The prospect of the U.S. healthcare system moving from paper to electronic medical records (EMR) has given rise to a host of thorny questions on matters of privacy, security, logistics and more. But according to EMR attorneys at the national law firm of LeClairRyan, the time to start making the switch is now–in part because the federal government will soon finalize important new guidelines on what healthcare providers need to do in order to "go digital."
Already, some $35 billion in EMR incentives are available through the federal Centers for Medicare & Medicaid Services (CMS). However, healthcare providers–who are required by law to make "meaningful use" of EMR in order to receive $44,000 EMR-implementation grants–have been waiting for the government to clarify the meaning of this term before investing in new systems, noted senior counsel Patrick J. Hurd, a veteran medical industry attorney based in LeClairRyan's Norfolk, Va., office.
"Healthcare providers need not sit on the sidelines any longer," said Hurd, who is the leader of the firm's Healthcare Industry Team. "The government published its preliminary EMR guidelines in the Federal Register on Dec. 28, its meaningful use regulations January 13, 2010, and it is now in the process of finalizing them. Although new requirements might be added, the benchmarks are unlikely to change dramatically. Much of the uncertainty about EMR-implementation has been removed."
Medical practices, hospitals and other healthcare providers also should be cognizant of the manifold other reasons to act now on EMR, added Stanley U. North, a Newark-based partner in LeClairRyan and frequent speaker on EMR-related issues. "For example, the legislation that created the current EMR incentives program temporarily relaxed certain regulations that can make it much harder for hospitals to collaborate with local physicians on EMR. Those more stringent regulations will kick in again after a phase-out period, so it only makes sense to act now."
The beginning of the year, meanwhile, saw the inauguration of an aggressive new auditing program created by Congress to ferret out improper Medicaid payments. The auditors, who are paid a bonus based on the amount of money they recoup, have earned a reputation for demanding clear documentation of medical necessity. "If they are unable to read a document because of illegible handwriting, or if the physician's signature is missing on an order, they will likely determine that the procedure in question 'never happened,'" Hurd advised. "This will likely result in the government payment for that procedure being labeled an 'overpayment' and either disgorged by the practice or subtracted from its next reimbursement check."
By contrast, EMR systems, so long as they are properly implemented and effectively used, generate thorough and legible records that are ideal to support reimbursement claims. "EMR also means that, when you are audited and the auditors ask for 20 records, you are not forced to go through boxes of files and take up staff time making photocopies," Hurd continued. "You have an electronic record that can easily be printed, converted to a PDF file and easily submitted for review."