Gov Info Security recently published their thoughts on the possible effects of the new Congress on the EHR incentive money known as the HITECH act.
Republicans, however, have made it clear that they’ll look for any opportunity to repeal some or all of the healthcare reform package. Observers say that means the HITECH Act likely won’t get as much attention, even though the EHR incentives are funded by President Obama’s economic stimulus package.
“One of the things that the Republican ‘pledge to America’ includes is a plan to take away any unobligated stimulus money,” says Dave Roberts, vice president of government relations at the Healthcare Information and Management Systems Society. “I don’t think that’s going to apply to the HITECH provisions. Folks on the Hill tell me that health IT is a bipartisan issue. Democrats and Republicans see it as a way to improve healthcare.”Nevertheless, Republicans will closely scrutinize all spending, Roberts acknowledges. “And they’re going to take a close look at all the provisions of the HITECH Act to make sure they’re being implemented as directed by Congress.”
Even if the presumed new speaker of the House, John Boehner, R-Ohio, was to push for spending cuts, such as eliminating the EHR incentives, getting such a proposal approved would prove very difficult, Roberts argues. “With the two chambers of Congress controlled by different parties, getting them to agree on something will be next to impossible,” he says.
In addition, President Obama, who is strongly supportive of healthcare IT, likely would veto any cuts in HITECH spending, notes Rob Tennant, senior policy adviser for the Medical Group Management Association. And overriding a veto would prove extremely difficult.
I tend to agree. Certainly something crazy could happen (it’s government work after all), but I think the likelihood of HITECH Act funding being taken away is pretty slim. As it describes above, it would take a really unique piece of legislation to get it through the house, senate and then the President. I just don’t see that happening at all.
Plus, I thought the point of the money being so far along in the regulation process is another good reason. Although, since checks haven’t been paid out yet, I’m guessing that there’s still potential that they’ll put it on hold. Just seems really unlikely to me.
Just for a bit of perspective. The entire national REC expenditure under ARRA/HITECH is roughly 1/205th of the FY2010 outlay for the wars in Iraq and Afghanistan (the latter two coming in at a combined $138.4 billion). Put another way, we spend the equivalent of the aggregate REC 4 yr allocation every couple of days in the Middle East.
I might add, as well:
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Title XIII of ARRA was given a subtitle: Health Information Technology for Economic and Clinical Health Act (HITECH). It is this section that deals with many of the health information communication and technology provisions including Subpart D – Privacy.
What is the total health IT funding?
$20.819 billion in incentives through the Medicare and Medicaid reimbursement systems to assist providers and organizations in the adoption of electronic health records.
$4.7 billion for National Telecommunications and Information Administration’s Broadband Technology Opportunities Program.
$2.5 billion for the U.S. Department of Agriculture’s Distance Learning, Telemedicine, and Broadband Program.
$2 billion for the Office of the National Coordinator (ONC).
$1.5 billion for construction, renovation, and equipment for health centers through the Health Resources and Services Administration.
$1.1 billion for comparative effectiveness research within the Agency for Healthcare Research and Quality (AHRQ), National Institutes of Health (NIH), and the Department of Health and Human Services (HHS).
$500 million for the Social Security Administration.
$85 million for health IT, including telemedicine services, within Indian Health Services.
$50 million for information technology within the Veteran’s Administration.
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Roughly $33.7 billion across the life of the program, or, about 3 months of the current wars’ cost.
But BobbyG, you know that the military budget isn’t on the block when it comes to cutting costs. Neither is Medicare or Medicaid. At least not the benefits. They’ll happily cut what they pay doctors though.
I agree that it is extremely unlikely that the HITECH Act and its provisions will undergo any significant cuts under the new Congress. This does not mean, however, that the programs are not in jeopardy of being compromised.
There is a major Medicare issue on the table for the upcoming “lame duck” Congress regarding the Medicare physician pay cut. If this is not addressed, it is possible that many physicians may opt out of Medicare (and therefore not participate in the Medicare EHR program). In addition, the incentive payments are directly tied to Medicare reimbursement, so a decrease in these rates can create a reduction in the incentive payments. Finally, due to the potential Medicare cuts, many practices are holding off on EHR purchases until the status is known, and may cancel plans for EHR if the cuts become reality.
Frank,
Great point about the cuts to Medicare impacting it. That could definitely play a role in some practices decision.
John … Not sure if you were aware but military dependant (active duty and mobilized Guard, reserves) and retiree health care services (TriCare) are tied to and administered by CMS.
Reimbursement rates for TriCare patients is also pegged below CMS’ Medicare rates since military dependant families and military retirees are younger than Medicare patients.
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