AHA: Stage 2 Provision Critiques

The American Hospital Association in a 68-page letter to the Centers for Medicare and Medicaid Services stated that 80% of hospitals have not yet met the Stage 1 Meaningful Use criteria and called for changes to several provisions of the proposed Stage 2 requirements. The Washington-based group called for an extension of the length of Stage 1, as well as a 90-day reporting period for the first year of Stage 2 to offer more adequate time for its hospitals to comply.

“The AHA is concerned that elements of the proposed rule for Stage 2 would stand in the way of a successful program to support widespread adoption by all hospitals,” the letter states. “Many of the proposals put regulatory requirements ahead of actual experience with these technologies —an approach that will likely have unintended consequences.”

But one specific AHA critique has garnered the attention of the Center for Democracy & Technology, a Washington-based not-for-profit Internet and consumer rights group. In a blog post, Deven McGraw, the organization’s director of the health privacy project, called attention to AHA’s request that CMS dismiss its Stage 2 objective of requiring hospitals to provide patients with the ability to view, download and transmit their discharge summaries.

While AHA maintains that the provision would raise significant security issues and challenges the authority of the Office of Civil Rights, which regulates HIPAA compliance, McGraw says HIPAA already includes such a provision. And a delay in getting patients this information could have a significant impact on their ability to recover.

“The argument that the existence of these HIPAA provisions prevents CMS from imposing more meaningful access to patient data as a condition of receiving substantial taxpayer subsidies is the legal equivalent of a “hail Mary” pass,” she said in her blog. “HIPAA is a baseline health privacy law. There’s no basis for the argument that CMS can’t create conditions on meaningful use dollars that give patients greater rights.

“From a legal standpoint, CMS is on firm ground in its decision to encourage patients to take an active role in their care by creating an innovative program that provides immediate access to health information useful to their continued care and recovery. If only the hospitals would agree.”

In its letter, AHA also called for other changes to the proposed Stage 2 requirements related to Medicare payment penalties and proposed quality reporting requirements among other provisions.