American Recovery and Reinvestment Act of 2009
(ARRA)
 

The government defines an Electronic Health Record (EHR) as an "electronic record of individually identifiable health information on an individual that can be drawn from multiple sources and that is managed, shared, and controlled by or for the individual."

Physicians are eligible for incentive payments from 2011-2015, early EHR adopters must start by 2010 and have a years worth of data to be eligible.

The electronic prescribing incentives (2%) and quality initiatives (PQRI / 2%) are available now.

Physicians can qualify under either the Medicare or Medicaid provision. Physicians must be office-based to be eligible, and they can not collect incentive payments from both.

Medicare Provision

Physicians who implement a certified solution and become meaningful users between 2010 and 2012 will be eligible for up to $44,000 each in incentive payments.

Physicians who wait to become meaningful users between 2012 and 2014 will be eligible for lower payments. Physicians who have not become meaningful users by 2014 will not qualify for any payments and will be subject to increasing penalties.

Incentives are based on the lesser of either 75% of the provider’s Medicare Part B billings or the maximum allowable incentive.

Medicaid Provision

Beginning in 2011, office-based physicians who qualify under the Medicaid provision could collect a sum total of $63,750—calculated as 85% of EHR costs not exceeding $25,000 in the first year, followed by 85% of annual costs not exceeding $10,000 over the next 5 years. To be eligible under this provision, office-based physicians must demonstrate “meaningful use” of a certified EHR, and more than 30% of their cases must be attributable to Medicaid, or 20% of their cases attributable to pediatrics. Office-based pediatricians are eligible to receive up to two-thirds of the maximum payment.

Payment Reduction

For office-based physicians who do not adopt EHR technology by 2015, Medicare payments will be reduced by:

1% in 2015––

2% in 2016––

3% in 2017 and beyond––

In 2018 and beyond, the HHS Secretary may decrease one additional percent per year (maximum of 5%) contingent upon the levels of overall EHR adoption in the market.

Meaningful Use of certified EHR technology including e-prescribing

• Use of electronic prescribing
• EHR is connected to provide electronic exchange of health information to improve quality and promote care coordination
• Ability to report on clinical quality measures as specified by the Secretary

“Meaningful use” is not specifically defined in the bill, but it gives the Secretary of Health and Human Services (HHS) advisory guidance regarding how to determine this.