OCHIN regularly comments on proposed regulatory and federal guidelines to share our perspective as a health innovation organization.
2019 Public Comments
July 1, 2019
The FCC proposed to cap the Universal Service Fund (USF) which is comprised of four programs providing funding assistance to extend broadband throughout the nation. OCHIN offered recommendations on how to improve efficiency of the program funding and administration.
The Technical Exchange Framework and Common Agreement (TEFCA) Draft 2 is the last of three sets of comments which encourage and support interoperability on the national scale. The TEFCA Draft 2 is a revision of TEFCA Draft 1, also commented on by OCHIN, that seeks to establish a national Network of Networks to improve health information exchange.
Medicare and Medicaid Programs: Patient Protection and Affordable Care Act; Interoperability and Patient Access for Medicare Advantage Organization and Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans in the Federally-facilitated Exchanges and Health Care Providers
CMS’s Interoperability Rule is the second of three sets of comments which encourage and support interoperability on a national scale. This rule is a proposal in an ongoing interoperability rulemaking process by CMS, which OCHIN responded to last year and can be found below.
ONC’s Information Blocking Rule is the first of three sets of comments which encourage and support interoperability on a national scale. The Information Blocking Rule is an evolving provision of The 21st Century Cures Act, designed to innovate care delivery by embracing advances in technology while overcoming emerging barriers.
OCHIN commented in response to the request to address the Office for Civil Rights (OCR) Request for Information on Modifying HIPAA Rules to Improve Coordinated Care, and provided recommendations on how the OCR can modify HIPAA rules to remove regulatory burdens while increasing the efficiency of care coordination.
OCHIN commented in response to the request to address the Office of the National Coordinator’s (ONC’s) Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs. We advocated for creating clear standards for the exchange of healthcare information, aligning national standards for provider reporting metrics for Medicaid and Medicare, supporting the use of CCDA as the standard basis for health information exchange (HIE), applying national standards for HIE, the Prescription Drug Monitoring Program (PDMP), and Social Risk Factors (SRF, or social determinants of health: SDH), and aligning 42 CFR Part 2 with HIPAA.
2018 Public Comments
Medicaid and Medicare Efficiency, Transparency, and Burden Reduction
OCHIN commented in support of reducing increasing transparency and reducing burden using a number of methods. We advocated for using MAT and other funding to onboard behavioral health providers, standardizing telehealth payer structure, continuing adoption of 2015 or greater CEHRT and enabling national framework’s standards, integrating external capabilities into the EHR such as PDMP, and finally, 42 CFR Part 2 reformation.
OCHIN, a leader in social determinant of health research took the opportunity to translate our learnings around social determinants into recommendations for ASPE. We advocated for standardizing EHRs and SDH definitions, incorporating extensive training to prepare for social risk factor collection, ensuring clinics compile robust community resources for addressing social issues, and the need for clinics to gain access to their claims data for a successful move towards value-based care.
OCHIN submitted comments echoing those of the California Telehealth Policy Coalition in response to updates to the California Telehealth Policy Manual. We advocated for funding to expand broadband connectivity and telehealth projects, standardization of payments and networks for eConsult and telehealth services, allowing non-CA based providers to virtually serve CA patients, and alignment of eConsult codes.
ONC Request for Information Regarding 21st Century Cures Act Electronic Health Record Reporting Program
OCHIN submitted comments about implementation of the 21st Century Cures Act requirements, which addresses interoperability and data sharing in the EMR. We advocated for reducing provider burden by promoting the exchange of healthcare information through national framework’s standards, continued adoption of 2015 or newer Certified electronic health record technology (CEHRT), the use of national health information exchange standards and metrics, regardless of health platform, and 42 CFR Part 2 reform to ensure needed data sharing and care coordination to address the opioid crisis.
OCHIN took the opportunity to advocate for common metrics between state and federal programs, reporting substance use treatment services performed by primary care providers, and extending telemedicine and virtual visits to those suffering from substance use disorder. We also made a number of specific comments on proposed changes.
OCHIN praised the format of the ISA but also made some recommendations on how to improve it. We advocated for reducing provider burden by promoting the exchange of healthcare information through national framework’s standards, such as Carequality or Commonwell, continuing adoption of 2015 or newer CEHRT, and standardization across all healthcare platforms.
Medicare Program: Proposed Changes to Hospital Outpatient Prospective Maybe and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Requests for Information on Promoting Interoperability and Electronic Health Care Information, Price Transparency, and Leveraging Authority for the Competitive Acquisition Program for Part B Drugs and Biologicals for a Potential CMS Innovation Center Model
OCHIN expressed its support for assisting providers adopt 2015 or newer CEHRT through national standardization and funding, improving virtual care reimbursement rates, and reducing provider burden by promoting and incentivizing use of national frameworks such as Carequality or Commonwell.
Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019l Medicare Shared Savings Program Requirements; Quality Payment Program; and Medicaid Promoting Interoperability Program
OCHIN provided comments on modernizing Medicare reimbursement for virtual care. We also expressed support of expanding virtual care, integrating PDMP into the electronic health record system, and incentivizing non-opioid alternatives to heal the opioid crisis.
Healthcare Innovation Caucus Request for Information
OCHIN took the opportunity to express the great need for utilize technology to expand care for the safety net. Increasing virtual screening, e-consults, tele-counseling, and remote patient monitoring will increase access to specialist care, and improve both outcomes and costs. OCHIN also advocated for an increase in reimbursement rates for virtual care.
OCHIN made recommendations on research design, baseline data considerations, possible confounding variables and other threats to study validity, target metrics, and best approaches based on experience as a leader in clinical safety-net data.
OCHIN echoed the importance of the HHS proposal to create this workgroup and suggested the group place emphasis on the Medicaid Reimbursement structure for telehealth expansion and utilization. OCHIN recommended including clinics, public health entities, health data researcher organizations, health IT perspectives, Primary Care Associations and related state and federal actors.
OCHIN suggested a measurement for closed loop referrals, another for reductions in ancillary orders with an increase in health information exchange (reduction in duplicated orders), and finally, a measure for interoperability between all healthcare sectors, including physical, mental, dental, and public health services.
Medicare Program: Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2019 Rates Proposed Quality Reporting Requirements for Specific Providers; Proposed Medicare and Medicaid Electronic Health Record Incentive Programs
OCHIN used this opportunity to comment on the need to align state and federal measures, employ the national interoperability framework, and incorporate the PDMP into the EHR.
Fore more information on OCHIN’s government affairs work, please contact:
Executive Vice President of Government Relations and Public Affairs