On June 1, 2010, Senator Debbie Stabenow (D-MI) led senators from New Jersey, New Mexico, New York, North Carolina, Pennsylvania, Washington, and West Virginia in urging U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius to make the electronic health records (EHR) "meaningful use" Proposed Rule applicable to the nation's dental school clinics.
The proposed rule would provide guidelines for implementation of the Health Information Technology for Economic and Clinical Health (HITECH) Act, which passed as part of the American Recovery and Reinvestment Act of 2009. The legislation states that in order for dentists to be eligible for Medicaid EHR incentives, 30% of patients served must be Medicaid recipients. The legislation also provides the HHS Secretary with the authority to create the methodology for calculating the percentage of Medicaid recipients.
Currently the proposed rule offers a calculation based on an individual service provider. Each must have at least 30% of his or her patients be Medicaid recipients to qualify. A dental school clinic is eligible for EHR incentives when an individual dentist assigns his or her Medicaid reimbursement to the clinic. The current methodology could serve as a barrier to dental school participation in the program. Even though dental school clinics provide services to Medicaid beneficiaries, few dentists working in dental school clinics have individual patient populations of at least 30% Medicaid patients.
The senators recommended two criteria that would overcome this obstacle. First, eligibility for the incentive would be based on the overall percentage of Medicaid beneficiaries within the dental school clinic, as opposed to the patient load of individual dentists. Second, eligibility would be based on patients' status as Medicaid beneficiaries, rather than on reimbursement for specific procedures.
Among the core goals of the HITECH Act are improvement of care coordination, improvement of care for low-income patients, and eliminating health care service disparities.
"EHR Medicaid funding for dental school clinics is critical to the oral health of our nation," said Sandra C. Andrieu, M. Ed., Ph.D., ADEA President. "This is where future oral health care providers will learn that the use of EHR technology to coordinate care with their patients' other health care providers is not just helpful but essential to the highest quality of care. Also, because dental school clinics typically are safety net providers of oral health care in their communities, ineligibility for this funding would have a disproportionately adverse impact on low-income families. These patients are at highest risk, and coordination of their care is especially critical."
"Health information technology will play a major role in developing a more dependable and accurate health care system," Stabenow said. "We must ensure that our dental safety net, including the clinics sponsored by University of Michigan and Detroit Mercy dental schools, has access to the latest technology. We know that meaningful use of electronic medical records will not only save Medicaid money, but also make sure Medicaid beneficiaries get the care that they need."
The nine other senators who signed the letter are Senators Jeff Bingaman (D-NM), Robert Menendez (D-NJ), Patty Murray (D-WA), Robert C. Byrd (D-WV), Frank R. Lautenberg (D-NJ), Bob Casey (D-PA), Kirsten Gillibrand (D-NY), Kay R. Hagan (D-NC), and Maria Cantwell (D-WA).