Medicare Compliance & Reimbursement

Leaders on both sides of the aisle get ready to hammer out details of shared goal

When Senate Republicans and Democrats offered their respective 2005 top legislative proposals last week, few areas of strong shared healthcare interest emerged. Both parties advocate initiatives aimed at enrolling all eligible children into Medicaid and the State Children's Health Insurance Program. Both also advocate offering some form of tax credits to help uninsured people buy coverage.

But a lack of funds, plus stark ideological differences about the kinds of insurance markets in which tax credits should operate, seem likely to sink the credit proposals. And the Medicaid/SCHIP initiative could turn out to be more sentiment than substance, given the near inevitability that the White House and congressional Republicans also will push forward significant federal funding cuts for Medicaid in 2005.

That leaves one area of shared interest in a relatively non-controversial area. Both parties strongly espouse facilitated development of an interactive national infrastructure for clinical health information technology. Observers inside and outside the Congress say that an IT bill may be the most likely healthcare proposal to see enactment.

So far, Democrats have offered the more fleshed-out proposal and are pushing for a fairly aggressive federal role in setting standards as well as funding health IT. With a Republican president in the White House, GOP lawmakers are waiting for the administration to take the lead on details.

President Bush said Jan. 27 that he would seek to double federal health IT funding in fiscal year 2005 to $100 million, while seeking $125 million in FY 2006 funding for IT demonstration projects. The administration also issued draft standards for e-prescribing under Medicare's new Part D drug benefit (see story, next article).

A document released by the office of Majority Leader Bill Frist (R-TN) summarizes all 10 top Republican legislative priorities for the 109th Congress. Health IT is included in a multiple-issue healthcare proposal, S. 4. The proposal would promote "the rapid adoption and widespread use of individually owned, privacy-protected electronic health records by fostering the development of standards to quickly and safely exchange electronic patient information, encouraging the use of cost saving technology, and ensuring a coordinated federal effort to promote health information technology," says the Frist summary.

Senate Democrats' main healthcare bill, S. 16, offers a more detailed and extensive set of proposals for federal action, including the following: adopt within two years "national data and communication health information technology standards that promote the efficient exchange of data between varieties of provider health information technology systems"; guarantee loans to eligible entities that promote in various ways development of local clinical IT systems; and award grants to help localities develop IT infrastructures and to purchase IT systems.

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