August 01, 2006

On July 27, 2006, the U.S. House of Representatives passed HB 4157, which promotes the use of Health Information Technology (HIT). It did so in hopes of improving patient safety and overall quality of care.

Of course, HB 4157 still has to be approved by the Senate and signed by the President before becoming effective. However, the passage of this bill is an important step towards making the implementation of HIT a reality. It also marks a more cohesive approach towards HIT by the House, where the House Energy and Commerce Committee and the House Ways and Means Committees had passed relatively dissimilar versions of the “Health Information Promotion Act of 2006” just this past June. Highlights from the HB 4157 are outlined below.

Clarification on the Role of the National Coordinator for HIT

HB 4157 establishes an Office of the National Coordinator for HIT within the Department of Health and Human Services (DHHS). The bill requires that the National Coordinator set forth and clarify the agency’s role with regard to HIT. Specifically, the bill outlines items for which the agency will be responsible, including maintaining and updating a strategic plan to guide the nationwide implementation of standards for HIT, serving as a principal advisor to the DHHS on the use of HIT, and coordinating HIT policies and programs across federal agencies.

New Stark Exception and Anti-Kickback Safe Harbor

HB 4157 also enables hospitals to provide physicians with HIT by creating a new exception to the Stark law and new safe harbors to the Anti-Kickback Statute. This may include supplying software and hardware or related services that are used for the electronic creation, maintenance, and exchange of clinical health information.

Specifically, the bill adds the following exception to 42 USC 1395nn(b), which delineates the general exceptions to both ownership and compensation arrangement prohibitions under Stark: “Any nonmonetary remuneration (in the form of health information technology or related installation, maintenance, support or training services) made by a specified entity to a physician” if it meets certain conditions.

Further, HB 4157 amends the Anti-Kickback Statute to state that inducements to reduce or limit services which are prohibited by the statute “shall not include the practical or other advantages resulting from health information technology or related installation, maintenance, support, or training services.”

HB 4157 states that for purposes of both the Stark law and the Anti-Kickback Statute, HIT shall be defined as “hardware, software, license, right, intellectual property, equipment, or other information technology (including new versions, upgrades, and connectivity) designed or provided primarily for the electronic creation, maintenance, or exchange of health information to better coordinate care or improve health care quality, efficiency, or research.”

Adoption of ICD-10 by 2010

HB 4157 also requires the replacement of the International Classification Diseases (ICD)-9 system, used for diagnosis coding since the 1970s, with the ICD-10 codes sets by October 1, 2010. The adoption of ICD-10 accounts for recent innovations in healthcare diagnostics as well as statistical analysis.

State and Federal Confidentiality and Security Laws

The bill also requires DHHS to look into the effect of the differences in the State and Federal confidentiality and security laws on HIT. Specifically, it requires DHHS to submit a report to Congress in eighteen (18) months regarding whether or not “there is a need for greater commonality of the requirements of State security and confidentiality laws and current Federal security and confidentiality standards to better protect, strengthen, or otherwise improve the secure, confidential, and timely exchange of health information among States, the Federal government, and public and private entities.”

Providers and hospitals should follow the progress of HB 4157 as it makes its way to the Senate, as this bill will have a significant impact on their ability to utilize HIT. To read more about HB 4157 click here: http://thomas.loc.gov/ If you have any questions about this e-alert, please contact Daniel J. Hayes at [email protected] or Virginia Alverson at [email protected].