Senate panel makes stimulus IT provisions more inclusive

The Senate Appropriations Committee approved its portion of the economic stimulus package Tuesday with a handful of changes to its $5 billion health information technology portion.

Senate Aging Chairman Herb Kohl amended the legislation to expand the definition of "health care provider" to include nursing and other long-term care facilities, in addition to skilled nursing facilities and home health entities. Kohl believed the original text requiring healthcare providers to receive certification to get funding snubbed long-term facilities because certification standards will not be developed until July 2010 by the commission that verifies e-health records and their networks.

Another Kohl amendment would provide for loans for hospitals that had the foresight to adopt health IT and improve services before direct federal funds were made available.

The loans would provide early adopters with funding so they are able to meet new federal privacy and compatibility standards, aides said. Initially, the stimulus offered funding only to providers who have not implemented health IT systems.

A third component championed by Kohl clarified the intent of Congress with report language to ensure that all personal health record vendors face substantially similar privacy rules. In its original form, the stimulus did not require companies such as Google or Microsoft to protect the health information they imported.

Microsoft officials were reviewing the changes and did not offer comment. An executive with the company's Health Solutions Group told the Senate Judiciary Committee hearing earlier in the day that "We recognize that consumers will only be comfortable sharing their information if they trust that they will have control over its use and know that it will be protected." The executive, Michael Stokes, added that Microsoft supports health IT privacy provisions included in the House stimulus package.

American Health Care Association lobbyist David Hebert said the long-term care provisions were welcome additions that his group had long been advocating. "We are part of a continuum of care and given the fact that we receive lot of patients from hospitals, it's critically important that their records follow them from the hospital to the nursing home," he said. The House stimulus language includes different proposals that include a $600 million, 10-state grant program to address long-term care and a larger grant program for providers that does not single out assisted-living facilities.

Sen. Tom Harkin, D-Iowa, successfully offered language that makes it clear that it is not a violation of privacy regulations for a pharmacy or other entity to communicate and market to a patient who has used a particular product.

For example, a pharmacy can send a customer a reminder to refill a prescription or send other information regarding a drug being used.