CMS Finalizes EHR Incentive Program Phase Two Rules; 50 Percent Threshold May Impact ASCs, Physicians

CMS has finalized its rules governing the second phase of the agency's electronic health record EHR incentive penalty program, according to an ASCA report.

ASCA says in general, the program does not apply to ASCs. However, the program applies to surgery centers in general, and the final rules retain a problematic policy that impacts physicians who bring their cases to ASCs.

According to the report, physicians must use 'certified' EHRs that meet CMS standards in at least 50 percent of their patient encounters to qualify as "meaningful users" of EHRs. Without certification, physicians cannot receive incentive payments or avoid penalties.

Because ASCs have not been subsidized like physician offices and hospitals to implement EHRs, it is unlikely that ASCs will have the necessary "certified" EHRs in place to help physicians meet the 50 percent requirement. Certification standards were developed without ASCs in mind, and more physicians could be affected if CMS increases the threshold for acceptable use in the future.

CMS did announce an exemption that protects physicians who may not meet the 50 percent threshold. Those physicians can apply to have their patient encounters excluded from facilities where they cannot control the purchase or presence of EHRs. That exception should protect physicians who frequently bring cases to an ASC, but the protection afforded to ASC owners is less certain.

ASCA continues to work with CMS and Congress on this issue.

Sign up for the ASCA Government Affairs Update here.

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