October 2, 2009 - Advocacy Corner

Senate Finishes Reform Markup. Concluding a marathon consideration of health reform legislation, the Senate Finance Committee early this morning wrapped up their deliberations on the “America’s Healthy Future Act” and scheduled a tentative Committee vote for October 6. In a statement issued early today, President Obama praised the bill authored by Senate Finance Committee Chairman Max Baucus (D-MT), calling it "another milestone in our effort to pass health insurance reform." As a result of lawmakers' work, "we are now closer than ever before to finally passing reform that will offer security to those who have coverage and affordable insurance to those who don't," he said.

Meanwhile the Congressional Budget Office (CBO) is analyzing or “scoring” the bill to determine if it meets certain cost targets. Before markup, CBO estimated the Finance bill at $774 billion over the next decade, less than the $900 billion limit set by the President. The House bill, really three separate bills at this time, is estimated to cost more than $1 trillion over the same period.

Staffs of the Senate Finance and Health, Education, Labor and Pensions (HELP) Committees have begun work on merging the Finance proposal with that of HELP, which includes a public option subsequently dropped by Finance. Floor consideration, beginning October 13, is scheduled to take two weeks resulting in cancellation of Congress’ Columbus Day recess. In the House, the Leadership and Committees are readying H.R. 3200 for a floor vote, but the timing is uncertain, pending outcome of Senate action.

Medicare’s spending growth was a major consideration during markup, leading the Finance Committee to approve a new Medicare commission with 15 members who would be appointed by President Obama and serve six-year, staggered terms. The new commission would be required to implement policies starting in 2014 aimed at cutting the Medicare spending growth rate by at least 1.5 percent annually. Failure to meet this goal would authorize the Secretary to implement a cumulative reduction in Medicare provider payments.

Progress Cited by ONC. As part of efforts of the Office of the National Coordinator (ONC) to keep the public informed, ONC head Dr. Blumenthal yesterday summarized progress and reaffirmed deadlines. To some who have questioned the rigor of the HIT Standards Committee recommendations, Dr. Blumenthal articulated HHS’ intent on meaningful use and prescribed legislative deadlines. He put it this way: “The concept of meaningful use is simple and inspiring, but we recognize that it becomes significantly more complex at a policy and regulatory level. As a result, we expect that any formal definition of “meaningful use” must include specific activities health care providers need to undertake to qualify for incentives from the federal government.”

CMS, he indicated, is expected to publish a formal definition of meaningful use for purposes of receiving incentive payments under Medicare and Medicaid by December 31, 2009. In the coming weeks, ONC will focus on “defining what constitutes a “certified” EHR, which is one of the requirements to qualify for Medicare and Medicaid incentives.”

His message to providers for the short-term is to “be as familiar as possible with the discussion of meaningful use criteria to date.” He also urged providers to examine how their current practices or organizations might be redesigned to improve the efficiency and quality of care through the use of an electronic health record system. For the full text, click here.

Randy McCleese Recipient of Inaugural CHIME State Advocacy Award. This award recognizes CIO Leadership Promoting State-level Education Efforts, Randy McCleese, CIO and Vice President of St. Claire Regional Medical Center in Morehead, Kentucky, has inspired chief information officers in other States to educate policymakers on the tools of health IT. He is also working with CHIME’s Advocacy Leadership Team (ALT) to encourage CIO involvement in more State efforts. For 2010, CHIME members are encouraged to nominate colleagues for the award. Self-nominations are encouraged as well.

The State Advocacy Award was presented at a CHIME-sponsored luncheon in conjunction with the HIMSS Policy Summit during National Health IT. Also during NHIT Week, CHIME members participated in the Advocacy Strategy and Policy Update that featured CMS CIO and Director, Office of CMS Information Services Julie Boughn. While CMS is mum on meaningful use during preparation of regulations due in December, she engaged the audience in a lively dialog around “what would healthcare look like in 2015” as a result of the implementation of EHRs. For her slides, click here.

Report Forms for Patient Information Breaches Released. The breach notification interim final rule requires covered entities to provide the Secretary with notice of breaches of unsecured protected health information. HHS has released the forms for use by hospitals for reporting breaches directly to the Department’s website. If a breach affects 500 or more individuals, covered entities must notify the Secretary concurrently with the individual notices to affected individuals. For a breach affecting fewer than 500 individuals, the covered entity may notify the Secretary on an annual basis.