Critics hammer feds at Congressional meaningful use hearing

Federal officials responsible for writing the meaningful use rule defended it Tuesday before a wary Congressional panel who had questions for most every facet of the rule.

Members of the House Ways and Means Subcommittee on Health grilled David Blumenthal, MD, National Coordinator for Health Information Technology, and Tony Trenkle. director of the Office of E-Health Standards and Services at the Centers for Medicare and Medicaid Services, on aspects of the meaningful use rule, particularly focusing on interoperability requirements, costs, privacy and health disparities.

Congress footed the bill on more than $36 billion on incentive payments for the adoption of healthcare IT in the American Recovery and Reinvestment Act, and with the July 13 release of the final meaningful use rule, the committee made it clear they want to know if they will get their money's worth.

According to Trenkle and Blumenthal, some of the questions asked showed that Congress isn't aware of certain aspects of adoption, particularly the policy and infrastructure needed to support health information exchange and the limited number of doctors and pharmacies ready for interoperability.

Some committee members wanted the interoperability requirements to be more strenuous. Blumenthal defended the stage method included in the meaningful use rule that will allow the use of "dummy data" for testing purposes. He reiterated again and again the interoperability requirements – and all requirements – would become more robust through stages 2 and 3.

Trenkle addressed the hospital multi-campus issue, a heated concern of hospitals.

Hospital officials want the meaningful use rule to grant incentives to each hospital in a hospital system. Both the proposed rule and final rule kept all hospitals within a system as one system for purposes of earning incentives.

"CMS carefully reviewed these comments and met with interested stakeholders, including the two largest hospital associations, the American Hospital Association and the Federation of American Hospitals, to hear their concerns with the policy described in the proposed rule," Trenkle said.

"Taking this input as well as the legislative language of the Recovery Act into account, we came to the conclusion in our final rule that we should define 'subsection (d) hospital' in alignment with how we have defined that term in other situations."

Trenkle said CMS would need Congress to change how hospitals are defined for reimbursement purposes. That's what the Premier healthcare alliance is advocating for its 2,300 community hospital members.

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