ARRA HITECH Act Summary

The American Recovery and Reinvestment Act of 2009 was signed into law in February of 2009. Part of this legislation is the HITECH Act (Health Information Technology for Economic and Clinical Health Act). This act is designed to encourage physicians and other healthcare organizations to implement and demonstrate Meaningful Use (MU) of Electronic Health Records (EHR).

ARRA's Meaningful Use programs are based on individual healthcare providers. Therefore, if you are part of a group practice, each eligible professional can qualify individually for the incentive payments under the ARRA and HITECH Act if they demonstrate Meaningful Use. DrFirst can help your practice meet the requirements for ARRA and Meaningful Use, and help navigate the unique needs of your practice.

The First Step to Becoming Eligible

The first step towards becoming eligible for incentive funds is to purchase a certified technology system. You can meet Meaningful Use requirements by using either multiple modular systems or a complete EHR.

Modular Approach

The benefit of choosing to go with a modular approach allows you to take smaller steps to achieve the final result while still meeting Stage 1 and 2 requirements.

EHR Approach

The benefit of going straight to an EHR is that you only make one transition from paper to electronic. No matter which system you choose, it must allow you to meet all 15 of the core objectives and 5 of the 10 menu requirements in order for you to attest to Meaningful Use for either Medicare or Medicaid.

Program Eligibility

It's all in the details Under the HITECH Act, an eligible provider (EP) must be one of the following:

  • Doctor of Medicine or Osteopathy
  • Doctor of Dental Surgery or Dental Medicine
  • Doctor of Podiatric Medicine
  • Doctor of Optometry
  • Chiropractor
    Note: A doctor is considered 'hospital based' and will not qualify as an EP under the HITECH Act if he or she performs 90% or more of his or her services in a hospital inpatient or emergency room setting.

Additional considerations:

  • All EPs must have a National Provider Identifier (NPI)
  • All EPs must be enrolled in the CMS Provider Enrollment, Chain and Ownership System (PECOS)
    • The PECOS system will also be used to attest MU compliance, but the exact details of this build-out are still being developed.
    • Most EPs will need to have an active user account in the National Plan and Provider Enumeration System (NPPES)

Medicare EPs who meet Meaningful Use criteria under the HITECH Act will receive an incentive payment equal to 75% of their Medicare allowable charges for covered professional services with a maximum payment of $44,000.

EPs can participate in the Medicare EHR incentive program as soon as the federal program launches in 2011. To be eligible for the first round of payments on or about May 2011 providers must demonstrate Meaningful Use for a minimum of 90 consecutive days to receive the full year's credit. Those who plan to meet the Meaningful Use incentive criteria will be allowed to receive both the Meaningful Use payments and the PQRI payments in the same year, but will not be allowed to receive the MU payments during the same year as the MIPPA e-prescribing payments.

Medicaid EHR Incentive Program

To be considered an 'eligible professional' under the Medicaid system, you must fit into one of the following categories:

  1. See a minimum 30% Medicaid patient volume and be a:
    • Physician
    • Physician Assistant
    • Nurse Practitioner
    • Certified Nurse-Midwife
    • Dentist
  2. See a minimum 20% Medicaid patient volume and be a:
    • Pediatrician
  3. Serve in a physician assistant led Federally Qualified Health Center or Rural Health Clinic and:
    • Spend a minimum 50% of service time in the FQHC or RHC facility
    • Have a minimum 30% patient volume attributed to 'need-based patients'

Unlike the Medicare program, Medicaid requires no additional enrollment to participate. If you see Medicaid patients and process claims with Medicare, you have the tools necessary to participate in the HITECH Act Meaningful Use incentive program.

Medicaid will award payments to any eligible professional for adopting, implementing, upgrading or demonstrating meaningful use of certified EHR technology in the first participation year. Demonstration of Meaningful Use under the HITECH Act is required for each subsequent year to qualify for payment.

HITECH Act Incentives for 2011

In 2011, CMS will not be prepared to accept feeds from certified EHRs, so the primary means of demonstrating Meaningful Use will be via an attestation through a secure CMS website. An attestation is a legally binding representation of the accuracy of the statement. Making a false attestation could be considered fraud under the Medicare/Medicaid programs. Civil penalties for willful neglect under the HITECH Act can extend up to $250,000, with repeat/uncorrected violations extending up to $1.5 million.

The maximum Medicaid payments total $63,750. The Medicaid payments are based on individual state participation so it is important to check the status of your particular state.

For more information on the EHR incentive program and the HITECH Act, complete the form above.