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Senate Finance, HELP Leaders Unveil Health Bills

JUNE 30, 2005 -- As senators reached across the aisle Thursday to introduce bipartisan measures to spur health information technology and link Medicare payment to the quality of care delivered, industry and government officials expressed concern that legislation not interfere with existing efforts to accomplish those goals.

At a joint press conference, Senate Health, Education, Labor and Pensions Committee Chairman Michael B. Enzi, R-Wyo., and the panel's ranking Democrat Edward M. Kennedy, D-Mass., unveiled legislation that would accelerate the adoption of health care information technology nationwide. Senate Finance Committee Chairman Charles E. Grassley, R-Iowa, and Sen. Max Baucus of Montana, the committee's ranking Democrat, introduced a measure that would link a portion of Medicare's reimbursement for health care services to the quality of care.

Dr. David Brailer, national coordinator for health information technology at the Department of Health and Human Services who is coordinating the administration's efforts on "Health IT," told a Senate panel that "there is concern about legislation slowing down this process" and that legislation "could create uncertainty about where we want to go." Brailer made his remarks during a Senate Commerce Subcommittee on Technology, Innovation and Competitiveness hearing on health information technology.

Karen M. Ignagni, president and chief executive officer of America's Health Insurance Plans, a trade group representing insurers, said it would be a "mistake" to relax federal fraud and abuse laws for the purpose of allowing hospitals to support physician use of health information technology, a provision in both bills.

"We are concerned about the unintended consequences of tying physicians to hospitals financially through equipment subsidies or electronic record sharing," Ignagni said in her written testimony to the panel.

And while the American Hospital Association (AHA) praised Grassley and Baucus for recommending incentives that would reward excellence in care, the group urged Congress not to disrupt an ongoing system that has more than 99 percent of eligible hospitals reporting quality data.

"It is important the legislation be clear that its intent is not to create a separate and duplicative mechanism for quality measurement and reporting," AHA Executive Vice President Rick Pollack said in a release.

Criticisms aside, the lawmakers said their measures would dovetail to improve the quality of health care delivered while reducing its cost.

The Enzi-Kennedy bill would create a public–private collaborative for developing necessary technical standards to implement health care information technology nationwide and provide grants to help smaller hospitals and doctors afford the technology needed for "Health IT."

Expanding the use of health information technology, Enzi said, "will change the way medical care is provided in this country." Enzi and other proponents say such technology can save the nation billions of dollars in unnecessary paperwork and medical procedures while ensuring that a patient's medical information remains confidential.

"Electronic medical records, software that can warn if a treatment could harm a patient, computerized prescribing—all these can save lives and dramatically cut costs," Kennedy said.

The Grassley-Baucus measure would implement recommendations from the Institute of Medicine and the Medicare Payment Advisory Commission on creating quality payments under Medicare for physicians and other providers, such as hospitals, health plans, and skilled nursing facilities.

"Today, Medicare pays the same amount regardless of quality of care. Some people would argue that in fact, the current Medicare payment system rewards poor quality," Grassley said. "This situation just doesn't make sense to me, nor should it to beneficiaries."

Baucus said the bill "takes a crucial step towards improving the value of our health care dollar as well as the safety and quality of our nation's health care system.

The Finance panel is expected to move the "pay for performance" bill by the end of the year, Grassley said, adding that ultimately the bill might move through the Senate with legislation to reverse a scheduled payment cut for Medicare physicians.

Enzi said his committee would mark up the health care information technology bill in July.

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