HIMSS Outlines Political Health IT Priorities and Progress on Regulatory and Congressional Issues

• Leveraging health IT related to [COVID-19] vaccine development and distribution, particularly if multi-dosing will be necessary
• Capturing data related to surprise billing and prescription drug pricing to present to the public
• Continuing activities related to reducing provider burden and increasing provider and patient control of healthcare
• Leveraging the non-healthcare technology community “to help accelerate healthcare and to get involved in bringing their solutions to the healthcare space,” said Leary, including the venture community

Democratic Platform

• Patient engagement and empowerment, and accelerating public health infrastructure improvements
• Using health IT to further support updates to the Affordable Care Act
• Precision medicine and the Cancer Moonshot; advancements around the 21st Century Cures Act, and keeping the United States at the forefront of healthcare research and leveraging technology
• Privacy and data ownership. “Updating HIPAA is front of mind for them,” said Leary, “specifically around patients being in control of their data.”

Overlap between the two parties exists with acceleration of EHR modernization and bringing technology solutions from other business sectors into healthcare.

HIMMS Outlines Progress Related to Regulatory Issues

Jeff Coughlin, senior director of government relations at HIMSS, addressed interoperability regulations, the Regulatory Sprint to Coordinated Care, and TEFCA Trusted Exchange Framework and Common Agreement (TEFCA). (TEFCA).

While the terms of the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services (CMS) interoperability rulings were published informally on March 9, the official compliance date went into effect on May 1. Due to the pandemic, a period of enforcement discretion has extended several key compliance dates.

According to Gray, CMS changes include:

• The admission discharge and transfer conditions of participation deadline was extended to May 3, 2021.
• The patient access API and the provider directory API deadlines will not go into place until July 1, 2021.
• Other parts of the CMS rule will be implemented as originally directed in the final rule.

Compliance on the ONC role was scheduled to take place on November 2, 2020. ONC changes include moving the deadline for minimum USCDI data elements, required for compliance with the 2015 21^st Century Cures Act update, to August 2, 2022.

“Implementing these rules fully would be helpful in addressing the pandemic,” Coughlin said. “On the other hand, I think some of the requirements … are kind of a sea change from some of the practices that providers, developers, and networks, et cetera, have been used to in the past. So I think it’s a balancing act that a lot of stakeholders are trying to figure out,” he said.

“It’s important to emphasize we are trying to listen to our members to try to find out where they are at, in terms of implementation and meeting these deadlines,” said Coughlin. “[We’re] also trying to communicate back to ONC and CMS so they have information to decide whether these dates should be continued to be put forward or if another extension is warranted.”

Work continues on the Regulatory Sprint to Coordinated Care, which is focused on trying to reduce the regulatory burden on providers and appropriately incentivizing coordinated care. This initiative included a review of the Stark Physician Self-Referral Law, the Anti-Kickback Statute, and the Civil Monetary Penalty Law.

“The other underlying point,” said Coughlin, “is [ensuring] that the different regulations that are in place are all working in concert with this Regulatory Sprint.”

• “The physician anti-kickback rule is something we’re still waiting on,” said Coughlin.
• Regarding physician self-referral regulation, CMS published a notice last week that they were considering a new timeline for finalizing that regulation, moving the date from August 2020 to August 2021.
  In July a final rule related to 42 CFR Part 2 was issued. “That’s something that we’re looking closely at,” said Coughlin, “and overall, I think we’re very supportive of efforts to eliminate any sort of barriers in care coordination among Part 2 providers. I think that this rule is definitely a step in the right direction.
  The “big piece” the Regulatory Sprint involves changes to HIPAA,” he said, which is currently in limbo. A request for information was published in late 2018 and the deadline for comment letters was February 2019.
  The Sequoia Project, the recognized coordinating entity for TEFCA, is working on finalizing draft one of the common agreements to share with ONC. In addition, the group also is working on draft two of the Qualified Health Information Network technical framework.

Congressional Progress Could Stall

While important issues remain before Congress that could impact healthcare, including a second COVID-19 relief package, David Gray, senior manager of government relations at HIMSS, reported that progress may stall due to partisan politics, election recesses, potential changes in the Administration, and other pending legislation.

The primary focus will be on the next COVID-19 package, USPS funding, and funding the government to ensure a shutdown doesn’t occur when the government fiscal year ends on September 30, Gray said. Regarding the latter point, the House has passed “11 of 12 appropriations bills, while the Senate has yet to get a single appropriation to go out of committee, which means that we will most likely see a continuing resolution (CR) to fund the government at current levels,” said Gray.

“The biggest remaining question,” said Gray, “will be [whether this will be] a short-term CR, pushing that debate until after the elections in December, or will this be a longer CR that sort of kicks a can into 2021 and gives the next iteration of the Trump administration or the Biden administration a few months to get their feet under them before they really strike up this conversation again for the COVID package. Both sides still insist that they want to reach a deal before the end of September, but the latest indications are that they’re still very far apart.”

Gray continued, “What happens after the election will depend on what they can accomplish before the end of September and how much of an appetite both chambers will have after the elections to get anything done before the next administration or the next Congress.”

From a HIMSS perspective, Gray said priorities include:

• Advancing comprehensive telehealth legislation.
• Advancing a nationwide strategy on patient matching beginning with the removal of the UPI appropriations ban. He pointed out this ban has already been removed by the House, “and we hope will be in consideration for the next appropriations package negotiations.”
• Continuing to support the Centers for Disease Control and Prevention ion data modernization initiative, which started with the Data: Elemental to Health Campaign, of which HIMSS is a founding member.