Republican Bill Would Make 'Meaningful Use' Meaningless

A group of U.S. House Republicans want to take President Obama up on his offer to cut wasteful spending by starting with incentives tied to health information technology.

Rep. Jim Jordan (R-Ohio) and more than 170 other House Republicans have introduced HR 408, a proposal to reduce federal spending by $2.5 trillion through fiscal year 2021, according to the text of the bill.

In a statement, Jordan said "after two years of reckless spending and putting record levels of debt on the backs of our children and grandchildren," he welcomed the president's call to curb spending in this week's State of the Union speech.

"I urge the president to put his call for spending cuts into action by pledging to sign our Spending Reduction Act, a $2.5 trillion spending cut package that will begin to restore fiscal responsibility to Washington," the three-term congressman said.

HR 408 - specifically Section 302 - would go after non-defense provisions of the American Recovery and Reinvestment Act (ARRA), better known as the "stimulus package," which brought us the HITECH Act. While the entire Act is not being nixed, it does repeal sections, including the EHR Incentive Program, i.e. "meaningful use." That means, according to Health Data Management, that $27 billion already authorized for incentive payments to physicians for implementing EHRs and proving "meaningful use" could disappear.

Section 706 of the proposed legislation deauthorizes appropriations through the Affordable Care Act and its companion legislation, the Health Care and Education Reconciliation Act of 2010, meaning future reliance on EHRs under the reform law would also become null in void, as would several other provisions where money has yet to be allocated.

So after years of preparation, perspiration, and getting to the bottom of "meaningful use," it seems physicians' practices could be left with shiny new software and hardware, but no reimbursement for their investment.

Granted, it would take a lot for the bill to get past the House, approved in the largely Democratic U.S. Senate and signed by President Obama, but the bigger question still a bit blurry after Tuesday night's speech is: The government is looking to cut funding, but from where?

"Unallocated" or "unobligated" funding - like lots of money in the HITECH Act - are usually the first places that get hit, so the trepidation of many physicians taking a wait and see attitude on EHRs and related incentives could be valid.

It is expected that several parts of the Affordable Care Act and other health-related bills passed over the last two years by a Democratic Congress will be the targets of repeal or at least long hearings aimed at getting exact answers, scrutinizing spending, and possibly opening up room for amendments.

So while it is unlikely HR 408 will ever get to the president's desk, it is sure to be one of many pieces of legislation attacking health IT and meaningful use incentives.