- Two top health regulators defended the administration's implementation of the data blocking and interoperability provisions of the 21st Century Cures Act in front of the Senate HELP committee Tuesday.
- Office of the National Coordinator for Health IT head Don Rucker and CMS Chief Medical Officer Kate Goodrich faced a slew of questions from senators on both sides of the aisle over the patient privacy provisions and the fast pace of the regulations, which would require insurers be able to digitally and at no cost share a patient's personal health information with them by Jan. 1.
- "My major concern is to remind the administration of the advice that my piano teacher used to give me before a recital," committee chairman Lamar Alexander, R-Tenn., said. "She'd say, 'Lamar, play it a little slower than you can play it. You're less likely to make a mistake.'"
The hearing is the second in recent months in front of the Senate HELP committee over implementation of Cures. Four industry stakeholders appeared in front of the committee late March to go over their major concerns with the two CMS and ONC rules — mainly, the timeline.
"Policymakers must strike a balance between their desire to make personal digital health information available and the burdens that these requirements place on health systems under proposed timelines," Lifepoint Health Chief Medical Informatics Officer Christopher Rehm said then, a concern echoed by top senators on the committee Tuesday.
Under the proposed interoperability rules released in February, insurers participating in CMS-run programs like Medicare, Medicaid and the federal ACA exchanges would be required to be able to give their some-125 million patients free electronic access to their personal health information by the beginning of 2020.
Industry groups would have to adopt standardized application programing interfaces, or APIs, two years after the rules are completed, and hospitals would have to be able to send a patient's doctors a notification when a patient is discharged from the hospital.
Beyond saving what they estimate as $3.3 billion per year, HHS officials contend the rules would give patients more control over their care.
But in the face of industry pushback that they didn't have enough time to draft appropriate comments to the almost-1,000 page interoperability rules, HHS extended the comment period by an additional 30 days from the original May 3 deadline. HHS has received 1,400 comments thus far (view CMS' here; ONC's here), which are now due June 3.
But that's not enough, according to Tuesday's HELP panel. Senators expressed interest in a phased-in approach for interoperability compliance as opposed to hard deadlines, or decreasing the size of the health dataset players need to be able to share.
Rucker pushed back slightly on timeline concerns, noting the dataset, called the U.S. Core for Healthcare Interoperability, is within reach given the current state of health sharing within the country and that it might not be within the interest of the public to further delay the rules.
"To the extent this is delayed or prevented, the American public is not in control of their healthcare," Rucker warned, though both he and Goodrich noted privacy and security concerns were paramount moving forward, especially when it comes to third party applications. The concern that not enough is being done to protect the privacy of patient data in such applications was raised by Sens. Patty Murray, D-Wash., Jacky Rosen, D-Nev., and Bill Cassidy, R-La.
Alexander, seeming to believe the Cures implementation requires more oversight, expressed interest in forming a working group of six or so senators to receive periodical updates on the project from HHS officials.