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D.C. Report: MU Stage 2 Timeline, Supreme Court to Hear Healthcare Challenge, ONC Strategic Plan, Telehealth Bill

March 29, 2011
by Sharon Canner, Sr. Director of Advocacy
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Workgroup Examines Flexibility for Stage 2 Timeline. Meeting earlier this week, the Health IT Policy Committee’s Meaningful Use Workgroup discussed various options for the Stage 2 Timeline. Providers and vendors have urged a delay in Stage 2 implementation, while consumers, purchasers, and health plans have advocated for the current timeline. Workgroup chair Paul Tang, chief medical information officer at the Palo Alto Medical Foundation, outlined options to permit more flexibility. This included delaying the deadline for meeting certain Stage 1 requirements; raising the threshold of data measures required under Stage 2, while maintaining Stage 1 functionalities; and requiring providers to collect data for three months, rather than one year.

In responding to the proposed Stage 2 criteria and timeline in February, CHIME sounded a similar note: “...we think it would be far evaluate actual experience under MU Stage 1 prior to considering potential MU objectives and measures for Stage 2. Absent such an assessment, we greatly fear that the HITPC’s proposals for Stage 2 may be unduly ambitious, even unattainable, for many eligible hospitals (EHs) and eligible professionals (EPs).” The workgroup will release Stage 2 public comments in late April and submit final recommendations to the HIT Policy Committee later in the spring.

Supreme Court to Hear Virginia Suit Against Health Reform Law. Not surprisingly, the U.S. Supreme Court has placed on its April 13 calendar a discussion of whether or not to take up the State of Virginia’s petition to hear its lawsuit against the Accountable Care Act (ACA). Given that the Court often splits 5-4 demonstrating a conservative tilt on many issues, their decision was not unexpected.

The lawsuit was originally scheduled for May 10 in the Fourth Circuit Court of Appeals. As reported earlier (Advocacy Corner, March 4), it is rare for parties to bypass the appellate court and ask for early review by the nation's highest court. Such a request is granted only in cases of “such imperative public importance" that it requires changing normal procedures. In January, the House passed legislation repealing the ACA with the Senate voting against repeal. Pending bills would eliminate all funding for implementation.

Under Supreme Court rules, consideration and voting on acceptance or rejection of the petition for an expedited review is conducted in private. For the case to move forward, four justices would need to vote in favor. The timing for all this is ironic, since the ACA is celebrating its one-year anniversary. In a series of events, the Administration is highlighting the law’s many benefits, including small-business tax credits covering up to 35 percent of health premiums for businesses with fewer than 25 full-time employees, banning lifetime benefit limits in insurance policies, allowing young adults to remain on their parents' insurance to age 26 and cutting the amount seniors must pay for prescription drugs under the Medicare "donut hole." The Administration hopes to create greater support for ACA as provisions take effect and benefit more Americans over time.

Strategic Plan Charts New Ground on Federal HIT Agenda. Updating the IT plan issued in 2008, the Office of the National Coordinator (ONC) this week released its vision for realizing Congress and the Administration’s health IT agenda over the next five years. The Federal Health IT Strategic Plan: 2011-2015 (“the Plan”) recognizes that medical care has entered the age of meaningful use with new opportunities to transform the health care system by improving the flow of information through health IT. Building off the current foundation, the Plan discusses ways that HIT can (1) enhance our ability to study care delivery and payment systems; (2) empower individuals to improve and participate more in their care; and (3) improve care, efficiency, and population health outcomes through tools such as clinical decision support, real-time feedback of performance to clinicians, and targeted public health campaigns. Chapters address various areas, including “health information exchange strategy with a focus on fostering business models that create health information exchange, supporting exchange where it is not taking place, and ensuring that information exchange takes place across different business models.” ONC has invited public comments, which are due April 22. CHIME is analyzing the Plan to determine its implications for CIOs.