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July 30, 2010 - Advocacy Corner
Incentive Program Focus of E&C Oversight Hearing. Following last week’s House Ways and Means Health Subcommittee hearing on the HITECH Act, the Energy and Commerce Health Subcommittee on Tuesday focused on many of the same themes, including the multi-campus issue. Compared to the initial hearing, the response to relaxed deadlines and reduced numbers of objectives was less intense, which may be a reflection of the Committee’s composition and its physician members.
On the issue of penalties, concern was expressed over the penalties that providers could potentially face for not adopting EHRs. Testifying for the Administration was ONC Dr. Blumenthal and CMS Office of Standards Tony Trenkle. Trenkle replied that providers would not be fined until 2015, and the final rule was crafted with exhaustive input from providers. Dr. Blumenthal also assured Committee members that ONC and CMS would continuously study provider experience to make sure they can implement the new technologies, and that vendors can continuously introduce new technologies into the market place. For multi-campus health systems, Trenkle confirmed that such a system would only get one payment, but individual doctors in physician practices would be eligible for individual payment if each demonstrates meaningful use. He also noted that the Agency would be open to discussing with the Congress other ways to augment the rule.
Subcommittee Chair Frank Pallone (D-NJ-6) expressed strong support for the rule and also related his experience on a recent
trip with CHIME members touring Mammoth Medical Center in New Jersey to learn about health IT initiatives in his constituency.
Monmouth Medical Center also testified. The hearing was later joined by Committee Chairman Henry Waxman (D-CA-30) who asked
witnesses about the role of health IT in improving the quality of public health. Dr. Blumenthal talked about secured information
that could be transferred in real time to the CDC to enable the Agency to learn about disease trends and potential epidemics. Trenkle
added that the health IT infrastructure would support this free flow of data to meet the objectives of health care reform. For hearing
testimony, click here.
Meaningful Use Dominates Standards Committee Meeting. Deputy Director of the Office of E-Health Standards and
Services/CMS Karen Trudel stated at the meeting on July 28 that Medicare providers will receive payments in May 2011
for becoming meaningful users. Registration for incentive payments will be available after January 1, 2011. While
the payment year for physicians starts in January, the payment year for hospitals will not begin until October of 2011.
Trudel stated that the CMS and the ONC will ensure that their regional offices and RECs communicate with each other.
CMS will set up a help desk to educate concerned providers about the incentive program.
Committee member Judith Faulkner expressed concern that no organization has yet been designated as an official
testing and certification body, making it difficult for some hospitals to demonstrate meaningful use throughout the 90-day
window. Director of the Office of Standards and Interoperability Doug Fridsma noted that there was uncertainty whether the HHS
would make the January 1 deadline to have testing and certification designated. Fridsma also spoke of the collaboration between
the NHIN Direct team and the ‘Tiger Team’ on developing policy to ensure security, and various pilot projects. The committee was
also updated on the Virtual Lifetime Electronic Record (VLER) project, which is expected to help providers to prepare for meeting
stage 2 criteria. For meeting materials, click here.
CMS Education Series for Providers Scheduled. The Centers for Medicare & Medicaid Services (CMS) has announced a series of national provider calls addressing the specifics of the Medicare and Medicaid EHR incentive programs for hospitals and individual practitioners. Calls are scheduled as follows:
- EHR Incentive Programs for Eligible Professionals:
Tuesday, August 10, 2010
2:00-3:30 pm EST
- EHR Incentive Programs for Hospitals:
Wednesday, August 11, 2010
2:00-3:30 pm EST
- EHR Questions and Answers for Hospitals and Individual Practitioners:
Wednesday, August 11, 2010
2:00-3:30 pm EST
Information on how to register for these calls is forthcoming.
Meaningful Use Matrix Tool Available. The MU Matrix of objectives and measures included with the Final Rule has been upgraded to assist CHIME members.
An additional column “Exclusions and Other Considerations” prepared by HPA adds yet another tool to support CIOs in becoming meaningful users.
Click here for the Matrix.
Final Breach Notice Withdrawn. Earlier this week, HHS withdrew from OMB review the Final Rule for Breach Notification for Unsecured Protected Health
Information issued under the HITECH Act. The Interim Final Rule published in August 2009, which became effective in September 2009, received approximately 120 comments.
As to an explanation for this action, HHS said, “At this time, however, HHS is withdrawing the breach notification final rule from OMB review to allow for further consideration,
given the Department’s experience to date in administering the regulations. This is a complex issue and the Administration is committed to ensuring that individuals’ health
information is secured to the extent possible to avoid unauthorized uses and disclosures, and that individuals are appropriately notified when incidents do occur. We intend
to publish a final rule in the Federal Register in the coming months.”
The actual reasoning behind HHS's action is unclear. Post & Schell's Ed Shay has speculated that one of the reasons
could be the controversy regarding the "harm threshold" element of the rule. This "harm threshold" essentially requires the organization which discovers a breach to undergo a risk assessment test to
determine whether a breach would cause "significant harm" to the affected person. Further, it is unclear what affect withdrawal of the final rule will have on the HIPAA NPRM, published July 14.
And for more on the breach notification rule, click here for a related blog posted earlier this year.
StateWatch. As more focus shifts to state implementation, CHME will report developments. Readers are also invited to also alert us to HIE/HIT happenings in our areas.
Illinois: Moving Rapidly Toward a Paperless Health System. On July 27, Gov. Patt Quinn created the Illinois Health Information Exchange
by signing House Bill 6441, passed unanimously by the General Assembly, into law. The legislation is effective immediately. Soon, the state providers
and insurers will begin sharing patient health information over a secure network. The project will be financed through the $18.8 million ARRA stimulus
funds from the federal government. On July 28, the Governor signed another bill, SB 2630 that will allow agencies to “transmit or retain records
electronically.” This law too was passed unanimously and takes effect immediately. It also creates an Advisory Board that will develop best practices
for these agencies. The architect of this bill, State Treasurer Alexi Giannoulias, stated that this law will “bring state government into the 21st
Century in both a fiscally and environmentally responsible way.” Hence, Illinois has now joined the rapidly expanding group of states that are initiating
their own HIEs.
Workgroup and Website Progress. Promoting collaboration and communication between StateNet Coordinators and State level HITECH stakeholders is a key goal for StateNet. Toward this goal, two StateNet workgroups established earlier this summer held first meetings and set their agendas for the coming weeks. The REC workgroup is chaired by Randy McCleese, StateNet coordinator for Kentucky and the HIE/Interoperability workgroup is chaired by Neal Ganguly, StateNet coordinator for New Jersey. Both groups are working closely with ONC, CMS, and other stakeholders to ensure that CHIME members have a say in state level health IT policy and implementation. All workgroup documents will be posted on the StateNet website.
The success of these workgroups will rely significantly on the state profiles. Many thanks to all state coordinators who have completed, or initiated their state profiles. Over thirty five states have begun their profiles, with thirteen states having already finished uploading all available documents. As states begin to finalize or implement their plans, the website will evolve becoming more comprehensive over time. Your suggestions to enhance this resource are most welcome..
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