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Washington Debrief: Mixed Reaction to HIPAA Final Rule

January 29, 2013
by Jeff Smith, Assistant Director of Advocacy at CHIME
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Jeff Smith, Assistant Director of Advocacy at CHIME

Better Late Than Never? 500-Page HIPAA Final Rule Makes Debut Recently, the long-awaited updates to the Health Insurance Portability and Accountability Act (HIPAA) were released. A version of the “omnibus” HIPAA final rule was made available on the Federal Register’s Public Inspection Desk a few weeks ago, but it officially published the 500-page rule last week. Most observers agree that provisions meant to move business associates and subcontractors into the world of covered entities will lead to more accountability of protected health information. But some worry that the rule does not clarify the emerging role of HIEs and population health management initiatives. CHIME members, Todd Richardson, CIO at Aspirus; Donna Staton, CIO at Fauquier Health and David Holland, CIO at Southern Illinois Healthcare all lent their thoughts in a recent article. "On one hand we have 'protect, protect, protect' and on the other hand we have 'share, share, share," Richardson said. "While the balance is 'protect and share,' the devil is always in the details."

The rule’s far-reaching implications will be a central concern of CIOs for weeks to come. As CHIME Public Policy delves into the issues raised by the new rule, please don’t hesitant to ask questions or supply comments. Be on the lookout for forthcoming alerts and summaries on the HIPAA omnibus rule.

New Year, New Congress, New Talk of Permanent ‘Doc Fix’ As the new Congress gets settled into new offices and new committees, talk of a permanent “doc fix” made an early appearance. The new House Ways and Means Health Subcommittee Chair Rep. Kevin Brady (R-TX) told reporters this week that he’s optimistic about getting a permanent fix plan ready in the first half of 2013. “We are blessed with a chairman…who is dead serious about our subcommittee working with Energy and Commerce to pass a permanent solution for the doc fix,” Rep. Brady said of Ways and Means Chairman Dave Camp (R-MI). The Energy and Commerce is the other major committee with jurisdiction over health issues and often works with Ways and Means on health legislation. The Congressional Budget Office says it will cost $245 billion over 10 years to pay for a permanent fix, which has proven time and again to be the major stumbling block. As a way to begin the process, the Energy and Commerce Health Subcommittee has tentatively set a hearing on the Medicare physician payment formula for February 14. Brady said lawmakers want to make sure everyone has plenty of time to give feedback.

Next Generation Blue Button Unveiled Officials have issued implementation guidance on the next generation of Blue Button, according to reports. BlueButton.org contains guidance for providers and personal health record vendors to enable patients to get records in a human-readable and machine-readable format; and to send them where they choose. The Blue Button initiative was developed by the VA and later CMS as a way for Veterans and beneficiaries to log onto the tool to and download their personal health information. But this earlier version did not have a user-friendly reporting function. According to the website, “With this implementation guidance, we are evolving the standards associated with the Blue Button. Dataholders (such as providers and payors, and their vendors) and receivers (such as PHRs and other apps and services) that choose to follow this guidance will be known as providing “Blue Button+” to their users.”

States See Medicaid, Mental Health Become More Prominent in 2013 Priorities These days, when you think Medicaid, you think Medicaid expansion, but that’s not the only change happening around the program right now. As states prepare for online health insurance exchanges, they must update their systems as mandated by ACA to handle online enrollment for all Medicaid beneficiaries, expansion or not. According to Politico, the current technology systems in many states will not be able to handle the volume come January 1, 2014. According to the article, some progress has been made, “Online applications for Medicaid or CHIP are now available in 37 states.”

Since the Newtown, CT tragedy in December, mental health care has been top of mind for healthcare leaders, as well as Federal and State legislators. But since the recession started in 2008, 30 states cut funding from mental health programs. The Associated Press researched some of the largest cuts – South Carolina cut funding by 40 percent over four years and Kansas by 12 percent over three years – and found they are a part of a group of ten states that cut mental health funding by over 10 percent since 2008. After the tragedy, many states are reversing this budget-cutting trend, the report says, as they recognize the need for better diagnosis and treatment for mental health.

Last Thursday, the Senate Health, Education, Labor and Pensions (HELP) Committee held its first hearing on mental health since 2007. This hearing focused on: “Assessing the State of America’s Mental Health System.” In Committee Chairman Harkin’s (D-IA) opening remarks, he noted that “a number of sheriffs in his state and other states have said that their jails are now the defacto mental health institutions in their states. The shame in this is that with access to the right treatments and supports, people living with mental illness can recover and lead healthy lives… We need to look at access to mental health care across the country.” This sentiment shares support from both sides of the aisle as newly voted Ranking Member Sen. Alexander (R-TN) expressed interest in finding out what they can do at the federal level to help identify who needs help, and who can provide help for those suffering from mental illness.

Edited by Gabriel Perna

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