CMS urged to close EMR funding loophole for critical access docs

The American Hospital Association (AHA) and National Rural Hospital Association (NRHA) have alerted CMS to a potential flaw in how the agency decides which doctors receive incentives for achieving Meaningful Use of electronic health records.   

Here's the problem: A critical access hospital (CAH) can elect how it bills Medicare. In one option, known as "method 2," eligible professionals can choose to assign their billing rights for outpatient services to the CAH. The services are still billed based on Medicare's physician fee schedule, but the CAH bills on behalf of the physician using a hospital inpatient billing UB-04 form, not the HCFA 1500 form that physicians typically use to bill outpatient services, the associations noted in a Dec. 16 letter to CMS

The associations are concerned that these physicians are being inappropriately classified as hospital-based, and thus ineligible to participate in the incentive program and that these charges are excluded from the calculation of incentive amounts. If CMS can't close the loophole, the associations have asked to find an alternative process for these physicians--and to do so quickly--so that the changes apply to 2011 payments. 

"Providers in rural areas offer much-needed access to care in areas that are often underserved," the associations write. "These providers also have limited capital resources to support investments in EHRs. The Department of Health & Human Services has confirmed its commitment to supporting EHR adoption nationwide. That commitment should extend especially to rural providers." 

To learn more:
- read the AHA letter (.pdf)

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