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Hospitals push HHS to align reporting requirements for health IT to ease burden


The Trump administration’s continued push to ease regulatory burden should include aligning reporting requirements for health information technology programs, a constellation of hospital and health IT groups said.

As mandated by the 21st Century Cures Act, the CMS and the Office of the National Coordinator for Health Information Technology last November released a draft strategy to simply reporting requirements under the Promoting Interoperability and Quality Payment Program—formerly known as meaningful use—and standardize the use of electronic health records. Industry groups had until this week to file comments.

A major concern from the industry was redundant reporting.

The American Hospital Association that ONC hasn’t done a good job in aligning reporting requirements across Medicare and Medicaid, noting that there are differences in the clinician requirements for both programs.

“The lack of alignment is particularly acute in 2019, when Medicaid programs will use more rigid, historical meaningful use criteria, while Medicare has shifted to the more flexible [Promoting Interoperability Program] approach,” AHA wrote in its comments.

Premier healthcare alliance added that ONC must address gaps in administrative and reporting requirements.

“For example, additional work is needed to advance data sets, standards and [certified EHR technology] criteria,” Premier wrote. “This would go a long way to alleviate differences across EHR platforms and help ensure more consistent EHR implementations.”

The Healthcare Information and Management Systems Society and the Association of Medical Directors of Information Systems zeroed in on the need to simplify clinical documentation. In a joint comment letter, the groups said the CMS should create several resources to demystify requirements to address the problem of clinicians documenting information in a patient’s clinical note and then re-documenting the same information in the EHR.

The two groups want the Trump administration to create a minimum data set that payers like the CMS would use to determine the “level of service delivered during a patient encounter and confirm reimbursement decisions.”

If there is clarity around a specific data element that a payer requires then “much of the documentation and re-documentation burden is lifted,” the two groups wrote.

The AHA also raised concern about the government’s push for industry to adopt new standards to improve automation for claims attachments and prior authorization. AHA believes the ONC’s desire to adopt new standards will interfere with current efforts by hospitals to adopt existing standards.

“ONC must build on existing work by first thoroughly reviewing the current standards and including these in ongoing discussions so that the agency does not compromise the work done to develop the HIPAA-mandated transactions for prior authorization and claims attachment,” the group said.

The CMS also has to improve its access to government data.

“Healthcare providers currently have limited access to Medicaid, the Children’s Health Insurance Program, Veteran’s Affairs and TriCare Data,” Premier said. “Streamlined and enhanced access to this information would assist healthcare providers with more effectively managing care transitions between state and federal health programs.”