With Republicans in charge of both houses of Congress in January, some health information technology legislation that has languished might get resurrected in 2015, and efforts to challenge the statutory authority of federal agencies to regulate HIT also may be renewed.
The U.S. House in particular has seen several bills introduced in the past two years, generally led by a Republican member but some also co-sponsored by a Democrat. None of the bills could likely move on their own, but could get attached to legislation going through both chambers. Example: A new ICD-10 compliance date and delayed enforcement of the Medicare two-midnight payment policy were part of the Doc-Fix legislation enacted last spring to stave off a huge cut in Medicare reimbursement rates for physicians.
The proposed HIT legislation, which dies at the end of this year if not enacted, can be reintroduced in the new two-year congressional session that starts in January. Major legislation moving through Congress, such as an emergency appropriations bill or another Doc-Fix bill early in the year, could include HIT provisions. HIT bills introduced in the current congressional session that could be brought back next year include:
* Legislation from Reps. Renee Ellmers (R-NC), a registered nurse for more than 20 years, and Jim Matheson (D-Utah) to mandate a 90-day electronic health records reporting period in 2015. Everyone except the Obama Administration wants a 90-day period and it is clearly necessary to save Stage 2, so bet on this proposal being tacked onto any appropriate bill that seems to have traction.
* A bill from Reps. Diane Black (R-TN) and Peter Welch (D-VT) to pilot outcomes and geographic-based reimbursement mechanisms for accountable care organizations and encourage ACO use of telehealth and remote monitoring services. Both members have been serving on powerful committees during the past two years--Black, a registered nurse, on Ways & Means and Welch on Energy & Commerce.
* Legislation from Rep. Pete Olson (R-TX) to develop clinical data registries. The House Energy & Commerce Committee in July voted to send the bill to the House floor, but it never went further. Democrats argued that supporters did not do their homework and it was not necessary because there are public and private programs already supporting development, and the measure would add duplication and bureaucracy.
* Legislation from Rep. Marsha Blackburn (R-TN) to limit authority of the Food and Drug Administration to regulate health information technology. This could come up sooner rather than later--a final plan is expected in early 2015.
* Legislation to repeal the Affordable Care Act-mandated 2.3 percent excise tax on medical devices, as reported by Bloomberg. Device manufacturers are putting a lot of pressure on the GOP. Speaking on CNN on Nov. 5, former House Majority Floor Leader Eric Cantor mentioned the device tax as a possible target next year.
But just because Republicans now will run Congress doesnt mean anything meaningful to the HIT industry will get done. Thats not a partisan snipe at the GOP: Democratic candidates for Congress ran away from their President and from their own party. They didnt even have the guts to tout the Affordable Care Act, which is working and no longer would be toxic if they had bothered to defend ACA programs that families of all stripes increasingly see as beneficial. Their cowardice was appalling; the Democratic Senate candidate in Kentucky would not even say if she voted for President Obama and thats when her support started to evaporate.
Now here come the Republicans, who dont play with each other any better than they play with the Democrats, and havent shown the ability or even the inclination to actually govern. And, many of them have no respect at all for their President. Fifty or so votes to repeal Obamacare do not raise confidence that governance will win the day over political games. The Tea Party wing in the House abhors Speaker John Boehner and the Tea Party wing of the Senate abhors presumptive Majority Leader Mitch McConnell. Seriously, McConnell is not conservative enough?
If they dont kiss and make up (and they initially wont) Republicans will act as though President Obama doesnt have a veto pen until enough members decide it is time to do some serious horse trading with the President, such as dropping onerous demands in a major appropriations bill in exchange for White House approval for the Keystone Pipeline.
Anytime major legislation that must be passed comes up, both sides will have to flex a little, and it is in these legislative battles that other appropriate bills can be added to the bigger package. And the next Doc-Fix bill--a perfect vehicle--will come up early.
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