E 1176 CONGRESSIONAL RECORD — Extensions of Remarks June 8, 1995

THE HEALTH INFORMATION MODERNIZATION AND SECURITY ACT

HON. DAVID L. HOBSON OF OHIO

IN THE HOUSE OF REPRESENTATIVES

Wednesday, June 7, 1995

Mr. HOBSON. Mr. Speaker, today I am introducing the Health Information Modernization

and Security Act with Mr. SAWYER. In the Senate, Mr. BOND and Mr. LIEBERMAN introduced

the same bill as S. 872. Our bipartisan, bicameral bill was developed over several years

in an open, cooperative effort between the private and public sectors. Our purpose is to reduce excessive paperwork and administrative

waste in the health care system by facilitating

the development of an electronic health information network.

Health information systems are on the verge

of a dramatic transformation. Today, financial

and administrative information commonly is

keyed into a computer, printed in paper form,

and then mailed or transmitted to another person who rekeys the information into another

computer. The constant demand for more information in less time is pushing the current

system toward electronic data interchange

[EDI], the computer-to-computer exchange of

information in a standard format.

The technology exists today to move away

from a paperwork system and toward an electronic health information network. Although

many institutions have internally automated

health information systems, there are barriers

to sharing information externally, among institutions. First, no single entity in the health

care industry has the market power to move

the industry toward a common standard. Second, antiquated State licensing laws make

computerized medical records technically illegal in 12 States and legally ambiguous in 16

others. Third, there are privacy concerns related to the degree of access to health information.

The Health Information Modernization and

Security Act removes the barriers that block

the modernization and simplification of health

information networks. Once these barriers

come down, the private sector will be able to

reduce unnecessary paperwork, which adds

nearly 10 cents to every health care dollar; expose fraud in ways that are impossible under

the confusing, disjointed paperwork system we

have today; protect patient privacy and the

confidentiality of health information; and provide consumers with the data they need to

compare the value of insurance plans and

health services.

Basically, our bill sets up a process that

moves the health care industry toward a common electronic language for sharing information. The Secretary of the U.S. Department of

Health and Human Services is required to

adopt standards for health information, but

only if those standards already are in use and

generally accepted. The Secretary is required

to adopt financial and administrative data

standards, security standards, privacy standards for individually identifiable health information, and special rules for coordination of benefits, code sets, electronic signature, and

unique health identifiers for individuals, employers, health plans, and health care providers.

The Secretary is not required to adopt

standards for clinical data or information in the

patient medical record. Financial and administrative data often is handled electronically

today, and there is general agreement on the

type of standards that should be adopted.

Clinical information, in contrast, is more complicated and there is little consensus on the

quantity or content of the data that should be

standardized. Further, adopting clinical standards involves complex privacy requirements

and a debate about whether or not data

should be centralized. However, after 4 years,

but sooner than 6 years, the Secretary must

recommend to Congress a plan for developing

and implementing uniform, electronic data

standards for information in the patient medical record.

Within 2 years after the Secretary adopts

the standards, health plans are required to

comply. The mandate is on the payer, not the

provider. Providers are required to comply with

the standards for any business they do with

Medicare. Payers and providers may deviate

from the standards by mutual agreement. For

example, a payer may agree to accept information on paper claims, but they are not required to accept that information if it is not in

the standard format adopted by the Secretary.

Similarly, a provider may agree to provide additional information requested by the payer,

but they do not have to provide that information if it is not among the standards adopted

by the Secretary. This creates the market-oriented leverage necessary to converge on a

single industry standard.

To conclude my remarks, I want to credit

the work and commitment of the people behind this legislation. In 1991, Secretary of

Health and Human Services Louis Sullivan articulated a vision of a health care information

system. Mr. BOND first introduced legislation to

achieve that vision in 1992, updated that work

in 1993—Mr. Sawyer and I were the House

sponsors—and now we introduce the final

product of our continuing efforts here today—

the Health Information Modernization and Security Act.

CONGRATULATIONS FLORIDA

fHOSPITAL

HON. BILL McCOLLUM

OF FLORIDA

IN THE HOUSE OF REPRESENTATIVES

Wednesday, June 7, 1995

Mr. MCCOLLUM. Mr. Speaker, congratulations to Florida Hospital in Orlando, FL, on the

occasion of the beginning of construction for

the Walt Disney Memorial Cancer Institute’s

new facility in my congressional district.

When its new facility is complete, the institute will bring honor to Orlando as a leader in

diagnosis, treatment, and prevention of cancer. We are grateful to Florida Hospital for

providing a service of this magnitude, including research and cancer prevention education,

for the citizens and families of central Florida.

We are fortunate to have dedicated

caregivers like Florida Hospital and the Walt

Disney Memorial Cancer Institute in Orlando.

We congratulate them on their commitment to

bring quality cancer care to our citizens.

TRIBUTE TO MARIANNE TETA AND

MARTIN GOLDEN, BAY RIDGE

COMMUNITY COUNCIL AWARD

DINNER DANCE

HON. SUSAN MOLINARI OF NEW YORK

IN THE HOUSE OF REPRESENTATIVES

Wednesday, June 7, 1995

Ms. MOLINARI. Mr. Speaker and distinguished colleagues, please join me as I recognize the dedication, determination and efforts

of two outstanding citizens of Bay Ridge, NY,

Marianne Teta, president of the Bay Ridge

Community Council and Martin Golden, president of the Fifth Avenue Board of Trade and

the recipient of the 1995 Bay Ridge Community Council Civic Award.

This dynamic team allied civic, business,

church, and veterans groups in an ongoing

public awareness campaign which resulted in

the continued operation of Fort Hamilton Army

Base, a historic landmark serving our country

since 1825.

Marianne J. Teta, lifelong resident of Brooklyn, presently serves as the director of NYNEX

Consumer Affairs for Brooklyn and Staten Island. Among the many organizations Marianne

is presently active in are the Bay Ridge Lions,

Ragamuffin and the Bay Ridge Parks and Waterfront Council.

Martin Golden resides in Bay Ridge with his

lovely wife Colleen and their son Michael. Together they manage the Bay Ridge Manor and

aid many worthly organizations such as the

Angel Guardian Home and Heart Share.

We are fortunate to be blessed with these

caring individuals who have encouraged community pride and involvement by supporting

our neighbors in the armed forces. They are a

credit to Bay Ridge, Brooklyn, and an important part of the fiber that strengthens our

neighborhoods and Nation.

INVESTORS MAKE LOUSY

fCROWBARS

HON. MICHAEL G. OXLEY OF OHIO

IN THE HOUSE OF REPRESENTATIVES

Wednesday, June 7, 1995

Mr. OXLEY. Mr. Speaker, I commend the

following column by Cynthia Beltz from the

Journal of Commerce to the attention of my

colleagues.

[The Journal of Commerce, May 25]

INVESTORS MAKE LOUSY CROWBARS

(By Cynthia Beltz)

The world’s major industrialized nations

this week launched two years of negotiations

to reduce barriers to cross-border investment. Just last week, the United States

threatened Japan with 100 percent tariffs on

luxury auto imports unless its auto parts

market is opened to U.S. companies. Unfortunately, such tit-for-tat tactics in the trade

arena are now spreading like an infectious

disease into the investment field, threatening to thwart the negotiations before they

get off the ground.

U.S. investment policy traditionally has

rejected aggressive reciprocity tactics. Instead, Washington has maintained open-door

policies at home while promoting them

abroad. The strategy has paid off. The best

companies in the world have flocked to the