The American Recovery and Reinvestment Act (ARRA) of 2009 has a number of provisions to encourage the expansion and further implementation of electronic health records for the purpose of increasing efficiency in the health care system while hopefully lowering costs. The Office of the National Coordinator for Health Information Technology (see website) has established a two-part strategic plan for expanding the installation of health records systems throughout the U.S.
Section 4101 of ARRA descibes the incentive payment process through the Medicare program for eligible professionals that are a “meaningful EHR user,” as that term is defined in subsection (o)(2) of the amended section 1848 of the Social Security Act (cited as 42 U.S.C. 1395w-4). The tortured definition provided within the statute has three basic requirements: (a) the certified EHR is being used in a “meaningful” manner to the satisfaction of the Secretary, (b) the EHR is connected to some “electronic exchange of health information to improve the quality of health care”, and (c) data is submitted to the Secretary on clinical quality measures on a regular basis. The data to be submitted to the Secretary is to be governed by contract between Medicare and the provider, and such proposed measures must go through the public notice and comment period in the Federal Register – similar to other proposed regulations under federal law.
The incentives payable to eligible providers are spread out over five years, with a maximum amount of 18,000 (if starting in 2011 or 2012), otherwise 15,000 that first year. That is, unless the first year of adoption of the EHR by the provider is after 2014, which in that case the provider is not eligible for any incentive at all through this section. So, a provider that adopted a certified EHR in 2011, demonstrated that: (a) he was using it in a meaningful manner, (b) connected to a data exchange, and (c) produced data to the Secretary as required, would be eligible for payments in total of $44,000 over a five year period starting in 2011 (18,000 in 2011, 12,000 in 2012, 8,000 in 2013, 4,000 in 2014, and 2,000 in 2015).
If instead the provider did all the above, but did not start until 2013, the first payment in 2013 would instead be 15,000, for a total of $41,000 over the five years 2013-2017. Sadly, if the provider did all of the above for the first time in 2015, they would get bupkis.