In a lively press briefing for members of the healthcare media assembled at the CHIME Fall Forum, the two Washington advocacy directors for the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME) shared their perspectives on current issues and initiatives, on Oct. 15, during the CHIME Fall Forum, being held at the JW Marriot Grande Lakes Resort in Orlando, Florida.
Leslie Kriegstein, CHIME’s vice president, congressional affairs, and her colleague, Mari Rose Savicikis, who joined CHIME last month as vice president, federal affairs, offered healthcare journalists attending the CHIME Fall Forum their insights on what is going on in the U.S. Congress and in the Obama administration around issues related to healthcare IT policy, and shared the organization’s advocacy goals for the near future.
Kriegstein began the joint presentation by outlining CHIMEs top advocacy priorities in working with Congress and the Obama administration, as of the beginning of calendar year 2015. She said those priorities were, in descending order: patient identity matching, cybersecurity, meaningful use, patient safety, telemedicine, quality measurement, and ICD-10. Obviously, the ICD-10 issue has largely been resolved, with the fulfillment of the October 1 deadline for the transition to that new coding system in the U.S.; but the other issues continue to e very active for the association.
It has been an exceptionally busy and development-filled time lately on Capitol Hill and in the federal agencies when it comes to healthcare policy connected with IT and data Kriegstein noted. For one thing, the federal agencies engaging in activities and initiatives that touch on healthcare IT has been expanding beyond some of the ones historically involved, particularly the Department of Health and Human Services (HHS), and within HHS, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC). Recently, she noted, ““We have seen folks kind of take more ownership over the health IT space. So we’re seeing non-traditional players like Homeland Security and the FDA [Food and Drug Administration] become active. The CDC [Centers for Disease Control and Prevention], the Office of Civil Rights, the Office of Science Technology Policy,” are among the numerous federal agencies whose regulatory activity has touched on healthcare IT. In fact, she said, “We’re seeing an unprecedented level of interest. And that has set the stage perfectly for the CIO,” and has naturally compelled CHIME and its lobbyists forward in moving to advance CIO/healthcare IT leader interests.
Meanwhile, the events of October 6 were of particular note, and both Kriegstein and Savickis made a number of comments about them and answered questions from the press. With regard to the modifications for the Stage 2 final rule for meaningful use under the HITECH (Health Information Technology for Economic and Clinical Health) Act, Kriegstein stated that “That was a huge priority for us, to get that modifications of the rule out. We were very much appreciative that there were actionable modifications from the Administration on certain measures,” she said. “The fact that we will be less accountable for actions of patients, we welcomed with open arms; the fact that they included some restrictions around e-prescribing, we appreciated. We appreciate that the Administration is often responsive to members’ concerns,” she said, “but sometimes because a change comes so late that it may not always be able to realized by CIOs and eligible providers.”
On the other hand, the fact that the modifications to Stage 2 were published within the same rule as the release of the Stage 3 final rule was baffling to the CHIME team, Kriegstein said. “We were definitely surprised to see that the two rules were connected, the Stage 2 modifications, and Stage 3. That was disheartening,” she said, “and you saw the big push working with the Capitol Hill community. Some of us sent letters seeking to separate Stage 3 from the modifications rule.” Savickis then confirmed that the rule containing both had officially been published Wednesday in the Federal Register. Based on that, the effective date for the implementation of the rule published Wednesday will be in 60 days, according to federal law.
“Because the attestation window is after the effective date, you can go forward with what’s been proposed,” Kriegstein went on to say. “The wild card is the fact that it’s a final rule with comment. CHIME does plan to move forward with formal comment,” she added. “We may include some comments on the modifications piece,” she said.
In response to a question from Healthcare Informatics on whether the publication of a final rule with a request for comment might be unprecedented, Savickis said that interim physician fee schedules had in the past been published as final, with comments. “What’s uncommon is for the government to issue a fee schedule with two individual rules that have two different trajectories,” she said. “The timing, the sequencing, is very strange, and then to have them married up at the last minute,” is very unusual, she said. “And the only portion of the rule open for comment is Stage 3, and not the modifications portion.”
A number of questions remain regarding how everything around the combined rule will sort out, Kriegstein said. As for how federal healthcare officials might respond to any comments made by healthcare leaders related to the supposedly final Stage 3 rule, she said, “That’s unclear; and it’s unclear what will happen with the final certification rule. CMS and ONC have said they’d eventually like to see certification outside the MU program, but so much of it is connected to the MU program.”
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