by Keith Pendleton, JD

 

Chiropractors, if you're interested in qualifying for EHR stimulus dollars, I have a very quick piece of advice for you -- submit your comments to the Department of Health & Human Services (HHS) as soon as possible.

 

Recently, HHS introduced two stimulus EHR stimulus regulations on Dec. 30, 2009.  When it did so, HHS made it clear that providers must satifsy ALL meaningful use regulations to qualify for stimulus dollars.

 

One of the meaningful use regulations entails e-prescribing.

 

This raises the question -- if e-prescribing is one of the meaningful use objectives, and you are a chiropractor who doesn't prescribe drugs, how are you to qualify for stimulus dollars?  

 

This is not the first time someone has suggested the possibility that chiropractors might not qualify for stimulus money given the e-prescribing requirement.  In an article published in the American Chiropractor a year ago, Future Health's CEO Steve Kraus, D.C. wrote:  "...Note: because chiropractic physicians do not have prescribing privileges, it is unknown whether this will remain a requirement for DC’s...."

 

Now that question has been answered. At the present date, the HHS has made it clear that all requirements, including the e-prescribing requirement, apply to everyone.  The HHS even recognizes that this "all-or-nothing" approach might actually rule out some providers. 

 

Writes the HHS: 

“While we believe that requiring satisfaction of all objectives is appropriate for the majority of providers, we are concerned that certain providers may have difficulty meeting one or more of the proposed objectives. We solicit comments on whether this may be the case, and invite commenters to identify the objectives and associated measures that may prove out of reach for certain provider types or specialties, and to suggest specific objective criteria we could use to determine whether an objective and associated measure is appropriate for different provider types or specialists.”  75 FR 1844-01 at p. 1854 (emphasis added)

 

My suggestion?  Submit a comment asking the HHS to make an exception

relating to the e-prescribing component.  In doing so, you may wish to elicit the assistance of your state and regional associations. 

 

The idea here is that if a particular meaningful use objective is outside the scope of chiropractic, then this would be the objective criteria that the HHS would rely upon in making an exception.

 

Under the original Act -- the American Recovery and Reinvestment Act of 2009 (ARRA), the HHS was specifically empowered to exercise this kind of discretion and specifically with respect to e-prescribing. 

 

“(A) [A]n eligible professional shall be treated as a meaningful EHR user for an EHR reporting period for a payment year ... if each of the following requirements is met: (i) MEANINGFUL USE OF CERTIFIED EHR TECHNOLOGY -- The eligible professional demonstrates to the satisfaction of the Secretary, in accordance with subparagraph (C)(i), that during such period the professional is using certified EHR technology in a meaningful manner, which shall include the use of electronic prescribing AS DETERMINED TO BE APPROPRIATE BY THE SECRETARY." (emphasis added).  American Recovery and Reinvestmetn Act, USPL. 111-5 (February 17, 2009) at pp.p. 469-470.

 

But again, let me reiterate -- at the present time, HHS has made it clear that providers must satifsy ALL meaningful use regulations to qualify for stimulus dollars. One of the meaningful use regulations entails e-prescribing.

 

Unless the Secretary of HHS actually makes a determination to the contrary, it may be very difficult for many chiropractors to qualify for stimulus dollars. 

 

So again, the suggestion? Submit a comment asking the HHS to make an exception based on scope of practice considerations.  You may wish to elicit the assistance of your state and regional associations in doing so.

 

To be assured consideration, your comments must be received no later than 5 p.m. on March 15, 2010.  You may submit comments in various ways, including electronically.  To submit them electronically, visit http://www.regulations.gov, and follow the instructions on the home page.

 

Source: Tipology