Congress approves $19 billion for health IT

Excerpt by Andrew Noyes, Congress Daily from NextGov.com

Deal Leaves Money, Language On Health IT Mostly Intact

The compromise stimulus deal leaves much of each chamber’s proposed funding for health information technology intact, according to an overview circulated by House Speaker Pelosi Wednesday and a preliminary summary of the compromise that was subject to change. The final package provides $19 billion to encourage nationwide adoption of electronic medical records, with $17 billion for Medicare and Medicaid incentives for federally qualified health centers, rural health clinics, children’s hospitals, and others. The Senate version, which won approval Tuesday after members stripped out $100 billion, included $16 billion for Medicare and Medicaid incentives, about $2 billion less than the House plan that passed last month. The Senate also imposed a $1.5 billion cap on incentive payments to “critical access hospitals,” while the House included no such language. Conferees reportedly accounted for those facilities, but it is unclear whether the cap remained.

The negotiated stimulus would provide temporary bonuses of as much as $64,000 for physicians and up to $11 million for hospitals that adopt e-health records, the summary document stated. Medicare penalties for noncompliance would also be phased in starting in 2014. The package would also codify the HHS Office of the National Coordinator for Health IT and establish a transparent process for developing standards for e-health records by 2010. An immediate $2 billion would be available to HHS for health IT infrastructure, training, telemedicine, and other grants. The Senate had previously asked for $3 billion, while the House wanted just over $2 billion.

The package would also expand federal privacy and security protections for health IT, such as requiring that an individual be notified if there is an unauthorized disclosure or use of their health information and requiring a patient’s permission to use their personal records for marketing purposes. Details had not emerged by presstime about whether complaints by the privacy community had been addressed. Some watchdogs pressed conferees to take specific steps to close what they argued were marketing loopholes left open in the House and Senate versions as well as make changes to breach notification language. Several sources said they believed a House provision mandating healthcare operations rules from HHS had been dropped entirely. Providers complained the regulations could have required either prior patient consent or the use of de-identified data before information could be exchanged.

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One response to “Congress approves $19 billion for health IT

  1. A big worry is that we’re pushing for the implementation of EHRs before the uniformity standards have been developed to ensure compatibility. The ONC has a public-private ‘board’ called CCHIT (http://www.hhs.gov/healthit/certification/cchit/) that gives out Health IT certification to products. I believe this board has received criticism for having private developers favoring products and/or not being stringent enough on the certification process.

    The purpose of the ONC is to:

    rigorously evaluate systems to establish that they truly meet these criteria for:

    * Functionality – ensuing that the systems can support the activities and perform the functions for which they are intended
    * Security – ensuring that systems can protect and maintain the confidentiality of data entrusted to them ; and
    * Interoperability – ensuring that system can connect to, and exchange information with, other systems
    (http://www.hhs.gov/healthit/certification/background/)

    So the obvious question is: If the ONC is supposed to be ensuring interoperability, why does the ARRA (stimulus bill) “codify the HHS Office of the National Coordinator for Health IT and establish a transparent process for developing standards for e-health records by 2010”??

    The ONC is coming out with a new website: http://www.healthit.gov . This is scheduled to roll out in March, but a month ago they had a long ways to go. Stimulus dollars will probably be allocated to that project…

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