, Navani says that "extensive club visits" have led to the incorporation of some capabilities to the EHR that reflect "the uniqueness of the NFL."

One big difference? "In this implementation, there will be a direct video feed from the NFL for players, play-by-play, and we are integrating these feeds into the EHR," he says. "The League will be able to view video footage in the EHR of the injury occurring, which will help with treatment plans and follow-up once the player is off the field."

And, of course, there are other features necessary for an EHR tailored toward athletes playing a dangerous game, where injuries are common. "The EHR will connect with labs, radiology, PACS imaging and a concussion app," says Navani.


http://www.healthcareitnews.com/node/56101

Survey: When it Comes to EHRs, U.S. is on the Right Track

Gabriel Perna, www.healthcare-informatics.com

A new study from the Commonwealth Fund and Harris Interactive has found that physicians from the United States have made progress in adopting EHRs when compared to similarly developed countries. The study compared the attitudes and thoughts of primary care physicians from the US, Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, and the United Kingdom.

According to the survey, which was conducted between March and July 2012 and appears in the journalHealth Affairs, 69 percent of US doctors report the use of EHRs. This puts them in the same realm as physicians from France and Germany. Above them are physicians from the Netherlands, Australia, New Zealand, Norway, and the U.K. The survey’s authors found that the spread of EHR usage in both the US and Canada has been “rapid” since 2009.

In addition, the survey's authors found that in places where EHR usage is commonplace, physicians routinely electronic order entry for lab tests and prescription drug. On the other hand, decision support was less common. In terms of multifunctional EHR capacity, the U.K. ranked near the top, while the US had much a lot of progress since the last survey from this group in 2009.

In terms of information exchange capability, New Zealand practices ranked near the top with 55 percent of physicians reporting the ability to do this, while Canada was ranked at the bottom.

Along with information on health IT usage, the survey looked at the attitudes of physicians from these various countries. In this realm, US physicians were ranked dead last. Only 15 percent of US physicians thought their system worked well. Germany was next with only 22 percent of their physicians thought that system was a good fit.