On July 27, 2006, the U.S. House of Representatives passed by a vote of 270-148 H.R. 4157, which is intended to promote the use of health information technology (HIT) to improve the safety and quality of the nation’s health care system. This legislation has several significant aspects affecting the use of HIT, including codification of the Bush administration’s Office of the National Coordinator for Health Information Technology. According to the legislation, some of the National Coordinator for HIT’s ongoing responsibilities shall include maintaining and updating a strategic plan to guide the nationwide implementation of standards for HIT, serving as a principal advisor to the Department of Health and Human Services (DHHS) on the use of HIT, and coordinating HIT policies and programs across federal agencies.
H.R. 4157 would create new statutory exceptions in the Federal physician self-referral law (Stark Law) and safe harbors to the Federal Anti-Kickback Statute that would allow hospitals to provide physicians with HIT software and hardware, or related services used for the electronic creation, maintenance, and exchange of clinical health information. Important to health care providers, this legislation earmarks $30 million for fiscal years 2007 and 2008 in grant money for “integrated health care systems” that provide coordinated care to underinsured, uninsured and medically underserved individuals. The legislation also provides $10 million in those two years to a demonstration program to provide grants to small physician practices in rural or medically underserved urban areas.
Another important aspect is the legislation requires adoption of international classification diseases (ICD)-10 codes sets by October 1, 2010. This date has been debated by several associations and provider groups within the health care industry. Several groups, such as the American Association of Health Insurance Plans and the Blue Cross and Blue Shield Association have commented that health care providers need until 2012 to switch from the existing ICD-9 system.
This HIT legislation passed by House requires DHHS to study the impact of variation between state security/confidentiality laws and federal security/confidentiality standards. The DHHS secretary is required to report to Congress within 18 months whether there is a need for greater commonality of the requirements of state security and confidentiality laws and current federal security and confidentiality standards to better protect, strengthen or otherwise improve the secure, confidential and timely exchange of health information among States, the Federal government and public and private entities.
A significant provision in earlier proposed language was not included in the version passed by the House which would have required hospitals to report uniform price data for selected procedures or services based on a range of charges and a range of prices actually paid grouped by type or payor.
The U.S. Senate passed by unanimous consent similar HIT legislation (S. 1418) on November 18, 2005. The Senate’s version, called the Wired for Health Care Quality Act, would provide for a paperless record system and would help rural areas adopt cutting edge information technologies and electronic health records to improve patient care and promote cost savings for health care providers. The Senate HIT bill calls for awarding competitive grants to hospitals, physician group practices, and other health care providers to facilitate the adoption of HIT.