What is the HITECH Act?
On February 17, 2009 a $787 Billion, the American Recovery and Reinvestment Act of 2009 aka “the Stimulus Bill,” was signed into law by the federal government. Included in this law is $22 Billion and $19.2 Billion of that is intended to be used to increase the use of Electronic Health Records (EHR) by physicians and hospitals; this portion of the bill is called, the Health Information Technology for Economic and Clinical Health Act, or HITECH Act. The government firmly believes in the benefits of using electronic health records and is ready to invest federal resources to proliferate its use. Title XIII in Division A, pages 112 through 165 and Title IV in Division B, pages 353 through 398, cover the HITECH portion of this economic recovery act.
How are the funds for the HITECH Act being allocated?
$18 billion through the Medicare and Medicaid reimbursement systems as incentives for hospitals and physicians who are “meaningful users” of EHR systems.
$2 billion to the Office of the National Coordinator for infrastructure necessary to allow for, and promote, the electronic exchange and use of health information for each individual in the United States; updating the Department of Health & Human Services’ technologies to allow for the electronic flow of information; integrating health IT education into the training of healthcare professionals; and, promoting interoperable clinical data repositories.
$1 billion to be made available for renovation and repair of health centers and for the acquisition of health IT systems.
$550 million for – among other things – the purchase of equipment and services including, but not limited to, health IT within Indian Health Service facilities.
$400 million for comparative effectiveness research on how use of electronic data impacts healthcare treatments and strategies.
$300 million to support regional and sub-national efforts towards health information exchange.
$40 million to be used by the Social Security Administration to use EMRs to submit disability claims.
Who and how will the policies and standards be determined for the HITECH Act?
Located within the Department of HHS is the Office of the National Coordinator for Health Information Technology (ONC). Created by Executive Order in 2004, it was legislatively mandated in the HITECH Act of 2009. The ARRA provides the HIT Policy and HIT Standards committees be created under the Federal Advisory Committee Act (FACA).
The HIT Policy Committee is charged with making recommendations to the National Coordinator for Health Information Technology on a policy framework for the development and adoption of a nationwide health information infrastructure, including standards for the exchange of patient medical information.
The HIT Standards Committee is charged with making recommendations to the National Coordinator for Health Information Technology on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information.
Who will be eligible for Medicare and Medicaid incentives?
The two incentive payment programs outlined in the HITECH Act are through Medicare and Medicaid. At this time physicians and providers will only be eligible for one of the programs at a time. Physicians and providers should analyze their public payer mix to determine the best program for their organizations. Both programs will require that proof of ”meaningful use” of an EHR system to qualify for the incentives.
For additional detail on Medicare and Medicaid Information Health Technology: Title IV ARRA, view the CMS Fact Sheet .
Are all physicians in the U.S. eligible for incentive bonus payments from Medicare and Medicaid?
While the majority of physicians stand to earn incentive payments if they meet the meaningful use threshold, there are some that will not qualify – those not accepting Medicare, or those that do not have a patient base that is comprised of more than 30% Medicaid patients. Additionally, physicians delivering all care in a hospital, such as anesthesiologists, pathologists or emergency physicians, do not qualify. Note that while most providers must demonstrate that 30% of their patients are using Medicaid in order to qualify for that portion of the program, pediatricians need only prove 20%. This is an effort to facilitate the participation of more pediatricians in the program who would not normally accept Medicare and very well might not have a sufficient Medicaid volume to qualify.
I keep hearing about “meaningful use” – what does this mean?
The focus on meaningful use is a recognition that better health care does not come solely from the adoption of technology itself, but through the exchange and use of health information to best inform clinical decisions at the point of care.
The ARRA authorizes the Centers for Medicare & Medicaid Services (CMS) to provide a reimbursement incentive through medicare and medicaid for physician and hospital providers who are successful in becoming “meaningful users” of an electronic health record (EHR).