Template trouble: Change worries stakeholders

BALTIMORE - Industry stakeholders aren't pleased with one aspect of the newest version of the proposed electronic clinical template for power mobility devices (PMDs): the removal of anything referencing use outside the home.

"For Medicare to pay for that equipment, it must be used within the home, so we removed those types of questions from the template," said Doris Jackson, a health insurance specialist at CMS, during an Open Door Forum to discuss the template last week.

That may be true, but stakeholders worry that the physicians who use the template for Medicare will also use it for other payers, which don't necessarily have the same payment policies.

Laura Cohen, executive director of The Clinician Task Force, suggested to CMS officials that they keep the references in the template and rely on reviewers to apply Medicare payment policies to documentation.

"Standard medical practice considers all of a person's needs and the environments they encounter," she said. "If we create a template that is adopted by electronic health record vendors and implemented across the board in medical practice, you are changing medical practice forever."

CMS officials told Cohen that when they send the template to the Office of the National Coordinator for Health Information Technology (ONC), which will prepare it be part of the electronic health record, other payers and policies will be taken into consideration.

"Right now, it is a CMS document but when we turn it over to the ONC, there will be other payers and electronic health record vendors at the table," said Melanie Combs-Dyer, deputy director of CMS's Provider Compliance Group. "I think you should rest assured, it will not, in the end, be a Medicare-only document."

Providers have until Sept. 25, the date of the next Open Door Forum, to submit comments to eclinicaltemplate@cms.hhs.gov. Soon after, CMS will turn over the template to the ONC, which will then host its own series of calls.