The American Recovery and Reinvestment Act of 2009  (ARRA) stimulus recovery plan that President Barack Obama recently signed into law on February 17, 2009 provides many incentives. The good news for the eye care industry is that the Health IT Incentive Program allocates $19.2 billion to doctors who adopt electronic health records (EHR), also known as electronic medical records (EMR).

Beginning in 2011, doctors who are “meaningful users” of “certified EHR technology” will be eligible to receive up to $44,000 paid out over a five year period. Incentives are based on “meaningful use” and are not tied to the actual cost of acquiring or maintaining an EHR.  Only HHS certified EHR are eligible for the incentives.

Of the $19.2 billion, $17.2 billion will be paid out over five years in the form of incentive payments through Medicare or Medicaid reimbursements – not both (see EHR Incentives by Year Payment table shown below).

While the federal government has only released EHR incentive objectives as to what qualifies doctors as a meaningful user, it’s imperative that you are several steps ahead of the federal mandates and not wait until the last minute to get started. As an early adopter of EHR, it will be much easier for you to capitalize on incentive dollars — 70% of the funding comes in the first two years.

According to a consensus at the spring 2009 Healthcare Information and Management Systems Society annual conference, you shouldn’t wait to purchase and implement EHR, as this will increase the risk that your practice may not be eligible to receive maximum incentive funds.

While 2011 may seem far off, moving to a new system takes time, patience and commitment. Poor planning, poor communication, and poor training can lead to unwelcome results if you try to rush through the process. 

To take full advantage of maximum incentive payments, start the purchase and deployment process of Filopto, evaluate office workflows, train your employees, and fully implement your EMR/EHR system.

Are There Penalties for Not Using EHR?

The EHR Stimulus Bill has a double edge sword. While you may qualify for incentive payments beginning in 2011, if you decide to forego implementing an EHR in your practice, starting in 2015, if you are not a “meaningful user,” you will see a 1% reduction in Medicare payments. The reduction increases to 2% in 2016 and 3% in each subsequent year.

If the Secretary of Health and Human Services (HHS) finds that by 2017, the proportion of physicians who are meaningful EHR users is less than 75%, HHS may continue to ratchet down payments by 1% a year (but may not reduce payments below 95%). Hardship exceptions may be issued on a case-by-case basis, such as exceptions for physicians who practice in rural areas without adequate Internet access.

What is a Meaningful User?

According to HHS, to qualify for the EHR incentives, doctors must meet all of the following three criteria:

1. Demonstrate use of a “certified EHR technology” in a meaningful manner, including electronic prescribing.
2. Demonstrate that the certified EHR technology is connected in a manner that provides for the electronic exchange of medical records.
3. Submit information on clinical quality measures specified by the Secretary of HHS.

Current Situation

Jan 2010 update

On December 29, 2009 a draft standard was released for a period of public comments (march 2010), this draft standard identifies 23 items that providers must complete and track to qualify for the incentive program.

 Initial reactions to the new draft standard suggest that many groups will be submitting comments to ARRA and that some changes to the draft standard are possible.

Filopto already supports most of the 23 items identified and we are working on implementing the remainder. 

The draft rules state that providers wanting to be eligible for the incentives will need to be using  a certified EHR for a minimum of 90 days in 2011 or for 12 months in 2012 to qualify.

The ARRA testing and certification will be done by several organizations.  The Drummond Group (Texas) and CHITT are the first to identify their intent in becoming a certifying body, with other organization having also express interest.

As of February 17, 2010 no testing standard or certifying body has been established and none is expected until later in the year.

Certification may only be available in 2011.

Currently no standard for the eye care industry has been established.  The current schedule is that the research phase for the ARRA standard will be done in 2009 with the development of the standard in 2010 and implementation in 2011.  (Note that already some are stating that these dates can slip). 

Therefore, currently, the Federal ARRA testing criteria are not yet available for any EMR/EHR software.  

Once the federal government ARRA releases the EHR/EMR certification criteria (HHS certification), Filopto will review and make the changes required to be fully HHS certified.   According to the American Academy of Ophthalmology, “A lack of current certification does not have significance for eye care specialty needs.”   

What is a Certified EHR Technology?

Rules and criteria for how the government will administer the incentives are still under development. HHS announced that Medicare incentive payments to eligible hospitals will begin no sooner than October 2010, while  Medicaid incentive payments to physicians and hospitals will begin no sooner than January 2011.

National Coordinator for Health IT David Blumenthal noted that the federal government will seek "enormous" public input in defining "meaningful use of EHRs". He added that policymakers are focusing on outcomes of the use of EHRs, rather than on the processes involved in the technology.

Once HHS defines and releases the certification criteria, Accra Med Software Inc. will begin the process of complying with the new EHR HHS federal government certification standards immediately and will become compliant and certified.

Filopto is a leader in innovative eye care technology and is built using many international standards, once the ARRA standard and requirements are defined we will incorporate it in our product line.  We currently support the e-prescribe and E&M coding initiatives and will continue to offer you the tools that are needed for you to grow your business.