The American Hospital Association (AHA) has submitted public comments to the Centers for Medicare and Medicaid Services (CMS) on the recent Notice of Proposed Rule Making (NPRM) entitled "Medicare and Medicaid Programs; Electronic Health Record (EHR) Incentive Program," published the Federal Register on January 13, 2010. (See, DM 11343).

In the 81-page comment letter, signed by AHA Executive Vice President Rick Pollack, the organization offered concerns and detailed suggestions, including:

--The Definition of Meaningful Use: The AHA stated concern for the short time frame in the proposed rule, and suggests replacing CMS' proposed adoption year concept with one that allows hospitals to satisfy the meaningful use definition if meeting 25 percent of the objectives in 2011 or 2012, and increasing the percentages in future years. The AHA also proposes expanding required levels of use and data sharing requirements over time; changing measures of meaningful use to decrease the reporting burden; allowing hospitals to meet the meaningful use objectives by "grandfathering" currently installed and functioning hospital EHR systems as certified; and relying on existing quality reporting structures until EHR quality measures and products for quality reporting are ready for broad use.

--The Definition of a Hospital-Based Eligible Professional: The AHA is presenting an alternative definition to allow more physicians to qualify appropriately for EHR incentives, so that eligible professionals will not be inappropriately excluded: "A pathologist, anesthesiologist, emergency physician, hospitalist, intensivist, or neonatologist for whom at least 90 percent of his/her billed claim lines have a site of service of the inpatient, outpatient or emergency department and for whom at least 90 percent of his/her claims do not contain an ambulatory-care visit code (as set forth in the e-prescribing policy) and for whom the hospital funded more than 85 percent of the cost of the EHR."

--Definition of a Hospital: The AHA asks that each hospital within a system that has a single CMS certification number be individually evaluated for meeting the meaningful use requirements, and individually eligible for incentive payments.

--Critical Access Hospitals (CAHs): The AHA urges that CMS reverse the decision to exclude CAHs from the Medicaid EHR incentive program.

All comments on the NPRM are due by March 15, 2010, and can be submitted at www.regulations.gov.

The AHA public comments can be accessed at: http://www.aha.org/aha/issues/HIT/100226-hit-meaningful.html

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