Stimulus Bill

On February 17, 2009, President Barack H. Obama signed into law the American Recovery and Reinvestment Act of 2009 (ARRA), commonly known as the ‘Stimulus Bill’.   ARRA provides over $20 billion for the development and adoption of health information.  The specifications within the ARRA provide incentives through the Medicare and Medicaid reimbursement systems to encourage to health care providers and hospitals to adopt and utilize health information technology and become meaningful EHR users by 2015.  Payments are tiered over a number of years with larger payments being made to early adopters and lower payments made to later adopters.  Health care providers and hospitals suffer penalties through reduced Medicare reimbursement payments if they do not become meaningful users of EHR by 2015.

American Recovery and Reinvestment Act of 2009 (ARRA)

On February 17, 2009, President Barack H. Obama signed into law the American Recovery and Reinvestment Act of 2009 (ARRA), commonly known as the ‘Stimulus Bill’ which will provide significant incentives in the form of reimbursement payment incentives to eligible hospitals and Medicare and Medicaid service providers who adopt a certified EHR system and demonstrate “meaningful use” of the EHR system by the end of 2014, and will impose penalties in the form of reduced reimbursement payments on providers who do not demonstrate “meaningful use”.  Physicians may only qualify for either the Medicare or the Medicaid funding based on their qualifications and the benefits provided, but cannot qualify for both.  The qualifier is the year in which a provider can demonstrate meaningful use of a certified EHR system and not the year in which such a system is implemented.  Providers have to demonstrate meaningful use by the end of 2014.  Providers must demonstrate meaningful use for each year of use and demonstrate performance during the reporting period for each payment year.    Incentive payments are likely to begin in 2011 and run through 2016, and penalties are likely to begin in 2015 and run through 2017 and beyond.   Providers in “provider shortage areas” are eligible for 10% increase.  Physicians who demonstrate meaningful use in 2011 or 2012 qualify for five annual payments for an aggregate maximum payment of $44,000.  The aggregate maximum payment will decrease over time.

Meaningful use

• Demonstrate use of electronic prescribing through certified EHR technology
• Demonstrate that such certified EHR technology is connected in a manner that provides for electronic exchange of health data to improve quality of care
• Submit information to the government on clinical quality measures and other measures

Certified EHR

• A certified EHR
• includes patient demographic and clinical health information, such as medical history and problem lists
• has the capacity to provide clinical decision support that includes physician order entry (to capture and query information relevant to health care quality)
• can exchange electronic health information with other sources