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EHR Vendors Seek Clarity from CMS


The HIMSS EHR association submits a letter to CMS, expressing concern and offering suggestions for MACRA payment requirements.

Welcome to Practice Rounds, our weekly column exploring what's being covered in the larger world of healthcare.

EHR Vendors ask CMS for Clarity

On Wednesday, the HIMSS EHR Association called for timeliness and clarity on requirements for Medicare payment reform in a letter submitted to the Centers for Medicare and Medicaid Services (CMS).

The letter, addressed to CMS Administrator Seema Verma, thanked the agency for involving providers in the design of the Medicare Access and CHIP Reauthorization Act (MACRA) while expressing concern with "repeated delays in program implementation timelines, as we have seen over several regulatory cycles, as well as a continued lack of clarity around requirements."

The HIMSS EHR association, a trade association of the EHR companies that believes adoption of EHRs will improve the quality of care and the productivity of the healthcare system, said it was reminded of similar delays in years past with Meaningful Use and ICD-10 regulations. Such uncertainty "can condition providers to delay implementing necessary and beneficial changes in technology and its use in clinical practice," wrote the association.

The letter also outlined the association’s concerns that many provider organizations have already invested in technical upgrades and process improvements and "being unable to realize a return on those investments because deadlines are moved creates disincentives to aggressive participation in future years."

The organization seeks clarification on: how virtual groups submit data, being clear on which certified EHR technology (CEHRT) will need to be used in 2018, and the proposal for multiple submission methods for the Merit Based Incentive Program (MIPS) quality measurements were all mentioned in a lengthy list of requests.

AMA to CMS: Simplify Quality Payment Program Regulations

On Monday, the AMA told the Centers for Medicare and Medicaid Services (CMS) that it supported many of the proposals it offered for the second year of the Medicare Quality Payment Program (QPP), while also encouraging the agency to further simplify the regulations for value-based payments.

In a letter to CMS Administrator Seema Verma, AMA Executive Vice President and CEO James L. Madara, made the agency's request clear. "With respect to the 2018 program year, while we believe CMS has included many improvements, we continue to urge the agency to seek ways to simplify and further streamline the program."

The letter goes on to lay out numerous suggestions for CMS including continuing to receive feedback and analyze data before making decisions on physician scoring and improvement and the belief that physicians should have maximum flexibility in the formation of the proposed virtual groups, among other things.

Physicians' QPP participation in 2018 will affect physicians’ Medicare payment levels in 2020.

EHR Vendor CliniComp Sues Government

CliniComp International, a San Diego-based electronic health record (EHR) vendor, is suing the government, claiming the Department of Veterans Affairs (VA) improperly awarded its EHR upgrade contract to Cerner without a competitive bidding process, according to Healthcare Informatics.

VA Secretary David Shulkin announced in June that the VA would award Cerner a contract to replace its legacy VistA system with a Cerner EHR. CliniComp claims to have filed a protest to contest the sole source award shortly after the announcement, according to the filed complaint. But the VA’s deputy assistant secretary for acquisition denied the protest on Aug. 7.

During the June announcement, Shulkin said the agency "does not have sufficient time to allow for full and open competition." CliniComp replied to Shulkin's statement, saying it "lacks a reasonable basis."

CliniComp is requesting a preliminary and permanent injunction, and claiming that its own EHR software is well-suited to meet the interoperability needs outlined by the VA, and that Cerner's no-bid contract will "cause great and irreparable injury to CliniComp" in the form of significant revenue loss.

Quote of the week:

The Doctors Who Defend MOC

"It implies that graduation from medical school is sufficient to say someone is good to practice medicine for their entire career. I don't believe that…I graduated medical school in 1998. If I practice medicine the way I was taught in 1998, I'd be killing people."
-Eric Green, MD on MOC

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