Unintended Consequences of New State “Meaningful Use” Mandate

| Posted On Dec 05, 2013 | By:

Atrius Health has a long standing history of investing tens of millions of dollars in the use of electronic health records (EHR) and electronic prescribing to improve the care of our 1 million patients. Over the past year, all of our practices have attested on behalf of our eligible providers as required by the federal government’s Meaningful Use (MU) requirements. Atrius Health has reinvested the funds received back into the EHR as well as other improvements to the care of our patients.

A little-known provision contained within last year’s payment reform bill (Chapter 224 of the Acts of 2012) included a requirement that all physicians “demonstrate the skills to comply with Meaningful Use requirements” as a condition of licensure effective January 1, 2015. Unfortunately, the language did not provide additional guidance to explain the intent or scope of the requirements. The federal government’s MU requirements clearly defined those individuals who are “eligible providers,” however Massachusetts’ Chapter 224 makes no distinction.

The original intent of the section in question was to advance adoption of electronic medical records in the Commonwealth. This is a goal we strongly support; however, linking licensure of physicians to federal meaningful use financial incentives is an inappropriate measure of progress. Massachusetts has a very high certification rate for meaningful use with over 14,000 individual physicians having met the requirements for stage 1, but, there are still approximately 40,000 licensed physicians in Massachusetts. Strict interpretation of the language from Chapter 224 would lead to denials of licensure renewal for 26,000 physicians.

In addition, there are approximately 4,800 physicians in training, residents and interns that are licensed in Massachusetts. Most would be ineligible for meaningful use certification because they have not treated patients for more than a year. Implementation of the meaningful use provisions in Chapter 224 could potentially end medical training programs in Massachusetts.

Although the Board of Registration in Medicine (BORM) has been made aware of the issue and has been asked to interpret this new requirement in the broadest way possible, to date no changes have been proposed by the BORM.

Legislation has been proposed to correct the unintended consequences of this language within Chapter 224 of the Acts of 2012, which we support. House Bill 1925,  “An Act Relative to Physician Health Information Technology”, was recently heard before the Joint Committee on Public Health. We encourage the Legislature to enact this bill quickly to ensure that over half the licensed physicians in the state are not suddenly faced with licensure action.

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