Kaiser Daily Health Policy Report

Wednesday, October 29, 2008

Capitol Hill Watch

      House Speaker Nancy Pelosi (D-Calif.) is committed to passing in the next session of Congress legislation that would require physicians nationwide to adopt health information technologies and could include negative consequences to encourage providers to do so, according to one of her senior advisers, CQ HealthBeat reports.

Wendell Primus, senior budget and health policy adviser to Pelosi, on Tuesday at the Healthcare Information and Management Systems Society public policy forum said, "She believes very strongly that it's a prerequisite, a foundation, upon which our health care system be built." Primus added, "We'll have a good Democratic [health IT] bill early" in 2009 that will make sure "every physician's office is wired as soon as possible," he said.

According to CQ HealthBeat, Primus later added, "You can have carrots or sticks" to encourage adoption of health care IT, and one strategy could be withholding Medicare payments from providers who fail to adopt the technology. Congressional Budget Office Director Peter Orszag at a Senate Finance Committee hearing in July suggested using negative consequences to spur health IT adoption among providers. Orszag said, "If you want to get to near universal health IT in the near future, meaning the next five years, it's got to be the stick."

Primus said congressional staffers currently are working on the measure. He added that the legislation likely will incorporate facets of a House bill (HR 6898) introduced in September by House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.), which includes penalties for providers who do not adopt the technology, and another House bill (HR 6357) introduced by Energy and Commerce Committee Chair John Dingell (D-Mich.) that does not include such penalties. Primus said that Pelosi will support health IT legislation moving forward whether it includes the penalties or not.

Predicting the Future
It is unclear when and how health IT legislation will be addressed in the next Congress because of the doubt surrounding a new administration and whether lawmakers will address larger health care reform, according to Primus (Weyl, CQ HealthBeat, 10/28). It still is unclear if health IT legislation next year will be a free-standing measure or part of a health care reform omnibus. Primus said that the main health care issues will be "access, cost-value and quality" and that they all could be addressed together. According to Primus, Pelosi believes health IT is an integral part of addressing all three (Noyes, CongressDaily, 10/28).

He said health IT "could move alone very early" but, "are we going to do health care legislation in one big bill or ... incrementally?" (CQ HealthBeat, 10/28). Before they take up health IT legislation, Primus said that congressional leadership first must draft an economic stimulus package and address appropriations before the continuing resolution runs out in March (CongressDaily, 10/28). Primus said, "The health care agenda is going to be very difficult in a world with $700, $800 billion deficits" (CQ HealthBeat, 10/28).

U.S. Meeting EHR Order
In related news, HHS Deputy Secretary Tevi Troy in an interview with CongressDaily said the U.S. is "well on the way" to meeting a goal of providing at least half of the U.S. population access to electronic health records by 2014 that was part of an executive order issued by President Bush in 2004. Troy's comments precede the final meeting of the Certification Commission for Healthcare Information Technology, a federal advisory panel established to monitor the challenges of implementing a national health IT system. CCHIT will be replaced with a $13 million public-private sector collaboration, Troy noted, which will continue the functions of CCHIT "no matter who wins the election." He said CCHIT is "a very good model" and should be preserved by the new administration because it has been critical "to provide the right type of standards for interoperability and privacy protection" and encourage future adoption of health IT (CongressDaily, 10/28).