The American Hospital Association has sent a letter to Congress asking members to reduce regulatory burdens for Medicare providers, including mandates affecting a wide range of health IT services.
The letter, which is addressed to the House Ways and Means Health subcommittee, notes that in 2016, CMS and other HHS agencies released 49 rules impacting hospitals and health systems, which make up nearly 24,000 pages of text.
“In addition to the sheer volume, the scope of changes required by the new regulations is beginning to outstrip the field’s ability to absorb them,” says the letter, which was signed by Thomas Nickels, executive vice president of government relations and public policy for the AHA. The letter came with a list of specific changes AHA is proposing.
Proposals of potential interest to health IT leaders include the following. The AHA is asking Congress to:
- Expand Medicare coverage of telehealth to patients outside of rural areas and expand the types of technology that can be used. It also suggests that CMS should automatically reimburse for Medicare-covered services when delivered via telehealth unless there’s an individual exception.
- Remove HIPAA barriers to sharing patient medical information with providers that don’t have a direct relationship with that patient, in the interests of improving care coordination and outcomes in a clinically-integrated setting.
- Cancel Stage 3 of the Meaningful Use program, institute a 90-day reporting period for future program years and eliminate the all-or-nothing approach to compliance.
- Suspend eCQM reporting requirements, given how difficult it is at present to pull outside data into certified EHRs for quality reporting.
- Remove requirements that hospitals attest that they have bought technology which supports health data interoperability, as well as that they responded quickly and in good faith to requests for exchange with others. At present, hospitals could face penalties for technical issues outside their control.
- Refocus the ONC to address a narrower scope of issues, largely EMR standards and certification, including testing products to assure health data interoperability.
I am actually somewhat surprised to say that these proposals seem to be largely reasonable. Typically, when they’re developed by trade groups, they tend to be a bit too stacked in favor of that group’s subgroup of concerns. (By the way, I’m not taking a position on the rest of the regulatory ideas the AHA put forth.)
For example, expanding Medicare telehealth coverage seems prudent. Given their age, level of chronic illness and attendant mobility issues, telehealth could potentially do great things for Medicare beneficiaries.
Though it should be done carefully, tweaking HIPAA rules to address the realities of clinical integration could be a good thing. Certainly, no one is suggesting that we ought to throw the rulebook out the window, it probably makes sense to square it with today’s clinical realities.
Also, the idea of torquing down MU 3 makes some sense to me as well, given the uncertainties around the entirety of MU. I don’t know if limiting future reporting to 90-day intervals is wise, but I wouldn’t take it off of the table.
In other words, despite spending much of my career ripping apart trade groups’ legislative proposals, I find myself in the unusual position of supporting the majority of the ones I list above. I hope Congress gives these suggestions some serious consideration.