May 28, 2010 - Advocacy Corner

Extenders Bill Includes MD Payment Fix. Earlier this week, House Democrats released a new version of the “American Jobs Creation and Closing Tax Loopholes Act of 2010” (tax extenders bill/HR 4213) that includes a provision to block a scheduled May 31 cut in physician Medicare payments. Also included are unemployment benefits and COBRA benefits extended through November 30 rather than December 31 in a move to cut the bill’s cost. In an effort to secure votes of moderate Democrats concerned over budget deficits, such cost-cutting has reduced the overall price tag from nearly $200 billion down to $144 billion.

The House is expected to take up the extenders bill today. Even if passage occurs, the Senate would not consider the legislation until after the Memorial Day Recess, returning to Washington the week of June 7. It is anticipated that CMS would suspend the physician payment cut for 10 days to allow for legislative action.

Today’s vote is expected to occur in two phases. Unemployment benefits and tax extenders will comprise phase I and the pending 19-month physician payment cut in the second. This split permits a separate vote on the physician fix which is exempt from the pay/go rules adopted earlier this year in which spending issues must be off-set by revenue measures. The exemption also provides political cover for Members during an election year.

Proposed New Rules for Telemedicine Credentialing. New CMS proposed rules would permit hospitals to use information from another location for purposes of credentialing and privileging decisions for physicians and other practitioners that will use telemedicine at their facility. CMS notes that small hospitals in particular find it difficult to perform a traditional credentialing process for all providers providing telemedicine services at their facilities. A new requirement would also permit the distant-site hospital to assess the quality and appropriateness of the diagnosis and treatment provided by its own staff when furnishing telemedicine services to a critical access hospital. Comments are due 60 days following the May 26 publication in the Federal Register. The website for online comments is http://www.regulations.gov.

Coordination of Privacy and Security Policy a Focus of the HIT Standards Committee. Meeting on Wednesday this week, the HIT Standards Committee reported on a number of ONC actions in an effort to assure that the multitude of implementation activities in progress are in sync with one another. Some members of the Privacy and Security Workgroup, for example, have called for a more rigorous privacy and security framework than authorized by the HITECH Act. As envisioned by Congress, HIPAA was deemed appropriate for development of the nationwide healthcare information network, a concept guiding the efforts of the NHIN Workgroup. A “Tiger Team” of Standards Committee members with strong privacy and security background cutting across all workgroups has been tasked with working on this privacy coordination issue. Its first assignment is a review of work products of ONC’s NHIN Direct, which permits one-to-one health information exchange.

The Clinical Quality Workgroup, charged with making recommendations on specific quality measures that should be included in the definition of meaningful use, is conducting an environmental scan of twelve healthcare systems and several selected registries. The intent is to determine which health IT tools would facilitate rapid improvement without requiring other solutions. This effort is preparatory for 2013. Vendors will also be contacted to determine which healthcare quality measures they include in their EHR solutions.

White House Chief Technology Officer Co-Chair Aneesh Chopra, Chair of the newly created Enrollment Workgroup, reported on details of the Health Care Act’s requirement to enable social services recipients to determine eligibility and enroll electronically in federal health programs or the new federal health insurance exchanges. To carry out its charge, the Workgroup will develop recommendations for: electronic matching across state and Federal data; retrieval and submission of electronic documentation for verification; reuse of eligibility information; capability for individuals to maintain eligibility information online; and notification of eligibility. Sam Karp, Vice President of Programs, California Healthcare Foundation, serves as the private sector co-chair. For meeting materials, past meeting minutes and other details, see this link (and scroll down to May 26).

June 16 CHIME Meeting During NHIT Week. Dr. Farzad Mostashari, Deputy National Coordinator for Policy and Programs with ONC, will kick-off the first in-person meeting of StateNet Coordinators on June 16. Intended as a dialog on issues central to state-level information exchange, CIOs will be encouraged to share their views on such issues as interoperability, inter-state functionality, sustainability, eMPI, and privacy and security. The meeting will be held from 1 – 3:30 pm at the Ronald Reagan Building and International Trade Center. There is no cost to attend, but registration is required. Registration is open to all CHIME CIO members. Please RSVP online by June 10. Space is quickly filling up. For more information on other National Health IT Week events, please visit the CHIME website.