Bills that would promote the adoption of health care information technology and address a scheduled cut in Medicare reimbursement to physicians "appeared to be just hobbling along Tuesday afternoon," CQ HealthBeat reports (Reichard [1], CQ HealthBeat, 9/26). The health care IT bill (HR 4157), which was approved by the House on July 27, 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, 9/25).

Prospects
Lawmakers cannot agree on funding, privacy protection, interoperability of the system, adoption of the billing code system or anti-kickback exemptions, according to CQ HealthBeat. An aide to a House Democrat said lawmakers likely will not reach a compromise by Friday. "I just think we're down to the wire with two very different animals," the aide said (Reichard [1], CQ HealthBeat, 9/26). HHS Secretary Michael Leavitt on Tuesday said, "I would argue that it's not lack of political will" that has stalled the legislation, adding, "I would argue that it's an abundance of political will" (Martinez, CongressDaily, 9/27). Meanwhile, sources with knowledge of negotiations on legislation to address the scheduled Medicare physician payment cuts "reported little progress," CQ HealthBeat reports (Reichard [1], CQ HealthBeat, 9/26).

Personal Health Records
Rep. Patrick Kennedy (D-R.I.) has drafted legislation he expects to introduce on Friday that would support the creation of "personal health records" -- Web-based health data maintained by individual patients that are interoperable with physician networks, CQ HealthBeat reports. The legislation calls for using PHRs for electronic patient registration that includes demographic, insurance, current medication, and family and medical history information. The data would be connected to physician, hospital, pharmacy, insurer and lab networks, among other health care participants. Under the draft, participating providers would receive $2 per patient per year to be funded by HHS (Reichard [2], CQ HealthBeat, 9/26).

State Efforts
State governors and legislators "are embarking on a variety of strategies to encourage the use of electronic health records," the New York Times reports. In the last two years, 38 states have entered into the early stages of discussing health IT initiatives and as many as 21 are beginning to coordinate efforts, according to Janet Marchibroda, CEO of the eHealth Initiative. The primary effort is to encourage the use of EHRs, so that doctors can have access to patient data statewide. Some state officials have organized task forces of hospitals, doctors, insurers and other groups to develop plans for regional interoperable systems, the Times reports. "It just takes a tremendous amount of time, investment and effort," Sheera Rosenfeld, senior manager at Avalere Health, said. "There is a tremendous amount of focus," on implementing health care IT, and "it continues to grow," she added (Abelson, New York Times, 9/27).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.