Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

Meaningful Use penalties—or to use the politically correct word, “adjustments”—are scheduled to begin in 2015 for providers who are not meaningful users of certified EHR technology by 2014. There’s something about the prospect of incurring a revenue reduction that seems to evoke a visceral response among providers—even among those who do not find the potential incentive money motivating.

Here’s what you need to know about the penalties:

1) Penalties apply to Medicare only.
- Adjustments will be applied as a percent of Medicare Part B Professional Fee Schedule Charges.
- They are scheduled to begin in 2015, and continue as follows:
2015: 1%
2016: 2%
2017: 3%
2018 and 2019: may increase 1%/year, at the discretion of the Secretary of HHS.

2) There has been speculation by some industry pundits that the penalties will be delayed or not implemented at all, but to rely upon that as a given would be a mistake.

3) There are no penalties associated with the Medicaid program—adjustments do not apply to Medicaid revenue. Pursuing the EHR incentives as a Medicaid provider, however, does not totally insulate a physician from the penalties. If a Medicaid provider does not become a meaningful user by 2014, the revenue he/she generates under Medicare would be subject to the adjustments above.

On the weekend I try and go a little big lighter since not as many people read on the weekend. This weekend I decided to go really light and post a couple video clips of Kathleen Sebelius’ appearance on The Daily Show with Jon Stewart.

Thanks to Neil Versel for pointing out this videos. Have a great weekend.

I’m sure that most of you in healthcare saw that Kathleen Sebelius was finally sworn in as the new HHS secretary. You can read the reuters report on the confirmation and swearing in of Kathleen Sebelius.

From the report, there’s no doubt that a lot of Kathleen Sebelius’s first job will be to work on this swine flu. No doubt a very important thing for her to keep an eye on and do what she can to protect us from having a major outbreak.

However, I must admit that I get the feeling that were going to hear very little from this new HHS secretary about EMR and EHR. I could be wrong, but I just don’t see her getting really involved in all the discussions of EHR implementation and the $18 billion of EHR stimulus money as part of the HITECH Act (ARRA).

Certainly she’ll be around for major announcements, but I get the strong impression that it’s actually David Blumenthal that’s going to be in the trenches doing the work of defining “certified EHR” and “meaningful use.”

Anyone know more about the situation that can help clarify what might happen, who will be responsible and whether Kathleen Sebelius will do much for EMR as HHS secretary?

An AP report is announcing that Kathleen Sebelius will be announced as Barack Obams’s new nominee for HHS secretary tomorrow. The article says the following about Kathleen Sebelius as HHS secretary:

Sebelius, 60, is seen as a steady hand, an experienced public official who knows how to work across political lines. As a former state insurance commissioner, she is unfazed by the complexities of health care and insurance issues.

Of course, Sebelius will still have to gain confirmation from the Senate which could be interesting because Sebelius has clashed with abortion opponents in Kansas and the fight might head to Washington.

Another delay in the nomination of the HHS secretary could mean even more delays in the HITECH act and EHR adoption. I for one hope that health care doesn’t have to wait even longer for the HHS secretary to start getting down to business. There’s just far too much to do for us to be without a leader.

UPDATE: It’s now official that Kathleen Sebelius has been named as Obama’s HHS secretary. Check out the Huffington Post report and the Washington Post.

If you’ve read this blog, then I’m sure you know that Tom Daschle withdrew his nomination for HHS secretary. Some people have suggeste Howard Dean to be a nice replacement for Tom Daschle as HHS secretary, but unless I missed something in the midst of the HITECH act mania nothing’s been officially announced by Obama.

All of this means that HHS is without a secretary to implement the HITECH act along with the $2 billion of discretionary funds, choosing an EHR certification criteria, and defining meaningful EHR use.

I can’t imagine the people at HHS are just sitting on their hands, but I sure wonder what impact not having an HHS secretary will have on Obama’s health care reform.

I haven’t really commented in the past about Tom Daschle’s appointment as HHS Secretary.  However, today it was announced that Tom Daschle has withdrawn his name from being HHS secretary.  I don’t know Tom Daschle that well, but from what I’ve read, it seems like Tom Daschle would have been more focused on implementing changes too health care not related to IT.  This guest post by Tom Daschle on the Huffington Post seems to indicate this feeling I have.

One thing is certain, it’s quite shameful that Tom Daschle could somehow have missed $128,203 in additional tax and $11,964 in interest.  Considering the amount of money Obama is planning on investing in EMR, I’m not sure I would have wanted Daschle involved in the process.

Of course, you have to wonder if there exists a politician that isn’t tainted in some serious way or another.  Whoever Obama appoints as HHS secretary, I hope it’s someone who will invest appropriately in HIT.  I also hope they’re as transparent and open as past HHS secretary Mike Leavitt was in his blog.

UPDATE:

I just found this interesting set of quotes and media put together by Alborg about Daschle and various special interests that he might have had.

I’m so happy that Daschle was forced to resign. He was one of the major HIMSS representatives on Obama’s team. From the HIIMSS website:

“HIMSS has arranged for members to personally add their support for Senator Tom Daschle to be confirmed as the next Secretary of the Department of Health and Human Services (HHS). “

In fact, he was paid off by HIMSS members, including speaking fees from Misys Healthcare Systems ($12,000) and GE Healthcare ($12,000) on 8/2008. Quote from article “Tax Cheat Daschle Favors Federal Reserve for Health“:

“GE Healthcare, one of several healthcare companies that paid Daschle tens of thousands of dollars to speak to their organizations, stands to profit if Daschle is confirmed and pursues Obama’s plan for more federal involvement in the health care field. Indeed, a part of the Obama plan, which is a specialty of GE Healthcare, is the electronic processing of medical records.”

Another quote from the recent media:

“While the tax cheating is getting some attention from the media, the $220,000 in speaking fees that Daschle collected from special interests in the health care field seems to be getting more coverage because of the fact, as noted by Kenneth P. Vogel of Politico.com, that many of these firms “stand to gain or lose millions of dollars from the work he would do once confirmed as secretary of Health and Human Services.” A front-page headline in the Washington Post, “Health Sector Enriched Daschle,” captures the obvious conflict of interest problem for the nominee. One of those firms is GE Healthcare, but chances are you won’t hear much about it from GE’s media properties…”

About Dashle’s book which includes HIT references:

“Daschle’s book, “Critical: What We Can Do About the Health Care Crisis,” published in early 2008, notes that “we are years, if not decades, behind European nations in harnessing health care information technology’s potential.” It calls for removing much health care policy-making from the political arena but states that at the same time the executive branch of the federal government should promote creation of an IT infrastructure for health information.”

The only question I still have is whether anyone exists that isn’t as bad or worse than Daschle.  At least maybe his replacement will know how to file his taxes.