HHS proposes health IT exception to anti-kickback laws

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The Health and Human Services Department wants physicians to be able to accept hardware, software and training from hospitals to encourage adoption of e-health records.

The Health and Human Services Department today proposed an exception to federal anti-kickback laws that would allow physicians to receive hardware, software and training from hospitals with which they have a relationship to encourage adoption of electronic health records.

In support of the proposed rule, HHS' Office of the Inspector General introduced safe harbors outlining the conditions for the donation of technology for e-prescribing and electronic health records so that they can be exempt from enforcement of the anti-kickback or Stark laws. The rule would be narrow until HHS approves nationwide product certification standards, for which a contract is expected to be awarded this week.

HHS also said that later this week it would release the final foundation standards for electronic prescribing that all Medicare prescription drug plans must support when the new Medicare drug plan takes effect Jan. 1, 2006.

The first set of e-prescribing standards, called for by the Medicare Modernization Act of 2002, include those that are widely used by retail pharmacies and pharmacy benefits managers for eligibility and communications.

The proposals represent a unified effort to allow for greater integration of health IT systems and promote wider adoption of electronic health records, said HHS secretary Mike Leavitt.

Together, e-prescribing and electronic health records will lower costs, reduce errors, improve quality and make health care less of a hassle, according to Leavitt.

'Computer-assisted prescriptions have been shown to cut errors by 70 percent over handwritten prescriptions,' Leavitt said at a press briefing at George Washington University Medical Faculty Associates, a nonprofit medical group in Washington.

There, Leavitt watched a physician use an electronic health record to assist in conducting cholesterol and blood pressure screenings for a patient with heart disease, with the patient's permission. The blood pressure apparatus automatically transmitted the data to the physician's laptop as he was speaking with the patient. The patient provided information about his diet and exercise, which the physician then entered into the record. The physician clicked on a variety of clinical categories, such as lab results and medications, to view the patient's history, make changes to medication dosages, look at trend data and enter new orders for treatment.

These proposals are the most significant steps in HHS' health IT strategy to date, said David Brailer, the national health IT coordinator at HHS.

'The linkage of these proposals to technology certification will ensure that adoption and interoperability occur together on an urgent basis,' he added.

The Centers for Medicare and Medicaid Services, an HHS agency, will award $6 million in pilots to test the e-prescribing standards.

On Friday, the public-private American Health Information Community, which will establish standards for interoperability and the early use cases for them, convenes for the first time.

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