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Washington Debrief: House Passes 21st Century Cures Act, Includes Interoperability, Patient ID Provisions

July 13, 2015
by Leslie Krigstein, Interim Vice President of Public Policy
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Congressional Affairs

House Passes 21st Century Cures Act, includes Interoperability, Patient ID Provisions

Key Takeaway: On Friday, the House passed the 21st Century Cures Act (HR 6), which in addition to increase NIH funding by $8.5 billion, included a number of EHR and health information exchange directives.

Why It Matters: The legislation, designed to help spur medical innovations, included language to deter information blocking and increase incentives for standards identification as a means to foster interoperability.

According to the bill passed by the House last week, with respect to all electronically accessible health information, health information technology systems must: allow for secure transfer of such information to and from other systems; allow for complete access to, exchange, and use of such information; and not information block. Information blocking is defined to include any technical, business, or organizational practices that an actor knows, or should know, prevents or materially discourages access to, exchange, or use of health information.

The legislation sets forth six categories of standards that are required for interoperability, which include: (1) vocabulary and terminology; (2) content and structure; (3) transport of information; (4) security; (5) service; and (6) querying and requesting health information for access, exchange, and use. Further, the House made $10 million available for contracts with American National Standards Institute (ANSI) accredited Standards Development Organizations to identify or develop standards in the six identified categories.

The legislation mandates compliance with interoperability criteria and standards is required for: vendors of health information technology offered for use by a provider participating in Medicare or Medicaid; health information systems (including health information exchanges); hospitals; and healthcare providers. electronic health record (EHR) systems may be found out of compliance, then decertified. In the case of decertified products, providers will receive a minimum of one-year hardship exemption from participation the Meaningful Use Program.

Additional disclosures are to be made by EHR vendors under the House bill, including pricing information, Application Programming Interfaces (APIs), and real-world test results among others.

CHIME applauded the language signifying the importance of ensuring the information in a patient’s record belong to that patient for care coordination and patient safety purposes. This language was viewed as an important next step in launching a national dialogue on need for a universal approach to patient identification.

“an individual should have the right to be confident that the data in the electronic health record of the individual pertains to such individual;

and the right described [above] will promote safety and care coordination for individuals.”

Prior to the bill’s passage, Representative Steve King (R-IA-04) introduced an amendment to eliminate Meaningful Use penalties for eligible provider’s dating back to January 1, 2015, while offering rebates to penalized physicians. The amendment was not include for consideration by the full House, but signals a continued interest among lawmakers to reform the Meaningful Use Program.

The Senate has begun a similar initiative, Innovation for Healthier Americans, which could also include health IT-related provisions resulting from the ongoing series of hearings hosted by the Committee on Health, Education, Labor and Pensions (HELP). HELP Committee Chairman Lamar Alexander (R-TN) announced his intention to have legislation for the Senate to consider early in 2016.


CHIME Submits Comments to Senate HELP Health IT Working Group

Key Takeaway: CHIME submitted recommendations to the Senate Health, Education, Labor and Pensions Committee following Chairman Lamar Alexander’s (R-TN) request for 5-6 solutions to “fix” EHRs and health IT.

Why It Matters: CHIME offered solutions that could result in tangible improvements in how providers employ health information technology to deliver better care to patients. CHIME made recommendations concerning patient identification, quality measurement, standards identification, certification, patient engagement and Meaningful Use.

CHIME pointed to the lack of a consistent patient identity matching strategy as the most significant challenge inhibiting the safe and secure electronic exchange of health information, calling for the removal of the prohibition barring federal regulators from identifying standards to improve positive patient identification.