Legislative/Executive Branch Update

1
Legislative/Executive Branch Update

• Thomas M. Leary
• Director, Federal Affairs
• September 23, 2005

2
Federal Government PrioritiesRemainder of
2005-2006

• Congress
• National Priorities
• Supreme Court Nominees
• Hurricane Relief
• Appropriations/Continuing Resolution
• Health Related Priorities
• Medicare Sustainable Growth Rate
• Healthcare IT
• HIT in Appropriations Bills
• Making Sense of the 11 HIT bills

3
Federal Government PrioritiesRemainder of
2005-2006

• Federal Agencies
• Biosurveillance and Disaster Management
• Medicare Prescription Drug Benefit
• E-Prescribing
• Integration and Interoperability
• Standards Harmonization
• Certification
• Making strides toward a National Health
  Information Network

4
FY06 HIT Funding

• U.S. Senate approved 95.2 million of the
  President's 125 million Budget Request for the
  Office of the National Coordinator for Health
  Information Technology (ONCHIT) and the Agency
  for Healthcare Research and Quality (AHRQ).
• Increase of 21 million over the FY 2005 level of
  funding.
• 45.2 million goes to fund ONCHIT initiatives and
  50 million is for AHRQ.
• U.S. House of Representatives funded entire 125
  million requested in President's Budget.
• Because of the two different levels of funding,
  this item will have to be worked out in
  conference committee between the House and Senate
  later this year.

5
Executive Branch Update

• ONCHIT Organizational Structure Announced in
  August 2005. Although ONCHIT has been in
  existence since April 2004, federal agencies have
  the responsibility of turning the intent of an
  executive order into a functioning office.
• Immediate Office of the NC with four director-led
  offices
• Office of Health Information Technology Adoption
• Office of Interoperability and Standards
• Office of Programs and Coordination
• Office of Policy and Research
• Response to Hurricane Katrina The ONCHIT has
  established KATRINA HEALTH (www.katrinahealth.org)
  a multi-organization response team that is
  addressing legal and technical aspects of evacuee
  registration/information access, field medical
  records development and deployment, dissemination
  and communications, as well as privacy, security
  and authentication components.
• Go to field solution being developed that has the
  best interest of the affected states at its
  center.
• Rebuilding the healthcare structures with a short
  term goal of helping the evacuees and long term
  goal of moving the communities into the
  electronic era.

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Executive Branch Update (cont.)

• American Health Information Community (AHIC) HHS
  Secretary Leavitt announced the formation on June
  6, 2005. AHIC has been described as a
  public-private entity that will advise HHS on
  specific actions necessary to achieve a common
  interoperable framework and serve as a forum for
  a wide range of healthcare industry
  constituencies.
• The AHIC will be chaired by Secretary Leavitt and
  will have an integral role in developing the work
  products from the four RFPs.
• Nominations sought through the Federal Register.
  Thousands of names received for 8 slots.
• Public Meeting October 7, 2005

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Executive Branch Update

• 4 RFPs associated with AHIC
• Standards Harmonization Award expected before
  9/30/2005
• Certification of EHR products Award expected
  before 9/30/2005
• Privacy and Security Award expected before
  9/30/2005
• Prototypes for a National Health Information
  Network Award expected in FY2006
• Medicaid Advisory Commission Commission
  established by HHS to address cost and quality of
  the Medicaid program. The Commission is
  co-chaired by former governors Don Sundquist (TN)
  and Angus King, (ME). Two-phased reporting
  process with
• Phase 1 Report (September 1, 2005) Addresses
  potential 10B in savings over 5 years
• Phase 2 Report (December 31, 2006) Long term
  recommendations on the future of the Medicaid
  program.

8
Executive Branch Update

• Military Health System CIO
• Carl Hendricks has been named the new CIO.
• He takes over for Jim Reardon, who retired in
  April 2005.
• Medicare Regions RFP

9
U.S. Congress

• Legislation
• H.R. 3617 Medicare Value-Based Purchasing for
  Physicians Act (Johnson)
• S. 4 Healthy America Act of 2005 (Frist)
• S. 1356 Medicare Value Purchasing Act of 2005
  (Grassley-Baucus)
• S. 1418 Wired for Healthcare Quality Act
  (Enzi-Kennedy-Frist-Clinton)
• S. 1503 Healthy America Act of 2005 (Frist)
• Markey Amendment to FY06 Appropriations

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U.S. Congress (cont.)

• Congressional Organizations
• 21st Century Health Care Caucus
• Senate Steering Committee on Telehealth and
  Healthcare Informatics
• Senate Health Care Quality Improvement and
  Information Technology Caucus
• New Democrats Coalition
• Senate Centrist Coalition
• Republican Main Street Partnership

11
Patient Safety and Quality Improvement Act (P.L.
109-41)

• First Introduced in 108th Congress by Senator
  Jeffords
• Re-introduced in 109th Congress
• S. 544
• Fast tracked by both Houses
• HIT and most key provisions watered down
• Signed into law on July 29, 2005

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Patient Safety and Quality Improvement Act (Key
Provisions)

• Patient safety data is designated privileged and
  confidential
• DHHS Secretary to designate/certify patient
  safety organizations and maintain patient safety
  network of databases
• No definition of medical error
• Secretary to develop or adopt voluntary national
  standards to promote electronic exchange of
  healthcare information
• Secretary to contract with a research
  organization to study impact of medical
  technologies and therapies of healthcare
• No funding is provided for implementation

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Value-based Purchasing (Pay For Performance)

• Two versions
• H.R. 3617 Medicare Value-Based Purchasing for
  Physicians Act of 2005 (Johnson)
• S. 1356 Medicare Value Purchasing Act of 2005
  (Grassley-Baucus)
• Promotes Value Based Purchasing
• House bill promotes improvements to Medicare
  reimbursement payment system to physicians and
  resolves sustainable growth rate dilemma
• Senate bill only promotes quality improvements

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Contact Information for HIMSS Washington, DC

• Thomas M. Leary
• Director of Federal Affairs
• Direct 703.837.9814
• Email tleary_at_himss.org

HIMSS Website www.himss.org