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Hospital groups lobby for bigger share of stimulus funds

Health care systems want the term "hospital" defined in a way that would allow their individual facilities to qualify for federal health information technology incentives.

By Pamela Lewis Dolan — Posted Dec. 24, 2009

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The definition of "hospital" could prevent some health care systems from getting a fair portion of incentive money from the federal stimulus package, according to a group of hospital systems urging the federal government to change the definition.

More than 40 hospitals signed a Dec. 4 letter to Kathleen Sebelius, secretary of the U.S. Dept. of Health and Human Services; Nancy-Ann DeParle, director of the White House Office of Health Reform; and Tony Trenkle, director of the Center for Medicare & Medicaid Services office of e-health standards and services. The letter asked that, for the purposes of distributing health information technology incentives provided in the American Recovery and Reinvestment Act, CMS define a hospital as a discrete site of service.

Under the stimulus package, a hospital is defined by its Medicare provider number or National Provider Identifier. Many hospital systems with multiple locations have one provider number that is shared between all its facilities.

Separating the facilities that are under one provider number into individual hospitals or groups, would allow each to apply for its own stimulus money. The alternative, "obtaining an individual provider number for each individual hospital, would be time and cost-prohibitive, and in some cases may not be possible because of state laws," the letter says.

The group also is urging CMS to change the definition of "hospital-based physician" because it could prevent some practices from collecting their own incentive funds. The hospitals argue that many hospital-employed physicians practice only in ambulatory settings and do not use inpatient electronic medical record systems.

"Accordingly, implementing an [EMR] in an ambulatory setting requires a significant cost separate" from the cost of an inpatient EMR, the letter said.

Initial rules on incentives are expected in December. A 60-day public comment period will begin before the rules go into effect. The hospitals said they wanted to highlight their concerns before the rules are published.

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