The Washington Debrief  provides CHIME members weekly news and information related to important healthcare IT legislative, regulatory and political developments in Washington, D.C.





Volume 5, No. 20
May 22, 2017
INSIDE THIS EDITION:
WannaCry Update

Key Takeaway: WannaCry cyberattack nabs headlines and creates wake-up call.

Why it Matters: The worldwide WannaCry cyber ransomware attack which began more than a week ago has U.S. healthcare providers and policymakers on high alert. The largest cyberattack of its kind, the American healthcare system sprung into action rushing to defend systems against an attack which originated in Europe and Asia. Below are the five bulletins released by the U.S. Department of Health & Human Services (HHS) and a compilation of medical device manufacturers alerts. 
  • HHS Bulletins and place to join HHS list serve found here.
  • Questions about cyberattack can be directed to CIP@hhs.gov (critical incident response)
  • Most recent list of manufacturer medical device bulletins can be found here.
HHS is pivoting from emergency response to lessons learned. To aid them in this process CHIME & AEHIS are hosting a call to learn from members about how we and HHS can improve their information sharing process and what was most helpful. The call will be held during the first week of June. Please email us if you are interested in joining the call. Also, those unable to make the call can email us their thoughts.
WORKING FOR YOU IN WASHINGTON

Leslie Krigstein
VP Congressional Affairs, CHIME


Mari Savickis
VP Federal Affairs, CHIME

Thoughts, Questions or Comments? Please contact  Leslie or Mari

Office Hours: 
9:00am - 5:00pm
NIST & FDA Cyber workshops

Key Takeaway: Last week both the National Institute for Standards and Technology (NIST) and the Food and Drug Administration (FDA) hosted workshops on cybersecurity.

Why it Matters: Coinciding with an already busy week on the cybersecurity front, NIST and FDA hosted long-planned workshops. NIST's workshop focused on their cybersecurity Framework. FDAs event focused on cybersecurity challenges associated with medical devices, regulatory science gaps and needed research.

AEHIS member, Matt Snyder, CISO with PennState Health, moderated the first panel on day one of the NIST workshop on use of the NIST cybersecurity framework in healthcare. Links to the webcast can be found here for day one and here for day two. 

Information including the agenda and webcast for the FDA workshop can be found here.
Members Request Hearing on WannaCry

Key Takeaway: The top Democrats on two House Committee on Homeland Security subcommittees have request a hearing on the WannaCry ransomware incident.

Why It Matters: Congress has been fairly quiet on the ransomware incident that has impacted many worldwide, including some hospitals and medical devices.

Representatives Cedric Richmond (D-LA) the ranking member of the Cybersecurity and Infrastructure Subcommittee and Donald Payne Jr. (D-NJ), ranking member of the Emergency Preparedness, Response and Communications Subcommittee called on the Committee leadership to hold a hearing on the WannaCry ransomware incident. 

The letter to subcommittee chairman Dan Donovan (R-NY) and John Ratcliffe (R-TX) called-on committee leadership to hold a hearing writing, "As such, our Committee needs to hear from the health care community, emergency services providers, and other lifeline sector representatives to learn what obstacles they face in securing their systems and maintaining continuous operations in the event of a cyber-attack. We request that the Subcommittees hold such a hearing promptly."
Telehealth Bill Advances in the Senate 

Key Takeaways: With unanimous approval, the CHRONIC Care Act, which includes a number of provisions to expand federal coverage of telehealth services, was cleared by the Senate Committee on Finance and will not be considered by the full Senate.

Why It Matters: Historically it has been a challenging to advance telehealth legislation in Congress because the Congressional Budget Office (CBO) generally believes greater expense will be incurred by the federal government if additional telehealth services are subject to reimbursement.

The Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act (S. 870) would expand telestroke reimbursement under Medicare, allows accountable care organizations (ACOs) and Medicare Advantage to provide telemedicine services. It would also allow for reimbursement of home dialysis treatment through telemedicine in Medicare. 

CHIME and AEHIT submitted a statement for the record of Tuesday's hearing on, "Examining Bipartisan Medicare Policies that Improve Care for Patients with Chronic Conditions," in which the CHRONIC Care Act and telehealth was discussed. The hearing examined, among other issues, how technology can improve care and outcomes for chronically ill patients.

The hearing and bill resulted from the nearly two years of work by the Finance Committee's bipartisan Chronic Care Working Group led by Senators Johnny Isakson (R-GA) and Mark Warner (D-VA.) The bill was approved by the Committee by a vote of 26-0. Finance Committee Chairman Orrin Hatch (R-UT) has indicated his interest in getting this bill across the finish line before the end of the year and keeping separate from healthcare reform efforts.
Medicare Payment Policies  Subject of House Hearing

Key Takeaways: The House Committee on Ways and Means evaluated ways to improve Medicare payment policies in a hearing last week.

Why It Matters: One of the must-pass pieces of legislation in 2017 are the Medicare Extenders. The House Ways and Means Health Subcommittee held a hearing last week on " Current Status of the Medicare Program, Payment Systems, and Extenders." The Committee heard testimony from Mark Miller, Chairman of the Medicare Payment Advisory Commission (MedPAC.)

Miller discussed MedPAC's payment cut recommendations for home health agencies and inpatient rehabilitation facilities and freeze rates for skilled nursing facilities. Miller discussed rural hospitals may be struggling to even accommodate overhead costs, and suggested Congress tailor its supplemental payments in a more diligent fashion. 

CHIME submitted a statement for the record of the hearing outlining improvements the Committee should consider to the Meaningful Use program and quality measurement. The statement also explained that patient care would improve and costs would decrease if we had a national solution for accurately identifying patients.
Take our Quick Survey on Readiness for 2015 Edition Certified EHRs!

Key Takeaway: Help us make the case more time is needed before use of 2015 Edition is required! Take our 3 question, 5 second survey!
  1. Have you received your     2015 Edition Certified EHR software from your vendor?    Y /N
  2. If no, do you expect to   receive it by July 1?
  3. Do you think you will be   ready for January 1, 2018?

Why it Matters:  CMS did not propose changing the required start date by which providers would need to start Stage 3 and begin using Version 2015 CEHRT, though they are requesting feedback on this. While CMS has proposed a 90-day reporting period of Meaningful Use, they have also proposed providers must report eCQMs for the first three quarters of 2018.

Click here to complete the survey.
Senate Democrats Cited Interoperability In Making Case for FY18 Budget 

Key Takeaways: A group of Senate Democrats wrote to President Trump to appeal for proper funding for the Department of Health and Human Services (HHS.)

Why It Matters: Among the reasons the group asked for adequate funding were some health IT policy-related. 

Lead by Senator Patty Murray (D-WA), the 11 Democrats cited the provisions in the 21st Century Cures Act that focused on improve healthcare interoperability and the need to properly fund HHS to execute the directives Congress set forth including efforts to thwart information blocking as well as improve the security, usability and interoperability functions of certified electronic health records (EHRs.)
The group also called for expanded access to mental healthcare services and the need for the Food and Drug Administration (FDA) to be properly equipped to evaluate new pharmaceuticals, biologics and medical devices.
Quality Measurement Grants Announced

Key Takeaway: The Centers for Medicare and Medicaid Services (CMS) announces grants on quality measure development.

Why it Matters: Last week CMS announced approximately $30 million for developing quality measures under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

The grant solicitation says, "This competitive funding opportunity will be for one cooperative agreement to fund the National Center for Benefits Outreach and Enrollment (NCBOE) which will provide technical assistance to States, AAAs, and other community service providers to provide outreach and benefits enrollment assistance, particularly to older individuals with greatest economic need, for Federal and state programs." Applications are due July 19th.The grant announcement can be found here.
In recognition of holidays, the Washington Debrief
will not be published on May 29, 2017.   Look for our next Debrief on June 5, 2017
Click here to view our  CHIME Public Policy Playbook
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