As we discussed in our post last week, the recently proposed 21st Century Cures Act holds promise for many aspects of healthcare. While we previously focused primarily on how the new bill would impact the FDA and NIH, the proposed legislation also holds major influence for health technology, such as telemedicine and interoperability with electronic health records (EHRs).
Legislative Changes for Telemedicine
In light of recent controversy around the quality of care patients receive remotely through telemedicine, Congress has asked the Centers for Medicare and Medicaid Services (CMS) to provide them with reports within a year of the bill’s passage containing the following:
- Who would most benefit from telemedicine
- Work that has been done for adoption and use to date
- Procedures that may be suitable for a telemedicine consultation
- Barriers to expanding telemedicine services
Additionally, with various states proposing contradicting legislation over the availability and reimbursement of telemedicine, the bill proposes common licensure requirements for states to facilitate multistate/cross state practices. Currently, care providers are limited to practicing telemedicine in the state in which they are licensed, largely restricting the potential reach of telehealth.
Opposition from the American Telemedicine Association
While the proposed rulings are receiving some praise for trying to eliminate regional barriers, the 21st Century Cures Act is also receiving harsh criticism as a “dummy bill” which doesn’t actually accomplish any real change. Rather than calling for the adoption or implementation of new procedures and regulations, the American Telemedicine Association (ATA) claims the new bill simply commissions another round of reports on the status of the telemedicine industry without enacting any real change.
Procedural Changes for Interoperability
In contrast to the telemedicine proposals, the rulings around EHR interoperability offer concrete procedural changes, primarily in banning information blocking between vendors to benefit patient safety. To enact this change, providers must first attest that they have not engaged in information blocking. If the Office of the National Coordinator (ONC) does find evidence of blocking, proposed legislation in this bill allows them to decertify the non-interoperable EHR, making it ineligible for Medicare reimbursements associated with Meaningful Use certifications.
The American Hospital Association (AHA) is pushing back against some of these measures, calling the enforcement and penalties associated with the new procedures heavy handed and duplicative of punishments already in place. While the organization agrees that vendors should be held responsible for creating solutions that are interoperable, it’s worried about the repercussions that vendor decertification could have on hospitals, such as the assignment of Meaningful Use penalties. The AHA is therefore seeking protection for hospitals for at least a year to give them time to replace their decertified EHR system, which can be very costly.
What are your thoughts on the 21st Century Cures Act as a whole? Do you agree with the unanimous vote of support the bill received from the House Energy & Commerce Committee?
Missed part one of this post? Read it here.