March 19, 2010 - Advocacy Corner

Down to the Wire on Reform. In the ups and downs of health reform, there were several times in the past year when the Congress appeared ready to finish the process. Sunday, March 21, could be that historic day that has eluded lawmakers in 70 plus years to enact nationwide health insurance coverage.

Senate-passed legislation with certain tweaks is scheduled for a House vote on Sunday. Estimated at $940 billion over 10 years, the bill would extend coverage to an additional 32 million Americans through expansion of Medicaid eligibility, create state-run insurance exchanges and federal subsidies for lower-income families without access to employer-provided coverage. Individuals would be required to obtain insurance or be subject to an annual penalty of $695, which some states such as Virginia, have already challenged through legislation declaring such mandates as unconstitutional. Private insurers would be prohibited from denying coverage to people with preexisting medical conditions and be required to permit adult children to remain on parents’ coverage until age 26.

Financing would come from a 3.8 percent Medicare tax on investment income for wealthy taxpayers (combined family income of $250,000 +) in addition to a Senate-proposed increase in the regular payroll tax for families. The proposal (HR 3590, the Patient Protection and Affordable Care Act) would cut $60 billion from Medicare with Medicare Advantage slated for particularly deep reductions. Rounding up the necessary 216 votes appears to be making progress with many of the “un-decideds” and “no’s” moving into the yes column. Procedurally, given a House yes vote on the Senate-passed package no conference committee is needed, thus paving way for the President’s signature on this historic legislation.

Health IT Workgroup Reports on EHR Patient Safety. Among reports presented during the HIT Policy Committee meeting on Wednesday, the Certification/Adoption Workgroup presented issues raised by a recent hearing. Intermountain Healthcare Co-Chair Marc Probst noted that many issues involving safety of IT systems are part of local configurations and use, not the IT code itself. He added that a rushed pace for implementation heightened the possibility for safety issues. Very little data on this question is available, with dependence on anecdotes and reports from users. The group made initial recommendations that could be fairly far-reaching, if implemented. The most notable of those was a recommendation that the next round of meaningful use criteria require reporting of technology-related patient safety concerns to a national patient safety organization. While avoiding a recommendation for regulation of EHRs and other health IT systems by FDA, the group seemed open to post-implementation surveillance activities to check for safety issues. For more details, see CHIME Summary and for the full report, see ONC HIT Policy Meeting materials.

Looking down the road for the Office of the National Coordinator (ONC) beyond the current regulatory phase, Policy Committee Chair Paul Tang and ONC’s Jodi Daniel provided a preview of the “Health IT Strategic Framework Vision & Themes.” The vision is stated as follows—a learning health system that is patient-centered and uses information to continuously improve health and health care of individuals and the population.” A public listening session on the proposed plan is scheduled for April 6, 2010 12 to 3 PM EDT. More on this when information becomes available.

And on the schedule for next week, the HIT Standards Committee meets on Wednesday, March 24. Please visit http://healthit.hhs.gov/FACAs for agendas and more information.

ONC Webinar on Certification Proposed Rule. As part of outreach efforts, the Office of the National Coordinator (ONC) and the National Institute of Standards and Technology (NIST) will hold an informational webinar, 4:00 – 5:00 PM ET on March 25. Public comment period for the Notice of Proposed Rulemaking (NPRM) for the Temporary program ends April 9 and the Permanent Program May 10. To participate, go to Join the meeting. Sponsors indicate there is limited space on this webinar. For those unable to join, there will be a transcript posted on the ONC website, http://healthit.hhs.gov, by March 29, 2010. Audio Information--:1-888-673-9805. Participant Passcode is 9033671.

ICD-10 Transition Challenges and Available Resources. With major focus on meaningful use, the transition to ICD-10 has received little attention recently, yet change is coming soon--October 1, 2013. Resources are available, however, to help with this transition. For example, CHIME is pleased to collaborate with AHIMA for the Second Annual ICD-10 Summit April 12–13, 2010, Washington, DC. Leaders from every segment of the healthcare industry will collaborate and exchange information to strengthen the industry. Take advantage of special pricing available only to collaborating organizations like CHIME by entering Coupon Code MX4376 when registering for the event. For more information, click here, or call Customer Relations at (800) 335-5535; e-mail info@ahima.org.

State Advocacy. A reminder of these State Advocacy Days coming up. CHIME is pleased to collaborate on these HIMSS State Chapter events.