Pierluisi: Make Puerto Rico Hospitals Eligible for Electronic HealthRecords Incentives

Resident Commissioner Pedro Pierluisi re-introduced legislation to make hospitals in Puerto Rico eligible to receive bonus payments under Medicare for becoming users of electronic health records. Puerto Rico hospitals, unlike hospitals in the states, were excluded from this program when it was established in 2009. In November 2014, Republicans on the House Committee on Ways and Means released a comprehensive bill containing the Committee’s priorities related to hospital reform, and Pierluisi’s bill to rectify Puerto Rico’s unequal treatment under the electronic health record program was included within that package. In the wake of that important step forward, the Resident Commissioner is now re-filing the bill in the hope that it will again be included within a broader legislative package and enacted into law.

It is estimated that Pierluisi’s bill, if approved, could result in the federal government allocating approximately $200 million in additional payments to island hospitals over the next decade.

“Puerto Rico has nearly 70 hospitals, employing over 40,000 individuals,” said Pierluisi.

Pierluisi’s bill seeks to amend the Health Information Technology for Economic and Clinical Health Act, known as the HITECH Act, which was enacted in 2009. The goal of the HITECH Act is to encourage doctors and hospitals to use electronic health records, which can improve patient care, reduce medical errors, and lower health care costs. To promote the adoption of electronic health records, the HITECH Act authorizes bonus payments under Medicare and Medicaid for doctors and hospitals that become “meaningful users” of electronic health records. Under the Medicare incentive program, physicians and hospitals will receive bonus payments if they adopt electronic health records, and will be penalized if they fail to adopt electronic health records by a certain date.

The HITECH Act omitted Puerto Rico hospitals from the Medicare incentive program, yet it makes local physicians eligible for bonus payments under both Medicare and Medicaid, and makes Puerto Rico hospitals eligible for bonus payments under Medicaid.

Under Pierluisi’s bill, Puerto Rico hospitals would become eligible for bonus payments starting in Fiscal Year 2016. Hospitals that become meaningful users of electronic health records starting in 2016, 2017 or 2018 would receive bonus payments for four consecutive years, hospitals that become meaningful users in 2019 would receive bonus payments for three consecutive years, and hospitals that become meaningful users in 2020 would receive bonus payments for two consecutive years. Penalties for hospitals that do not convert to electronic health records would begin to be assessed in 2022.

“Puerto Rico hospitals are not seeking preferential or special treatment. They are simply seeking fair, equal and state-like treatment. This bill would ensure that Puerto Rico hospitals receive the same bonus payments as hospital in the states if they adopt electronic health records, and be subject to the same penalties if they do not, ” said Pierluisi.

Last Congress, Senator Robert Menendez of New Jersey introduced an identical companion bill to Pierluisi’s bill, which was cosponsored by Senator Marco Rubio and Senator Bill Nelson, both of Florida.