Subcommittee advances electronic health records bill

Legislation would require Federal Employees Health Benefits Program insurance carriers to offer two types of e-records.

The House Government Reform Federal Workforce Subcommittee on Wednesday referred legislation to the full committee that would require insurance carriers covering federal employees and their families to create electronic health records for each beneficiary.

The Federal Family Health Information Technology Act of 2006 (H.R. 4859), which passed by voice vote, requires the federal government's Office of Personnel Management to require all insurance carriers to provide members of the Federal Employee Health Benefits Program (FEHBP) with two types of electronic health records.

The first type of record would contain information already tracked by carriers, such as hospital and physician visits, claims information and prescription drug records. The bill would require that the information be made available to FEHBP members within four years after the bill's enactment.

The bill also requires that carriers make personal electronic health records available to members. These records - which would contain personal health information such as medical history, symptoms and diet - are to be controlled by FEHBP members.

The bill stipulates that carriers must comply with the privacy regulations under the Health Insurance Portability and Accountability Act of 1996 in handling the electronic records.

House Government Reform Federal Workforce Subcommittee Chairman Jon Porter, R-Nev., who co-sponsored the legislation with William Lacy Clay, D-Mo., said that the bill would empower federal workers to have ownership over their own medical records. "The only person who doesn't know much about his own health care is the insure[d]," he said. He argued that failure to pass the legislation would allow "senseless deaths" through medical errors to continue.

In response to suggestions by the Government Accountability Office and subcommittee members, Porter offered a substitute amendment, which also passed by voice vote, making several adjustments to the original bill. The substitute requires carriers to offer grants and incentives to medical providers to implement interoperable health records. The grants would be funded by private donations to a trust fund managed by the Office of Personnel Management.

The substitute amendment also adds a provision mandating that carriers provide hard copies of these records to FEHBP members without access to the internet and allow those members to make changes. The amendment also requires that any savings that occur as a result from the implementation of electronic records translate into lower premiums for members.

Rep. Danny Davis, D-Ill., said that the bill did not include sufficient privacy protections. He raised concerns that FEHBP members could be coerced by insurance carriers into disclosing their personal records. Rep. Davis also called for a provision that would require carriers to notify an FEHBP member if his or her personal information has been improperly released.

House Government Reform ranking member Henry Waxman, D-Calif., who did not attend the debate, released a statement opposing the bill. He recommended that legislation wait until a Department of Health and Human Services task force on interoperability standards finishes its work.

Waxman also called for additional privacy provisions, including the assurance that FEHBP members can take legal action if there is a security breach involving their records.

Porter agreed to work on incorporating some of the Democratic recommendations into the bill. "I think some of these would be a real asset to final legislation," he said.

A full committee markup has not yet been scheduled. Porter wrote in a statement that Sen. Thomas Carper, D-Del., is leading an effort to write a similar bill in the Senate.