• Highlights of Health Information Technology Provisions
  • February 26, 2009 | Author: Bruce O. Tavel
  • Law Firm: Crowell & Moring LLP - Washington Office
  • The American Recovery and Reinvestment Act promotes the adoption of health information technology ("HIT") systems that are intended to save money, reduce medical error and improve the quality of patient care. The Act provides an expansive framework for the adoption of HIT and also provides incentives for hospitals and physicians to adopt new systems.

    • Office of the National Coordinator for Health Information Technology
      • Codifies the Office of the National Coordinator for Health Information Technology. The office is headed by a National Coordinator who is appointed by and reports to the Secretary of Health and Human Services.
      • The National Coordinator shall perform his or her duties in a manner consistent with the development of a nationwide health information technology infrastructure that allows for electronic use and exchange of health information.
      • The National Coordinator's responsibilities include review and endorsement of HIT standards, specifications, and certification criteria.
    • HIT Policy Committee
      • Establishes the HIT Policy Committee to make policy recommendations to the National Coordinator, including implementation of the strategic plan.
      • The HIT Policy Committee shall recommend the areas in which standards, implementation specifications, and certification criteria are needed for the electronic exchange and use of health information. The standards and implementation specifications shall include named standards, architectures, and software schemes for authentication and security.
      • The HIT Policy Committee shall make recommendations, including: the technologies that protect the privacy and security of health information in a qualified electronic health record; technologies that allow individually identifiable health information to be rendered unusable, unreadable, or indecipherable to unauthorized individuals; the use of electronic systems to ensure the comprehensive collection of patient demographic data; and technologies that address the needs of children and other vulnerable populations.
      • The Secretary shall, through the rule making process, adopt an initial set of standards, implementation specifications, and certification criteria no later than December 31, 2009.
    • HIT Standards Committee
      • Establishes the HIT Standards Committee to recommend to the National Coordinator standards, implementation specifications, and certification criteria for the electronic exchange and use of health information.
      • The HIT Standards Committee shall, as appropriate, provide for the testing of standards and specifications by the National Institute for Standards and Technology.
      • The HIT Standards Committee shall serve as a forum for participation by stakeholders to provide input on development, harmonization, and recognition of standards, implementation specifications, and certification criteria.
      • The HIT Standards Committee shall develop a schedule for the assessment of policy recommendations developed by the HIT Policy Committee. The HIT Standards Committee shall conduct open public meetings to allow for public comments on the schedule. The schedule shall be updated annually.
    • Federal Health Information Technology
      • The National Coordinator shall make available qualified electronic health record technology unless the Secretary determines through a needs assessment that the needs and demands of providers are being met through the marketplace.
      • The National Coordinator may impose a nominal fee. The fee shall take into account the financial circumstances of smaller providers, low income providers, and providers located in rural or other medically underserved communities.
    • Application and Use of Adopted Health Information Technology Standards
      • Federal agencies shall require in contracts with health care providers, health plans, and health insurance issuers, that the contractor implements, acquires, or upgrades health information technology systems, that it shall utilize health information technology systems and products that meet adopted standards and implementation specifications.
    • Research and Development Programs
      • The Director of the National Institute of Standards and Technology, in consultation with the Director of National Science Foundation and other appropriate agencies, shall establish a program of assistance to institutions of higher education of consortia to establish a multidisciplinary Centers for Health Care Information Enterprise Integration.
    • Immediate Funding to Strengthen the Health Information Technology Infrastructure
      • The Secretary shall invest in the infrastructure necessary to allow for and promote the electronic exchange and use of health information consistent with the goals outlined in the strategic plan.
      • Funds shall be invested through appropriate agencies, such as the Centers for Medicare and Medicaid Services.
    • Health Information Technology Implementation Assistance
      • The National Coordinator shall establish a health information technology extension program to provide technology assistance to assist health care providers to adopt, implement, and effectively use certified electronic health record (EHR) technology.
      • The Secretary shall create a Health Information Technology Research Center to provide technical assistance and develop or recognize best practices. The centers are intended to provide a forum for the sharing of information and best practices.
      • The Secretary shall provide assistance with the creation and support of regional Health Information Technology Research Centers.
    • State Grants to Promote Health Information Technology
      • The Secretary may award a grant to a State or qualified State-designated entity to facilitate and expand the electronic movement and use of health information.
    • Competitive Grants to States and Indian Tribes for the Development of Loan Programs to Facilitate the Widespread Adoption of Certified HER Technology
      • The National Coordinator may award competitive grants to entities to establish programs for loans to health care providers to purchase certified EHR technology.
    • Demonstration Program to Integrate Information Technology Into Clinical Education
      • The Secretary may award grants to carry out demonstration projects to develop academic curricula integrating certified EHR technology in the clinical education of health professionals.
      • The entity must submit to the Secretary an application that includes a strategic plan for integrating EHR technology into the clinical education of health professionals to reduce medical errors, increase access to prevention, reduce chronic diseases, and enhance health care quality.
    • Medicare Payments to Hospitals
      • Beginning in FY 2011, CMS will make payment under Part A for hospitals that are "meaningful users" of health information technology. A meaningful user is a hospital that uses a certified HER system during the reporting year.
      • Payments are phased-down over four years to eligible hospitals.
      • Hospitals that are not meaningful users by FY 2015 are subject to payment adjustments.
    • Medicare Payments to Physicians
      • Beginning in CY 2011, CMS will make incentive payments under Part B to physicians that are "meaningful users" of health information technology. A meaningful user is a physician that uses certified EHR technology with e-prescribing, information exchange, and reporting on quality measures.
      • Incentive payments may be up to $18,000 per physician in the first year, on a decreasing scale in subsequent years.
      • Medicare Advantage organizations that are organized as a health maintenance organization are eligible for incentive payments if:
        • Physicians are employed by the Medicare Advantage organization; or.
        • Physicians are employed by or partners of an entity that contracts with a Medicare Advantage organization and furnishes at least 80% of the entity's Medicare patient services to enrollees of the Medicare Advantage organization; and
          • The physician provides at least 80% of the professional services to enrollees of the Medicare Advantage organization; and
          • The physician furnishes, on average, at least 20 hours per week of patient care services.
        • The qualifying Medicare Advantage organization must submit an attestation as part of the bid submission process.
      • The Secretary shall conduct a study and submit a report to Congress no later than 120 days after the enactment of this law concerning payment incentives and adjustments that could be made to professionals who are not eligible for HIT incentive payments and receive payments for Medicare patient services nearly-exclusively through contractual arrangements with Medicare Advantage organizations or an intermediary. The study shall assess approaches for measuring meaningful use of qualified HER technology and mechanisms for delivering incentives
      • Fee schedules will be reduced for physicians that do not implement by 2015. Fee schedules are reduced 1% per year (1% in 2015, 2% in 2016 and 3% in 2017).