June 24, 2012
What are the Electronic Health Record requirements for dental offices?
Over the past year, the CDA has received numerous calls from dental offices that have been told by vendors that they are required to implement electronic records systems, including digital x-ray equipment, by 2014. While many offices are making the voluntary switch to electronic records systems, it’s important to have the truth about what’s actually required by law.
What some vendors are saying:
• Electronic medical records systems will be required by 2014.
• The government is requiring you to buy an electronic medical records system.
• The government is requiring you to use digital x-ray equipment by 2014.
• Simply buy an electronic medical records system and you can qualify for stimulus money.
• You must act now in order to qualify for stimulus money from the government, and you must show that you are using the electronic medical records system by 2012.
In addition, a new variation of this sales pitch has recently surfaced. The latest variation states that film processing chemicals for x-ray equipment will be unavailable for shipping to dental offices starting in 2014.
What is actually true:
Electronic health records are not required – not now and not in 2014. The American Recovery and Reinvestment Act of 2009 (commonly known as the “stimulus bill”) offers some incentives to encourage healthcare providers to switch to electronic records systems, including grants of stimulus money for the purchase of electronic records systems. However, the legislation explicitly states that participation in the installation of electronic records systems is voluntary.
Qualified dental offices that switch to electronic records systems could be eligible for incentive payments of up to $63,750. To qualify for a grant, at least 30% of the dentist’s patients must be covered by Medicaid, the system purchased must be certified by the federal Health and Human Services (HHS) Administration, and the dentist must demonstrate that the system is effectively utilized. Dentistry has faced several barriers in accessing these grants, even when the above criteria are met. HHS has been slow to certify dental records systems, though a few dental software programs appear to have been certified in late 2011 and early 2012. While maximum stimulus money is available to dentists who demonstrate use in 2011 and 2012, those who show utilization of systems in 2013 or 2014 can still qualify for the majority of the funding available.
Under this bill, Medicaid providers who do not utilize electronic medical records systems will be penalized on Medicaid reimbursement rates starting in 2016, if there are no intervening repeals or implementation delays. Starting in 2016, rates would be reduced by 1% per year with a maximum total reduction capped at 5%. This rate reduction only affects Medicaid providers. The CDA is not aware of any parallel policies by private insurance providers.
While the Patient Protection and Affordable Care Act of 2010 (commonly known as the healthcare reform bill) contained some references to developing an information technology infrastructure, it did not create any new requirements for electronic health records.
Neither of these bills specifically addresses the use of digital x-ray technology.
Finally, there has not been any documentation or evidence provided to support rumors that there will be a shortage or regulation limiting access to x-ray processing chemicals in 2014. While a shortage could happen at any time, the CDA has consulted with several reputable suppliers of x-ray equipment. They are not expecting any shortages or manufacturing discontinuations for processing chemicals. In addition, the CDA is not aware of any new state or federal regulations that would limit access to film processing chemicals. The CDA will promptly inform members of any regulation changes of this nature.