Thursday, August 03, 2006

Doc -- You're getting a computer!

The Secretary of the (U.S.) Dept of Health and Human Services has announced that the healthcare provider anti-kickback regulations will soon be amended. The statutes and rules (more or less) prohibit medical providers who bill Medicare or Medicaid (i.e., more or less all of them) from accepting gratis anything of value from vendors (the economic theory being that such gifts will cause the providers to buy with less of a jaded eye on price, or to refer business for self-interested reasons rather than good medicine). The laws can be interpreted as saying anything of more value than your typical peppercorn is a potentially illegal kickback, and exceptions are strictly limited to items that are expressly allowed under the rules issued by HHS. (And, if you want to learn more about all that, the Cyberspace Law Committee is hardly your best resource! Go find some blog by health law attorneys...)

The cyberspace angle is that the rules will have a new exemption -- One that allows doctors to accept computers as 'donations.' (Doctors in need of 'donations' might seem a bit incredible for many of us, but we should remember that there are plenty of docs doing good work in less than well-funded circumstances.)

The weird thing is that HHS is saying that this is a good idea because their rules will require that any donated computer be interoperable with any other electronic health system. Sayeth the AP:
They also specify that the computer systems that are donated must be able to talk and interact with other health care computer systems around the country. Such "interoperability" requirements will prevent providers from supplying equipment that deters competition, said Health and Human Services Secretary Mike Leavitt. Some donors would be glad to give doctors equipment if it tied that doctor to doing business only with them, he said.

That seems fair on its surface, but I wonder what the Secretary is really trying to say? Is it really possible, in 2006, that a doctor would accept a non-general purpose personal computer (or a network that wasn't a general purpose system)? Or, if the doc did accept one that it wouldn't be quickly relegated to the basement? While the new exemption is probably justifiable on all kinds of reasons (particularly as we try to get all of the world to start using the new electronic medical records systems which will save money as well as improve medical care), I don't see why this idea of interoperability is the big justification where the docs are obviously going to be getting personal computers that are, almost by definition, interoperable. This sounds like the mind of some PR person at work...

[Props to Prof. Michael Geist for pointing to the story in his [BNA] Internet Law News for 8/2/2006]

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