American College of Physicians: Internal Medicine — Doctors for Adults ®


Policy briefs

From the September ACP Observer, copyright 2006 by the American College of Physicians.

ACP President testifies on Capitol Hill

College President Lynne Kirk, FACP, appeared before the House Energy and Commerce Committee's Subcommittee on Health last week to testify on reforming the Medicare payment system.

During the hearing, “Medicare Physician Payment: How to Build a Payment System that Provides Quality, Efficient Care for Medicare Beneficiaries,” Dr. Kirk recommended that Medicare pilot test a patient-centered medical home model of care.

She urged Congress to direct Medicare to institute the new model of financing and delivering care. The patient-centered medical home would give patients incentive to connect with a personal physician who is part of a team of health care professionals providing continuous and comprehensive care.

“Congress can maintain a flawed system that rewards fragmented, high volume, over-specialized and inefficient care,” Dr. Kirk said in concluding her testimony. “Or, it can put Medicare on a pathway to a payment system that facilitates high quality and efficient care centered on patients’ relationships with their primary and principal care physicians.”

Read Dr. Kirk’s full written statement is online.

Government approves new protections for HIT

New federal rules allow physicians to accept donated e-prescribing and electronic health records (EHR) software and hardware from hospitals without running afoul of fraud and abuse laws, as long as they pay a percentage of the cost.

Both HHS’s Office of the Inspector General (OIG) and Centers for Medicare and Medicaid Services (CMS) announced the new “protections” on Aug. 1. The rules are published in the Aug. 8 Federal Register.

Current fraud and abuse laws prevent physicians from referring Medicare patients for certain services to hospitals with which they have financial ties. As a result, hospitals have been hesitant to give physicians computer equipment and software that would be used to transmit patient data back and forth between physician offices and hospitals, according to the Aug. 1 Modern Healthcare. The new rule would allow such a transaction to occur, so long as the recipient physician pays 15% of the cost of the donated EHR technology items and services.

In the new rule, CMS and OIG stipulated that the protections relating to EHRs will expire on Dec. 31, 2013, with the assumption that protection will no longer be needed by that time because technology will have become a widely used part of medical practice. All donations of items and services related to electronic health records must occur by this date.

In previous comments to CMS and OIG on the proposed rules, ACP stressed the importance of providing protections in order to encourage the adoption of these new technologies, and encouraged moving forward on the final rules as soon as possible.

In letters to CMS and OIG, Joseph Stubbs, FACP, chair of ACP’s Medical Service Committee, commended the then-proposed rules. “Donors and recipients need to have the necessary comfort to engage in these types of arrangements," he said, "and the final rule should do nothing to discourage such engagements.”

A summary of both rules can be found on ACP's web site. The final rules appear in the Aug. 8 Federal Register.

'Seal of approval’ for EHR systems

When deciding which electronic health records (EHR) system to buy for their practice, physicians can now look for a government-sanctioned “seal of approval.”

The Certification Commission for Healthcare Information Technology (CCHIT) last week released its first list of 20 certified ambulatory EHR products, said a July 18 CCHIT news release. CCHIT, a private, nonprofit group, was awarded $2.7 million in 2005 by the U.S. Department of Health and Human Services (HHS) to develop a set of standards and certify vendors who meet those requirements.

To become certified, products must meet 100% of CCHIT's criteria, including providing broad functionality, offering security features and the ability to eventually become interoperable with other systems. Its standards and certifications have been endorsed by ACP and many other professional medical organizations.

“CCHIT has simplified the selection process for physicians,” said ACP Executive Vice President and CEO John Tooker, FACP. “We believe our constituents—and the entire healthcare community—should look to certification to help ensure their EHR needs are met today and to lay the groundwork for future interoperability.”

Advocates of electronic health records hope that product certification will provide physicians and hospitals with the assurance they need to justify significant investments of time and money in new systems, said the news release. A list of CCHIT’s certified products is available online. Additional certifications will be announced at the end of July and quarterly thereafter.


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