HIPAA Regulatory Alert

HIMSS backs Wired for Health Care Quality Act

The Healthcare Information and Management Systems Society (HIMSS) has endorsed S. 1693 — the Wired for Health Care Quality Act of 2007 — and has strongly urged action on it. David Roberts, HIMSS vice president for government relations, tells HIPAA Regulatory Alert Congress was not likely to deal with the bill in 2007 but he hoped it could be approved in 2008.

In a letter to Sens. Edward Kennedy (D-MA), Hillary Clinton (D-NY), Mike Enzi (R-WY), and Orrin Hatch (R-UT), HIMSS said it endorsed the legislation subject to these additions and clarifications:

  • the "partnership" language in Section 3003 is intended to be AHIC 2.0 that is focused on the sequence of activities from issue identification (use case) to adoption and is not duplicative of CCHIT or HITSP;
  • the "partnership" language in Section 3003 addressing development of a body to implement HIT standards should specifically include the recognition of the existing standards developed by the Health Information Technology Standards Panel (HITSP) and certification requirements established by the Certification Commission for Health IT (CCHIT);
  • the privacy and security provisions in Section 3013 will be deleted from the legislation and handled in separate legislation, and therefore those concerns need not be raised at this time;
  • the authors of the bill will be more inclusive of key private sector membership constituencies including specific references to health care IT vendors and other stakeholders directly affected by the legislation and the authors are flexible on the membership requirements to make them "less governmental;"
  • the legislation would codify AHIC 1.0 as the governmental body that deals with the policy issues that are government's responsibility including but not limited to security and privacy policies, and interoperability use-cases necessary to support federal programs that require the sharing or exchange of health information.

The Congressional Budget Office has estimated S. 1693 would cost $47 million in 2008 and $317 million over the period 2008-2012, assuming appropriation of the necessary amounts.

S. 1693 would amend the Public Health Service Act to codify the establishment and responsibilities of the Office of the National Coordinator of Health Information Technology and the American Health Information Community (AHIC) to support adoption of health information technology. The two groups were established by executive order in 2004. The bill also would authorize funding for grants to facilitate widespread adoption of certain health information technology.

The National Coordinator of Health Information Technology is the senior advisor to the HHS secretary and the president on all health information technology programs and initiatives, and is responsible for:

  • developing and maintaining a strategic plan to guide the nationwide implementation of electronic health records in both the public and private health care sectors;
  • coordinating spending by federal agencies for health information technology programs and initiatives;
  • coordinating outreach activities to private industry and serving as the catalyst for change in the healthcare industry.

S. 1693 would specify the responsibilities of ONCHIT, AHIC, and a new organization to be known as the Partnership for Health Care Improvement. AHIC's current responsibilities would be divided between AHIC and the partnership, with AHIC focusing on development of policy and the partnership focusing on the technical aspects of developing and promoting adoption of health information technology.

Roberts says he hopes that in 2008 differences over privacy provisions can be resolved so the bill can be voted on. "We need to have more input so we can be sure doctors have the data they need," he says.

Study: National provider numbers are outdated

Some 20% of business addresses of physicians who were issued a National Provider Identifier (NPI) by the Centers for Medicare & Medicaid Services (CMS) are invalid because the physician moved to a new location, retired, or died, according to a 2007 audit by SK&A, a health care solutions and research company.

Findings showed 68% of NPI numbers were enumerated more than eight months before, and the average age of an NPI number is 13.16 months. CMS began issuing the identifiers in May 2005.

SK&A said it found the data to be inaccurate, even though CMS delayed release of the full NPI database numerous times to give health care providers an opportunity to update their mailing addresses and other contact data.

"This study on NPI data quality highlights the challenges that health care payers and marketers will face when trying to accurately match or link their provider legacy information to the new federally mandated NPI number," said SK&A President Dave Escalante.