American Recovery & 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 man-aged, shared, and controlled by or for the individual."

  • Physicians are eligible for incentive payments beginning January 1, 2011, as long as a system has been installed by year-end 2009. Early EHR adopters need a years worth of data and are eligible for the one-time “early adopter” incentive of $3,000.

  • 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 pro-grams.

  • Medicare incentives of up to $44,000/physician over 5-years and Medicaid incentives of up to $63,750/physician over 6-years will be available.

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 2015 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.

Adopt Yr 1
2011		 Adopt Yr 2
2012		 Adopt Yr 3
2013		 Adopt Yr 4
2014		 Adopt Yr 5
2015+
2011 18,000
2012 12,000 18,000
2013 8,000 12,000 15,000
2014 4,000 8,000 12,000 12,000
2015 2,000 4,000 8,000 8,000 0
2016 0 2,000 4,000 4,000 0
TOTAL $44,000 $44,000 $39,000 $24,000 0

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:

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.