CMS recently published a final rule on its exception to the physician self-referral law that reflects concerns raised by the AAFP when the proposed rule was released last April.
The final regulation, "Physicians' Referrals to Health Care Entities With Which They Have Financial Relationships: Exception for Certain Electronic Health Records (EHR) Arrangements,"(www.gpo.gov) was published in the Dec. 27 Federal Register and is effective on March 27. It revises the exception to a physician self-referral law that permits donation of EHR items and services in certain instances.
The AAFP's comments on the initial proposal were conveyed to CMS Administrator Marilyn Tavenner, M.A., in a June 5 letter from (then) AAFP Board Chair Glen Stream, M.D., M.B.I., (now) of La Quinta, Calif., and included a recommendation to exclude specific types of donors such as laboratory companies, durable medical equipment suppliers and independent home health agencies as a way to "prevent potential improper actions by certain categories of donors."
In the final rule, CMS partially addresses the AAFP's concerns by excluding laboratory companies from the types of entities that may donate EHR items and services. The final rule also removes an exception dealing with an electronic prescribing capability requirement. That suggestion was included in the proposed rule and was supported by the AAFP.
In addition, the final rule
- extends the expiration date of the exception to Dec. 31, 2021, and
- clarifies the requirement that prohibits any action that would limit or restrict the use, compatibility or interoperability of donated items or services .
According to CMS, the final rule "modifies an existing exception to the physician self-referral law" and permits certain entities to provide to physicians with certain software, health information technology, training and services "used predominantly to create, maintain, transmit or receive electronic health records."
Furthermore, writes CMS in the final rule, "We expect the exception, as modified by this final rule, to continue to facilitate the adoption of electronic health records technology."
In June, Stream called on CMS to "finalize policies that further strengthen the use of core electronic health records features" as a means of helping family physicians "improve access, efficacy, efficiency and service for patients."