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Two new studies largely confirm the nature of concerns Sens. Thune, Burr, Roberts, and recently raised about the management and outcomes of the Administration’s electronic health record program. In their letter, the Senators asked the Administration four questions, including (1) whether “the use of taxpayer-subsidized electronic health records (EHRs), in some circumstances, actually increase[s] the utilization of diagnostic tests rather than reduce[s] them,” and (2) if “some health care providers received federal subsidies for EHR systems they already had in place prior to the adoption of federal standards and mandates.”

A new study reported in the Journal of the American Medical Association (JAMA) shed additional light on the first concern. The study concluded that “having online access to medical records and clinicians was associated with increased use of clinical services compared with group members who did not have online access.” This largely confirms the Senators concerns that federal health IT policy could lead to increased utilization and costs.

Second, a new report coming out today from the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (attached) offers “an early assessment of CMS’s oversight of the Medicare electronic health record (EHR) incentive program, for which CMS estimates it will pay $6.6 billion in incentive payments between 2011 and 2016.” The OIG found that “CMS faces obstacles to overseeing the Medicare EHR incentive program that leave the program vulnerable to paying incentives to professionals and hospitals that do not fully meet the meaningful use requirements.” As the OIG explained, CMS currently “has not implemented strong prepayment safeguards, and its ability to safeguard incentive payments post payment is also limited.”

This largely confirms the Senators concerns that CMS and ONC may not have appropriate safeguards in place to ensure the appropriate use of taxpayer dollars. In fact, the OIG warned that “ONC requirements for EHR reports may contribute to CMS’s oversight obstacles.” Troublingly, CMS did not agree with the OIG’s recommendation that CMS first “obtain and review supporting documentation from selected professionals and hospitals prior to payment to verify the accuracy of their self reported information.”

Given the nature of the concerns, additional Congressional oversight is likely expected.