The American Hospital Association, American Medical Association and 51 other organizations on May 3 sent a letter to Health and Human Services Secretary Kathleen Sebelius asking for significant changes in the forthcoming final rules for incentive payments for meaningful use of electronic health records. Among their recommendations:

* Require providers to implement a percentage or limited number of the meaningful use objectives and offer providers greater flexibility in choosing which requirements to implement;

* Extend the transition to meaningful use an additional year to 2017;

* Immediately take steps to include representation from small physician practices in future meetings of the HIT Policy Committee;

* Enable physicians to receive feedback on whether the information they report through attestation has been successfully submitted and received;

* Drop the meaningful use criteria for electronic insurance eligibility checks and electronic submission of claims;

* Define a hospital as a discrete facility of service so that individual sites of hospitals are eligible to separately qualify for incentives;

* Require only reporting of health information technology functionality measures that can be generated directly from EHRs, with no need for manual chart reviews;

* Postpone required submission of quality metrics until the means to capture the data from EHRs and submit the data is validated;

* Change the retention policy of maintaining evidence of qualification to receive incentive payments from 10 years to five years;

* Develop one set of meaningful use criteria for the Medicare and Medicaid programs; and

* Enable critical access hospitals to qualify for Medicaid incentive payments.

The letter is available on the home page of

--Joseph Goedert


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