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McKinney School of Law expert comments on OIG report assessing electronic health records subsidies

INDIANAPOLIS — The Office of the Inspector General in the U.S. Department of Health and Human Services released a critical, early assessment of the Centers for Medicare and Medicaid Services oversight of the subsidy program for electronic health records.

Under the American Recovery and Reinvestment Act of 2009, about $30 billion was appropriated to encourage the adoption of electronic health record technology — computerized record-keeping systems that store patients’ health-related information, including medical histories and procedure notes.

Subsidies or incentives are disbursed to doctors and hospitals based on the “meaningful use” of approved electronic health record systems. About 500,000 doctors and 5,000 hospitals are eligible for funding. The first funds were disbursed in 2011, and the program will end around 2016.

The new OIG report found:

•CMS has not implemented strong prepayment safeguards, either by verifying self-reported data or requiring supporting documentation.
•CMS’ proposed postpayment audit program is limited and potentially flawed

“There have been several criticisms of the meaningful use program,” said Nicolas P. Terry, Hall Render Professor of Law at Indiana University Robert H. McKinney School of Law on the Indiana University-Purdue University Indianapolis campus. “These include emerging concerns about the ineffectiveness of electronic health records in general, the lack of rigor perceived in some of the meaningful use criteria, and the quality of oversight or audit by the Centers for Medicare and Medicaid Services, particularly in the face of self-reported data.”

Terry, also co-director of the Hall Center for Law and Health at McKinney School of Law, is one of the country’s leading experts on electronic health records. He has written extensively on their privacy and safety implications as well as the meaningful use program. Terry offers background information on the program in “Meaningful Adoption: What We Know or Think We Know About the Financing, Effectiveness, Quality, and Safety of Electronic Medical Records.”

Terry can be reached for interviews by phone at 317-274-8087 or by email at