• Julie Barnes

December 24, 2020

Maverick's Update

Only What Matters on Health Information Policy

Maverick Health Policy wishes that all of you can squeeze a little happiness and some joy out of this holiday season. If you manage to do more than a little joy or some happiness, send photos. We are going to need proof.

You would think that we wouldn’t have much to say at this time of year. But this year keeps demanding to be special (“special” -- an adjective meaning singular, unusual, different, unique -- not necessarily a super-positive word). Here we go:

  1. In January 2021, the Sequoia Project will launch an initiative to help providers, health IT developers, and health information exchanges (HIEs) comply with interoperability rules.

  2. The HHS Office of Civil Rights issued guidance on how HIPAA allows provider, health plans, and their business associates to use HIEs to disclose protected health information to a public health authority -- giving COVID-19 examples.

  3. CMS is considering new quality measures for Medicare that would require the digital collection of information... something that has been obvious for a very long time, but that the pandemic made even clearer.

One Thoughtful Paragraph

This week’s big news is the year-end spending bill + economic stimulus package -- and whether it will actually become law. Our takeaways on the good and the bad for health information policy:

  • ONC, the principal federal entity charged with helping the health care industry achieve interoperability, was allotted a budgetary increase of $2M -- for a whopping total of $62M. That doesn’t seem like a lot.

  • Patient matching -- Congress once again prohibited the use of federal funds to create unique patient identifiers that would make it easier to match patients to their electronic health records. Congress also rejected an ONC-supported idea to give health care providers access to a tool that standardizes postal addresses.

  • Health Care Transparency -- State All Payer Claims Databases (that collect medical claims data across a region to learn what services costs and how to improve the quality and efficiency of the health care system) got a funding boost. The legislation also bans gag clauses in contracts between providers and health plans that keep cost and quality data secret, requires brokers to disclose financial incentives for steering people to certain health plans, and requires health plans to report information on medical costs and prescription drug spending to the Secretaries of HHS, Labor, and the Treasury -- and how drug pricing trends are impacting premiums will be published online.

  • Public Health Infrastructure -- $100M per year for 5 years to modernize data transmission and exchange between the CDC, states, public health labs, health care providers. On the same day Congress passed this language, the Harvard Business Review published this article about how the country’s health IT infrastructure is not equipped to track vaccine distribution, but this opinion is not new and widely-shared.

  • Prescription Drug Transparency -- Medicare Part D health plans must use a “real-time benefit tool” that connects to electronic health care records so doctors and seniors know how much they will pay for a drug if it is prescribed.

  • Telehealth -- Virtual care options have allowed millions to get access to care when in-person visits were too scary during a pandemic, but Congress mostly failed to make permanent the pandemic-related waivers or reimbursement boost that made this convenient form of medical care possible. Two bright spots: virtual behavioral health services will no longer have "only-in-rural areas" geographic restrictions, and the FCC got more money to give grants to provider groups that need capital for telehealth devices and connectivity.

We will check back int next week to see if these provisions became law.

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