What’s Next for Health IT Policy and Legislation in 2023

With Congress providing a telehealth exemption as part of its omnibus spending bill in late 2022, delaying the “telehealth cliff” for two years, HIMSS says it is now considering the case for permanent reimbursement of virtual care. Ready to prepare.

Also on its policy agenda for the coming year: advocating for data standardization, offering input to interoperability rulemaking, and engaging with agencies and states to increase telehealth access. We spoke with the HIMSS Government Relations team for those priorities and their thoughts on 2023 and beyond.

Making the Case for Telehealth to Control Costs

Telehealth has proven to reduce the burden on healthcare providers and improve access and has been a priority for HIMSS for many years, but the Congressional Budget Office has long complained that all data is available on non-Medicare patients. explains Tom Leary, Senior Vice President and Head of Government Relations at parent company HIMSS Healthcare IT News,

Budget leaders have asked, “How do you know exactly what the impact will be on the Medicare population and the Medicare Trust Fund? We now have three years of data on the impact on the Medicare Trust Fund,” he said.

While the pandemic-era telehealth waivers answered many questions at the federal level, a two-year extension to offer telehealth in high-deductible health plans with health savings accounts included in the final legislative package for 2022 has provided further room for progress. A new window has opened. permanent change.

HIMSS “will use the next two years to gather additional data to inform both Congress and the CBO on the cost of avoidance or cost containment aspects,” Leary said.

In addition to making telehealth coverage sustainable, easing patient access is another goal for the mission-driven nonprofit, which aims to improve the global health ecosystem through the power of information and technology.

Amanda Krzepicki, government relations manager at HIMSS, said HIMSS has also aggressively supported the Connect for Health Act, and a bill is expected to be reintroduced this year.

In 2023, HIMSS will work to not only advance telehealth with really strong data on how these services help patients achieve broad improvement, but also to discuss how telemedicine can reach more patients. Will also work with the licensing boards at the state level for

HIMSS members will be informed of the long-term impact of multiple provider types and care settings as they relate to reimbursement.

One example is audio calls and how to set up reimbursement rates based on the care needed and the appropriateness of care delivery through that channel.

Audio playback can be helpful, especially in areas where internet connectivity is not reliable.

By July 2022, all state Medicaid programs will provide at least some audio-only coverage for behavioral wellness, according to a recent report from the Kaiser Family Foundation.

According to the report, most states want to keep expanding telehealth programs and have broad authority to do so without federal approval.

Krzepicki said that while we need to be concerned about bad actors in the space, the data “isn’t really true that the use of the telehealth space has led to cost increases.”

“It’s really important for HIMSS that we are at least using technology in a way that improves patient access to care,” Leary said.

Pushing for wider broadband adoption

HIMSS has worked with the Senate Broadband Caucus to expand broadband on an ongoing basis.

“Broadband access as a whole is an issue we’re moving towards,” Leary said.

The Infrastructure Improvement Act had several billion dollars in it, and HIMSS will work with the Federal Communications Commission on last-mile connectivity in the coming year, he said.

The agency has launched more broadband expansion programs to increase connectivity for more communities, such as the Affordable Connectivity Outreach Grant Program, which will announce grant recipients on or before March 10.

The program provides funding to eligible state, local and tribal housing agencies as well as nonprofit and community-based organizations and others for outreach activities that raise awareness of the ACP for families receiving federal housing assistance and encourage participation.

The FCC will also award outreach grants to “trusted, neutral third-party entities, such as schools and school districts, or other local or state government entities.”

“It’s free to enroll in ACP, but many people are reluctant,” Craig Settle wrote in November for Healthcare IT News about how telehealth’s efficacy depends on meeting the broadband requirement.

Telehealth and broadband advocate Settles says, “Telehealth can win over fence-sitters. The universal need for healthcare combined with telehealth can make ACP a win-win for everyone.”

Healthcare access from home or to a clinic is just as important as educational access, Leary echoed.

He said previous legislation with funding for broadband, such as the 2009 American Recovery and Resilience Act, defines what needs to be done to receive the money.

What is less clear this time, Leary said, is how the money gets to the communities most in need of aid.

“How do you leverage that for healthcare, and how does healthcare get involved in those discussions?” Leary said.

Harmonizing Standards for ‘Interoperability 3.0’

HIMSS government relations experts said there has been a back-and-forth on what to do about the provider burden for several years.

The Centers for Medicare and Medicaid Services released a proposed rule to improve the electronic exchange of healthcare data and streamline procedures related to prior authorization for further interoperability.

HIMSS members are interested in seeing information transport standards that are common to most health and pharmacy data used in rule making.

“I think CMS is seeing the writing on the wall and really taking advantage of the fact that this is part of the public discourse,” Leary said.

Comments are due in early March. In his comments, Leary says he expects HIMSS to emphasize using the most current information sharing standards HL7, using cases from the Integrative Healthcare Enterprise, and marrying them with National Council for Prescription Drug Program standards.

“So that we can create some synergy, not create something that increases provider burden,” he said.

Another priority for members is to see CMS become more in lock-step with the Trusted Exchange Framework and Common Agreement, or TEFCA, and qualified health information networks.

“Let’s make sure [Office of the National Coordinator for Health IT] is proposing, does not make and does not take us in a different direction on CMS interoperability,” Leary said.

Fighting for more seamless patient records

Substance abuse privacy regulations prohibit the sharing of mental health records with providers – even when patients have provided access.

The US Health and Human Services published a Notice of Proposed Rulemaking on December 2 that calls for significant changes to better align the substance use privacy regulations – 42 CFR Part 2 – with HIPAA. The deadline for submitting comments is January 31.

HIMSS is a founding member of the Patient ID Now coalition and has long been known as a national patient identifier for patient safety, Krzepicki said, explaining that a lack of access to substance abuse records hinders care. It can happen and it can even lead to death.

The rule change could make it easier for providers to share patient records and help create a data cleaner.

“We will not lose information as we pass it on to the patient, and patients will not have to sign waivers that allow some physicians to see different information inputs from other providers,” she said.

Andrea Fox is a senior editor for Healthcare IT News.
Email: [email protected]

Healthcare IT News is a HIMSS publication.

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