Secretary Leavitt Sends Letter to HELP committee re: S,1693
HHS Secretary Michael O. Leavitt sent a letter to the Senate Committee on Health, Education, Labor and Pensions (HELP) on Tuesday June 26, the day before the committee was scheduled to mark up the Wired for Health Care Quality Act (S. 1693). In the letter, the Secretary noted that "this legislation, as presently drafted, would create significant barriers to continued progress already underway."
The Secretary indicated that the Administration would oppose the bill unless significant changes were made namely by striking the provisions that would create a Partnership for Health Care Improvement (the Partnership) and the American Health Information Community (AHIC).
AHIC and the Partnership:
Secretary Leavitt voiced strong concerns about "freezing a particular set of structures in statute", noting that the "existing charter for the AHIC will expire in 2008 and there is an ongoing public process determining what kind of successor entity should be established." The Secretary also outlined the need to keep the AHIC free from "deadlines and deliverables dictated by legislation."
Regarding the creation of the Partnership, the Secretary said it would be "counterproductive" and akin to "adding an additional layer of complexity to the health IT governance structure."
Leavitt urged the HELP committee to strike both the AHIC and the Partnership provisions of the bill.
Quality Provisions:
Secretary Leavitt posed several questions regarding various aspects of Section 3006 of the bill, the section which creates Quality Reporting Organizations (QROs). The Secretary questioned the feasibility of any federal agency, including HHS, obtaining all of the necessary data that is seemingly required to conduct the reports outlined in the bill. Questions over privacy matters relating to data usage were also posed.
Title III of the bill requires the Secretary within 90 days of enactment to designate a single organization to promote the development of performance measures. To this, Secretary Leavitt said that, "Ninety days is too short a time to endorse a single quality organization; the leadership in this area of the industry is still emerging, and no one organization is ready to lead the whole enterprise for all parts of the health care community." The Secretary also recommended that the bill assign authority to the Secretary, rather than to the Agency for Healthcare Research and Quality (AHRQ).
Grants and Loans:
In Leavitt's letter, he opposed the use of grants and state loan programs to help providers adopt health IT, arguing that "market forces" are the most efficient way to achieve widespread adoption.
Privacy Provisions:
Section 3012 of the bill would designate operators of health information electronic databases as HIPAA-covered entities. Regarding this section, the Secretary said, "It is premature to determine, as the draft bill provides, that all of these entities should be transformed into full-fledged covered entities under HIPAA." He also noted that the AHIC is currently examining this issue.
Section 3008 would require all grant recipients to notify individuals in the event of a wrongful disclosure of individually identifiable health data. The Secretary believes "this provision is too broad," because some disclosures would not present a significant risk for misuse of the information, but the resources needed to implement such notifications would require a significant amount of resources.
Secretary Leavitt concluded the letter by saying that HHS shares the goals of the HELP committee regarding HIT, but hopes to work with the committee to address his concerns prior to consideration by the full Senate. A date for full Senate consideration has not yet been set. To download a copy of the Secretary's letter, click here.
