On September 1, 2009, CMS issued a letter to State Medicaid Directors to provide initial guidance on state administration of the incentive payments for eligible Medicaid providers who adopt and become meaningful users of electronic health records. These incentives were authorized by the American Recovery and Reinvestment Act (ARRA), specifically section 4201 titled Health Information Technology for Economic and Clinical Health (HITECH). Under the ARRA, HHS is authorized to reimburse states 100% of the incentives paid to eligible providers, and 90% of the state’s planning and implementation expenses incurred to administer the Medicaid incentive program. The criteria that states must meet, as set forth in this initial guidance, illustrates that states should act promptly to engage in certain, significant planning activities in order to ensure that the ARRA Medicaid incentives can be made available in a timely manner to eligible Medicaid providers in the state.
Electronic Health Records
HHS and FTC Issue Breach Notification Rules
On August 17, 2009, the Federal Trade Commission (FTC) issued its final rule requiring vendors of “personal health records” to notify consumers when the security of their electronic health information is breached. On August 19, 2009, the U.S. Department of Health and Human Services (HHS) issued its interim final rule requiring health care providers, health plans, and other entities covered by the Health Insurance Portability and Accountability Act (HIPAA) to notify individuals when their health information is breached. These rules were issued pursuant to the Health Information Technology for Economic and Clinical Health Act (HITECH), which is part of the American Recovery and Reinvestment Act of 2009 (ARRA). HITECH required FTC and HHS to collaborate on development of the breach notification rules. The FTC’s press release and a link to its Breach Notification Rule is available here. The HHS press release and Breach Notification Rule is available here. HHS published the Breach Notification Rule in the Federal Register on August 24, 2009.
HIT Policy Committee Workgroup Releases Second Draft of “Meaningful Use”
On Thursday, July 16, 2009, the HIT Policy Committee presented its revised recommendation on the “meaningful use” definition. At the end of this meeting, the HIT Policy Committee forwarded its recommendation on the “meaningful use” definition to the Office of National Coordinator per the Health Information Technology for Economic and Clinical Health Act (“HITECH Act”). The revised meaningful use matrix, 2011 Draft Quality Measures and other materials presented or discussed during the MU meeting on July 16, 2009 are available on the HIT Policy Committee webpage.
ARRA’s Competitive State HIT Grants and the Small Physician Practice
Many small physician practices may be relying on health information technology (HIT) loans from their state to adopt electronic health records (EHRs) in their practices. Before a physician can seek such a loan, the state must have such loans available. The American Recovery and Reinvestment Act of 2009 (ARRA) provides grants to states to make such EHR loans available to health care providers. However, states must competitively bid for the ARRA HIT grant money to be made available for such loans.
CMS Website on ARRA’s Health Information Technology Includes Fact Sheet with FAQs
On June 16, 2009, on the same date the ONC HIT Policy Committee released the first draft of “meaningful use” of electronic health records (EHRs), the Centers for Medicare and Medicaid Services (CMS) launched the CMS Health Information Technology Website to address health information technology (Health IT or HIT) under the ARRA’s Health Information Technology for Economic and Clinical Health Act (HITECH Act). The CMS HIT website focuses on the following three areas of ARRA Health IT:
- Health IT incentives and support for adoption
- Establishment of Health IT standards and infrastructure
- Privacy and security pertaining to Health IT
These are the three main areas pertaining to Health IT in which CMS will be involved under the HITECH Act.
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