Health Care Reform and Health IT Stimulus: ARRA and HITECH

AHIMA is actively monitoring and developing resources to assist in understanding the key components of this law and the impact on the industry and practice. Information on healthcare reform will be continually evolving in the next months.

What's Coming

Medicaid Recovery Audit Contractors (RACs)

The Centers for Medicare and Medicais Services (CMS) issued a proposed regulation to develop and implement a Medicaid RAC program by April 2011.
Accountable Care Organizations (ACOs)
The goal of ACOs is to pay providers in a way that encourages them to work together, to pay providers in a way that does not encourage supplier induced demand, and to create an organization that is rewarded for providing high quality care.
President's Council of Advisors on Science and Technology (PCAST)

PCAST is an advisory group of the nation’s leading scientists and engineers who directly advise the President and the Executive Office of the President. PCAST makes policy recommendations in the many areas where understanding of science, technology, and innovation is key to strengthening our economy and forming policy that works for the American people. PCAST is administered by the Office of Science and Technology Policy (OSTP).

On December 8, PCAST released a report entitled “Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward.” Continue to watch for future developments.
Helpful resource on ARRA - HITECH Due Dates - what's required and what's coming

What's New

Registration for the Medicare and Medicaid EHR Incentive Programs is now open.
Meaningful Use Stage 2 and 3

The HIT Policy Committee Meaningful Use workgroup is currently developing recommendations for Stages 2 and 3.
Accounting of Disclosures (AOD) final regulation
Breach Notification Rule

The HIM To-Do List

Read the AHIMA Meaningful Use White Paper Series.
Read and understand the Meaningful Use final regulation requirements, measures and timelines.
Work with vendors on implementing meaningful use measures and standards if your organization is eligible and has decided to pursue incentive payments .
Read and understand the key components of ARRA/HITECH.
Organize an implementation team for ARRA/HITECH and Meaningful Use requirements.
Participate in EHR implementation planning.
Develop breach notification policies and response plans.
Evaluate security to mitigate chances for breaches.

ARRA-HITECH Frequently Asked Questions

What is the difference between ARRA and HITECH?
The American Recovery and Reinvestment Act (ARRA) is officially Public Law 111-5 and was signed on February 17, 2009 by President Barack Obama. ARRA provides many different stimulus opportunities, one of which is $19.2 billion on health IT. Title XIII of ARRA was given a subtitle: Health Information Technology for Economic and Clinical Health Act (HITECH). It is this section that deals with many of the health information communication and technology provisions including Subpart D – Privacy.

What is the total health IT funding?

$20.819 billion in incentives through the Medicare and Medicaid reimbursement systems to assist providers and organizations in the adoption of electronic health records.
$4.7 billion for National Telecommunications and Information Administration’s Broadband Technology Opportunities Program.
$2.5 billion for the U.S. Department of Agriculture’s Distance Learning, Telemedicine, and Broadband Program.
$2 billion for the Office of the National Coordinator (ONC).
$1.5 billion for construction, renovation, and equipment for health centers through the Health Resources and Services Administration.
$1.1 billion for comparative effectiveness research within the Agency for Healthcare Research and Quality (AHRQ), National Institutes of Health (NIH), and the Department of Health and Human Services (HHS).
$500 million for the Social Security Administration.
$85 million for health IT, including telemedicine services, within Indian Health Services.
$50 million for information technology within the Veteran’s Administration.

Where can I find the actual ARRA legislation?
http://www.thomas.gov/home/approp/app09.html#h1

Where can I find AHIMA’s review of ARRA?
/downloads/pdfs/advocacy/ARRAReviewDDAFinal4102009.pdf

Where can I find a list of important ARRA dates?
/downloads/pdfs/advocacy/AHIMAReviewofARRARequiredReports.pdf

Where can I find AHIMA’s analysis of ARRAs impact on Privacy?
/advocacy/arralegislationregulation.aspx

When do Medicare and Medicaid incentives begin?
Initial funding begins in 2011 for both organizations and providers; however it varies depending on the program. Funding also varies due to complex mathematical formulas and when providers or organizations begin. Everyone is encouraged to prepare early.

What types of providers and organizations are eligible for Medicare incentives?
Eligible providers are clearly defined as “physicians” in section 4101 of the Act. Organizations are defined as Acute Care Facilities and Critical Access Hospitals.

What types of providers and organizations are eligible for Medicaid incentives?

Eligible providers for Medicaid incentives include:

Non-hospital based providers who have at least 30% of their patient volume attributed to Medicaid patients; this includes: Dentist, Certified Nurse Mid-wives, Nurse Practitioners, and some Physician Assistants
Non-hospital based Pediatric Providers who have at least 20% of their patient volume attributed to Medicaid patients.

Eligible organizations include:

Children’s Hospitals
Acute Care Hospitals with at least 10% of their patient volume attributed to Medicaid patients
Federally qualified rural health clinics with at least 30% of their patient volume attributed to Medicaid patients.

Are incentives for providers designated by practice or providers?
Each provider (as defined by ARRA as listed above) may receive incentive payments. If the provider is a part of a group practice, each physician within the practice would be eligible independently of the others.

Where can I find resources from ONC or CMS?
ONC has developed a comprehensive website on Health IT at www.healthit.hhs.gov. CMS also has a webpage and resources on HIT at http://www.cms.gov/Recovery/11_HealthIT.asp.