The Headlines
- Congress works to enact an economic relief package in response to the COVID-19 virus.
- FY 2021 appropriations work continues.
- HHS releases final rules on data sharing.
The Details
1. COVID-19 virus updates
Staff for Senator Richard Burr (R-NC) are in regular contact with Duke Health experts on the health system's preparedness plans and testing capabilities. This week, Senator Thom Tillis (R-NC) and Reps. David Price (D-NC-04) and Richard Hudson (R-NC-08) sent a letter to Vice President Mike Pence urging the administration to provide additional resources to increase testing for COVID-19 in North Carolina.
On Wednesday, House Democrats introduced legislation to provide protections for Americans who may contract the COVID-19 virus. The Families First Coronavirus Response Act (H.R. 6201) includes, among other provisions, over $1 billion in food assistance, increases for state unemployment trust funds, waivers for the costs of coronavirus testing, and emergency paid sick leave requirements and reimbursements for employers. House Democrats continue to negotiate with Republican leaders on the parameters of a final relief package.
On Tuesday, North Carolina Governor Roy Cooper declared a state of emergency, which in part allows the state to draw down federal funds that were enacted as part of an emergency spending bill last week. The American Hospital Association and its members, including the North Carolina Healthcare Association, are urging the White House to declare a public health emergency in order to authorize more federal flexibility for action.
2. The congressional FY 2021 appropriations season continues
This week, the Senate Appropriations Chairman Richard Shelby (R-AL) said that the FY 2021 appropriations cycle will remain on schedule as long as it is still safe to hold hearings, markups, and votes amid the COVID-19 virus. Our office continues to contact congressional offices in support of Duke Health's priorities.
On the House side, 234 members sent a letter to congressional leaders urging a funding level of at least $44.7 billion in FY 2021 for the National Institutes of Health (NIH). Duke Health Government Relations requested support for this funding, and North Carolina delegation members G.K. Butterfield (D-NC-01), David Price (D-NC-04), Richard Hudson (R-NC-08), and Alma Adams (D-NC-12) signed onto the letter. Senator Burr is co-leading a similar effort in the Senate, which requests that Senate appropriators “maintain a strong commitment to funding for the National Institutes of Health.” Senator Thom Tillis signed onto the letter.
At the request of Duke Health, Rep. Alma Adams (D-NC-12) also signed onto letters in support of increased funding for Title VII health professions programs and Title VIII nursing workforce development programs. Rep. Butterfield signed onto a letter in support of increased funding for the Department of Defense Reconstructive Transplant program.
3. HHS releases final rules on data sharing
On Monday, the Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare and Medicaid Services (CMS) finalized rules to promote sharing of electronic health information.
The final rule from ONC implements prohibitions and outlines exceptions for certain types of information blocking, which are practices not required by law or necessity that interfere with the exchange of health data, mandated by the 21st Century Cures Act. The rule also updates the 2015 Edition certification criteria for health information systems to ensure that certified health IT systems can send and receive e-health information in a structured format, make that e-health information available through apps, and export a patient’s e-health information to a location designated by the patient.
While supporting greater patient access and control over their health data, the American Hospital Association (AHA) has criticized the ONC rule as insufficient in protecting patient privacy and promoting security. In a statement, AHA President and CEO Rick Pollack noted that “nearly all hospitals and health systems have made health information available to patients electronically,” but warned that the “rule lacks the necessary guardrails to protect consumers from such actors as third party apps that are not required to meet the same stringent privacy and security requirements as hospitals.” Duke Health did not take a formal position on the ONC rule but generally supports greater patient access to health data.
The CMS final rule requires Medicare Advantage organizations, Medicaid, and the Children’s Health Insurance Program, including managed care programs, and qualified health issuers that are part of federally managed health care exchanges to implement the same data sharing rules as ONC by 2021. Further, Medicare-participating acute-care hospitals, long-term care hospitals, inpatient rehabilitation facilities, psychiatric hospitals, children's hospitals, cancer hospitals, and critical access hospitals are required to send e-notifications to providers when a patient is admitted, discharged, or transferred. This provision will go into effect in September 2020.