Hospital based physicians get new definition for HITECH incentives

HR 4851, the Continuing Extension Act of 2010 was signed into law in April. It extends unemployment benefits, delays Medicare reimbursement cuts for physicians, and amends the definition of hospital-based eligible professionals for the HITECH incentives. It is apparent that the lobbying and commenting, especially from provider organizations, to the current CMS rules initiated the change of definition.

The exclusion of all hospital-based physicians was even recognized by CMS that a significant amount of family physicians would not be eligible for the incentives. But they were unsure how to include or revise this part of the HITECH Act. Industry stakeholders have been working behind the scenes and rallied enough support and found the first piece of legislation slated to pass to attach the clarifying language. Congressional supporters had no problem with supporting the effort as they indicated there was never the intent to exclude these physicians in the first place.

The law removes the word “outpatient” from the description of a hospital-based “setting” and replaces it with “inpatient or emergency room setting.” So physicians who treat patients in hospital-based outpatient clinics will be eligible for incentive payments under the HITECH Act. The exclusion will remain on inpatient or ER physicians as they are using the hospital resources in their settings.

An additional bill HR 5040, Health Information Technology Extension for Behavioral Health Services Act of 2010 has been introduced by Rep. Patrick Kennedy (D-RI) and has been referred to committee. This bill would further expand the eligibility of professionals for the HITECH incentives by including clinical psychologists, clinical social workers, psychiatric hospitals, substance abuse treatment facilities and mental health treatment facilities. You can keep updated on the status of this bill at OpenCongress.