By Jeff Smith, Assistant Director of Advocacy at CHIME
During National Health IT Week, two pieces of legislation were announced – one that will focus on expanding incentive payments to safety net providers and the other to focus on privacy harmonization among state and federal standards. Introduced Thursday by Senator John Kerry (D-Mass.) the Medicaid Information Technology to Enhance Community Health (MITECH) Act would extend Medicaid incentives to providers that practice predominantly in a qualified safety net clinic, QSNC. The act defines a QSNC as “a clinic or network of clinics that is operated by a private non-profit or public entity and that has at least 30 percent of its patient volume attributable to needy individuals.” The act also directs the HHS Secretary to develop a methodology to allow these clinics to be eligible for meaningful use payments as an entity, similar to the current process that exists for hospitals.
A backgrounder on the bill says that due to low Medicaid eligibility levels in many states, it is difficult for many safety net providers to meet the 30 percent Medicaid threshold required to participate in the Medicaid EHR incentive program even though their patients are predominately low-income. “Congress addressed this problem only for practitioners working in federally-qualified health centers and rural health centers by creating a 30 percent “needy” threshold in ARRA for those providers. Unfortunately, ARRA fails to provide a similar standard for other providers serving low-income individuals.”
In addition to Sen. Kerry’s bill, Sen. Richard Blumenthal (D-Conn.) told media representatives during NHIT Week that he plans to introduce legislation to address conflicts between varying state privacy laws and federal efforts to spur health information exchange. "I do think that there is a role that the federal government has to play to establish standards that states would have to meet, not necessarily impose a one-size fits all straightjacket," Blumenthal said.
Just days ahead of the White House report on how next year’s sequestration will affect funding on domestic and defense programs, the American Hospital Association, the American Medical Association and the American Nurses Association issued a report warning lawmakers that 766,000 jobs will be lost by 2021 and nearly 500,000 jobs will be cut in the first year. As a reminder, sequestration is the automatic budget “trigger” that was put in place by the 2011 Budget Control Act meant to shave $2.1 trillion from the federal deficit over the next 10 years. Part of those cuts are a mandated 2 percent cut to Medicare, which is expected to reduce federal spending on the program by about $11 billion in 2013, according to a spring analysisby the Center on Budget and Policy Priorities. The report released by the AHA and others looked at direct impacts (direct effects of cuts to organizations that are funded by Medicare spending), indirect impacts (impact of local industries buying goods and services from other local industries) and induced impacts (the multiplier effect modeled through several re-circulations). Nationally, more than 144,000 hospital jobs would be lost by 2021, the reportsaid, which also details total job losses by state.
Members of Congress were cool this week when asked about the prospects of finding an alternative to the sequestration cuts by year’s end. Expect this issue to be front-and-center following the elections in November.
Viewing, Downloading and Transmitting (VDT) was all the rage this week during National Health IT Week in Washington – or at least pledging to develop such capabilities was. During the second annual ONC Summit on Consumer Health IT, Dr. Mostashari and ONC officials scrambled to get vendors and providers to develop and implement so called, “Blue Button” capabilities by next year so that patients could easy access their health information. Blue Button was developed by the Veterans Affairs Department to allow veterans to access their information through their HealtheVet personal record in a simple ASCII text file. More than 1 million veterans have downloaded their information, according to the VA. Military service members and Medicare beneficiaries also have a Blue Button capability, and it is beginning to be deployed in the private sector. Dr. Mostashari said the new capability, was “underappreciated for how significant that’s going to be to the concept of consumer-mediated health information exchange.”
View, Download and Transmit capabilities will be required for all hospitals in 2014, regardless of Meaningful Use Stage.
This week, the Federal Communications Commission released the final ruleon medical body area network (MBAN) devices, allocating spectrum for wireless transmitters that are used for patient monitoring. The FCC said the MBAN final rule “represents an improvement over traditional medical monitoring devices,” as it allows for increased patient mobility, comfort, and could represent annual savings of $1.2 billion, just from the expenses accrued after relocating patients to different clinics and departments. Industry observers say this rule will lead to a new landscape of apps and devices meant to improve patient care.
The U.S. is the first country in the world to dedicate spectrum for Medical Body Area Networks in hospitals, clinics, and doctors’ offices. The FCC and the Food and Drug Administration, which has regulatory control over mobile medical devices, are working together to streamline the approval process for medical devices that use the wireless spectrum. While the FDA is regulating how those devices are used in a medical setting, the FCC is regulating the devices as a means of communication.