Watching the omnibus bill

With help from Arthur Allen (@arthurallen202), Dan Diamond (@ddiamond) and Mohana Ravindranath (@ravindranize)

THE WHEELS ON THE OMNIBUS TURN ‘ROUND AND ‘ROUND: Omnibus watch took up another evening for the capital’s reporters and wonks, as Congress failed to nail down a final product: a mammoth, trillion-dollar-plus spending bill meant to keep the machinery of government churning just ahead of the deadline.

APPLE EHR INITIATIVE TO EXPAND API USE?: The consumer tech giant’s recent entry into electronic health record display could prompt EHR vendors to invest more in application programming interfaces, especially if they want to get other commercial tech companies to integrate their records into apps.

It’s been fewer than two months since Apple announced its pilot with a handful of vendors, allowing patients at certain provider sites to download their EHRs directly through the iPhone Health app instead of using a provider portal. But it’s not clear yet how the partnership is going — vendors and providers have generally been reluctant to share details about user numbers during the beta phase.

For Cerner, the partnership is going well enough to expand the number of participating provider sites from four to nine, company vice president John Gresham told POLITICO.

The partnership could also lead to new integrations. Jonathan Bush, CEO of athenahealth, told POLITICO the company is working “really hard” to convince Apple to come up with an appointment calendar interface in addition to the EHR download. Bush pointed to services like Kayak and OpenTable as good consumer-facing apps to emulate.

Pros can get the rest here.

ADMINISTRATION EXPECTED TO ANNOUNCE NEW CDC CHIEF TODAY: Robert Redfield, the Baltimore-based AIDS researcher, is the Trump administration’s choice. POLITICO on Friday scooped that Redfield was favored for the role. The public health agency has been without a permanent leader since Brenda Fitzgerald stepped down almost two months ago following mounting questions about financial conflicts.

eHealth tweet of the day: Jenny Gold @JennyAGold “5 phone calls later, I still haven’t been able to get my medical records transferred from one practice to another. IN THE SAME HEALTH SYSTEM. $%$$ing #healthcare.”

TUNE IN: Join POLITICO online this morning for a conversation on how to provide high-quality care at lower costs to a growing population of aging Americans. Tune in to Avoiding 911 — How to Improve Health Care in Nursing Homes and Bend the Cost Curve — March 21 at 8:00 a.m. Watch live here.

WEDNESDAY: Your correspondent can’t resist a cheap joke, which is why he’s really tingling with anticipation for the usual comedy of errors whenever D.C. faces even the lightest dusting of snow. Whether it’s people forgetting to remove snow and ice from their sidewalks, or oddly terrified and passive drivers, your correspondent is constantly amused by the shell-shocked reaction of the entire city. Share your terror of snow at [email protected]. Discuss winter wonderlands (in spring!) socially at @ravindranize, @arthurallen202, @dariustahir, @POLITICOPro, @Morning_eHealth.

VA QUESTIONS DEEPEN: The various questions surrounding the Department of Veterans Affairs continued to swirl Tuesday:

— Minnesota Democrat follows up on POLITICO reporting: Sen . Tina Smith wants to know more about the VA’s pending contract and implementation of its Cerner EHR after POLITICO raised questions about the first phase of the software rollout at some of the Department of Defense’s Pacific Northwest facilities. In a letter to VA Secretary David Shulkin, Smith asks for more information on budget and personnel devoted to the plan, and more detail about VA providers’ ability to get data from both VistA and Cerner’s EHR.

— Meanwhile… A bill further overhauling the VA’s health delivery system is on hold, the Washington Post reports, due to objections from Nancy Pelosi’s office. Pelosi apparently believes the bill, the Caring for Our Veterans Act ( S. 2193 (115)), would outsource too much care to the private sector, among other objections.

There’s a micro and macro view to the bill here, of course. From a micro perspective, the bill would legislatively secure VA providers’ right to provide telemedicine across state lines, which the Trump administration had already worked to resolve administratively. It would also require the VA to report to Congress on the effectiveness of telemedicine in its system.

More broadly, the bill adds to the wider drama surrounding the department. Shulkin’s job security has been under question for weeks, amid some conservative frustration that he has been slow to adopt their their preferred policies. (Among their other department priorities: expanding privately furnished care.)

HITAC TODAY: If you’re cold or dreading being outside amid the flurries, perhaps today’s virtual meeting of the Health IT Advisory Committee will tide you over. The committee is scheduled to consider Trusted Exchange Framework draft recommendations from the relevant task force. You can read the draft here. The task force wants clear goals with non-duplicative requirements, among several suggestions.

AHIMA MEMBERS TOOK THE HILL: The American Health Information Management Association’s members took to the Hill on Tuesday to advocate for two bills — the Overdose Prevention and Patient Safety Act ( H.R. 3545 (115)) and Protecting Jessica Grubb’s Legacy Act ( S. 1850 (115)) — intended to change privacy laws governing substance use data.

“We are facing one of the nation’s deadliest substance abuse epidemics, and it’s time for the laws put into place decades ago to reflect the needs of the industry today,” said Pamela Lane, the association’s vice president of government relations.

SENATORS WRITE LETTERS: Sens. Sheldon Whitehouse and Bill Cassidy really want Alex Azar to push fee-for-value payment models, having written a letter to the HHS secretary on the issue. They warn that if HHS slackens, the private sector will pull back accordingly.

PDMP IN THE STATES: A couple of PDMP bills in the states to track:

— Florida Gov. Rick Scott signed House Bill 21 earlier this week. The bill, intended to offer a battery of responses to the opioid crisis, contains some relevant provisions to the state’s prescription drug monitoring program. It allows VA and Indian Health Service providers to access the PDMP and allows the state to share data, but it also requires the system purge data that’s more than four years old, among other adjustments. It marks a notable transformation for Scott, who came into office trying to scale back the program.

— Colorado may join the trend of states requiring prescribers to query the PDMP, as a new opioids bill was introduced earlier in the session. The legislation also requires the PDMP to allow direct access from an EHR.

TANGENT TIME: In a report examining potential overpayments to hospitals accounting for $4.4 million, HHS’s Office for the Inspector General returns to a familiar hobbyhorse: the need for unique device identifiers.

The report examined hundreds of claims concerning recalled cardiac medical devices, and concluded that hospitals should’ve properly reported receipt of rebates for some of these devices, with potential overpayments flowing from them.

Of course, OIG has an idea for helping with these problems: putting unique device identifiers in claims forms, which would allow CMS to more closely track such devices. Trump’s CMS has not stated a definitive position on the matter.

WHAT WE’RE CLICKING ON:

How augmented reality can improve surgery.

Allegations of research misconduct surround possible CDC nominee.

Early warning signs from Theranos, dating back to 2014.

Aledade’s Farzard Mostashari and Travis Broome believe Medicare Advantage is the lever to enact ACO reform.