The College of American Pathologists (CAP) is urging the Centers for Medicare and Medicaid Services (CMS) to grant pathologists a full five-year exception from meeting meaningful use requirements of electronic health records (EHRs). The Medicare meaningful use (MU) program was created to help all physicians adopt interoperable EHR systems. However, the focus on primary-care and office-based physicians has frustrated a number of medical specialists, including pathologists, whose scope of practice and the information systems they use prevent them from qualifying for the program’s incentives but provide no protection from penalties, which would come in the form of pay cuts—up to 2 percent per year, starting in 2015 based on 2013 reporting. CMS has granted pathologists a hardship exception from penalties in 2015, but the exception is only for one year at a time, up to five years. Legislation (H.R. 1309) is pending in Congress that would exempt pathologists from participating in the program and protect them from penalties for failing to meet federal requirements for meaningful use of EHRs. In a letter send to Marilyn Tavenner, CMS administrator, the chair of CAP’s Council on Government and Professional Affairs and co-chair of its HIT Policy Working Group urged the agency to […]
The College of American Pathologists (CAP) is urging the Centers for Medicare and Medicaid Services (CMS) to grant pathologists a full five-year exception from meeting meaningful use requirements of electronic health records (EHRs).
The Medicare meaningful use (MU) program was created to help all physicians adopt interoperable EHR systems. However, the focus on primary-care and office-based physicians has frustrated a number of medical specialists, including pathologists, whose scope of practice and the information systems they use prevent them from qualifying for the program’s incentives but provide no protection from penalties, which would come in the form of pay cuts—up to 2 percent per year, starting in 2015 based on 2013 reporting.
CMS has granted pathologists a hardship exception from penalties in 2015, but the exception is only for one year at a time, up to five years. Legislation (H.R. 1309) is pending in Congress that would exempt pathologists from participating in the program and protect them from penalties for failing to meet federal requirements for meaningful use of EHRs.
In a letter send to Marilyn Tavenner, CMS administrator, the chair of CAP’s Council on Government and Professional Affairs and co-chair of its HIT Policy Working Group urged the agency to work with the college and Congress to extend the exception for pathologists.
“It continues to be the case that the vast majority of pathologists practice using laboratory information systems (LISs), not certified EHRs,” wrote Richard Friedberg, M.D., Ph.D. “LISs are highly specialized systems that are required and engineered specifically to support laboratory operations in pursuit of patient testing.”
Friedberg notes a recent CMS “Specialist Tipsheet” appears to provide a pathway for a small number of pathologists who practice at integrated settings to meet MU at least in Stage 1.
“Indeed, according to a CMS April 2, 2013, publicly available data file, only 324 pathologists, representing approximately 1.8 percent of all practicing pathologists, have attested to Stage 1 MU,” he writes. “Most pathologists practicing in community hospitals and independent laboratories, outside of large integrated and often academic medical centers, will still be unable to meet either Stage 1 or Stage 2 MU.”
While a small minority of pathologists in large integrated practices may be able to “ride the data” of other eligible providers, particularly in Stage 1 to meet MU, it is unlikely that doing so is practical in Stage 2, Friedberg says.
“Most pathologists also do not control what electronic systems they have access to or use or what data is entered by other eligible providers so their ability to meet MU even through the data riding path—which is the only route currently available to them—is completely outside their control,” he writes.
