Though many medical practices have some type of EHR in place, others still have not started the process of instituting such a system. "The costs associated with putting these systems in place can seem prohibitive, and anything that can defray these costs is welcome," said David Schoolcraft, an attorney with Washington-based Ogden Murphy Wallace, PLLC.
Schoolcraft and Elana Zana, also of the firm, presented a session called "Double Dipping for EHR Funding" at the 2014 Medical Group Management Association Annual Conference on Tues., Oct. 28.
Stark Law Donation Extended
The Stark Law sets out guidelines regarding financial arrangements between hospitals and practices, but has historically stood in the way for hospitals that have been willing to help practices pay for EHR systems. Nonetheless, an extension to Stark Law donation guidelines will allow hospitals and hospital systems to help pay for 85 percent of the cost of these systems until 2021.
Specifics of what can and cannot be funded with an EHR donation are clearly spelled out, and Schoolcraft recommended practices intereste
d in taking advantage of this extension consult with an attorney familiar with the legal territory to ensure the practice is in compliance. "The penalties are severe if you get it wrong," Schoolcraft said. Nonetheless, he said, some of the things that can be paid for using this donation including software for the patient portal, maintenance, training, and support. Hardware and payroll cannot be covered, he said.
Schoolcraft noted that the decision to accept funding from a hospital or hospital system should not be taken lightly as this is very much like a marriage. Practices should think about how compatible the organizations will be and what the situation would look like if the two organizations decide to part ways.
Discuss all possible scenarios and consequences of this partnership before drawing up a contract for the partnership, Schoolcraft advised. Pre-negotiate terms in the case of a separation. "It's as complicated as an EHR contract can be," he said. "It's like an EHR contract on steroids."
Partnering with a Hospital for Meaningful Use Benefits
Providers who are using certified EHR technology and can show meaningful use are eligible for financial incentives, but the last year an eligible professional can begin participation is 2016, said Zana. If practices want to take advantage of meaningful use, they need to start now to ensure they are fully prepared to move through the incentive program's three stages. Partnering with a local hospital for an EHR donation arrangement and assistance in achieving meaningful use can help offset additional costs.
Like Schoolcraft, Zana suggested practices think through what it means to choose a particular hospital as a partner. Think about how your needs fit in with the big picture of the hospital. "Understand when upgrades to the system are going to happen," she said. "How will you meet meaningful use together?"
The earliest providers will demonstrate Stage 2 of meaningful use is by the end of this year. Those practices meeting the Stage 2 rules of meaningful use with a hospital as a partner need to have six years' worth of documentation. Before leaving a current vendor, practices need to make sure they have collected all the documentation they might need during the meaningful use review process. "When you think about moving, you need anything for your CMS audits and anything you'll need for your state's audit requirements," she said. Zana suggested running a mock audit in preparation of a CMS audit to make sure a practice has everything before moving on.