Prospect for passage of final health care IT bill uncertain

Negotiations to reconcile House and Senate versions of legislation that would promote the implementation of health care information technology have not progressed, and prospects for passage of a final bill prior to the midterm elections are uncertain, according to congressional aides, CongressDaily reports (Lee, CongressDaily, 9/12).

The House on July 27 approved a bill (HR 4157) that would codify the Office of the National Coordinator for Health Information Technology within HHS; establish a committee to make recommendations on national standards for medical data storage; and develop a permanent structure to govern national interoperability standards. The bill also would clarify that current medical privacy laws apply to data stored or transmitted electronically and would require the HHS secretary to recommend to Congress a privacy standard to reconcile differences in federal and state laws. Under the bill, the number of billing codes health care providers use to file insurance claims would increase from 24,000 to more than 200,000 by October 2010. In addition, the legislation includes an exemption of anti-kickback laws that would allow hospitals to provide health care IT hardware and software to individual physicians. The Senate in November 2005 passed a different version of the bill (S 1418) that does not include the provision on billing codes or the exemption of anti-kickback laws (Kaiser Daily Health Policy Report, 9/8). "The biggest sticking point" in negotiations to resolve the differences in the bills involves the exemption of anti-kickback laws, CongressDaily reports (CongressDaily, 9/12). In addition, lawmakers cannot agree on funding, privacy and interoperability issues (CongressDaily, 9/11). A spokesperson for Senate Health, Education Labor and Pensions Committee Chair Mike Enzi (R-Wyo.) said, "There are difficult issues being addressed," adding, "But we hope we can reach a compromise that Congress can vote on" (CongressDaily, 9/12).

AARP Priorities

AARP CEO Bill Novelli last week in a Sept. 8 letter to several lawmakers wrote that final legislation should include at least $280 million in funding over the first two years -- the amount in the Senate bill -- and that a broader grant program in the House bill would better promote the implementation of health care IT. In addition, he wrote that final legislation should include interoperability requirements in the Senate bill. Final legislation also should exclude the exemption of anti-kickback laws in the House bill and should expand the privacy protections in the Senate bill (Crowley, CQ HealthBeat, 9/11).