Cures 2.0 campaign commences

With help from Arthur Allen (@arthurallen202) and Darius Tahir (@dariustahir)

PROGRAMMING NOTE: POLITICO’s Morning eHealth will not publish on Friday, Nov. 29. We’ll be back on our normal schedule on Monday, Dec. 2.

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Quick Fix

— Cures 2.0 campaign commences: Reps. Fred Upton and Diana DeGette are calling for input on a refreshed health tech bill they say would expand patients’ access to new treatments and digital health products.

— FCC chairman talks data privacy: Ajit Pai said patients won’t be able to take full advantage of the virtual care bolstered by FCC programs without stronger federal privacy protections.

— More than 100 nursing homes touched by ransomware attack: Virtual Care Provider, which sells IT services to nursing homes, fell victim to Russian hackers earlier this month.

eHealth tweet of the day (with typo corrected from “can’t” to “can”): Raj Ratwani, director of MedStar Health National Center for Human Factors in Healthcare. @RajRatwani “Guess whose 60th birthday it is? The seat belt! Why should you care?

1. It’s a major industry driven safety innovation that has saved millions of lives.

2. The @volvocars innovation is freely shared with everybody to protect all. #EHR stakeholders can learn from this.”

It’s MONDAY at Morning eHealth. What are you tracking during this abbreviated week? Let us know at [email protected]. Tweet the team at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

Driving the Day

YOUR CHANCE TO RANT ABOUT THE CURES LAW — Reps. Fred Upton (R-Mich.) and Diana DeGette (D-Colo.) are calling for public input on a potential new bill building on the expansive 21st Century Cures Act, which touched health data, precision medicine and NIH funding.

Last week they released their broad vision for a health law improving patients’ access to digital health products and new medical therapies. They called their effort “Cures 2.0,” which would in part focus on insurance, including speeding coverage of FDA-approved drugs and devices by Medicare, Medicaid and private payers.

...Among other goals are increasing the use of real-world evidence in FDA’s regulatory approval process and improving family caregivers’ health literacy, Upton and DeGette wrote. They requested additional input on a bill by Dec. 16.

HHS is still fulfilling provisions of the original law, enacted in 2016. ONC handed its rule outlining exceptions to Cures’ ban on information blocking to OMB for review only last month, for instance.

...There’s skepticism about whether such a bill will come to fruition. The original 21st Century Cures Act’s passage in the Senate was eased by a boost for NIH research and support for the Biden Cancer Initiative. This time around, Senate lawmakers haven’t shown much interest; last week Sen. Bill Cassidy (R-La.), who sits on the HELP committee, told POLITICO he wasn’t aware of any similar efforts on the Senate side.

FCC SEES LICENSING, PAYMENT AS KEY TELEHEALTH BARRIERS — Onstage at the American Telemedicine Association’s policy conference last week, FCC chief Ajit Pai urged attendees and members to talk to lawmakers about successful uses of virtual care, as well as about FCC’s grant programs supporting providers’ broadband connectivity. The agency is moving forward with a $100 million pilot program funding remote patient monitoring and digital health, for instance. “Telemedicine is not just a luxury,” Pai said. “It’s a necessity.”

...Virtual care could be a central part of the Trump administration’s rural health efforts, as Bloomberg reported last week — officials have floated the idea of a potential partnership between FCC and HHS.

A few other takeaways from Pai’s appearance at ATA:

— FCC doesn’t have privacy oversight, but the agency is still invested. Consumers and patients won’t use potentially lifesaving technology if they don’t trust that their data is safeguarded by network operators, content providers or health care systems, Pai said. FCC doesn’t have jurisdiction over privacy — that responsibility falls squarely on the Federal Trade Commission — but Pai noted that it’s “important for Congress to speak with a bipartisan voice on this issue ... and set basic rules for the road.”

..."I really hope that folks in this room are able to help [Congress] become better informed on this issue, because we need to resolve this sooner rather than later,” he added.

— Interstate licensing, payment and broadband also major barriers to the expansion of virtual care. Pai described a recent meeting in Colorado with medical professionals who said they couldn’t treat patients across state lines — even if they were nearby — because of state medical licensing laws requiring the practitioner to be licensed in the state the patient is in. “We want to be able to encourage Congress to break down some of these barriers,” he said.

He acknowledged that CMS has made progress in expanding Medicare coverage for telehealth, but warned against “skimping on reimbursement at the front end” when deciding what virtual services to incorporate into the payment schedule.

...FCC’s Connect2Health Task Force is examining some of these issues, he said. That group was instructed to set up a memorandum of understanding with the National Cancer Institute to see if broadband connectivity can improve cancer outcomes, and health outcomes overall. The agency’s goal is to ensure that “broadband is not the rate-limiting step, as the chemists say.”

— Public-private partnerships could play a major role in expanding broadband and improving health outcomes. “Certainly we think the private sector is best positioned to drive investment in construction of broadband networks,” especially since the government doesn’t “have the caliber and funds.” But he added that the FCC’s grant programs, and even city governments, can support broadband deployment in areas where no one else will.

..."There’s no core business case for deployment in some of these communities,” he said. “I don’t oppose a city saying they need to build the infrastructure themselves.”

RUSSIAN HACKERS DEMANDED $14 MILLION FROM IT PROVIDER —Virtual Care Provider couldn’t afford the ransom hackers demanded in exchange for data related to more than 100 nursing homes, acute care providers and other health systems, the Milwaukee Journal Sentinel reports. The attack affected health records, medication orders and payroll. The IT provider, which sells internet security and data storage, is still working on restoring services that stalled after the Nov. 17 attack; it has also launched an investigation into the incident.

MGMA TO CMS: HOLD OFF ON ANY CDS FOR PRIOR AUTH — Using clinical decision support software to support prior authorization should be voluntary, the Medical Group Management Association told CMS in response to an agency request for information.

In theory, such software could offer a standardized format to authorize imaging or other orders. In practice, MGMA points to CMS’ Appropriate Use Criteria program for radiological imaging tests, which the group says identifies only a limited number of outlier orders in exchange for provider burden. Instead, MGMA suggests incentivizing use of such software and collecting data on inappropriate tests.

HITRUST ABSORBS CALIFORNIA PRIVACY STANDARDS — The Health Information Trust Alliance has incorporated standards from the sweeping California Consumer Privacy Act into its compliance framework for data sharing and storage. CCPA takes effect in January.

That new law requires that organizations “look at data in a new way, as we are not used to data subjects having the type of rights granted them under the CCPA,” Anne Kimbol, HITRUST’s chief privacy officer, said in a release. That law provides that people must be able to opt out of the sale of their information, for instance.

AMIA WANTS MORE FHIR GRANTS—The American Medical Informatics Association is urging NIH to come up with a targeted strategy for research and development efforts related to the FHIR data sharing standard.

That standard, promoted in ONC and CMS’ recent information blocking and interoperability rule proposals, is likely to “become the standard for exchange of most common categories of clinical data over the next two to three years, “ AMIA wrote in comments to NIH. (NIH requested public input about what’s needed to better support the use of the FHIR standard in research.)

...AMIA suggested NIH lead efforts to use the standard for federally funded research, and that it educate groups that have shown an interest in FHIR. "[W]e note that this vision for the use of FHIR is distant and in need of federal support,” the group wrote.

What We're Reading

— MobiHealthNews’ Laura Lovett reports on Google’s new EHR-like product.

— New York City has created a chief algorithms officer position, according to GovTech.

— Vox’s German Lopez reports on insurers refusing to cover drug rehabilitation.