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Health IT provisions of ARRA

Page history last edited by Mark 14 years, 9 months ago

$2 billion to invest in Health IT


Creates "Office of National Coordinator for Health Information Technology"


Requires that electronic health records be addressed in Federal Health Information Technology Strategic Plan by 2014


Program offers grants to states for Health IT initiatives, but requires the states match the money according to the following requirements:

• FY 2011, not less than $1 for every $10 of federal grant funding;

• FY 2012, not less than $1 for every $7 of federal grant funding; and

• FY 2013 and thereafter, not less than $1 for each $3 of federal grant funding. (Source: ARRA)


Establishes HIT Policy and Standards Committees that are comprised of public and private stakeholders (e.g., physicians) to provide recommendations on the HIT policy framework, standards, implementation specifications, and certification criteria for electronic exchange and use of health information. (Source: American Medical Association)


From Kansas Health and Human Services:

The proposal directs assistance for implementation of health information technology,

with the goal that funding could be used for the following:

• HIT architecture that will support the nationwide electronic exchange;

• Integration of HIT into training of health professionals and others in the healthcare


• Training on and dissemination of information on best practices to integrate HIT into a

provider’s delivery of care. Such efforts must be coordinated between HHS and state

agencies administering Medicaid and the State Children’s Health Insurance Program


• Regional or sub-national efforts towards health information exchange;

• Infrastructure and tools to promote telemedicine; and

• Promotion of the interoperability of clinical data repositories or registries.


Grants to states to create loan programs.


The proposal would create a competitive grant program to allow eligible states or Indian tribes to establish a certified electronic health record (EHR) technology loan fund.



Grants to states/tribes could be awarded no earlier than January 1, 2010. States would be

required to match federal contributions of at least $1 for every $5 in federal grant

funding. Public funds and private sector contributions are permissible sources for the

non-federal match.

The loan fund would allow states/tribes to distribute a loan to a provider or other eligible

entity if the provider/entity agrees to certain requirements, for example providers must

agree to report on quality measures. Private sector contributions to the loan fund are

permissible. Loan funds could only be used for specified EHR-related technology




Medicaid HIT-related funding (Title IV, Sec. 4201).


States may reimburse eligible Medicaid providers for the cost of qualified electronic health record (EHR) purchases, implementation and certain operation costs. The federal financial participation (FFP) rate

for such payments is:

• 100 percent for Medicaid providers’ purchase of certified EHR, including training and maintenance.

• 90 percent for certain administrative expenses.

The reimbursement payment for non-hospital based Medicaid providers with 30 percent Medicaid caseload is:

• 85 percent of the net allowable costs incurred for the purchase, implementation, and use of certified EHR technology.

• A separate reimbursement is applied for children’s and acute care hospitals.

• Other hospitals are to be reimbursed according to the Medicare incentive policy.

The higher FFP is contingent upon states meeting several requirements, including:Page 7

• Determine providers are demonstrating “meaningful use” of the EHR technology, as determined by the state and HHS Secretary;

• Reimburse providers directly, without a deduction or rebate; and

• Track the use of EHRs, conduct oversight, encourage adoption of certified EHRs and exchange of health care information.



Limits are placed on provider “incentive” payments – which may be more appropriately characterized as a reimbursement payment, including:

• $25,000: maximum net allowable costs for purchase and initial implementation.

• $10,000: maximum net allowable costs for subsequent year EHR related expenses.

• $63,750: aggregate maximum net allowable costs.

• Reimbursement is limited to five years and cannot be provided after 2021.

• Providers would be responsible for any technology related expense not referenced.



-->The Act seeks to minimize duplication and harmonize requirements for providers

participating in both Medicaid and Medicare.


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