21 ways health reform affects wireless health

By MHN Staff

President Obama Health ReformWill the health reform law affect the emerging wireless health industry? Yes, of course. There are at least 21 specific provisions that will have an effect on the connected health and personal health industry.  With help from the policy wonks over at the Continua Health Alliance, we have assembled the following 21 provisions that are relevant to connected health.

(We broke them into separate pages to make the content more digestible, but if you'd rather read the bills themselves, they are thousands of pages long, you can locate them at: H.R. 3590 Patient Protection and Affordable Care Act and the H.R. 4872 Health Care and Education Reconciliation Act of 2010.)

The provisions below do not include every health IT or EHR mention in the health bills, but only those that seemed most relevant to Continua's members and others in the connected health industry. Here's a list of the provisions to help you jump to particular ones:

Administrative/Enrollment Simplification
Rewarding Quality through Market Based Incentives
Accountable Care Organizations
Physician Face-to-Face Encounter Requirement
Annual Wellness Visit
Independence At Home Demonstration Project
Center for Medicare and Medicaid Innovation
Community Health Teams to Support the Medical Home
Primary Care Training and Enhancement
Medicare Advantage
Skilled Nursing Facilities/Long-Term Care Facilities
Workforce Advisory Committee
State Option to Provide Health Homes for Individuals with Chronic Conditions in Medicaid
Comparative Effectiveness Research
Assistant Secretary for Health Information/Key Health Indicators
Community-Based Collaborative Care Networks
Indian Health
Physician Quality Reporting Initiative
Part D Medication Therapy Management Programs
Incentives for State Medicaid Programs to Offer Home and Community-Based Services
Quality and Efficiency Measures

Administrative/Enrollment Simplification

Accelerates HHS adoption of uniform standards and operating rules for the electronic transactions that occur between providers and health plans that are governed under HIPAA, including benefit eligibility verification, prior authorization, and electronic funds transfer payments. Requires that standards: enable determination of eligibility; be comprehensive; provide for a transparent claims and denial management process, and; describe all data elements in unambiguous terms. Establishes a process, using recommendations of a qualified nonprofit entity and the National Committee on Vital and Health Statistics, to regularly update the standards and operating rules for electronic transactions. Requires health plans to certify compliance or pay a penalty fee. Provides for an additional penalty for misrepresentation of compliance. Includes deadlines for various rulemaking, including: unique health plan identifier; electronic funds transfer, and; health claims attachments. (Sec. 1104)

Requires, within 180 days after enactment, the Secretary to develop standards and protocols, in consultation with the HIT Policy and Standards Committees, to promote the interoperability of systems for enrollment of individuals in Federal and State health and human services programs. These standards shall allow for electronic matching against federal and state data, simplification of electronic documentation, reuse of stored eligibility information, capability for individuals to apply, recertify and manage their information online, ability to expand enrollment system to integrate new programs, rules and functionalities, notification of eligibility, recertification and other communication, and other functionality to streamline the enrollment process. The Secretary may require State or other entities to incorporate such standards as a condition of receiving Federal health information technology funds. Provides grants for state and local government entities to develop new and adapt existing technology systems to implement the HIT enrollment standards and protocols developed under this section. (Sec. 1561)

Requires the Secretary of HHS to develop a plan (and a detailed budget for the resources needed to implement such plan) to modernize the computer and data systems of CMS to support improvements in care delivery. (Sec. 10330)