The Senate last week passed a bill that seeks to protect physicians who refer patients to ambulatory surgery centers (ASCs) from potential payment penalties under the Medicare meaningful use program.
To qualify for Medicare EHR incentive payments, eligible professionals must furnish at least 50 percent of their patient encounters during the reporting period in locations with certified electronic health record technology. However, under the meaningful use program, ambulatory surgery centers are not eligible and certified EHRs are not used in ASCs.
Consequently, EPs providing services to ASCs are more likely to receive a Medicare payment penalty.
According to the ASC Association (ASCA), this policy serves to dissuade physicians from bringing patients to ASCsoften a lower-cost optionif they are concerned they may have their professional fee cut because they are close to the 50 percent threshold. The Electronic Health Fairness Act of 2015(S. 1347), sponsored by Sen. Johnny Isakson (R-Ga.), attempts to remedy the unfairness of this policy by excluding ASC services from being counted toward the 50 percent meaningful use threshold for EPs.
This bill relieves physicians who practice in the ASC setting from being unfairly penalized for failing to meet meaningful use requirements tied to electronic health records that they are currently prevented from being able to meet, said William Prentice, CEO of ASCA, in a written statement. Allowing physicians to perform procedures in ASCs without fear of being penalized encourages them to continue choosing the lower cost, high-quality setting for patient care and saving the Medicare program, patients and insurance providers across the country billions of dollars each year.
In June, a similar bill sponsored by Rep. Diane Black (R-Tenn.) was passed by the House of Representatives. Now, the House and Senate must meet in a conference committee and agree on final legislative language before sending it to President Obama for his signature.
As the Electronic Health Fairness Act points out in its legislative language, development of EHR products specifically for the ASC setting has not been a vendor priority and certification of ASC-specific technology is not included in the Office of the National Coordinator for Health IT certification process. The legislations proposed exclusion of ASCs from being counted toward the 50 percent meaningful use threshold for EPs would end three years after the Health and Human Services Secretary determines that ASC CEHRT is available.
ASCs never got any money to install certified EHR systems but were working on trying to get there, says Kay Tucker, ASCAs director of communications. Doctors bring patients to ASCs from many different practices and it affects them. They are penalized if they bring too many of their patients to an ASC.
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