House Bill Would Extend EHR Medicare Incentive Payments to Rural Providers

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Legislation (H.R. 3458) introduced in the House Nov. 17 would amend current law to make rural health clinics eligible for Medicare incentive payments for installing electronic health record systems.

In a Nov. 17 Dear Colleague letter to House members, the bill's sponsor, Rep. Aaron Schock (R-Ill.), and three other lawmakers said that because of RHCs' “unique reimbursement structure,” they had not been eligible for Medicare electronic health records incentive payments. The lawmakers said the Centers for Medicare & Medicaid Services developed a “flawed methodology” that prevented RHCs from gaining access to the payments.

Joining Schock on the Dear Colleague letter were Reps. Cathy McMorris Rodgers (R-Wash.), Bill Huizenga (R-Mich.), and Greg Walden (R-Ore.).

The bill would make RHC providers eligible for electronic health record incentive payments, Schock said in a press release. He said it would:

• have no cost to the federal government;

• add no new funding to the incentive program; and

• not change CMS's meaningful use requirement.

Accounting Error

“RHCs should not be discriminated against simply because they bill Medicare differently than hospitals or other health care practitioners who practice in rural areas,” Schock said. “I represent 20 counties in Illinois, several of which include health clinics that are penalized by this accounting error. This is a flaw in the system that needs to be fixed.”

“The last year an eligible provider can start participation in the Medicare EHR incentive program is 2014,” Schock said. “Therefore, it is imperative for Congress to quickly level the playing field for health care providers who choose to practice medicine in RHCs.”

The Dear Colleague letter said, “RHCs were created to address physician understaffing in rural areas and improve access to primary care services.” They “use a team-based approach of physicians and mid-level medical providers, such as Nurse Practitioners and Physicians Assistants, to provide a variety of health care services,” the letter said.

Incentive Programs

Incentive payments for the adoption and meaningful use of certified EHR technology were authorized in the Health Information Technology for Economic and Clinical Health Act, part of the American Recovery and Reinvestment Act. Such payments will be made through the Medicare and Medicaid programs.

The Medicare and Medicaid EHR Incentive Programs will provide incentive payments to eligible professionals, eligible hospitals, and critical access hospitals (CAHs) as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology, according to CMS.

Eligible professionals can receive up to $44,000 over five years under the Medicare EHR Incentive Program. In 2015 and later, Medicare payments will be reduced for Medicare-eligible professionals, eligible hospitals, and CAHs that do not successfully demonstrate meaningful use.


Schock's bill is at http://op.bna.com/hl.nsf/r?Open=jcon-8nqqlr . The Dear Colleague letter is at http://op.bna.com/hl.nsf/r?Open=jcon-8nqs4w .