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Washington Debrief: Meaningful Use Adjustments Included in Republican Healthcare Reform Agenda

June 27, 2016
by Leslie Kriegstein, Vice President of Congressional Affairs, CHIME
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Congressional Affairs

Meaningful Use Reforms Included in Republican Obamacare Replacement Outline

Key Takeaway: House Republicans, led by Speaker Paul Ryan (R-WI-01) released a white paper outlining their healthcare reform agenda last week, which included references to reforming the Meaningful Use program and transparency in the regulation of mobile medical applications.

Why It Matters: In the six years following the passage of the Patient Protection and Affordable Care Act (PPACA), Congressional Republicans have discussed their interest in repealing and replacing the legislation passed in 2010. The proposal unveiled this week offered insight into the principles they hope to include in their legislative package.

The proposal cites an interest in policies to spur innovation and break down legal and regulatory barriers to advance the use of electronic health records. Interest in adjustments to the Meaningful Use program would be focused on interoperability and data exchange.

The proposal calls for creation of a figurative health care “backpack”, which would include one’s insurance as well as a portable medical record that can be transported by the patient. CHIME supports the development of longitudinal healthcare records, but will continue to work with Congress and the Administration to outline the existing policy and technical barriers that prohibit the creation of such records today. The health care “backpack” discussed in the proposal will only be possible when a patient can be correctly and consistently linked to their healthcare data, and when a clear set of enforceable data standards are in place to facilitate data exchange.

While we await the specific legislative text of the proposal outlined by Speaker Ryan last week, CHIME is encouraged that there is interest in reorienting the Meaningful Use program toward interoperability and outcomes. We look forward to reviewing the specifics when they are released and will continue to advocate for bipartisan, sensible, reasonable policies that enable health IT tools to be valued resources for patients and clinicians alike.

House Bill Would Extend MU Incentive Payments to Long-Term and Home Health Communities

Key Takeaway: As part of a legislative package to reduce health disparities, Meaningful Use program eligibility would be extended to long-term care centers, home health providers and physician assistants. 

Why It Matters: The proposal introduced into the House earlier this month, would expand eligibility under the Meaningful Use program and directs the Department of Health and Human Services (HHS) to study the use of health information technology in medically underserved communities.

The Health Equity and Accountability Act of 2016 (H.R. 5475), was introduced by Representative Robin Kelly (D-IL-02), and has 17 cosponsors.

VA Officials Tell Congress Department is Moving Ahead with a Commercial EHR System

Key Takeaway: In testimony before the Senate Committee on Veterans Affairs, officials from the Department of Veterans Affairs (VA) told lawmakers that Veterans Health Information Systems and Technology Architecture (VistA) is outdated and they are likely moving ahead with a commercial electronic health record (EHR) system.

Why It Matters: Lawmakers have expressed concern with the lack of interoperability between the EHRs of the Department of Defense and the VA, and have criticized the amount of money spent over the years to improve their legacy systems.

During the hearing entitled, “Examining the Progress and Challenges in Modernizing Information Technology at the Department of Veterans Affairs,” the committee heard testimony from Under Secretary of Health, Department of Veterans Affairs, Dr. David Shulkin, who was accompanied by other VA officials including the CIO, Laverne Council.

The Commission on Care proposal cites serious flaws in the existing VA electronic medical record systems, including difficulty communicating with major commercial vendors. Appoint scheduling, billing, coding and payment were areas of weakness for the VA health IT systems today.

VistA will continue to be used by the VA at least through 2018, when the agency starts creating a cloud-based Digital Health Platform that may include some VistA elements, with the hope of leveraging the HL7 FHIR standard.

Federal Affairs

CMS proposed rule for hospitals has IT components including changes to Conditions of Participation

Key Takeaway: New CMS proposed rule takes aim at patient access to medical records and CEHRT