The Department of Health and Human Services faces legal barriers,
related to fraud and abuse precautions, to the adoption of its proposed
health IT system, and its efforts to address them have so far been limited
in scope, the Government Accountability Office has said. GAO said various
experts it interviewed “indicated that beyond legal issues related to the
privacy and security of health information, there are various laws — some
specifically health-related and some not — that present barriers to the
adoption of health IT.
For example, the laws involve antitrust, federal income tax, intellectual
property, malpractice and state licensing. Laws related to fraud and abuse
include the Physician Self-Referral – Stark — law and the Anti-kickback
statute, which GAO says impede arrangements between providers such as
sharing IT resources.
Because the laws do not specifically address health IT arrangements, there
is some uncertainty among health care providers as to what would result in
violations of the laws, so there is some reluctance to invest in health IT,
according to GAO-04-991R.
Experts it spoke with felt HHS had not addressed the legal issues enough
to reassure providers. HHS has 19 health IT initiatives, some of which
are designed to provide overall leadership and coordination for health IT
across HHS, other federal agencies, and other public and private sector
organizations, and collectively represent $228 million in fiscal 2004, said GAO.
It said the majority of initiatives and funding are for health IT programmatic
activities and grant programs to support the development of standard clinical
terminologies and fund demonstrations of health information systems.
