Capitol Update on Health Insurance

August 4, 2010
Capitol Update
Here is a summary of what has been happening in Washington, as of July 30, 2010.
Republicans Criticize New Rules for Electronic Health Records Program
During a July 27 hearing, Republican members of the Energy and Commerce Health Subcommittee stated that eligibility requirements for a new federal program designed to encourage health care providers to adopt electronic health records (EHRs) are too stringent. Democratic Subcommittee members and the Obama Administration defended the new requirements.
The EHR program, which was mandated by the American Recovery and Reinvestment Act of 2009 (ARRA), will provide additional Medicare and Medicaid payments to health professionals and hospitals that adopt and make “meaningful use” of certified EHRs beginning in 2011. Health care providers that fail to make “meaningful use” of certified EHRs by 2015 will be subject to Medicare payment penalties. On July 13, the Obama Administration released regulations outlining initial eligibility requirements for the additional Medicare and Medicaid payments.
Republican Subcommittee members, including Representatives John Shimkus (IL) and Michael Burgess (TX), warned that too many health care providers will be unable to meet the eligibility requirements for additional Medicare and Medicaid payments. They also warned that many health care providers will be unable to adopt certified EHRs by 2015.
Dr. David Blumenthal, the Obama Administration’s National Coordinator for Health Information Technology (IT), responded that the EHR program accommodates the challenges facing providers, while appropriately encouraging the adoption of EHRs. He also stated that certain health care providers can qualify for hardship exemptions from the Medicare payment penalties that begin in 2015. Committee Chairman Henry Waxman (D-CA) expressed support for the new rules, stating that EHRs and other forms of health information technology will play a vital role in the implementation and administration of quality improvement and care coordination programs included in the new health care reform law.
The July 13 regulations are the first in a series of EHR program rules and will apply to additional Medicare and Medicaid payments in 2011 through 2013. The Department of Health & Human Services intends to impose more stringent eligibility requirements in 2014.
House Republicans Request Hearing with New CMS Administrator
Republican members of the Energy and Commerce Committee have asked Committee Chairman Henry Waxman (D-CA) to hold a hearing with Dr. Donald Berwick, the new administrator of the Centers for Medicare & Medicaid Services (CMS). He is expected to play a significant role in the implementation of health care reform. Republicans opposed President Barack Obama’s nomination of Dr. Berwick on the grounds that he may ration patient access to care under Medicare and Medicaid.
Dr. Berwick was given a recess appointment by the president during the Fourth of July congressional recess, in order to temporarily circumvent what was expected to be a contentious Senate confirmation process. As a recess appointee, Dr. Berwick has all the powers of a permanent appointee. However, his appointment will expire in late 2011 per the Constitution, unless he is formally confirmed by the Senate.
Chairman Waxman has not indicated whether he intends to convene a hearing with Dr. Berwick.
Public Health Bills Reported Favorably Out of House Committee
On July 28, eight public health bills were favorably reported by the House Energy and Commerce Committee. The bills include the following:

• The Dental Emergency Responder Act (H.R. 903)

• The Family Health Care Accessibility Act (H.R. 1745)

• The Combat Methamphetamine Enhancement Act (H.R. 2923)

• The Emergency Medic Transition (EMT) Act (H.R. 3199)

• The Nationally Enhancing the Wellbeing of Babies through Outreach and Research Now (NEWBORN) Act (H.R. 3470)

• The National All Schedules Prescription Electronic Reporting Reauthorization Act of 2010 (H.R. 5710)

• The Training and Research for Autism Improvements Nationwide (TRAIN) Act of 2010 (H.R. 5756)

• The Safe Drug Disposal Act of 2010 (H.R. 5809)

Energy and Commerce Committee Chairman Henry Waxman (D-CA) stated that the Committee will work with House leadership to move the bills to the House floor this year. Health Subcommittee Chairman Frank Pallone (D-NJ) also stated that he intends to mark up additional bills in the Health Subcommittee when Congress returns from its August recess.
Only three of the eight bills reported by the Committee have companion bills in the Senate. The three Senate companion bills are:

• The Combat Methamphetamine Act of 2009 (S. 256). S. 256, passed by the Senate on June 8, 2009.

• The Safe Drug Disposal Act of 2009 (S. 1336)

• The National All Schedules Prescription Electronic Reporting Reauthorization Act of 2010 (S. 3575)

The Senate has yet to take action on S. 1336 and S. 3575. For more information, visit the Energy and Commerce website.
Looking Ahead
The House of Representatives began its August recess on Monday, Aug. 2, while the Senate remains in session until Aug. 6. The Senate is spending the first part of the week on additional funding measures for education and Medicaid. Democratic leaders are also slated to bring an energy package (S.3663) for a vote. Neither of the two measures is expected to reach the 60-vote threshold. The remainder of the week will focus on the confirmation of Elena Kagan to the Supreme Court.