Legislative/Executive Branch Update Thomas M. Leary Director, Federal Affairs September 23, 2005

Federal Government Priorities Remainder of 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

Federal Government Priorities Remainder of –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

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.

Executive Branch Update ONCHIT Organizational Structure: Announced in August 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 ( 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.

Executive Branch Update (cont.) American Health Information Community (AHIC): HHS Secretary Leavitt announced the formation on June 6, 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

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.

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 Medicare Regions RFP

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

U.S. Congress (cont.) Congressional Organizations –21 st 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

Patient Safety and Quality Improvement Act (P.L ) First Introduced in 108 th Congress by Senator Jeffords Re-introduced in 109 th Congress S. 544 Fast tracked by both Houses HIT and most key provisions watered down Signed into law on July 29, 2005

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

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

Contact Information for HIMSS – Washington, DC Thomas M. Leary Director of Federal Affairs Direct: HIMSS Website