Advocacy Dispatch | Vol. 1 | 4.3.19



HHS Health Sector Cybersecurity Coordination Center Threat Briefing on AI Threats

Key Takeaway: The HHS Health Sector Cybersecurity Coordination Center (HC3) released the following Traffic Light Protocol (TLP): white threat intelligence briefing report on Artificial Intelligence (AI0 threats).

Why It Matters: HC3 seeks to make AI’s integration into healthcare safe and secure. The briefing rolls through the various types of threats with specific examples like “DeepPhish,” a Deep learning application that generates phishing URLs, which have a significantly greater chance of bypassing defense mechanisms. The report contains links to other resources for those looking for more in-depth information.

Release of the 2019-2022 National Health Security Strategy (NHSS)

Key Takeaway: The U.S. Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) released an updated quadrennial strategy to safeguard the nation’s health in times of crisis.

Why It Matters: The 2019-2022 National Health Security Strategy (NHSS) provides a vision to strengthen our nation’s ability to prevent, detect, assess, prepare for, mitigate, respond to, and recover from disasters and emergencies. It describes strategies to improve readiness and adapt operational capabilities to address new and evolving threats. The plan aims to better safeguard the health and well-being of people across the country by coordinating a whole-of-government approach that engages external partners and supports public health authorities and healthcare stakeholders.

The 2019-2022 NHSS is focused on three overarching objectives. As health security threats continue to emerge and evolve, these objectives are intended to be flexible and adaptable.

  1. Prepare, mobilize, and coordinate the Whole-of-Government to bring the full spectrum of federal medical and public health capabilities to support State, Local, Tribal, and Territorial (SLTT) authorities in the event of a public health emergency, disaster, or attack.
  2. Protect the nation from the health effects of emerging and pandemic infectious diseases and chemical, biological, radiological, and nuclear (CBRN) threats.
  3. Leverage the capabilities of the private sector. Specifically, the plan calls for developing and sustaining robust public-private partnerships for Medical Countermeasures (MCM) development and production, fostering the creation of a resilient medical product supply chain, and incentivizing and sustaining private sector healthcare surge capacity for large-scale incidents.



Deadline Approaches to Apply for USAC Telecommunications Program for Rural Healthcare

Key Takeaway: Through its Rural Health Care (RHC) Telecommunications Program, Universal Service Administrative Company (USAC) provides assistance to healthcare providers for eligible expenses related to broadband connectivity based on the urban-rural price difference in an area. The deadline to apply for USAC’s funding program ends May 31, 2019.

Why It Matters: Complete the following steps to determine if your organization is located in a rural area for RHC Program eligibility:

  1. Select your state in the drop-down menu below and click the "Search" button.
  2. A list of all counties for that state will display in alphabetical order.
  3. The "Rural Eligibility" column will identify if your county is urban, rural, or partly rural.

Next, determine your county’s census track number or BNA. To determine your county's census tract number, you can call your regional census bureau office for assistance, or visit the Texas A&M website to use their geocode location tool. As of July 2013, the RHC Program is using this tool instead of the Federal Financial Institutions Examination Council (FFIEC) website.

  1. Type in your organization's street address (do not enter a P.O. Box).
  2. Select "TwoThousandTen" from the "Year of Census" drop down menu.
  3. Click the "Geocode" button.
  4. Write down the "Census Tract" number displayed under the "Best Geocode Output Census Values" box.

Compare this number to the census tract codes displayed in the RHC Eligible Rural Areas Search tool results for your state and county. If your census tract code is listed for your county, your site is eligible as rural. If you have any questions, email the RHC Help Desk or call them at: (800) 453-1546.


America’s Digital Divide Narrows Substantially

Key Takeaway: The digital divide between Americans with and without access to modern broadband networks has narrowed substantially, according to the draft 2019 Broadband Deployment Report.

Why It Matters: Narrowing the divide between urban and rural areas is paramount to America’s development and deployment of the 5G network and fostering rural Americans’ access to telehealth services. The FCC report to Congress shows that since last year’s report, the number of Americans lacking access to a fixed broadband connection meeting the FCC’s benchmark speed of 25 Mbps/3 Mbps has dropped by over 25 percent, from 26.1 million Americans at the end of 2016 to 19.4 million at the end of 2017. Moreover, the majority of those gaining access to such high-speed connections, approximately 5.6 million, live in rural America, where broadband deployment has traditionally lagged. Other key findings of the report include the following, based on data through the end of 2017:

  • The number of Americans with access to 100 Mbps/10Mpbs fixed broadband increased by nearly 20 percent, from 244.3 million to 290.9 million.
  • The number of Americans with access to 250 Mbps/50 Mbps fixed broadband grew by over 45 percent, to 205.2 million, and the number of rural Americans with access to such service more than doubled.




CMS to use FHIR to Share Medicare Claims Data with ACOs

Key Takeaway: CMS is launching a new application programming interface (API) that lets Accountable Care Organizations (ACOs) retrieve bulk Medicare claims data for their beneficiaries.

Why It Matters: The Beneficiary Claims Data API (BCDA) will enable Accountable Care Organizations (ACOs) participating in the Shared Savings Program to retrieve Medicare Part A, Part B, and Part D claims data for their assigned or assignable beneficiaries. This includes Medicare claims data for instances in which beneficiaries receive care outside of the ACO, allowing a full picture of patient care. When it is in production, the API will provide similar data to Claim and Claim Line Feed (CCLF) files, currently provided monthly to Shared Savings Program ACOs by CMS. This comes as CMS and ONC released dual proposals that would require insurers participating in federal programs, and health IT vendors, to make patient data accessible through APIs using Fast Healthcare Interoperability Resources (FHIR) standards. Separate from BlueButton 2.0, which provides FHIR-formatted data for one individual Medicare beneficiary at a time, the BCDA provides FHIR-formatted bulk data files to an ACO for all the beneficiaries eligible to a given Shared Savings Program ACO. For more information join the Google Group.


Available Now: New Resources for the 2019 Program Year for the Promoting Interoperability Programs

Key Takeaway: CMS is currently updating the Promoting Interoperability Programs website to include new resources for the 2019 program year.

Why It Matters: Below are resources that are now available online:

For more information on the Promoting Interoperability Program reporting requirements for 2019, please visit the Promoting Interoperability Programs website. Additional information for the Medicare and Medicaid Promoting Interoperability Programs for 2019 will be posted on the Promoting Interoperability Programs website in the coming weeks.




Senators Klobuchar and Portman Reintroduce Mandatory PDMP Check Bill

Key Takeaway: Sen. Amy Klobuchar (D-Minn.) and Sen. Rob Portman (R-Ohio) reintroduced the Prescription Drug Monitoring Act (S.778), which would require clinicians to check a prescription drug monitoring program (PDMP) database before prescribing opioids.

Why It Matters: The bill would require drug dispensers in covered states to report to the PDMP each opioid prescription they dispense to patients within 24 hours. Also, it requires practitioners in covered states to consult the PDMP database before prescribing opioids to patients, requires states to actively notify practitioners when the PDMP shows that a patient exhibits patterns indicative of opioid misuse, and requires states to make their PDMP data available to other states. The measure is known to reduce the number of opioids prescribed to patients. According to the PDMP Training and Technical Assistance Center at Brandeis University, only eight states do not already mandate provider check of a PDMP. Another 45 states already mandate PDMP data reporting within one calendar or business day.


Administration Update


CMS Projects Healthcare Spending Will Hit 19.4% of GDP in the Next Decade

Key Takeaway: Healthcare spending growth will rise at an annual average of 5.5 percent over the next decade, slightly faster than in the past few years, due to the aging of the baby boomers and healthcare price growth, the CMS Office of the Actuary projects.

Why It Matters: Because that growth will exceed gross domestic product growth, the CMS predicts healthcare's share of GDP will rise from 17.9 percent in 2017 to 19.4 percent in 2027. These spending trends could boost public support for policy proposals to regulate prices and boost competition for healthcare services and drugs. For instance, Democratic proposals for Medicare-for-all and public plan options would pay providers at Medicare prices, which generally are significantly lower than what private insurers pay. However, experts say the projected spending growth over the next decade—which is sharply less than the 7.3 percent average annual growth from 1990 to 2007—may not be sufficiently alarming to spur politically thorny policy changes. Healthcare costs will continue to be a major topic driving conversations.