Understanding the HITECH Act - The Stimulus Bill, EHR and You

On February 17, 2009, President Obama signedphysician incentive total of $44,000. Those
the American Recovery and Investment Act ofphysicians who show meaningful use beginning in
2009. The HITECH (Health Information2013 are eligible for a maximum of $39,000 per
Technology for Economic and Clinical Health) Act isphysicians; those who show meaningful use in
part of this legislation and is designed to2014 are eligible for a maximum of $24,000 per
encourage physicians and other healthcarephysician; and those who show meaningful use
organizations to adopt and use (in a meaningfulbeginning in 2015 or later will not be eligible for
way) Electronic Health Records (EHR).incentive payments.
The HITECH Act will be administered by the- Providers who do not show "meaningful use" of
Office of the National Coordinator for Healthan EHR by 2014 will see a reduction in their
Information Technology (ONC) and appropriatesMedicare payments beginning in 2015 as follows:
$19.2 Billion dollars, most of which will be used as2015 - 1% reduction
incentive money for hospitals and physicians who2016 - 2 % reduction
adopt Electronic Health Records. The incentive2017 - 3% reduction
payments are structured in a way that rewardsSubsequent years - 3 to 5 percent
early adopters and ultimately penalizes thoseThe Medicaid Program:
physicians who have not implemented an EHR by- To be eligible to receive incentive payments
reducing their Medicare payments beginning infrom Medicaid, eligible professionals must
2015.demonstrate that a minimum of 30 percent (20
Incentive funds will be distributed through bothpercent for pediatricians) of their patients are
Medicare and Medicaid to physicians and hospitalscovered by Medicaid.
who are "meaningful EHR users." Physicians will be- Since Medicaid is administered by the states, the
able to choose program participation throughcriteria will vary among states. However, the
either Medicare or Medicaid but can participate inrequirements must be acceptable to the
only one of the programs, not both.Secretary of HHS and aligned with the ones used
According to the CMS website, the criteria forby Medicare.
incentives are still under development but the- Eligible professionals can receive up to 85
HITECH Act specifically states that the followingpercent of the net average allowable costs for
conditions for meaningful use must be met:certified EHR technology, including training and
support up to a total of $64,000 in payments
1. The EHR must use certified technology;over 5 years. First year costs are applied to the
2. The EHR must include ePrescribing;purchase, installation and training of the certified
3. The EHR must allow for the "electronicEHR system.
exchange of health information to improve the- Incentive payments are available as follows: First
quality of health care";Year - $25,000
4. The EHR must be able to submit clinical qualitySecond Year - $10,000
measures to HHS.Third Year - $10,000
The Medicare Program:Fourth Year - $10,000
- The Recovery Act established financialFifth Year - $10,000
incentives beginning in January 2011 for eligible- Unlike Medicare, payments for adoption do not
professionals who are meaningful EHR users;decrease based on the year the EHR is initially
- The incentive payment is equal to 75 percent ofadopted. Therefore, an eligible professional who
Medicare allowable charges for covered servicesadopts by 2015 will be eligible for the same yearly
furnished by the physician in a year subject toincentive payments as outlined above for a
maximum payments each year as follows: Firstmaximum of $64,000.
year - $15,000- There is no Medicaid reimbursement penalty for
Second year - $12,000not adopting an EHR after 2016. You will note in
Third year - $8,000the descriptions of each of the programs above,
Fourth year - $4,000the words "eligible," "maximum," and "up to" are
Fifth year - $2,000used frequently. Physician practices must factor
- For early adopters whose first payment year isthose words into their decision-making process in
2011 or 2012, the maximum payment is $18,000terms of how much of an incentive these
the first year. What this means is that only earlyprograms actually are and how much incentive
adopters are eligible to receive the maximum permoney for which they might actually be eligible.