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HHS Wants to Slash ONC Funding by 28% Despite Cures Act Work

In the Trump administration’s FY 2020 budget request, HHS is proposing to cut ONC’s budget by 28 percent, despite its heavy workload in implementing health IT interoperability and other provisions of the 21st Century Cures Act.


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By Fred Donovan

- In the Trump administration’s FY 2020 budget request, the Department of Health and Human Services (HHS) is proposing to cut ONC’s budget by 28 percent, despite its heavy workload in implementing health IT interoperability and other provisions of the 21st Century Cures Act (Cures Act).

In a notice of proposed rulemaking (NPRM) released Feb. 11, ONC laid out a series of measures intended to implement sections of the Cures Act.

Among the NPRM provisions, ONC laid out new application programming interface (API) certification criteria, new standards and implementation specifications, and conditions and maintenance of certification requirements. In addition, the NPRM defines what activities would be exempt from the information blocking prohibition in the Cures Act.

HHS is proposing to cut ONC funding from $60 million in FY 2019 to $43 million in FY 2020. Despite the cuts, HHS stressed the importance of ONC’s work in promoting health IT interoperability, common data standards, innovation, competition, and improved patient outcomes.

“In a large and complex health care delivery system, achieving an interoperable health IT system is critical. A safe, secure, and efficient health IT infrastructure improves health care delivery, reduces health care costs, and supports better health for all Americans,” HHS stated in its FY 2020 budget document.

HHS said that the FY 2020 budget request “reflects ONC’s continued commitment to achieving a nationwide interoperable health IT system through coordination of health IT stakeholders. ONC works closely with public and private sector stakeholders, including providers, patients, payers, researchers, and policymakers, to advance a safe and secure health IT infrastructure.”

The budget request includes funding for the Health IT Advisory Committee, which provides recommendations to the ONC related to implementing a health IT infrastructure that facilitates health data electronic access, exchange, and use. HITAC, which was established by the Cures Act, is comprised of 30 members from the U.S. healthcare industry.

The HITAC has contributed to development of the Trusted Exchange Framework and Common Agreement, U.S. Core Data for Interoperability, and the strategy for reducing regulatory and administrative burden associated with the use of health IT and electronic health records.

In addition, the budget request includes funding for implementing the Trusted Exchange Framework, which will establish a set of common principles, terms, and conditions that would promote trust between health information networks.

In FY 2020, ONC will be implementing the framework and working with the private sector to promote health data access, exchange, and use across networks. This is intended to expand patient and provider access to health data, improve care coordination and delivery, and enable patients to participate in their care and manage their health data.

ONC is also working with CMS and healthcare stakeholders – physicians, nurse practitioners, physician assistants, and other clinicians – to reduce clinician burden from health IT barriers and regulatory documentation requirements.

As part of that effort, CMS issued a final rule in November of last year that significantly changed documentation policies to reduce burdens on clinicians who treat Medicare patients.

In FY 2020, ONC will focus on supporting standardized APIs to improve clinical workflow, promote competition for interoperable health IT products, and expand patient access to their health data.

HHS said the FY 2020 budget prioritizes ONC’s mandate to operate the Health IT Certification Program, which maintains close to 60 certification criteria used to standardize information across 21 federal efforts.

By the end of last year, there were health IT products from more than 600 health IT developers on the Certified Health IT Products List, which is used to register the EHR products of 550,000 care providers and hospitals participating in Medicare and Medicaid.

In FY 2020, ONC will implement the Certification Program rules that prohibit information blocking, create and promote channels for reporting information blocking, and enforce provisions of the Cures Act.

The Certification Program will continue oversight responsibilities, improve surveillance of certified products for compliance with technical, security, and regulatory requirements for interoperability, and assess the potential for information blocking.

Commenting on the FY 2020 budget, HHS Secretary Alex Azar concluded: “The budget will advance HHS’s work on increasing the affordability of individual health insurance, bringing down the price of prescription drugs, transforming our healthcare system into one that pays for value, and combating the opioid crisis.”


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