Feds Turn Focus to Healthcare IT

Congress can’t seem to resist tinkering with healthcare through legislation.

EDITOR’S NOTE: The following is a lightly edited transcript of remarks made by the College of Healthcare Information Management Executives (CHIME) Vice President of Congressional Affairs Leslie Krigstein during last week’s edition of Talk Ten Tuesdays.

As the sultry D.C. summer rolls in, we’ve seen Congress and the Administration hard at work on a number of healthcare issues.

Last week was a momentous one in healthcare IT when the U.S. House of Representatives passed an amendment to strike the longstanding ban on the U.S. Department of Health and Human Services (HHS) using federal funds for a unique patient identifier. More than 20 years in the making, the amendment, introduced by Reps. Bill Foster (D-Ill.) and Mike Kelly (R-Pa.), passed 246-178, as one of the many amendments the House considered for the broader the Fiscal Year 2020 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill. That bill is expected to pass the House later this week.  While we are still far from the establishment of a national patient identification strategy, we are farther down the road than we have been in many, many years.

The Senate Health, Education, Labor, and Pensions (HELP) Committee continued its initiative to lower healthcare costs with a hearing this morning to discuss draft legislation that addresses everything from out-of-network billing to air ambulances, public health infrastructure improvements, and credit for providers for adopting good cybersecurity practices. It is likely to be merged with the drug pricing plan coming out of the Senate Finance Committee. This bipartisan effort promises some spirited dialogue on contentious policies for the hospital, physician, and pharmaceutical industries, so it will be worth tracking.

We’ve also seen numerous hearings on Medicare-for-All and single-payor healthcare proposals. Lowering the cost of prescription drugs remains a priority for both the House and Senate, and the volume of hearings and legislative proposals on the topic demonstrates just that.

The Energy and Commerce Committee majority unveiled its infrastructure proposal a few weeks back, notably including funding to modernize the public health IT infrastructure – as well as funding to improve hospital infrastructure, including $2 billion set to be prioritized for those seeking grants for cybersecurity modernization.

We’ve also been following the conversations that the House Veterans’ Affairs Committee is having concerning its migration to a commercial electronic health record (EHR), The Committee has both focused on leadership issues between the Department of Defense (DoD) and Department of Veterans Affairs (VA), but also technical issues like patient identification and data standards.

Privacy remains the name of the game on Capitol Hill. The Senate Commerce Committee’s bipartisan privacy working group has been hard at work, and we await its legislative proposal. The tech giants are under fire, and conversations are starting to account for healthcare data that may fall outside of HIPAA. Just last week Sens. Amy Klobuchar (D-Minn.) and Lisa Murkowski (R-Ark.) introduced the “Protecting Personal Health Data Act,” a bill that would implement privacy restrictions on wearable health applications while setting a new federal standard for biometric consent. As we all know, the Health Insurance Portability and Accountability Act (HIPAA) provides data privacy and security provisions for safeguarding medical information, but the law to this point hasn’t addressed wearables or health apps.

The Administration has been churning out rules at a record pace. Just yesterday, the comment period for the Office of the National Coordinator (ONC) for Health Information Technology’s Trusted Exchange Framework and Common Agreement (TEFCA) closed. The comment period for the Inpatient Prospective Payment System (IPPS) closes next Monday. The Centers for Medicare & Medicaid Services (CMS) released its Patients over Paperwork request for information a few weeks ago, with an Aug. 2 deadline.

Just yesterday, CMS released a proposal for a new transaction standard for the Medicare prescription drug benefit program’s (Part D) e-prescribing program, as required by the “SUPPORT for Patients and Communities Act.” Under the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, the Secretary is required to adopt standards for the Part D e-prescribing program to ensure secure electronic prior authorization request and response transmissions.

We are eagerly awaiting the release of the Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program rules and the Physician Fee Schedule (PFS) governing 2020 physician payment rates. Beyond that, any day now, the Substance Abuse and Mental Health Services Administration (SAMHSA) is expected to unveil regulatory changes to 42 CFR Part 2, as many in the industry, including CHIME, have called for alignment for the purposes of Payment, Treatment, and Operations (PTO) under HIPAA. It’s worth remembering that the comment periods for ONC’s interoperability and information blocking rule and CMS’s patient access and interoperability rule closed within the last month.

I’m not sure I remember a time when there was this much policy activity in the health IT arena. It seems that there will be no rest for the weary. Each day brings new interest from federal officials as we continue to pore through hundreds of pages of rules.