Senators seek more input on health IT language in stimulus bill

Two key Senate Republicans on the Finance Committee raised concerns today over health information technology language in the economic stimulus package. Sen. Orrin Hatch, R-Utah, who co-sponsored an unsuccessful health IT bill last year with Senate Health, Education, Labor and Pensions Chairman Edward Kennedy and ranking member Michael Enzi, said the stimulus plan is being crafted "without the input of Republican offices, including mine, who have demonstrated a long-standing interest" in health IT.

The Finance Committee is marking up today the tax title, which includes most of the health IT provisions. Hatch made his comments during a Judiciary Committee hearing on health IT. Senate Finance Chairman Max Baucus' mark included standard-setting and interoperability language as well as incentives for Medicare and Medicaid to adopt electronic health records, but the Appropriations Committee -- marking up its title today -- is taking up language on privacy.

Meanwhile, Sen. Olympia Snowe, R-Maine, said today she is concerned that Finance is overlooking several health IT measures she has pushed in regards to privacy. In an e-mail, she noted that unintentional disclosures of health information are exempted from the bill's breach provisions, while the measure includes an "excessively broad" research exception would allow use of patients' records for research without their consent.

"There are certainly outstanding critical issues," she said. Snowe fought unsuccessfully to include stricter privacy protocols in last year's HELP bill and argued that changes negotiated by Judiciary Chairman Patrick Leahy in May fell short.

During today's Judiciary hearing, Leahy said protecting patient information is critical in any debate over health care. "If you don't have meaningful privacy safeguards, you're not going to get a meaningful health IT system," he said.

The House stimulus measure, which is expected to be voted on Wednesday, drew criticism today at the Senate Judiciary hearing. University of Pittsburgh Medical Center Vice President John Houston warned the House bill does not provide a "comprehensive and workable framework" for health IT because of costs and administrative burdens related to accounting of disclosures; certain healthcare operations; de-identification of patient data; and new rules for entities that have historically not been covered by federal health privacy laws. David Merritt of the Center for Health Transformation said proposals to replace existing health IT certification and standards bodies "would turn the clock back five years."