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News of the Day ... In Perspective


CMS pushing for national health information network—even though Medicare computers are riddled with security problems

CMS Acting Administrator Leslie Norwalk said on Nov 1 that the agency would continue to work toward a national health information infrastructure (NHIN) by regulatory means, even if Congress fails to pass a health information technology (HIT) bill in the lame-duck session.

For example, she cited the CMS-led exceptions to the Stark “anti-kickback” rules that prohibited hospitals and larger physicians offices from donating HIT equipment to smaller, cash-strapped offices. The exceptions went into effect last month (Health IT Strategist 11/1/06).

The fast-tracked Health Information Technology Promotion Act of 2006 came to an impasse in part because Senators from both parties were concerned about such broad exceptions to the Stark rules. The Senate bill does not include the exceptions; the House bill does. A conference committee has not been appointed.

Other concerns over the legislation include rapid replacement of CPT and ICD-9 codes with the ICD-10 system, which has almost 10 times as many diagnosis codes, and the lack of privacy protections.

Outgoing CMS Adminstrator Mark McClellan downplayed concerns about security in his response to a GAO report released in August 2006. The report stated that “Until CMS ensures that all information security policies are being fully implemented, there is limited assurance that its sensitive data will be adequately protected against disclosure and that network services will not be interrupted.” McClellan said most of the gaps should be fixed by January (AM News, Oct 23/30, 2006).

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