Washington Debrief: 21st Century Cures Initiative Expected to Include Interoperability Provisions

May 4, 2015
Last week, the House Committee on Energy and Commerce released the latest draft of legislation focused on making significant changes in the regulation of drugs and medical devices, which included placeholders for forthcoming language to address health IT interoperability and telehealth.

Washington Debrief for May 4, 2015

Congressional:

House 21st Century Cures Initiative Legislation Expected to Include Interoperability Provisions

Key Takeaway: Last week, the House Committee on Energy and Commerce released the latest draft of legislation focused on making significant changes in the regulation of drugs and medical devices, which included placeholders for forthcoming language to address health IT interoperability and telehealth.

Why It Matters: Lawmakers are keenly aware of the nearly $30 billion in federal investments disseminated through the Meaningful Use program and have indicated an intention to pursue a legislative solution to generating nationwide interoperability.

Representative Michael Burgess (R-TX-26), M.D.,  has taken the lead among Committee members to draft the language that is likely to be included in the next iteration of the legislation relative to interoperability. During the Health Subcommittee hearing on the draft legislation, Representative Burgess said “This [interoperability] is not a tech problem. This is a bureaucracy problem, and we can fix it.”

The telehealth section was also blank, as the Energy and Commerce Bipartisan Telemedicine Member Working Group is crafting proposals for consideration. According to the committee’s 10-page section-by-section overview of the draft, the Working Group continues to work toward a permanent solution that will allow for the adoption of new technologies to improve care.

Despite the inclusion of placeholders in these two sections of the draft, several committee members expressed a strong desire to ensure language related to telemedicine and interoperability are included in the final legislative proposal resulting from the 21st Century Cures Initiative. The legislation is expected to be considered by the full Energy and Commerce Committee before Memorial Day and on the House floor in June, according to committee Chairman Fred Upton (R-MI).

Senators Request Evaluation of Cyber Threats to Electronic Health Data

Key Takeaway: Last week, the leadership of the Senate Committee on Health, Education, Labor and Pensions (HELP) requested that the Government Accountability Office (GAO) investigate cybersecurity threats to EHRs and other health IT systems.

Why It Matters: Healthcare data breaches have garnered the attention of lawmakers and the latest request made by HELP Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) is only the latest demonstration of Congressional intent to improve the nation’s cybersecurity preparedness. Earlier this year, the HELP Committee established a partisan staff working group to evaluate the cyber threat landscape and opportunities to strengthen the digital infrastructure of the healthcare industry.

The letter requested that GAO to identify the types of “cyber threats” facing health IT systems and potential consequences of those threats. Further, GAO has been asked to identify potential gaps in existing regulations and enforcement of such mandates, specifically calling for an examination of the extent to which HHS and ONC oversee and monitor the implementation and enforce compliance with information security and privacy requirements.

The senators also asked for an analysis of the cybersecurity standards developed by the National Institute of Standards and Technology (NIST) that includes an overview of issues related to those standards and an estimate of the rate of their adoption by health-care organizations.

The request from GAO came days before the committee leadership announced a bipartisan, full committee working group to identify ways to improve electronic health records.  According to Chairman Alexander, the goal of this working group is to identify the five or six things that can “make the failed promise of electronic health records something that physicians and providers look forward to instead of something they endure.”

Federal:

Proposed Payment Rule to Require Hospitals to Submit Electronic CQMs in 2016

Key Takeaway: Hospitals participating in the CMS Inpatient Quality Reporting (IQR) program will be required to submit 16 clinical quality measures (CQMs) electronically in 2016. Hospitals also participating in EHR Incentive Program can use the same 16 CQMs to satisfy Meaningful Use requirements in 2016.

Why it Matters: This is the first time that CMS is proposing to require submission of electronic CQMs, foreshadowing rulemakers’ intention to further cement the use of IT in quality measurement. Will your organization be positioned to submit electronically specified CQMs in 2016? Send your feedback here.

CMS released a proposed rule outlining payment policy for hospitals and long-term care facilities. The Inpatient Prospective Payment System (IPPS) rule also set policy for Stage 3 meaningful use CQM requirements and requirements for participation in the IQR program. Specifically, the NPRM sets forth proposals related to electronically-specified, or eCQMs, meant to allow hospitals to report once and receive credit for both MU and IQR. According to the proposal, hospitals participating in MU will have the option of submitting 16 CQMs electronically to satisfy both MU and a portion of the IQR program requirements, and it ties the submission periods of these programs together in 2016.

However, in a departure from years past, CMS is requiring hospitals participating in IQR to submit 16 CQMs electronically, rather than making this optional as they’ve done in years past. If finalized as proposed, the policy requiring hospitals to submit eCQMs for IQR will be more stringent than the requirements for MU, as hospitals can still report CQMs through attestation under MU rules, also described in this NPRM.

CHIME will provide a review of proposed changes and offer public comment. If you’d like to share your thoughts, please send feedback here.

Edited for style by Gabriel Perna

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