A draft version of an $85 billion "Jobs Bill" that could be introduced on Feb. 11 includes language to expand the types of physicians eligible for meaningful use incentive payments under the American Recovery and Reinvestment Act.

ARRA's language--and the Centers for Medicare and Medicaid Services' proposed meaningful use rule--excluded hospital-based physicians from receiving incentive payments. But many industry stakeholders believed that congressional intent was to include physicians who primarily work in ambulatory care facilities owned by hospitals.

The House and Senate are working on a new "mini-stimulus" bill, with the House already passing a version with about $155 billion in spending. The Hill, a newspaper that covers Congress, recently leaked the Senate version, called "The Hiring Incentives to Restore Employment Act."

ARRA excluded "hospital-based eligible professionals" from receiving meaningful use incentive payments. The law defined these professionals as "an eligible professional, such as a pathologist, anesthesiologist, or emergency physician, who furnishes substantially all of such services in a hospital setting (whether inpatient or outpatient) and through the use of the facilities and equipment, including qualified electronic health records, of the hospital."

The Senate bill would remove "setting (whether inpatient or outpatient)" from the definition, and insert "inpatient or emergency room setting." Consequently, physicians furnishing substantially all services in an inpatient or emergency room setting would be excluded, but those in ambulatory facilities owned by the hospital would be eligible for incentive payments.

The proposed revamped language is in SEC. 620 of the Senate bill, titled EHR CLARIFICATION. The bill is available here.

--Joseph Goedert

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