Heating Up in Washington, DC: Capitol Hill Recap

It was a busy week for health IT on Capitol Hill with hearings ranging from MACRA to mobile apps, mark-ups and new legislation introduced. Below is an overview of what the House and Senate focused on prior to adjourning for the summer recess.


Mobile Health


The House Energy and Commerce Committee continued its “Disrupter Series” with a hearing on healthcare apps. Members of the Commerce, Manufacturing, and Trade Subcommittee heard testimony on the need for government regulation to address mobile medical apps and the medical advice they provided, often with or without physician consultation depending on the particular app. Designing regulation for this technology poses unique challenges including how to ensure that it does not impede the rapid innovation occurring within the industry. Witnesses also discussed the differences in Medicare reimbursements based on location of the care being administered and called for updates that would encourage the use of telehealth.




The Senate Appropriations Subcommittee on Military Construction, Veterans Affairs, and Related Agencies held a hearing to review the Department of Veterans Affairs VistA EHR system, the VA’s progress towards interoperability with the Department of Defense (DoD), and its future plans. During the hearing, VA’s Chief Information Officer, Laverne Council, indicated that the VA was working with several consulting firms to explore utilizing an off-the-shelf product for its EHR system. Council indicated that the VA will continue to upgrade VistA, but will eventually replace its EHR system with a commercial product.


A major point of contention during the hearing surrounded the claim that the VA is currently interoperable with the DoD, a claim that is based on DoD and VA’s implementation of the Joint Legacy Viewer. Despite recent efforts to upgrade the Joint Legacy Viewer (JLV) and the Enterprise Health Management Platform (eHMP), Chairman Mark Kirk noted that the JLV lacks the ability to exchange images and to perform basic analytics, raising questions regarding what being fully interoperable means.


Meanwhile, the House Appropriations Committee passed their FY17 Labor-HHS spending bill by a vote of 31-19.  The bill would cut AHRQ by $54 million dollars (as opposed eliminating funding for the agency as it has in years past) but directs $15.74 million for the agency's HIT research portfolio. The bill also included a $5 million increase for the ONC.  In the report language that accompanies the bill to add additional detail and context for the funding, the Committee included additional details related to patient matching, combating the opioid epidemic, including technical assistance to help providers better utilize the Prescription Drug Monitoring Programs, EHRs and e-prescribing, among other areas. Earlier this spring, the Senate Appropriations Committee approved a $10 million cut for AHRQ in its Labor-HHS spending measure. Floor action on the Labor-HHS bills in either chamber is unlikely.




On Wednesday July 13, the Senate Finance Committee held a hearing to examine the Centers for Medicare & Medicaid Services’ (CMS) implementation of MACRA. The sole witness was CMS acting administrator Andy Slavitt. During the hearing Slavitt stated that the administration is open to consider delaying implementation, saying CMS is "open to multiple approaches," including alternative start dates, shorter reporting periods, and other ways for physicians and clinicians to gain experience with the program prior to being impacted. As of now the MACRA final rules are set to be published in early November with a program start date of January 1st 2017.  


Meaningful Use

Six Republican Senators, including members of the original Senate “Reboot” group, introduced S. 3173, the EHR Regulatory Relief Act, which would remove Meaningful Use’s “all or nothing approach,” extend hardship exemptions and reduce the 2016 reporting period to 90 days, which CMS proposed last week. The bill would consider eligible professionals and eligible hospitals to be meaningful users if they meet 70 percent of the program's standards.