The AHA (American Hospital Association) is calling on the agency to further decrease the regulatory burdens on hospitals and health systems by cancelling Stage 3 of the meaningful use (MU) program, in reaction to the CMS’ (Centers for Medicare & Medicaid Services) appeal for data on CMS flexibilities and efficiencies.
Additionally, CMS is being asserted by the AHA to suspend the star ratings from the Hospital Compare website, suspend electronic clinical quality measure (eCQM) reporting requirements and decrease the the other regulatory requirements linked with the EHR program.
In the letter, written by Thomas Nickels, executive vice president of AHA, government relations and public policy and addressed to Seema Verma, CMS Administrator, AHA officials assert that the regulatory burden confronting hospitals “is substantial and unsustainable.” “One small instance of the volume of latest regulatory activity, in the year of 2016, CMS and other agencies of the Department of Health and Human Services (HHS) issued 49 hospital and health system-related rules, comprising nearly 24,000 pages of text. In regard to the sheer volume, the significance of changes needed by the new regulations is beginning to outstrip the ability of field to absorb them,” AHA wrote in the letter.
Drilling down into the request of AHA, regarding cancelling Stage 3 of the MU program, AHA officials assert that hospitals already confront “extensive, burdensome and unimportant ‘meaningful use’ regulations from CMS that need significant reporting on use of EHRs with no obvious benefit to patient care. These excessive requirements are set to become even more onerous when Stage 3 starts in the year of 2018. They also will raise charges by compelling hospitals to spend huge sums upgrading their EHRs solely for the purpose of meeting regulatory requirements.”
According to AHA, CMS should institute a 90-day reporting period in every future year of the program, removing the all-or-nothing approach and collect input from stakeholders on ways to further decrease the burden of the meaningful use (MU) program from current requirements.
AHA also needs CMS to suspend the hospital star ratings on its Hospital Compare website because of the ongoing concerns of agency about CMS’s “flawed” methodology. “Our uncertainty is amplified by the fact that further analysis performed since the star ratings were first issued show that substantive mistakes were made in executing chosen methodology of CMS. As an outcome, far too several hospitals have been inadequately classified into star rating categories that are different in contrast to those that should have been assigned.”
AHA also emphasizes that hospitals have spent significant time and resources to revise certified EHRs to meet eCQM requirements of CMS for the year of 2016, “with no benefit for patient care.” The agency is concerned with proposals of CMS to enhance the eCQM reporting requirement by 50% for the years of 2017 and 2018, which, AHA claims, “develops additional burden without an expectation that the data generated by EHRs will be precise,” hence the organization recommends that CMS suspend all regulatory requirements that mandate submission of eCQM.
Moreover, AHA also suggests that CMS “undo” agency overreach on so-called “information blocking.” According to the explanation of AHA officials: “Hospitals need to share health information to support care and do so when they can. But technology companies and the federal government have so far failed to develop the infrastructure to make sharing information electronically convenient and efficient. CMS went beyond statutory intent in inquiring hospitals to attest to 3 separate statements.”
CMS is being urged by the AHA to eliminate the second two attestations and keep just the statutory requirement that hospitals didn’t knowingly or willfully take action to limit or restrict the compatibility or interoperability of their EHRs.
AHA also calls on CMS to expand the coverage of Medicare of telehealth services. This change should extend to the Medicare Advantage (MA) program so that MA policies can make services delivered through telehealth available more widely to their Medicare enrollees, in accordance with AHA letter.