Mostashari Describes ONC Budget Request, Certification Fee Proposal

April 23, 2013
Speaking at the April 17 Health IT Standards Committee meeting, National Coordinator for Health IT Farzad Mostashari briefed committee members about the Obama Administration's 2014 budget request, which calls for an increase in ONC funding. He noted that since the office was founded in 2006, the annual appropriation for it has remained at $61 million per year.

Speaking at the April 17 Health IT Standards Committee meeting, National Coordinator for Health IT Farzad Mostashari briefed committee members about the Obama Administration’s 2014 budget request, which calls for an increase in ONC funding. He noted that since the office was founded in 2006, the annual appropriation for it has remained at $61 million per year.

Of course, ONC has also had $2 billion in one-time funds to oversee contracts to get specific work done, such as development of a standards and interoperability framework. That has led to many advances, he said, including the harmonization on one patient summary of care record. “We have made great progress over the past few years and made very good use of one-time funds, but they expire in September 2013,” he said.

The budget document acts as a statement of priorities for the administration, he explained. And it calls for an increase in ONC’s budget to $78 million. Mostashari said ONC uses its funding well to leverage community participation in ongoing policy and standards development activities. “We are hopeful Congress will understand this and will act on it,” he said.

The second element of the budget related to ONC is the proposal of a fee on EHR vendors that would raise $1 million total to help cover costs associated with the certification process.

“Having an assured funding base for certification would reduce uncertainty for the industry,” he noted. “If we get certification wrong and don’t have enough resources, that translates into extra time, money and developer resources the vendors can’t afford,” he said. “But the only way this is going to work is if vendors perceive they are getting more in benefits than whatever it would cost them in certification fees.”

HIT Standards Committee Chair John Halamka, M.D., asked Mostashari whether institutions with self-developed EHRs would be subject to such a fee. Mostashari responded that issues such as that would have to be worked out in the regulatory process.

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