HHS rules on doctor IT subsidies muddy the waters

Last year, HHS took a step which should have been a big relief to hospital IT departments--it gave hospitals guidance on how they could provide doctors with EMR systems without running afoul of federal anti-kickback and self-referral provisions. However, as it's turning out, the new regs may have done more to muddy the waters than clear them. Why the confusion? In essence, it's because the scheme HHS has set up make it very difficult for a hospital to buy an approved EMR system.

To qualify for anti-kickback and self-referral rule exceptions, hospitals must prove that their systems are interoperable with other clinical data systems elsewhere (which, presumably, makes sure that physicians aren't locked in to a particular facility once they accept an EMR). Sounds good in theory. However, to meet this criteria, hospitals must either a) attest that their systems are interoperable under HHS specs, a difficult and dicey move or b) buy a system which has gotten a CCHIT certification within the last 12 months.

If you're thinking that b) is an easy solution, think again. Unfortunately, most EMR vendors have 18 to 24 month development cycles, so few are expected to get recertified by CCHIT annually. That cuts hospital's EMR choices down drastically. For that reason, vendors are pushing hard to get HHS to accept CCHIT's three-year certification period. However, to date HHS hasn't budged on the issue. Add this to the fact that the IRS has its own regs on the subject of EMR donations, and things look even stickier. What a mess.

To learn more about this issue:
- read this Modern Healthcare article

Related Articles:
CCHIT gets official, approves new vendors. Report
IRS gives physician EMR donations the OK. Report
Want shared EMRs? Drop the technology debates. Editorial
HHS, IRS rules on EMR donations clash. Report

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