Health Reform Bill References to Health Information Technology–Part I
Plus: Roundup of Health IT articles on Reform (Link to Part II)
Through the first 1,050 pages of the “Patient Protection and Affordable Care Act” approved by the House of Representatives on March 21, 2010 and passed by the Senate in December 2009, here are the references to health information technology and the Office of the National Coordinator for Health IT with page numbers from Senate pdf:
[PDF of Senate version which was approved by House]
1. Table of Contents: “Sec. 1561. Health information technology enrollment standards and protocols.” p. 5
2. Table of Contents: “Sec. 6114. National demonstration projects on culture change and use of information technology in nursing homes.” p. 13
3. QUALITY REPORTING.—‘‘(1) IN GENERAL.—Not later than 2 years after the date of enactment of the Patient Protection and Affordable Care Act, the Secretary, in consultation with experts in health care quality and stakeholders, shall develop reporting requirements for use by a group health plan, and a health insurance issuer offering group or individual health insurance coverage, with respect to plan or coverage benefits and health care provider reimbursement structures that… (C) implement activities to improve patient safety and reduce medical errors through the appropriate use of best clinical practices, evidence based medicine, and health information technology under the plan or coverage;” p. 31
4. Administrative Simplification: Operating Rules for Health Information Transactions…(9) OPERATING RULES.—The term ‘operating rules’ means the necessary business rules and guidelines for the electronic exchange of information that are not defined by a standard or its implementation specifications as adopted for purposes of this part.’’ p. 60
5. ‘‘REVIEW AND RECOMMENDATIONS.—The National Committee on Vital and Health Statistics shall…(D) evaluate whether such operating rules are consistent with electronic standards adopted for health information technology;” p. 65
6. ‘‘(B) COORDINATION OF HIT STANDARDS.—In developing recommendations under this subsection, the review committee shall ensure coordination, as appropriate, with the standards that support the certified electronic health record technology approved by the Office of the National Coordinator for Health Information Technology.” p. 73
7. American Health Benefit Exchanges…”(C) the implementation of activities to improve patient safety and reduce medical errors through the appropriate use of best clinical practices, evidence based medicine, and health information technology.” p. 149
8. ESTABLISHMENT OF PRIVATE PURCHASING COUNCIL.—(1) “IN GENERAL.—Qualified nonprofit health insurance issuers participating in the CO–OP program under this section may establish a private purchasing council to enter into collective purchasing arrangements for items and services that increase administrative and other cost efficiencies, including claims administration, administrative services, health information technology, and actuarial services. p. 178
9. SEC. 1561. HEALTH INFORMATION TECHNOLOGY ENROLLMENT STANDARDS AND PROTOCOLS. ‘‘(a) IN GENERAL.—
‘‘(1) STANDARDS AND PROTOCOLS.—Not later than 180 days after the date of enactment of this title, the Secretary, in consultation with the HIT Policy Committee and the HIT Standards Committee, shall develop interoperable and secure standards and protocols that facilitate enrollment of individuals in Federal and State health and human services programs, as determined by the Secretary.
‘‘(2) METHODS.—The Secretary shall facilitate enrollment in such programs through methods determined appropriate by the Secretary, which shall include providing individuals and third parties authorized by such individuals and their designees notification of eligibility and verification of eligibility required under such programs.
‘‘(b) CONTENT.—The standards and protocols for electronic enrollment in the Federal and State programs described in subsection (a) shall allow for the following:
‘‘(1) Electronic matching against existing Federal and State data, including vital records, employment history, enrollment systems, tax records, and other data determined appropriate by the Secretary to serve as evidence of eligibility and in lieu of paper based documentation. ‘‘(2) Simplification and submission of electronic documentation, digitization of documents, and systems verification of eligibility. ‘‘(3) Reuse of stored eligibility information including documentation) to assist with retention of eligible individuals. ‘‘(4) Capability for individuals to apply, recertify and manage their eligibility information online, including at home, at points of service, and other community-based locations.‘‘(5) Ability to expand the enrollment system to integrate new programs, rules, and functionalities, operate at increased volume, and to apply streamlined verification and eligibility processes to other Federal and State programs, as appropriate. ‘‘(6) Notification of eligibility, recertification, and other needed communication regarding eligibility, which may include communication via email and cellular phones.‘‘(7) Other functionalities necessary to provide eligibles with streamlined enrollment process.’
‘‘(c) APPROVAL AND NOTIFICATION.—With respect to any standard or protocol developed under subsection (a) that has been approved by the HIT Policy Committee and the HIT Standards Committee, the Secretary— ‘‘(1) shall notify States of such standards or protocols; and ‘‘(2) may require, as a condition of receiving Federal funds for the health information technology investments, that States or other entities incorporate such standards and protocols into such investments.
‘‘(d) GRANTS FOR IMPLEMENTATION OF APPROPRIATE ENROLLMENT HIT.—‘‘(1) IN GENERAL.—The Secretary shall award grant to eligible entities to develop new, and adapt existing, technology systems to implement the HIT enrollment standards and protocols developed under subsection (a) (referred to in this subsection as ‘appropriate HIT technology’).
‘‘(2) ELIGIBLE ENTITIES.—To be eligible for a grant under this subsection, an entity shall—‘‘(A) be a State, political subdivision of a State, or a local governmental entity; and ‘‘(B) submit to the Secretary an application at such time, in such manner, and containing—‘‘(i) a plan to adopt and implement appropriate enrollment technology that includes–‘‘(I) proposed reduction in maintenance costs of technology systems; ‘‘(II) elimination or updating of legacy systems; and ‘‘(III) demonstrated collaboration with other entities that may receive a grant under this section that are located in the same State, political subdivision, or locality; ‘‘(ii) an assurance that the entity will share such appropriate enrollment technology in accordance with paragraph (4); and Title XXX of the Public Health Service Act (42 U.S.C. 10 300jj et seq.) is amended by adding at the end the following:‘‘Subtitle C—Other Provisions ‘‘SEC. 3021. HEALTH INFORMATION TECHNOLOGY ENROLLMENT STANDARDS AND PROTOCOLS. ‘‘(iii) such other information as the ecretary may require.
‘‘(3) SHARING.—|
‘‘(A) IN GENERAL.—The Secretary shall ensure that appropriate enrollment HIT adopted nder grants under this subsection is made available to other qualified State, qualified political subdivisions of a State, or other appropriate qualified entities (as described in subparagraph (B)) at no cost.
‘‘(B) QUALIFIED ENTITIES.—The Secretary
shall determine what entities are qualified to receive enrollment HIT under subparagraph (A)taking into consideration the recommendations of the HIT Policy Committee and the HIT Standards Committee.’’ p.368
10. SEC. 2703. STATE OPTION TO PROVIDE HEALTH HOMES FOR ENROLLEES WITH CHRONIC CONDITIONS…‘‘(f) MONITORING.—A State shall include in the State plan amendment—‘‘(1) a methodology for tracking avoidable hospital readmissions and calculating savings that result from improved chronic care coordination and management under this section; and ‘‘(2) a proposal for use of health information technology in providing health home services under this section and improving service delivery and coordination across the care continuum (including the use of wireless patient technology to improve coordination and management of care and patient adherence to recommendations made by their provider).”
11. ‘‘(g) REPORT ON QUALITY MEASURES.—As a condition for receiving payment for health home services provided to an eligible individual with chronic conditions, a designated provider shall report to the State, in accordance with such requirements as the Secretary shall specify, on all applicable measures for determining the quality of such services. When appropriate and feasible, a designated provider shall use health information technology in providing the State with such information.
12. Subtitle J—Improvements to the Medicaid and CHIP Payment and Access Commission(MACPAC): ‘‘(A) IN GENERAL.—The membership of MACPAC shall include individuals who have had direct experience as enrollees or parents or caregivers of enrollees in Medicaid or CHIP and individuals with national recognition for their expertise in Federal safety net health programs, health finance and economics, actuarial science,health plans and integrated delivery systems, reimbursement for health care, health information technology, and other providers of health services, public health, and other related fields, who provide a mix of different professions, broad geographic representation, and a balance between urban and rural representation.” p. 555
13. PART II—NATIONAL STRATEGY TO IMPROVE HEALTH CARE QUALITY…”‘‘(2) REQUIREMENTS.—The strategic plan shall include provisions for addressing, at a minimum, the following:…‘‘(F) Incorporating quality improvement and measurement in the strategic plan for health information technology required by the American Recovery and Reinvestment Act of 2009 (Public Law 111–5).” p. 686
14. SEC. 3012. INTERAGENCY WORKING GROUP ON HEALTH CARE QUALITY…”(1) IN GENERAL.—The Working Group shall be composed of senior level representatives of—…(G) the Agency for Healthcare Research and Quality; (H) the Office of the National Coordinator for Health Information Technology;” p. 689
15. ‘SEC. 931. QUALITY MEASURE DEVELOPMENT…‘‘(c) GRANTS OR CONTRACTS FOR QUALITY MEASURE DEVELOPMENT.—‘‘(1) IN GENERAL.—The Secretary shall award grants, contracts, or intergovernmental agreements to eligible entities for purposes of developing, improving, updating, or expanding quality measures identified under subsection (b).‘‘(2) PRIORITIZATION IN THE DEVELOPMENT OF QUALITY MEASURES.—In awarding grants, contracts,or agreements under this subsection, the Secretary shall give priority to the development of quality measures that allow the assessment of—…‘‘(D) the meaningful use of health information technology;” p. 694
16. “PART III—ENCOURAGING DEVELOPMENT OF NEW PATIENT CARE MODELS SEC. 3021. ESTABLISHMENT OF CENTER FOR MEDICARE AND MEDICAID INNOVATION WITHIN CMS”(models include)‘‘(v) Supporting care coordination for chronically-ill applicable individuals at high risk of hospitalization through a health information technology-enabled provider network that includes care coordinators, a chronic disease registry, and home telehealth technology.” p. 716
17. ”SEC. 3024. INDEPENDENCE AT HOME DEMONSTRATION PROGRAM…‘‘(vi) uses electronic health information systems, remote monitoring, and mobile diagnostic technology;” p. 755
18. ‘‘(4) PREFERENCE.—In approving an independence at home medical practice, the Secretary shall give preference to practices that are—‘‘(A) located in high-cost areas of the country;‘‘(B) have experience in furnishing healthcare services to applicable beneficiaries in the home; and‘‘(C) use electronic medical records, health information technology, and individualized plans of care.” p. 761
19. ”SEC. 3201. MEDICARE ADVANTAGE PAYMENT.‘‘(viii) Health information technology programs, including clinical decision support and other tools to facilitate data collection and ensure patient-centered, appropriate care.” p. 871
20. The Center for Quality Improvement and Patient Safety of the Agency for Healthcare Research and Quality (shall) ‘‘(G) expand demonstration projects for improving the quality of children’s health care and the use of health information technology, such as through Pediatric Quality Improvement Collaboratives and Learning Networks, consistent with provisions of section 1139A of the Social Security Act for assessing and improving quality, where applicable…”(2) LINKAGE TO HEALTH INFORMATION TECHNOLOGY.—The Secretary shall ensure that research findings and results generated by the Center are shared with the Office of the National Coordinator of Health Information Technology and used to inform the activities of the health information technology extension program under section 3012, as well as any relevant standards, certification criteria, or implementation specifications…PRIORITIZATION.—The Director (of the Agency) shall identify and regularly update a list of processes or systems on which to focus research and dissemination activities of the Center,taking into account—…‘‘(6) the evolution of meaningful use of health information technology, as defined in section 3000…(f) COORDINATION.—The entities that receive a grant or contract under this section shall coordinate with health information technology regional extension centers under section 3012(c) and the primary care extension program established under section 399W regarding the dissemination of quality improvement, system delivery reform, and best practices information.’’” p. 1040
21. SEC. 3502. ESTABLISHING COMMUNITY HEALTH TEAMS TO SUPPORT THE PATIENT-CENTERED MEDICAL HOME…‘‘(f) COORDINATION.—The entities that receive a grant or contract under this section shall coordinate with health information technology regional extension centers under section 3012(c) and the primary care extension program established under section 399W regarding the dissemination of quality improvement, system delivery reform, and best practices information.’’…(2) support patient-centered medical homes, defined as a mode of care that includes,(A) personal physicians; (B) whole person orientation; (C) coordinated and integrated care; (D) safe and high-quality care through evidence-informed medicine, appropriate use of health information technology, and continuous quality improvements; (E) expanded access to care; and (F) payment that recognizes added value from additional components of patient-centered care; quality improvements;” p. 1050
Part Two of these references will follow later this week. Please share any additional references or comments with e-Healthcare Marketing blog. Thank you.
Roundup of Health IT articles
Joseph Goedert on March 22, 2010 reported in HealthDataManagement on revamping of EDI requirements noting the bill has “language to significantly revamp the HIPAA transaction standards. The bill also has significant new administrative simplification provisions.”
Diana Manos of Healthcare IT News reported on March 22, 2010, “The new law builds on a platform of pay-for-performance and includes provisions to simplify healthcare administration, calling for the widespread use of healthcare IT.”
Marianne McGee of InformationWeek posted a column on March 22, 2010, titled “Healthcare Reform Already Underway” about the role Health IT is already playing in changing healthcare .
Joseph Conn, HITS staffer for ModernHealthcare.com, reported March 22, 2010, on feedback from HIT industry leaders, who were not yet clear on what was and was not included in final bill.
iHealthBeat’s Roundup on March 22, 2010: “House OKs Senate Health Reform Bill With Health IT Measures.”
Erik Sherman, of BNET.com, wrote a post on March 22, 2010, titled “Healthcare Reform May Trigger Big Tech Spending” highlighting more than a dozen references to health information technology in the bills passed by the house. It’s a quick check list though points to government units or processes already in place, and does not acknowledge the specialized role of Health IT vendors.
