Advocacy News

October 13, 2015



AAOS Disappointed in Release of Meaningful Use Stage 3 Final Rules

Bonefied News

Senators Introduce Legislation to Improve Electronic Health Records

What We’re Reading

Senate HIT Hearing

Legislators Introduce Loan Forgiveness Legislation for Pediatric Subspecialists

Risk Evaluation & Mitigation Strategies: Understanding and Evaluating Their Impact on the Health Care Delivery System & Patient Access

PQRS Informal Review Process

Ambulatory Surgery Center Association Meets in DC

MDEpiNet PPP Annual Meeting- October 1 -2, 2015

AAOS Orthopaedic PAC Online Contribution Center


AAOS Website

AAOS Calendar

House of Representatives Legislative Activities
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Senate HIT Hearing

On October 1, 2015 the Senate Committee on Health, Education, Labor, and Pensions (HELP) held a hearing entitled, “Achieving the Promise of Health Information Technology.” This hearing was the sixth hearing in the 114th Congress on health information technology (HIT) and electronic health records (EHR). The two key witnesses were Dr. Karen B. DeSalvo, MD, MPH, MSc, National Coordinator for Health Information Technology, and Dr. Patrick Conway, MD, MSc, Acting Principal Deputy Administrator, Deputy Administrator for Innovation and Quality, and Chief Medical Officer at the Centers for Medicare and Medicaid Services (CMS).

Sen. Lamar Alexander, Chairman of the HELP Committee, stated that the goal of the committee is to move forward, not backward, with EHR and that implementing MACRA needs to be a top priority. Sen. Alexander also made it clear that he believes that Meaningful Use (MU) Stage 2 Final Rule should be adopted immediately, and has asked the government to make Stage 3 rules final no sooner than Jan 1, 2017, and that the Stage 3 requirements should be phased in at a rate that reflects how successfully the program is being implemented.

Sen. Patty Murray, Ranking Member of the HELP Committee, emphasized that EHR and a strong HIT infrastructure are extremely important to way our nation’s health care is delivered. Sen. Murry stated that she is focused on prioritizing standards, so that systems developed by different vendors are actually able to communicate with each other. Sen. Murray noted that security also needs to be a priority; as the nation moves toward greater HIT use, standards and best practices need to be developed that stand up to the reality of today’s cybersecurity threats. Sen. Richard Burr echoed Sen. Murray’s comments regarding safety and security

Dr. DeSalvo and Dr. Conway both testified that their respective organizations are committed to working with providers and stakeholders to improve of HIT. Dr. DeSalvo referred to the Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Draft Version 1.0, and the Federal Health IT Strategic Plan as ways in which ONC has worked with stakeholders and federal agencies on HIT and interoperability issues. Dr. Conway noted that physician use of EHR has increased from 18 to 78 percent between 2001 and 2013, and 94 percent of hospitals now use certified EHRs. He also noted that the Medicare Access and CHIP Reauthorization Act (MACRA) supports Secretary Burwell’s goals to move Medicare towards payments based on quality rather than quantity. Complete testimonies for Dr. DeSalvo and Dr. Conway are both available online, here.

Sen. Bob Casey noted the need for flexibility with child health, and stated that there needs to be a balance with confidentiality restrictions. Sen. Al Franken noted that there are significant resource restraints for rural providers to successfully adopt EHR systems.

Sen. Bill Cassidy emphasized the need to get the MU program right, and stated that he believes that subspecialties should be able to define what Meaningful Use is for their group, and that the process should occur at the front end of the Stage 3 rule-making process, instead of at the back end; that the specialty societies should give input before the rule is made final, instead of choosing from the measures that CMS has already decided upon. Sen. Cassidy also stressed the importance of a unique identifier, and suggested that, absent a unique identifier, CMS and ONC should consider a ‘global entry’ type of system that is voluntary for patients, but will ensure doctors can correctly identify a patient.

Sen. Elizabeth Warren noted that one way to improve quality and lower the cost of healthcare is to consider alternative payment models such as bundled payments. She noted that interoperability is integral to facilitate alternative payment models. Sen. Warren also asked the witnesses if the converse were true: if alternative payment models help promote interoperability. Dr. DeSalvo responded that alternative payment models require a HIT infrastructure that works. Sen. Warren finally noted that she is fully supportive of CMS moving forward with the Comprehensive Care for Joint Replacement Model, and noted that the Congressional Budget Office (CBO) estimated that the widespread use of bundled payments could save the healthcare system $46.6 billion.