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Washington Debrief: How the Republican Election Victories Impact Health IT Reform

November 10, 2014
by Jeff Smith, Vice President of Public Policy at CHIME
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Jeff Smith, Vice President of Public Policy at CHIME

Top News

Republicans Take Control of Senate, Expand Margin in House

Key Takeaway: The Republicans will take over leadership of the Senate and will have an expanded majority in the House when the 114th Congress begins in January. Shifts in committee leadership, especially in the Senate, increase the likelihood that health IT reform legislation will be considered by Congress in 2015. Rumors of a full repeal of the Medicare Sustainable Growth Rate (SGR) and the passage of legislation focused on cyber security and information sharing have increased, even as agenda-setting for the lame duck session has begun.

Why It Matters: With an author of the “REBOOT” report and a long-time health IT champion, Sen. Lamar Alexander (R-TN) and Sen. Orrin Hatch (R-UT), likely to assume the chairmanships of the Senate HELP and Finance committees, respectively, health IT advocates are optimistic about a variety of legislative reforms that could be considered by these two committees.

Sen. Patty Murray (D-WA) probably will assume the HELP Committee Ranking Member slot, while Sen. Ron Wyden (D-OR) is expected to remain the top Democrat on the Finance Committee.

Come January 2015, the Republicans will control the Senate with a minimum of 52 votes, while the number of Republicans in the House increased to 243, up from 233 in the 113th Congress.

In the House, Rep. Fred Upton (R-MI) will remain the Chairman of the House Committee on Energy & Commerce, while Reps. Paul Ryan (R-WI) and Kevin Brady (R-TX) will vie for the top spot on the Ways & Means Committee. Among Democrats competing for the ranking member role on the Energy & Commerce Committee are Reps. Frank Pallone (D-NJ) and Anna Eshoo (D-CA). Eshoo has been endorsed by House Minority Leader Nancy Pelosi (D-CA). Rep. Sander Levin (D-MI) is expected to remain the ranking member on the Ways & Means Committee.

Health IT topics likely to be addressed in the Republican-controlled 114th Congress include: cyber security, the Meaningful Use Program, telemedicine, software regulation, quality measurement and patient safety reporting.

For the remainder of 2014

The current continuing resolution (CR) expires on Dec. 11, 2014; lawmakers will return to Washington with several issues requiring immediate action, including funding the government through Fiscal Year 2015. Recent reports from Republican leadership show an interest in passing an omnibus bill to fund the government through Sept. 30, 2015. Other issues needing attention before the 113th Congress ends are expiring tax breaks, including the popular research and development tax credit, and the extension of terrorism risk insurance.

Discussion around a permanent fix for SGR, the physician Medicare reimbursement approach, has increased among the leaders of health-focused committees. The issue of finding offset savings remains a hurdle to passing a permanent payment solution. Additionally, with top Republicans on the Senate and House Select Intelligence committees set to retire at the end of the 113th Congress, Sen. Saxby Chambliss (R-GA) and Rep. Mike Rogers (R-MI), expectations are rising that there will be additional pressure to pass cyber security information sharing legislation before they leave Capitol Hill.


As 2014 MU Attestations Lag, Healthcare IT Leaders Worry about 2015

Key Takeaway: Centers for Medicare and Medicaid Services (CMS) data released during the November Health IT Policy Committee indicate that 2014 attestations are lagging, compared with 2013. Approximately 1,900 hospitals have attested to either Stage 1 or Stage 2 of Meaningful Use (MU) in 2014, compared with nearly 3,400 in 2013.

Why it Matters: Participation rates released last week validate industry concerns that changes to MU, meant to provide flexibility in 2014, will be greatly muted by providers’ inability to meet more difficult program requirements for a full year in 2015.

CMS figures indicate that approximately 2,560 hospitals were scheduled to meet Stage 2 Meaningful Use in 2014. However, new flexibility from a final rule released on September 4 gave hospitals the ability to repeat Stage 1 if they could not meet Stage 2 requirements, and they could attest to having troubles with 2014 Edition CEHRT implementation. Despite lowered expectations of Stage 2 hospital participation, CMS data released last week show that 840 hospitals have met the Stage 2 bar, over a 90-day reporting period, in 2014; this amounts to less than one-third of hospitals scheduled to meet Stage 2 in 2014, and health IT leaders worry this data paints an ominous picture of the program’s near-term future.

In 2015, nearly 4,000 hospitals are scheduled to meet Stage 2 Meaningful Use requirements for a 365-day reporting period. CHIME and other health IT leaders say this will put senseless stress on program participants and will impede program success, because many hospitals will be unable to achieve the next phase of MU.