The Washington Debrief  provides CHIME members weekly news and information related to important healthcare IT legislative, regulatory and political developments in Washington, D.C.

Volume 5, No. 18
May 8, 2017
Government Finally Funded for FY17, Includes Progress on Patient ID 

Key Takeaway: Congress passed an omnibus appropriations bill that funds the federal government through the end of the fiscal year, in the explanatory statement that accompanied the bill, the Department of Health and Human Services (HHS) was cleared to provide technical assistance to the private sector for patient identification and matching.

Why It Matters: The Committee report language that accompanied the funding bill, is the largest step forward on the issue of patient identification since 1998, when then-Representative Ron Paul (R-TX) included a ban to prohibit HHS from using federal funds to promulgate or adopt a unique health identifier.

The five-month, $1.2 trillion dollar spending bill called for just over $60 million in funding for ONC, keeping their budget level with FY16. Overall, HHS will receive a $2.8 billion increase over their FY16 funding level despite the Administration initially proposing an 18 percent cut for the remainder of 2017. The National Institutes of Health (NIH) were given a $2 billion increase of FY16. In support of a top healthcare priority Administration's, efforts to fight opioids received a boost of $801 million within the Centers for Disease Control (CDC), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Health Resources and Services Administration (HRSA). HRSA also got $1.5 million boost for a telehealth center of excellence. The Food and Drug Administration (FDA) is set to get $2.8 billion, up $39 million from last year. Notably, the Department of Homeland Security (DHS) is set to receive nearly $1 billion in additional support for their cyberspace activities.

Leslie Krigstein
VP Congressional Affairs, CHIME

Mari Savickis
VP Federal Affairs, CHIME

Thoughts, Questions or Comments? Please contact  Leslie or Mari

Office Hours: 
9:00am - 5:00pm
On Patient Identification, the Committee report language, similar to that language supported by CHIME and 25 other organizations in a letter delivered to appropriators earlier this year, says:

"Unique Patient Health Identifier.-The Committee is aware that one of the most significant challenges inhibiting the safe and se- cure electronic exchange of health information is the lack of a consistent patient data matching strategy. With the passage of the HITECH Act, a clear mandate was placed on the Nation's healthcare community to adopt electronic health records and health exchange capability. Although the Committee continues to carry a prohibition against HHS using funds to promulgate or adopt any final standard providing for the assignment of a unique health identifier for an individual until such activity is authorized, the Committee notes that this limitation does not prohibit HHS from examining the issues around patient matching. Accordingly, the Committee encourages the Secretary, acting through the Office of the National Coordinator for Health Information Technology and CMS, to provide technical assistance to private-sector led initiatives to develop a coordinated national strategy that will promote patient safety by accurately identifying patients to their health in- formation."

Additional acknowledgement of patient mismatches was also included in the instruction of how the Office of the National Coordinator for Health IT (ONC) should use their federal funding:

"Electronic Health Records.-The Committee believes HHS' work to encourage the adoption of electronic health records has provided important new opportunities to improve the quality, safety, and cost-effectiveness of health care. The Secretary is directed to further this work by studying approaches to improve person-centered healthcare through patient access to health information. That work should examine accurate and timely record matching so that all EHR systems are collecting the information necessary for a fully interoperable system that protects patients from identity mismatch errors, but also considers patient privacy and security."
Letter Nudges HHS Committee to tackle patient identity

Key Takeaway: CHIME calls on key advisory committee to have hearing on patient identity issues.

Why it Matters: For the second year in a row, CHIME has called upon a little known yet powerful committee in Washington charged with making recommendations to the U.S. Department of Health & Human Services (HHS) on issues related to the Health Insurance Portability and Accountability Act (HIPAA). The HIPAA mandates a series of standards be named for use in healthcare including a patient identifier. Given the movement on the Hill discussed above, we have pressed the National Committee on Vital and Health Statistics (NCVHS) to host a hearing on this topic to hear from the industry.
ONC announces new challenge

Key Take Away: The Office of the National Coordinator for Health IT (ONC) has announced a patient matching algorithm challenge.

Why it Matters: Last week, ONC announced an upcoming Patient Matching Algorithm Challenge and wrote about it in a blog post. ONC has said they view the challenge as complementary to the CHIME National Patient ID Challenge and they are seeking to better get a sense of the current state and capabilities in the industry today.
Meaningful Use / Certified EHRs   Meaningful_Use
We need your input!

Key Takeaway: Take our 3 question, 5 second survey!

  1. Have you received your     2015 Edition Certified EHR software from your vendor?    Y /N
  2. If no, do you expect to   receive it by July 1?
  3. Do you think you will be   ready for January 1, 2018?
Why it Matters: CMS did not propose changing the required start date by which providers would need to start Stage 3 and begin using Version 2015 CEHRT, though they are requesting feedback on this. While CMS has proposed a 90-day reporting period of Meaningful Use, they have also proposed providers must report eCQMs for the first three quarters of 2018. Got a story to tells us on 2015 CEHRT? Send us your thoughts and concerns. Also, don't forget our next IPPS workgroup call is Friday, May 12th at one. Anyone interested in joining please let us know and we will add you.

Click here to complete the survey.
House Passes American Health Care Act

Key Takeaway: Last Thursday the House passed the American Health Care Act, amending provisions of the Affordable Care Act that could be changed using budget reconciliation, in turn only warranting 51 votes for passage in the Senate.

Why It Matters: Early indications are that the Senate will use the House bill as a starting point, but will work on their own ACA replacement language on their own time schedule.

Despite earlier failed attempts, the House was able to advance their ACA replacement bill last week by a vote of 217-213. The bill only adjusts the provisions that will have implications on the federal budget to enable the use of the budget reconciliation process, which only needs a simple majority in the Senate for passage. A timeline for Senate action is unclear. Thirteen republican senators have formed a health care working group to develop a bill, while others tout existing proposals as viable alternatives.
Telehealth Subject of Bill, Hearing in Senate

Key Takeaway: The role of telehealth in care delivery were both the subject of a CHIME-supported bill and hearing in the Senate last week.

Why It Matters: Expanding telehealth continues to receive bipartisan interest in Congress.

The CHIME-supported CONNECT for Health Act was reintroduced by Senators Brian Schatz (D-HI), Roger Wicker (R-MS), Ben Cardin (D-MD), John Thune (R-SD) and Mark Warner (D-VA) last week. The legislation, receiving broad support from more than 50 healthcare organizations, including CHIME.

The legislation would expand the use of telehealth in accountable care organizations (ACOs) and Medicare Advantage. The bill also expands coverage of home dialysis patients and the evaluation of an acute stroke. Remote patient monitoring for certain patients with chronic conditions would also be extended under the legislation and increase access to tele-mental health services.

The Senate Appropriations Subcommittee on Military Construction, Veterans Affairs, and Related Agencies held a hearing last week hosted a hearing on " Telemedicine in the VA: Leveraging Technology to Increase Access, Improve Health Outcomes & Lower Costs." The hearing explored how cost savings and care improvements that have occurred within the Department of Veterans Affairs (VA) resulting from the use of telehealth and remote patient monitoring services.

Senator Schatz (D-HI), the Ranking Member of the subcommittee, mentioned the possibility of additional legislation, either resources or authority changes, for the VA to expand their telehealth footprint. He also alluded to the importance of avoiding interoperability challenges such as those with the Department of Defense (DOD) and VA electronic health records, with telehealth software.
Click here to view our  CHIME Public Policy Playbook
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