House Passes Major Health IT Bill to Promote Adoption

The House July 27 passed a sweeping health information technology (HIT) bill that includes a provision designed to boost the use of electronic clinical trial data, but the measure came under swift attack by Democrats who charged that it would not improve technology adoption but would endanger the privacy of patient medical records.

HIT advocates generally praised the bill's passage, though many lamented its failure to include a tax incentive to entice smaller medical practices to invest in new technology.

Other organizations also lauded the bill for taking important steps forward on the thorny issue of standards. A lack of standards is widely viewed as slowing many HIT initiatives, including RFID.

The bill -- H.R. 4157, the Better Health Information System Act of 2006 -- would establish the Office of the National Coordinator for Health Information Technology within HHS that would be responsible for a number of HIT-related policies.

Among those policies is a dictate directing the national coordinator to promote the "efficient and streamlined development, submission and maintenance of electronic healthcare clinical trial data." Under the legislation, the coordinator would be responsible for ensuring that other government agencies adopt policies that help create a national interoperable health information system.

Some Good Reviews

"We believe our members [will benefit] from this because they will consult with smaller practices and supply [HIT products] to them," Computing Technology Industry Association (CTIA) tax analyst Lamar Whitman told PIR. CTIA pushed hard for the failed tax break, but otherwise sang the praises of H.R. 4157.

"Unlike other HIT bills, H.R. 4157 establishes an implementation date for the ICD-10 coding system, which is critical to the adoption of and quality reporting for medical technologies," said AdvaMed President and CEO Stephen Ubl in a July 26 statement supporting the bill.

The legislation also requires the HHS secretary to issue within a year of the bill's enactment a report on the work conducted by the American Health Information Community. That report would include information on the progress toward:

Establishing uniform industrywide HIT standards; Achieving an internet-based nationwide health information network; and Achieving interoperable electronic health record adoption across healthcare providers.

Even though the bill vote -- 270-148 -- did not break along party lines, some House Democrats quickly issued statements dismissing the measure's potential effectiveness.

"Today, our Republican colleagues are wasting a golden opportunity to make real progress in an area that most members of Congress support," Rep. John Dingell (D-Mich.) said in a joint statement issued with Rep. Charles Rangel (D-N.Y.).

"We have a chance to not only save money and time, but also save lives.Instead, the Republicans have offered a bill that fails on many issues -- patient privacy, funding, electronic communication between providers and protecting against fraud."

The two Democrats quoted a Congressional Budget Office (CBO) report that found the bill would not "significantly affect either the rate at which the use of health information technology will grow or how well that technology will be designed and implemented." That same CBO report said the bill would cost the federal government $4 million in fiscal 2007 and $38 million in additional spending through fiscal 2011.

Privacy Issues Raised

CTIA's Whitman and other Capitol Hill analysts said the privacy issues raised could possibly slow or even derail the bill from becoming law. It still must be reconciled with a Senate version, S. 1418, that contains more privacy provisions than the House version. "It's hard to say when it will become law," Whitman said, noting that the legislative session is relatively short until after the November elections.

House Republicans may have felt that the Health Insurance Portability and Accountability Act covered patient erecord privacy issues adequately, H.R. 4157 supporter Steve Pacicco, CEO of eHealth Solutions, told PIR. He applauded the bill for, in part, helping physicians "overcome their reluctance to adopt new technology."

Democratic opponents charged that the House Republican leadership had refused to consider a Democratic substitute to the HIT bill that they had written, which largely mirrored the Senate bill, S. 1418. That bill passed the Senate last fall and has been referred to the House Energy and Commerce Committee, of which Dingell is the ranking minority member. -- Robert Barton (mailto:rbarton@fdanews.com), Michael Causey