D.C. Report: Workgroup Makes Recommendations to HIT Standards, HIPAA 5010 Compliance Delayed

Implementation Workgroup Relays Recommendations to HIT Standards Committee The Health IT Standards Committee held its monthly in-person meeting this week, where members of the Implementation Workgroup discussed their recommendations to facilitate meaningful use, given feedback from early adopters in the field. Based on feedback from CIOs, vendors and other senior IT leaders, the Implementation Workgroup made recommendations that echoed much of what CHIME and others said in a letter (.pdf) and presentation (.pdf) submitted to HHS last summer. The Workgroup suggested that ONC and CMS “create a grid that shows the standards, certification criteria, testing methodology, and implementation guidance for each of the Stage 2 MU Measures, including the quality measures.” They also recommended that HHS launch a unified website that serves as the “single source of truth” for CMS’s MU and ONC’s certification programs, while establishing a clear process to manage updates to specifications for MU measures and quality measures. Led by Liz Johnson of Tenet Healthcare and Judy Murphy of Aurora Healthcare, the group also asked ONC and CMS to “build realistic software development and implementation timelines into regulatory requirements,” though it remains to be seen what kind of timeline HITSC will consider “realistic.”

CMS Announces HIPAA 5010 Compliance Delay In a recent announcement (.pdf), the Centers for Medicare and Medicaid Services (CMS) said it will delay enforcement of HIPAA 5010 standards until March 31, 2012. The CMS Office of E-Health Standards and Services (OESS) said the 90-day period of enforcement discretion was “based on industry feedback revealing that, with only about 45 days remaining before the January 1, 2012 compliance date, testing between some covered entities and their trading partners has not yet reached a threshold whereby a majority of covered entities would be able to be in compliance by January 1.” The OESS continued, saying, they have also received reports that many covered entities are still awaiting software upgrades. HIPAA 5010 provides more functionality for transactions such as eligibility requests and health care claims status. Implementation of Version 5010 also is a prerequisite for using the updated ICD-10 CM diagnosis and ICD-10-PCS inpatient procedure code set in electronic health care transactions effective October 1, 2013. Despite the enforcement delay, CMS said the compliance date for implementation of these updated standards remains January 1, 2012.

HHS Issues $1 Billion Jobs Challenge through CMS Innovation Center The Department of Health and Human Services will award grants ranging from $1 million to $30 million for finding “innovative projects across the country that test creative ways to deliver high-quality health care services and lower costs. Priority will be given to projects that rapidly hire, train and deploy new types of health care workers.” Providers, payers, local government, public-private partnerships and multi-payer collaborative are eligible to receive portions of the $1 billion pie being managed by the CMS Innovation Center. Letters of Intent are due December 19, 2011 with applications due January 27, 2012.

ACA’s ‘Individual Mandate’ and Medicaid Provisions Head to Supreme Court The Supreme Court unveiled plans this week to hear lawsuits over the Affordable Care Act. One of the issues being decided is whether Congress exceeded its constitutional powers to regulate interstate commerce and to levy taxes when it adopted the so-called "individual mandate" at the heart of the health care law. Many healthcare observers were surprised by the Court’s planned review of ACA’s Medicaid expansion provision. Under the health-care law, beginning in 2014, states will be required to cover all residents with incomes up to 133 percent of the poverty level, including childless adults, adding an estimated 17 million uninsured Americans to Medicaid’s rolls. The case before the Court is being argued on behalf of 26 Republican state attorneys general and governors who contend that these changes to Medicaid unconstitutionally force them to increase their spending on the program. Oral arguments will be heard this spring with a final ruling expected in early summer.

GOP Supercommittee Co-Chair Asks Dems to Get Serious about Entitlements Republican Representative Jeb Hensarling (Texas) called on Democrats Thursday to make an offer that included significant changes to Medicare, Medicaid and overall healthcare spending. “I’m waiting for the Democrats to put fundamental reform on the table,” Hensarling said. The Supercommittee co-chair indicated that Democrats must offer to seriously tackle entitlement spending before Republicans move off their principal public offer of $1.2 trillion in budget savings, with $250 billion in new net taxes. These comments come as leaders in both parties sought to bridge an ideological gulf exactly one week before the Supercommittee’s Nov. 23 deadline to propose at least $1.2 trillion in deficit savings.

Edited by Sharon Canner, Senior Director of Advocacy, CHIME