American Recovery And Reinvestment Act
On February 17, 2009, President Barack Obama signed into law the American Recovery and Reinvestment Act of 2009, H.R. 1. The American Recovery and Reinvestment Act provides approximately $19 billion to aid in the development of a robust IT infrastructure for healthcare and to assist providers and other entities in adopting and using health IT.
Summary: Health Information Technology (HIT)
- Officially establishes the Office of the National Coordinator for Health Information Technology (ONCHIT) within HHS to promote the development of a nationwide interoperable HIT infrastructure; President Bush already created ONCHIT by Executive Order in 2004.
- Establishes HIT Policy and Standards Committees that are comprised of public and private stakeholders (e.g., physicians) to provide recommendations on the HIT policy framework, standards, implementation specifications, and certification criteria for electronic exchange and use of health information.
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HHS would adopt through the rule-making process an initial set of standards, implementation specifications, and certification criteria by December 31, 2009. ONCHIT would be authorized to make available an HIT system to providers for a nominal fee.
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Provides financial incentives through the Medicare program to encourage physicians and hospitals to adopt and use certified electronic health records (EHR) in a meaningful way (as defined by the Secretary and may include reporting quality measures). Authorizes ONCHIT to provide competitive grants to states for loans to providers.
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Medicare incentive payments would be based on an amount equal to 75% of the Secretary’s estimate of allowable charges, up to $15,000 for the first payment year. Incentive payments would be reduced in subsequent years: $12,000, $8,000, $4,000, and $2000, after 2015. Physicians who report using an EHR that is also capable of e-prescribing would be eligible for EHR incentives only.
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Early adopters, whose first payment year is 2011 or 2012, would be eligible for an initial incentive payment up to $18,000. In 2014, the payment limit would equal $12,000. Adopters, whose first payment year is 2015, would receive $0 payment for 2015 and any subsequent year.
- For eligible professionals in a rural health professional shortage area, the incentive payment amounts would be increased by 10 percent.
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Incentives under the Medicaid program are also available for physicians, hospitals, federally-qualified health centers, rural health clinics, and other providers; however, physicians cannot take advantage of the incentive payment programs under both the Medicare and Medicaid programs. Eligible pediatricians (non-hospital based), with at least 20 percent Medicaid patient volume, could receive up to $42,500, and other physicians (non-hospital based), with at least 30 percent Medicaid patient volume, could receive up to $63,750, over a six-year period.
- Physicians who do not adopt/use a certified HIT system would face reduction in their Medicare fee schedule of -1% in 2015, -2% in 2016, and -3% in 2017 and beyond. E-prescribing penalties would sunset after 2014.
- Allows HHS to increase penalties beginning in 2019, but penalties cannot exceed -5%. Exceptions would be made on a case-by-case basis for significant hardships (e.g., rural areas without sufficient Internet access).
Additional Information
In March of 2009 The Healthcare Information and Management Systems Society (HIMSS) released a summary of the Health Information Technology provisions outlined in the American Recovery and Reinvestment Act. The report is available below.
 The American Recovery and Reinvestment Act of 2009: Summary of Key Health Information Technology Provisions
If you have additional questions about the American Recovery And Reinvestment Act and how it benefits physicians implementing EMR/EHR please contact a Physicians Practice Solutions consultant.
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