A bipartisan group of U.S. senators are urging CMS to modify its definition of the "meaningful use" of electronic health records to allow more hospitals and physicians, including those working in outpatient facilities, to qualify for incentive payments for adopting EHRs.

The senators join a chorus of other critics who have argued that providers would have a tough time meeting the definition of "meaningful use" CMS outlined in January. Under that proposal, hospitals and physicians that use EHRs would have to demonstrate that they meet all 23 "meaningful use" objectives and requirements in order to qualify for federal incentive payments beginning in 2011.

In their letter, 27 senators urge CMS to scrap the "all-or-nothing approach in which hospitals would be required to adopt all 23" criteria and consider "a longer transition that recognizes a practical, incremental approach to EHR adoption."

They single out CMS' definition of a "hospital-based physician" as a particular area of concern in the meaningful use rule, saying that it "inappropriately excludes physicians practicing in outpatient centers and clinics from being eligible for EHR incentive payments because their offices or clinics are located in facilities owned by the hospital system." They urge CMS to amend the language to include physicians who practice outside of traditional private practice settings, such as in hospital ambulatory care sites.

The senators also express concern that the quality reporting requirement associated with meaningful use "is not yet possible to meet" and therefore should be deferred.

Irene Tsikitas