March 24, 2011
Last week, Sen. Sheldon Whitehouse (D-R.I.) introduced the Behavioral Health Information Technology Act of 2011 (S 539) to expand eligibility for meaningful use incentive payments to include behavioral health, mental health and substance misuse treatment professionals and facilities.
Under the 2009 federal economic stimulus package, hospitals and eligible professionals who demonstrate meaningful use of electronic health records can qualify for Medicare and Medicaid incentive payments. Under the current law, most mental health providers and facilities are excluded from the health IT incentive payments.
Whitehouse introduced the same legislation (S 3709) in the Senate last year, but the measure -- which was co-sponsored by a bipartisan group of 12 senators -- failed to advance past the Senate Finance Committee before Congress adjourned. In addition, Rep. Tim Murphy (R-Pa.) and former Rep. Patrick Kennedy (D-R.I.) in April 2010 introduced a similar measure -- the Health Information Technology Extension for Behavioral Health Services Act of 2010 (HR 5040) -- to extend incentive payments included in the HITECH Act to the mental and behavioral health community. The House bill did not advance past the House Ways and Means Subcommittee on Health.
What Would the Legislation Do?
In a statement, Whitehouse said, "By expanding the use of electronic health records, my legislation will give mental health professionals access to comprehensive and up-to-date medical histories, enhancing the precision of diagnoses and reducing medication errors."
Specifically, the Behavioral Health Information Technology Act would:
- Expand the types of health care providers eligible for meaningful use Medicare and Medicaid incentive payments to include licensed psychologists and clinical social workers;
- Expand Medicare hospital incentive eligibility to include inpatient psychiatric hospitals;
- Expand Medicaid hospital incentive eligibility to include community mental health centers, mental health treatment facilities, psychiatric hospitals and substance misuse treatment facilities; and
- Clarify eligibility of behavioral health care providers -- such as community mental health care centers, psychiatric hospitals and mental health professionals -- for technical assistance from regional extension centers.
Support for Bill
Dave Roberts -- vice president of government affairs for the Healthcare Information and Management Systems Society -- said that HIMSS supports Whitehouse's legislation, noting that one of the policy principles adopted by the HIMSS board of directors is to consider expanding the focus of the stimulus package incentive funding to include health care professionals and settings that currently are not eligible. He added, "HIMSS is pleased to see that there [are] folks on Capitol Hill talking about making the program more expansive to make sure that all care settings can take advantage" of the meaningful use incentive payments.
Chuck Ingoglia -- vice president of public policy at the National Council for Community Behavioral Healthcare -- said his organization is a "huge fan" of the legislation.
Noting that recent studies have found individuals with serious mental illnesses have an average age of death of 52, Ingoglia said, "The ultimate goal of widespread adoption of health information technology -- to save American lives through improved coordination of care -- is particularly relevant to persons with mental and addictive disorders."
He said, "Health information technology is the essential cornerstone of efforts to address this emerging public health crisis," adding, "The Behavioral Health Information Technology Act of 2011 would allow for these mental health and substance use providers, hospitals and facilities to be on par with the rest of the nation in regards to the electronic exchange of health information, and, as a result, improve the health and safety of all patients."
Concerns Related to Legislation
Mention IT or mental health, and you're likely to hear the word "privacy" soon after. Mention IT and mental health together, and that's pretty much a certainty.
Roberts said, "Some people have mentioned concerns about ensuring that this data is kept private," adding, "We believe that the technology that is being implemented is going to do that."
Ingoglia said, "All Americans are concerned that their health information will remain private, and that is no different for persons living with mental illnesses. The bigger concern from our perspective is for mental health to be left behind the rest of health care as electronic exchange of information becomes the expectation."
Another potential issue is that many of the data collection requirements under Stage 1 of the meaningful use program -- such as blood pressure measurement and immunization status -- do not apply to mental and behavioral health providers.
Roberts said, "Should this legislation pass, the meaningful use criteria would have to be re-evaluated," adding, "I think the current meaningful use rules would be hard for this community to meet, so they'd have to re-look at that."
Chances of Becoming Law
Roberts noted, "Every year, up to 10,000 pieces of legislation are introduced into either the House or Senate, and just a fraction of those actually get passed into law and signed by the president."
He said, "I think that any time you have a member, such as Sen. Sheldon Whitehouse, introducing a piece of legislation like this, it's because he wants to have a discussion. He would like to see change made, and sometimes it takes years and years for that change to be made." Roberts added, "It may not happen this year, but I think that this gives them that vehicle to work on it."
Ingoglia said, "We know that this is a tough year for health legislation." However, he added, "Health IT remains one of the only bipartisan health issues, as it has the potential to reduce costs and increase quality. We hope that fact will help get the legislation passed in the 112th Congress."
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