| On February 17, 2009, President Obama signed | | | | 2013 are eligible for a maximum of $39,000 per |
| the American Recovery and Investment Act of | | | | physicians; those who show meaningful use in |
| 2009. The HITECH (Health Information | | | | 2014 are eligible for a maximum of $24,000 per |
| Technology for Economic and Clinical Health) Act is | | | | physician; and those who show meaningful use |
| part of this legislation and is designed to | | | | beginning in 2015 or later will not be eligible for |
| encourage physicians and other healthcare | | | | incentive payments. |
| organizations to adopt and use (in a meaningful | | | | - Providers who do not show “meaningful |
| way) Electronic Health Records (EHR). | | | | use” of an EHR by 2014 will see a reduction in |
| The HITECH Act will be administered by the | | | | their Medicare payments beginning in 2015 as |
| Office of the National Coordinator for Health | | | | follows: |
| Information Technology (ONC) and appropriates | | | | 2015 – 1% reduction |
| $19.2 Billion dollars, most of which will be used as | | | | 2016 – 2 % reduction |
| incentive money for hospitals and physicians who | | | | 2017 – 3% reduction |
| adopt Electronic Health Records. The incentive | | | | Subsequent years – 3 to 5 percent |
| payments are structured in a way that rewards | | | | |
| early adopters and ultimately penalizes those | | | | The Medicaid Program: |
| physicians who have not implemented an EHR by | | | | - To be eligible to receive incentive payments |
| reducing their Medicare payments beginning in | | | | from Medicaid, eligible professionals must |
| 2015. | | | | demonstrate that a minimum of 30 percent (20 |
| Incentive funds will be distributed through both | | | | percent for pediatricians) of their patients are |
| Medicare and Medicaid to physicians and hospitals | | | | covered by Medicaid. |
| who are “meaningful EHR users.” | | | | - Since Medicaid is administered by the states, the |
| Physicians will be able to choose program | | | | criteria will vary among states. However, the |
| participation through either Medicare or Medicaid | | | | requirements must be acceptable to the |
| but can participate in only one of the programs, | | | | Secretary of HHS and aligned with the ones used |
| not both. | | | | by Medicare. |
| According to the CMS website, the criteria for | | | | - Eligible professionals can receive up to 85 |
| incentives are still under development but the | | | | percent of the net average allowable costs for |
| HITECH Act specifically states that the following | | | | certified EHR technology, including training and |
| conditions for meaningful use must be met: | | | | 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 “electronic | | | | EHR system. |
| exchange of health information to improve the | | | | - Incentive payments are available as follows: |
| quality of health care”; | | | | First Year - $25,000 |
| 4. The EHR must be able to submit clinical quality | | | | Second Year - $10,000 |
| measures to HHS. | | | | Third Year - $10,000 |
| The Medicare Program: | | | | Fourth Year - $10,000 |
| - The Recovery Act established financial | | | | Fifth 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 of | | | | adopted. Therefore, an eligible professional who |
| Medicare allowable charges for covered services | | | | adopts by 2015 will be eligible for the same yearly |
| furnished by the physician in a year subject to | | | | incentive payments as outlined above for a |
| maximum payments each year as follows: | | | | maximum of $64,000. |
| First year - $15,000 | | | | - There is no Medicaid reimbursement penalty for |
| Second year - $12,000 | | | | not adopting an EHR after 2016. |
| Third year - $8,000 | | | | You will note in the descriptions of each of the |
| Fourth year - $4,000 | | | | programs above, the words “eligible,” |
| Fifth year - $2,000 | | | | “maximum,” and “up to” are used |
| - For early adopters whose first payment year is | | | | frequently. Physician practices must factor those |
| 2011 or 2012, the maximum payment is $18,000 | | | | words into their decision-making process in terms |
| the first year. What this means is that only early | | | | of how much of an incentive these programs |
| adopters are eligible to receive the maximum per | | | | actually are and how much incentive money for |
| physician incentive total of $44,000. Those | | | | which they might actually be eligible. |
| physicians who show meaningful use beginning in | | | | |