The state of hyperfluidity in the deficit-reduction/debt-ceiling discussions in Washington last week could be likened to pouring mercury down a bobsled run—lots of high speed twists and turns, frequent scatterings and gatherings, and who knows what will wind up at the end.
On July 13, when Dave Roberts, vice president of government relations for the Healthcare Information and Management Systems Society, made his annual "Report from the Hill" presentation at the Physician-Commuter Connection symposium in Ojai, Calif., hosted by the Association of Medical Directors of Information Systems, he expressed confidence that the tens of billions of dollars authorized for the federal health information technology incentive payment programs were not really in play with the D.C. deficit hawks.
Roberts said several bills that target the American Recovery and Reinvestment Act of 2009, the Christmas-tree economic stimulus bill onto which the EHR payment programs and other health federal IT booster baubles where hung, had been filed but that they had little chance of passage.
The stimulus law contained a $2 billion appropriation for the Office of the National Coordinator for Health Information Technology at HHS to spend on IT initiatives such as workforce training and the regional health IT extension centers that are peripheral to the much larger Medicare and Medicaid electronic health-record system incentive programs offering direct payments to providers.
But Roberts said the sections of the stimulus law that created the provider EHR incentive payment programs operate as "entitlements" and would be a lot harder to defund, particularly for those providers already registered with the programs.
"Once you have the legal liability, you have to pay the legal liability," Roberts said. "It is next to impossible for anyone on Capital Hill to stop this from moving forward. They would have to uncreate the entitlement to stop the program." But that was mid-month.
So far, however, those potions of the $700-plus billion stimulus law not associated with health IT are still the only parts of the stimulus law that are getting the sharp eye, Roberts said in a phone conversation Friday.
With the EHR incentive payment program, "The rules and regs are in place, so they'd have to undo all that stuff. What they're trying to do is get at the (other stimulus-law) project work that's not been spent and undo that. That's the money they're trying to get at, outside of health IT."
Stay tuned, though. The mercury’s still flowing.
Follow Joseph Conn on Twitter: @MHJConn.
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