ONC to impose user fee on EHR vendors

One of the more unique provisions of the Office of the National Coordinator for Health IT's proposed 2014 budget is the imposition of a new "user fee" on electronic health record vendors and developers to support ONC's certification and standardization activities. The fee would be assessed on vendors who certify their products through the ONC health IT certification program. The estimated $1 million fee is part of ONC's $26.3 million request to support standards, interoperability and certification.

According to the proposed budget, ONC's workload to certify EHR products has greatly increased, and the funds for certification activities from the American Recovery and Reinvestment Act (ARRA), which created the Meaningful Use incentive program, are scheduled to expire in 2013.

"Consequently, a new revenue source is necessary to ensure that ONC can continue to fully administer the certification program, as well as invest resources to improve its efficiency," the proposed budget notes. Some of the improvements contemplated include additional tools and resources and technical assistance.   

The fee will be imposed on vendors and developers because they're the primary beneficiaries of the certification program. Providers must use a certified product to qualify for Meaningful Use incentive payments.

The Analytical Perspectives on the budget, released by the White House, reiterated the need for the new fee to support and improve the certification and testing program. The fee would be phased in gradually. 

The HIMSS EHR Association, in a statement released late last week, said it did not support the fee and suggested that the U.S. Department of Health & Human Services evaluate the necessity and value of "all requirements in the Meaningful Use program and the associated certification activities."

The statement continued: "At the same time, we encourage Members of Congress to ensure that they are appropriating sufficient funds to the Office of the National Coordinator to enable execution of the critical programs they have been asked to roll out. The adoption of standards-based, interoperable health information technology benefits many stakeholders, including providers, payers and most importantly, patients and their families."

As of March 2013, the Certified Health IT Product List on ONC's website included over 1,750 unique certified EHR products from 945 vendors and developers.

ONC's overall funding jumps from $61 million to $78 million in the budget, a 28 percent increase from last year's budget.

To learn more:
- here's the proposed ONC budget
- read the White House's Analytical Perspectives
- here's the HIMSS EHR Association statement

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