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Uncertainty Grows About Passage This Year of Health Care IT Bill

SEPTEMBER 8, 2005 -- Legislation to promote the adoption of health care information technology (IT) has moved down Congress' priority list as new concerns about spending and responding to Hurricane Katrina have moved to the forefront, congressional aides said Thursday.

And Katrina's budgetary hit—more than $60 billion to date but expected to rise far higher—creates new doubt about finding money to prevent Medicare payment cuts to doctors and thus their ability to invest in health care IT if the cuts take effect, aides suggested at a Washington D.C. conference.

But HHS Secretary Micheal O. Leavitt and other speakers said the devastation caused by the storm is a powerful argument for promoting health care IT.

Katy Barr, an aide to Senate Health, Education, Labor and Pensions Committee Chairman Michael B. Enzi, R-Wyo., said her boss had hoped to get floor time this month to pass a bill promoting health IT, which Congress is counting on to make health care safer and less costly. "But right now, with so many things on the plate, that doesn't look too likely," she said at the Health Information Technology/HIPAA Summit.

She said it is hard to predict if health IT bills can get through both chambers, clear a conference committee, and be signed into law this year.

Momentum appeared to be growing for health IT legislation when Enzi's committee passed The Wired for Health Care Quality Act shortly before the August recess. The measure combined the efforts of Enzi, Senate Majority Leader Bill Frist, R-Tenn., Sen. Edward M. Kennedy, D-Mass, and Sen. Hillary Rodham Clinton, D-N.Y., and appeared headed for rapid floor action.

At the same time, action was heating up in the House, with Rep. Nancy L. Johnson, R-Conn., floating a draft bill and the Energy and Commerce Committee beginning work on legislation as well. Johnson aide Dan Elling said Thursday that in light of the demands on Congress this fall, "the end of this year is certainly an aggressive goal" for House passage of legislation.

The pending House and Senate measures would promote the adoption of standards to ensure that computer systems function together efficiently and authorize limited grant money to ease the costs of adopting the technology.

Elling said Johnson remains hopeful, despite Katrina's costs, that Congress will act to prevent a projected Medicare cut of about 5 percent in payments to doctors next year.

"Obviously anything that costs a significant amount of money is going to be affected by the budgetary constraints we're working under," he said. But at the same time, Katrina makes a strong case for preventing Medicare cuts to doctors, given the public health needs created by the hurricane.

Key to prospects for a costly permanent fix to the Medicare physician payment formula is administrative action by the Centers for Medicare and Medicaid Services. Those administrative changes in the payment formula would sharply reduce the costs of a payment fix. Johnson met at the White House with Office of Management and Budget Director Joshua B. Bolten shortly before the August recess to encourage him to agree to the administrative changes, Elling said.

Leavitt said 1 million people have been displaced by Katrina and that in most cases their medical records are gone. A system of electronic medical records could prevent that from happening in the future, he said.

Leavitt also said Katrina raised the question in his mind of U.S. readiness to deliver the widespread emergency care that would be needed in 48 states in a pandemic. A national health IT system would perform the critical function of allowing public health officials to quickly detect local outbreaks of disease in that situation, he suggested.

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