Federal Budget Battle Won't Threaten 'Meaningful Use' DollarsFederal Budget Battle Won't Threaten 'Meaningful Use' Dollars

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Despite threats from fiscal conservatives to withdraw unspent money from President Obama's stimulus legislation, it is highly unlikely that Congress will cut off future funding of Medicare and Medicaid subsidies for Meaningful Use (MU) of electronic health records, according to a key health IT public policy expert.

Recent speculation has suggested that deficit hawks in Congress could refuse to appropriate EHR incentive money in the 2012 federal budget. Even though the 2009 American Recovery and Reinvestment Act authorizes a net $27 billion in spending to support EHR adoption through 2017, lawmakers must fund the program each year. But withdrawing the cash would not be simple.

Since Jan. 5, the date the U.S. Department of Health and Human Services first allowed healthcare providers to register for incentive money, the federal government has had a legal liability to move forward with plans to pay bonuses for EHR MU, said David Roberts, VP of government relations for the Healthcare Information and Management Systems Society (HIMSS).

"Now that the funding is flowing, this is an entitlement program, and it is next to impossible for anyone on Capitol Hill to stop this from going forward," Roberts said Wednesday in Ojai, Calif., at the 20th annual Physician-Computer Connection, the annual conference of the Association of Medical Directors of Information Systems (AMDIS).

That statement may have calmed a lot of nerves. "Probably the No. 1 thing I'm asked is: 'What is the status of this funding?'" Roberts said.

While it is possible to roll back an entitlement program--Medicare itself is a prime example--it is more than a matter of stripping a line item from an appropriations bill, according to Roberts. Congress must specifically vote to narrow the scope of or outright kill MU. That, Roberts said, probably will not happen, even in this contentious political climate.

The 112th Congress has introduced at least seven bills that would take away funding for MU, according to the HIMSS executive. "Many people on the Hill still have an idea that this is not a good use of funds," Roberts said. Few who hold this viewpoint are in a position to move legislation through either house of Congress, though.

Roberts noted that one proposal, the Spending Reduction Act of 2011 (H.R. 408), came from the Republican Study Committee, which Roberts called "the most conservative committee in the House." To date, the bill has been referred to 17 different committees and subcommittees, but none has acted on the plan.

One bill to end the EHR incentives made it to the House floor, but Roberts said that every Republican on the House Appropriations Committee voted against it.

Conversely, there does not appear to be much will to expand MU. Senator Sheldon Whitehouse (D-R.I.) has advanced legislation to open up incentive payments to nonphysician behavioral health professionals, a group conspicuously left out of ARRA. Roberts said Whitehouse sees the bill as a "placeholder" for the next Congress to address because neither Republicans nor the Obama administration would support increased spending before the 2012 presidential election.

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