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D.C. Report: Congressional Panel Asks 'Is Meaningful Use, Meaningful?'

November 20, 2012
by Jeff Smith, Assistant Director of Advocacy at CHIME
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Jeff Smith, Assistant Director of Advocacy at CHIME

Congressional Panel Asks, ‘Is Meaningful Use, Meaningful?’ A House subcommittee on Science, Space and Technology held a hearing this week on Meaningful Use.  The focus on Meaningful Use was to ask the question, “has the program truly been meaningful?”  The response from all witness, which included ONC National Coordinator Dr. Farzad Mostashari and Intermountain VP & CIO Marc Probst, was a resounding “Yes.”  However, witnesses acknowledged that much more work is yet to come.  “We must set a clear road map and support an exchange infrastructure and the adoption of standards that will make it easier to share health information so clinicians and patients have the information in the form and time they need it to make appropriate health care decisions,” Probst said.  Lawmakers questioned the effectiveness of over $7.7 billion spent on the program to date and cited concerns over the lack of interoperability and the role of government in setting standards.  Witnesses countered by describing Stage 2 rules that would help make gains in both these areas: 1) more explicit proof of true interoperability would have to be demonstrated to meet Stage 2 criteria and 2) standards on transport, vocabulary and content – as prescribed in the final rule – would prove a role for government in the standard-setting process.  Check out a listing of testimony and an archive of the hearing.

‘Doc Fix’ Back in the Spotlight as Congress Contends with Fiscal Cliff The Sustainable Growth Rate (SGR), otherwise referred to as the Doc Fix, is due to expire at the end of the year, saddling providers with approximately 17 percent cut to reimbursement payments.  This week, one of Washington’s most powerful lobbies, the AARP, stepped in to help advocate for a more permanent fix.  Joining five other groups, the AARP sent a letter to lawmakers asking for “the longest possible” payment patch to allow time to develop a sustainable replacement for the current payment formula.  “These stopgap measures have served to increase the size of future cuts, the cost of long-term reform and the insecurity among people with Medicare about their ability to maintain access to their doctors,” the groups said in the letter to Senate Finance Chairman Max Baucus, D-Mont., and ranking Republican Orrin G. Hatch of Utah and to House Ways and Means Chairman Dave Camp, R-Mich., and ranking Democrat Sander M. Levin of Michigan.

The main obstacle to action on a permanent SGR fix is cost.  According to the Congressional Budget Office, a one-year patch to block the scheduled cuts and keep rates level would cost $18.5 billion over 10 years.  Providers over the last year have sought to use “Overseas Contingency Operations” funds – money set aside for wars in Iraq and Afghanistan – to pay for a permanent fix because operations in the Middle East are subsiding.  Late last spring and early summer, there was some movement by Republicans to use war funds; however, most lawmakers dismissed the option as “budgetary gimmickry,” as the Obama administration has sought to use those funds for a host of domestic projects including transportation and infrastructure enhancements.  Most recently, the GOP Doctors’ Caucus has suggested that Sen. Tom Coburn’s “Wastebook 2012 Projects,” be used to pay for a one-year delay.  The Wastebook is a list of government programs that Sen. Coburn has deemed irrelevant and inefficient.

Rep. Michael C. Burgess, R-Texas, has introduced a bill (HR 6142) to keep payment rates level for one year.  And Reps. Allyson Y. Schwartz, D-Pa., and Joe Heck, D-Nev., have a measure (HR 5707) that would set up a five-year transition period for testing new payment models.  Neither bill has been given a hearing or been marked up.

Congresswoman, Industry Await HHS Study on Health IT Safety In November 2011 the Institute of Medicine (IOM) published a report entitled, Health IT and Patient Safety: Building Safer Systems for Better Care.  This report highlighted how some of the complexities associated with EHRs have introduced new risks into the healthcare system.  In a blog post after its publication, Dr. Farzad Mostashari said, “The report also highlights the importance of health IT to continuously improving health care quality and safety by rapidly and reliably flagging potential patient safety risks and preventing adverse events in the clinical setting.”  The IOM mandated a full report be published by HHS regarding its approach to patient safety and health IT by the end of November 2012.  While HHS has nearly half a month still to produce the report, some on Capitol Hill are getting impatient.  In a letter sent to HHS Secretary Kathleen Sebelius this week, North Carolina Republican Renee Ellmers said, “after the one year anniversary of the IOM’s report, we have heard nothing from the Department…Meanwhile, we continue to see media reports of patient safety risks related to health IT.”