On February 27, the House Ways and Means Committee passed the Electronic Health Fairness Act (HR 887), which would exempt ambulatory surgical centers (ASCs) from the EHR Incentive Program.

Ambulatory surgical centers are health care facilities focused on providing same-day surgical care, including diagnostic and preventive procedures.  ASCs do not provide primary health care services.  Instead, they treat patients who have already seen a health care provider and have selected surgery as the appropriate treatment for their condition.  Because ASCs are specialized and function on a smaller scale, they generally provide services at a lower price than a full-service hospital.

Under the EHR Incentive Program, hospitals and eligible professionals that demonstrate the meaningful use of electronic health records qualify for Medicaid and Medicare incentive payments.  They may also be penalized for failing to meaningfully use EHR.  Eligible professionals must demonstrate that 50% or more of their outpatient encounters occur at locations equipped with EHR technology in order to be considered a meaningful user.

The Electronic Health Fairness Act would exempt “any patient encounter . . . occurring at an ambulatory surgical center from being treated as such an encounter” when determining whether the professional qualifies for EHR incentive payments.  The Committee noted that this bill would benefit eligible physicians who have a significant number of patient encounters at ASCs.  These physicians are currently at a disadvantage when attempting to meet the 50% meaningful use requirements because EHR technology is not currently certified for ASCs.  The bill’s exemption would sunset three years after EHR technology is certified specifically for use in ASCs.

The bill will also benefit the ASCs and may improve beneficiary access to ASCs, because physicians will be able to bring more cases to surgical centers without a fear of incurring Medicare payment penalties.  According to the Ambulatory Surgery Center Association, this bill would remove a major disincentive “to provid[ing] care in an ASC when appropriate.”

The bill has been sent to the House for a full vote.

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Photo of Anna D. Kraus Anna D. Kraus

Anna Durand Kraus has a multi-disciplinary practice advising clients on issues relating to the complex array of laws governing the health care industry. Her background as Deputy General Counsel to the U.S. Department of Health and Human Services (HHS) gives her broad experience…

Anna Durand Kraus has a multi-disciplinary practice advising clients on issues relating to the complex array of laws governing the health care industry. Her background as Deputy General Counsel to the U.S. Department of Health and Human Services (HHS) gives her broad experience with, and valuable insight into, the programs and issues within the purview of HHS, including Medicare, Medicaid, fraud and abuse, and health information privacy. Ms. Kraus regularly advises clients on Medicare reimbursement matters, the Medicaid Drug Rebate program, health information privacy issues (including under HIPAA and the HITECH Act), and the challenges and opportunities presented by the Affordable Care Act.