Washington, DC-Today, with the support of 12 bipartisan cosponsors, Resident Commissioner Pedro Pierluisi reintroduced legislation to ensure that Puerto Rico hospitals can receive bonus payments from the federal government under the Medicare program for adopting electronic health records. Senator Robert Menendez (D-NJ) and Senator Marco Rubio (R-FL) are filing an identical bill in the Senate.

Pierluisi's legislation, known as the Puerto Rico Hospital HITECH Amendments Act of 2013, seeks to correct an oversight in the Health Information Technology for Economic and Clinical Health Act, known as the HITECH Act, which was enacted as part of the American Recovery and Reinvestment Act in February 2009. The goal of the HITECH Act is to encourage doctors and hospitals to use electronic health records, which can improve patient care, curb medical errors, and reduce health care delivery costs.

To promote the adoption of electronic health records, the HITECH Act authorizes bonus payments under Medicare and Medicaid for eligible doctors and hospitals that become "meaningful users" of electronic health records. The Medicare incentive program consists of "sticks" as well as "carrots"; physicians and hospitals will be penalized if they fail to adopt electronic health records by a certain date.

Unfortunately, the HITECH Act omitted Puerto Rico hospitals from the Medicare incentive program. This exclusion appears to have been inadvertent, since the bill makes Island physicians eligible for both the Medicare and Medicaid bonus payments and makes Island hospitals eligible for the Medicaid bonus payments.

"There is no principled basis to exclude Puerto Rico hospitals from the Medicare component of the HITECH Act and this exclusion will significantly hamper efforts to adopt electronic health records -and thereby improve patient care and reduce delivery costs-on the Island," said Pierluisi.

Accordingly, the Resident Commissioner's legislation would amend the HITECH Act to treat Puerto Rico hospitals like hospitals in the States, making them eligible for Medicare bonus payments if they become meaningful users of electronic health records and subjecting them to penalties-in the form of reduced Medicare reimbursement rates-if they fail to do so by a certain date.

"Puerto Rico hospitals are not seeking preferential or special treatment. They are simply seeking fair and equal treatment. This bill would ensure they receive the same bonus payments as hospital in the States for adopting electronic health records, which have been shown to improve patient care," said Pierluisi.

It is estimated that including Puerto Rico hospitals in the Medicare portion of the HITECH Act would result in approximately $100 million in additional federal payments to island hospitals over the next decade.

The Resident Commissioner expressed gratitude to the Puerto Rico Hospital Association for endorsing his legislation, and thanked the Association and its Washington-based advocates for raising awareness about the bill in both the House and Senate and among both Democrats and Republicans.

"When Congress and the President created the HITECH ACT with the intent to upgrade medical recordkeeping in our Nation's hospitals, they forgot to include the hospitals which serve hundreds of thousands of seniors residing in Puerto Rico and participating in Medicare. Our goal is always to improve the quality of health care for the patients we serve and we are pleased that Resident Commissioner Pierluisi's legislation to right this wrong has received bipartisan support with its introduction in the House and Senate. We urge Congress to move forward and pass this important legislation promptly," said Puerto Rico Hospital Association President Jaime Plá.

Pierluisi also expressed his gratitude to Senator Menendez and Senator Rubio for their strong support for the people of Puerto Rico and introducing legislation identical to the Resident Commissioner's bill.

"Increasing the use of electronic medical records is a common-sense way to improve coordination between providers, increase efficiencies in care delivery and, ultimately, lead to lower costs and better health outcomes. This is true for all providers, including those in Puerto Rico. This legislation will ensure that providers in Puerto Rico are allowed to participate in the HITECH program to increase utilization of health information technology throughout the island," said Senator Menendez.

For his part, Senator Rubio said: "Promoting the use of electronic medical records is an important part of delivering better patient care and reducing sky-rocketing health care costs that threaten budgets at both the family and national levels. This legislation is important to ensure that our fellow Americans in Puerto Rico are not excluded from the HITECH Act's initiatives to encourage hospitals to better integrate electronic medical records."

The original House cosponsors of Pierluisi's legislation on the Republican side are John Mica (R-FL); Ileana Ros-Lehtinen (R-FL); Peter King (R-NY); Mario Díaz-Balart (R-FL); and Don Young (R-AK). The original cosponsors on the Democratic side are: Raúl Grijalva (D-AZ), Donna Christensen (D-VI), Eni Faleomavaega (D-AS), John Conyers, Jr. (D-MI), José Serrano (D-NY), Madeleine Bordallo (D-GU), and Alan Grayson (D-FL).

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