21st Century Cures Act Has Supporters, Detractors as Markup Begins

The House Energy and Commerce Committee will begin its markup today of the 21st Century Cures Act, with opening statements by committee members late this afternoon and the proceedings continuing tomorrow morning. However, stakeholder opinions about the proposed legislation run the gamut from praise to outright condemnation regarding such hot-button technology issues as health information technology interoperability and telehealth.


The House Energy and Commerce Committee will begin its markup today of the 21st Century Cures Act, with opening statements by committee members late this afternoon and the proceedings continuing tomorrow morning. However, stakeholder opinions about the proposed legislation run the gamut from praise to outright condemnation regarding such hot-button technology issues as health information technology interoperability and telehealth.

A May 15 memo from the committee’s majority staff argues that the “ability to share research and clinical data is a cornerstone of our drive for new cures” and notes that the Office of the National Coordinator for Health IT has led the charge in the area of HIT interoperability “but recently has identified barriers to nationwide interoperability of health technology.” Section 3001 of the draft bill, titled “Ensuring Interoperability,” is an attempt by Congress to “refocus national efforts on making systems interoperable and holding individuals responsible for blocking or otherwise inhibiting the flow of patient information throughout our healthcare system,” asserts the committee.

Premier Inc., a healthcare alliance of 3,000 hospitals and 110,000 other providers, is strongly urging the committee to support the 21st Century Cures Act’s interoperability standards and approve the bill.

“With this legislation, members of Premier remain hopeful that we will create strong policies that enable applications to exchange data and information among disparate systems in healthcare,” said Keith Figlioli, Premier senior vice president of healthcare informatics and a member of ONC’s HIT Standards Committee. “With interoperability standards, providers will be in a much better position to manage population health across the care continuum and support advanced payment initiatives such as shared savings and bundled payment. This is an essential step to optimize HIT investments, improve the quality of care across settings and avoid the cost burdens associated with the work around solutions that are needed today for systems to ‘talk’ to one another.”

Figlioli adds that the new interoperability standards proposed by 21st Century Cures Act “have the potential to move us in the right direction for the advancement of health information technology.” However, others—including ONC—are critical of legislative language in the bill that is designed to advance health IT interoperability by decertifying electronic health records products that block information sharing.

Also See: EHR Decertification in 21st Century Cures Act Raises Concerns

At last month’s HIMSS15 conference in Chicago, ONC’s Director of the Office of Policy Jodi Daniel told Health Data Management that congressionally-mandated product decertification could have unintended consequences that negatively impact the healthcare industry as a whole. Daniel described decertifying EHR products a “blunt instrument” that “might penalize the bad action by a vendor, but it will cause harm to innocent providers” who will not have a certified product and will either “have to switch products or they will fall out of compliance with Meaningful Use.” 

Section 3021 of the bill is also controversial, requiring specific government actions to develop a long-term policy for telemedicine.

But, both the American Telemedicine Association (ATA) and the Healthcare Information and Management Systems Society expressed disappointment at the lack of substantive telehealth provisions in the current version of the 21st Century Cures bill.

“The new version of the bill leaves the Medicare program in the slow lanes while states, private payers and every other developed nation are quickly adopting the use of technology to transform the delivery of healthcare,” said Jonathan Linkous, CEO of ATA. “It is ironic that a bill titled the 21st Century Cures will leave Medicare and Medicaid patients firmly in the 20th Century when it comes to delivering healthcare.”

The Health IT Now Coalition is encouraging Congress to remove current barriers to telehealth services under Medicare. “Any legislation to remove telehealth barriers under Medicare will not be complete without addressing interstate medical licensure,” said Joel White, executive director of Health IT Now. “In order to provide quality care, promote care coordination, and reduce redundancy in the healthcare system, Health IT Now believes that Medicare doctors should be able to treat Medicare patients across state lines without having to obtain multiple state licenses.”

The full text of the proposed 21st Century Cures Act legislation can be found here.

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