Key senators introduce health IT legislation

MGMA Connexion, Aug 2005

The push for greater use of information technology (IT) in the health care sector received a legislative boost when two key senators, Majority Leader Bill Frist, R-Tenn.; and Hillary Rodham Clinton, D-N.Y., introduced the Health Technology to Enhance Quality Act of 2005 (S. 1262) on June 16. The legislation is intended to increase the use of health information technology to improve health care quality, reduce medical errors and enhance the coordination of health care delivery.

I MGMA President and CEO William F. Jessee, MD, FACMPE, attended the introduction of the legislation at a press conference at George Washington University Hospital in Washington, D.C. In expressing support for the bill, Jessee said, "It includes important legal protections for medical group practices seeking to collaborate with other organizations in exchanging electronic health information and developing health information networks."

The legislation addresses various facets pertaining to widespread IT adoption and implementation. The legislation's provisions include legal protections, establishment of a national IT coordinator, grants, security of health information exchange, and quality measures.

Legal protections

The bill would create legal protections from the federal physician self-referral (Stark) and antikickback laws for hardware, software and support services provided to physician group practices and other health care providers. The legal protections would apply as long as the tools are used to exchange health information as part of a system designed to improve health care quality and safety, reduce medical errors, reduce health care costs, improve care coordination, simplify administrative processes, and promote transparency and competition.

The legislation also would direct the Department of Health and Human Services (HHS) to establish a safe harbor from federal antitrust laws to allow providers to collectively purchase hardware, software and support services for the electronic exchange of health information. In addition, HHS would establish guidelines to permit health information technology-sharing arrangements between health plans and providers. Any savings that accrue to the plans from the use of health IT must be shared with providers under the bill.

Establishment of national coordinator

The legislation would establish in statute the Office of the National Coordinator of Health Information Technology (ONCHIT), which President Bush created by an executive order in April 2004. The national coordinator would continue to carry out a range of activities to help develop a nationwide, interoperable health information technology infrastructure that reduces health care costs, improves quality, facilitates health care research and the reporting of health care information, and ensures that patients' access to health information is secure and protected.

The legislation also would establish a collaborative public-private standards working group for the recommendation and adoption of standards for the electronic exchange of health information. This process would use the structure of the National Institute for Standards and Technology. Furthermore, the legislation would direct HHS and ONCHIT to designate a private entity or entities that will certify and assist with mandatory public and voluntary private implementation of such standards.

"This step, together with sufficient funding for ONCHIT, demonstrates the federal government's commitment to federal IT initiatives," Jessee said. "While it is important that all federal IT efforts be coordinated within this office, it also is critical that Congress endorses consultation with private industry by establishing the Standards Working Group, thus ensuring that the national IT infrastructure achieves its intended results."

Grants

Under the legislation, HHS, in conjunction with ONCHIT, would be able to award competitive grants to implement regional or local health information plans to improve health care quality and efficiency through the use of interoperable health IT. To receive a grant, eligible entities would have to be consortiums of community stakeholders that adopt policies demonstrating a commitment to open and fair participation by all.

Secure health information exchange

HHS will examine privacy laws and practices to determine how variations in such state laws and practices may affect the electronic exchange of health information among states, between states and the federal government and among private entities. Based on its findings, HHS is required to make recommendations relating to the harmonization of state laws to promote the secure electronic exchange of health information nationwide. In addition, the legislation would authorize HHS to award grants to states to develop and implement policies that would facilitate the electronic exchange of health information. The agency would place priority on awarding grants to reduce barriers related to privacy, confidentiality and the security of health information.