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The American Recovery and Reinvestment Act (ARRA) is a $789 billion economic stimulus package, passed by the 111th United States Congress and signed into law in 2009 by President Barack Obama.

Health Information Technology for Economic and Clinical Health (HITECH) Act

The Health Information Technology for Economic and Clinical Health (HITECH) Act is part of ARRA. HITECH encourages adoption of comprehensive electronic medical records (EMR) systems by physicians and hospitals. The act allocates $19 billion to hospitals and physicians who demonstrate meaningful use of certified electronic medical records. The HITECH Act mandated the creation of the Office of the National Coordinator for Health Information Technology (ONC) within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS).

The Congressional Budget Office estimates that 90 percent of physicians and 70 percent of hospitals will use these systems by 2020 due to this legislation. The following sections summarize the major points of HITECH.


Financial Incentives

Under the economic stimulus plan, physicians and providers can qualify for $44,000 in Medicare incentives if they demonstrate "meaningful use (MU)" of an Electronic Health Record starting in 2011.

Practices with 30% or more of their patient population paying with Medicaid (20% for pediatricians) are eligible for stimulus incentive payments of up to $65,000. Practices operating in a "health provider shortage area" (HPSA) can qualify for bonus incentives. e-prescribing, Medicare's physician quality reporting initiative (PQRI) and Medicare Care Manage Performance (MCMP) can also increase your bonuses.

HITECH provides $20 Billion in potential incentives to physicians and hospitals for "meaningful users" of certified EMR systems. The elibility period runs from 2011-2016. Users (prior to 2014) may receive up to $18k for year one, $12k for year two, $8k for year three, $4k for year four, and $2k for year 5 of eligibility. Incentive is 10% higher in health professions shortage areas.

Meaningful use includes electronic prescribing, electronic information exchange, and reporting quality measures. "The eligible professional demonstates to satisfaction of the Secretary (HHS)... using certified EHR technology in a meaningful manner..."

$2 Billion is available as grants and loans to support health information technology research and development of a national health IT network (sections 13301 and 3013-3015.)

Financial Penalties

In section 3006, private entities, including government contractors, are not required to implement meaningful use of certified electronic medical record. However, The National Coordinator may assess a "nominal fee" for the adoption by health care provider of a certified EMR or for provding such technology.

For non-users, reimbursement decreases by 1% per year from 2015-2017. If the percentage of EMR users is still >75% of eligible professionals, reimbursement decreases by 1% per year, but not may not exceed a 5% reduction.

"Significant Hardship" exception to payment adjustments may apply on a case-by-case basis, for up to 5 years, to eligible non-users "such as in the case of an eligible professional who practices in a rural area without sufficient internet access."

As of 2014, less than half of eligible hospital had met either stage I or stage II of the Meaningful Use requirements, however. [1]

Operational Plan

With $167 billion dollars in American Recovery and Reinvestment Act Funding available for the Department of Health and Human Services, the ARRA legislation requires all federal agencies take responsible for managing ARRA.

  • The amount of and expected availability date of health information technology funding
  • The department of jurisdiction’s timeline for delivering completed projects
  • Measurables for tracking success

The Recovery Plan implementation effort will be headed up by the Office of Recovery Act Coordination, headed by Deputy Assistant Secretary for Recovery Act Coordination Dennis Williams. HHS has made transparency a priority, and the office is posting updates to these efforts on . HHS was required by ARRA to submit the implementation plan within 90 days of the passage of the ARRA legislation before funding would be released.

The Office of the National Coordinator for Health IT was required to submit its Operating Plan for spending the $2B appropriated funds prior to allocating any of its funds to projects. We understand the funding description in the operational plan is consistent with the goals of the strategic plan that the Office of the National Coordinator released in June 2008 , which will be the baseline for future ONC Strategic Plans and Operational Plans.

ONC is required to update the Operational Plan on November 1st of each year between 2009-2014. Office of the National Coordinator for Health Information Technology (ONC) Operational Plan

ONC Funding

  • Privacy and Security – $24.3 million
  • NIST – $20 million
  • Regional HIT Exchange – $300 million
  • Unspecified – $1.65 billion
  • Total, HIT - $2 billion

ONC Objectives

To improve the health of Americans and the performance of the nation’s health system through an unprecedented investment in health information technology (HIT) by:

  • Informing Health Care Professionals: Provide critical information to health care professionals to improve the quality of care delivery, reduce errors, and decrease costs.
  • Improving Population Health: Simplify collection, aggregation, and analysis of anonymized health information for use to improve public health and safety.

ONC Achievement Metrics

  • Increase physician adoption of EHRs
  • Increase the percentage of small practices with EHRs
  • Percent of physician offices adopting ambulatory EHRs in the past 12 months that meet certification criteria
  • Current performance measures for the Office for Civil Rights privacy measures:
  • Percentage of privacy cases resolved per privacy case received
  • Percentage of privacy complaints that require formal investigation, resolved within 365 days
  • Percentage of privacy complaints that do not require formal investigation, resolved within 180 days

Centers for Medicare and Medicaid Services (CMS)

Medicare and Medicaid Health IT Adoption Incentive Payments

CMS Funding:

  • Medicare Incentives – $23.1 billion (available in FY11)
  • Medicaid Incentives – $21.6 billion (available in FY11)
  • State Medicaid Administration – $1.05 billion
  • Medicare Administrative Costs – $745.0 million
  • Medicaid Administrative Costs – $300 million
  • Total, Mandatory Recovery Act HIT Funds = $46.8 billion

CMS Objectives

  • Promote and provide incentives for the adoption of certified electronic health records (EHRs)
  • Have eligible providers (EPs) and hospitals become meaningful users of certified EHR
  • Meaningful user:
  • Meaningful use of EHR technology
  • Information exchange
  • Reporting on measure using EHR

CMS Delivery Schedule

  • 2009 Milestones:
  • Coordinate with ONC to develop policies such as the definition of meaningful use
  • Develop proposed rules to allow public input to the incentive program policies
  • Plan system and other requirements needed to support the incentives program
  • Plan national outreach program
  • 2010 Milestones:
  • Conduct outreach to eligible professionals and providers and to State Medicaid Agencies
  • Develop systems to support the payment of incentives
  • Develop final rules to establish policies needed to pay incentives
  • Develop systems to monitor and evaluate incentive payments
  • No Sooner than October 2010:
  • Start to pay hospital incentives for Medicare and monitor payments
  • No sooner than January 2011
  • Start to pay eligible professionals for Medicare and monitor payments
  • Begin and monitor Medicaid incentive payments to eligible professionals and hospitals
  • 2011 – 2016:
  • Continue paying hospital incentives for Medicare and monitor payments
  • Continue paying eligible professionals incentives for Medicare and monitor payments
  • 2011 – 2021:
  • Continue paying Medicaid incentives to eligible professionals and hospitals and monitor payments
  • 2015 and thereafter:
  • Initiate payment reduction to Medicare hospitals and eligible professionals that fail to adopt EHR

CMS Achievement Metrics

  • Initial outcome measure will be developed by December 1, 2009
  • The measures below will be reported quarterly on
  • Meaningful use of certified EHRs by Eligible Professionals (Medicare) - # of EPs qualifying as meaningful users under the Medicare incentives program
  • Meaningful use of certified EHRs by Eligible Professionals (Medicaid) - # of EPs qualifying as meaningful users under the Medicaid incentives program
  • Meaningful use of certified EHRs by hospitals (Medicare) - # of hospitals qualifying as meaningful users under the Medicare incentives program
  • Meaningful use of certified EHRs by hospitals (Medicaid) - # of hospitals qualifying as meaningful users under the Medicaid incentives program

Privacy and Security

HITECH takes into account the Health Insurance Portability and Accountability Act (HIPAA) laws pertaining to health information standards and implementation. HITECH gives states' attorneys general the authority to prosecute HIPAA violations (section 13410). Civil and criminal penalties now apply to both Covered Entities and their business associates. Business associates of covered entities are now subject to the same HIPAA security provisions.

In the event of a security breach, all individuals with at risk unprotected health information must be notified by the Covered Entity, and Business Associates must notify their respective Covered Entities. All notifications must be made within 60 days from the first discovery of the security breach. Notification may be via certified mail, electronic mail, and/or public anouncement on the Covered Entities website and broadcast/print media.

Media notification is required if at least 500 individuals are potentially affected. In that case HHS Secretary is also notified to place a notice on the DHS website.

The American Recovery and Reinvestment Act of 2009, signed by President Obama on February 17, 2009, includes $19.2 billion in provisions for healthcare information technology (health IT). In its role as the leading authority on the appropriate implementation and use of Health IT.

Congress passed the Health Insurance Portability and Accountability Act (HIPAA) in 2003 as the federal law on privacy and security of health information. HIPAA places the burden on clinical providers, and other “covered entities” in the healthcare system (health insurance companies and other providers) to restore a patient’s ability to make privacy choices about their information. The American Reinvestment and Recovery Act was passed in 2009 and included numerous provisions affecting Health Information Management including health information technology (HIT) incentives, workforce education and training to facilitate implementation, maintenance of health information communications and technology (HICT), and a number of new privacy provisions (1). Federal HIPAA law does not preempt state law when the state law can be shown to hold compliance to a higher standard (1). The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act, was enacted to promote the adoption and meaningful use of health information technology.

Some new provisions under HITECH include the following.

  1. Covered entities who use or maintain an electronic health record (EHR), must provide individuals with an accounting of disclosures for treatment, payment, and operations of their protected health information (PHI) made during the three-year period prior to the request.
  2. Covered entities and their business associates must notify individuals whose unsecured PHI has been—or is reasonably believed to have been—accessed, acquired, or disclosed as a result of a privacy or security breach.
  3. Covered entities must withhold release of PHI to a health plan for payment or healthcare operations if the individual has paid for the service out of pocket in full and requests that the information not be released. This means health information made available to payers may have to be segregated from information used for patient care, if some of the treatment was paid for out of pocket by the individual.
  4. Covered entities that use or maintain EHRs must provide patients with copies of their PHI in electronic format if requested.


Some updates and clarifications to existing HIPAA regulations include some of the following to strengthen the privacy requirements.

  1. A change to the HIPAA rule, which permitted the covered entity to deny restrictions requested by an individual has been more strictly defined and the HITECH law requires covered entities to comply with HIPAA when they limit the PHI used, disclosed, or requested to the limited data set as defined by the privacy rule or to the minimum necessary to accomplish the intended purpose. [1]. HIM departments must be prepared to interpret and follow the guidelines and these restrictions on disclosure of information will add to the administrative burdens of HIM departments with integrated records used for treatment and billing purposes.
  2. Prohibition on the sale of electronic health records or PHI unless covered by a valid authorization, which must specify whether the entity receiving the PHI can further exchange the information for remuneration.
  3. Prohibition on marketing to individuals which includes communication by a covered entity or business associate that is about a product or service that encourages recipients of the communication to purchase or use the product or service are not allowed.
  4. Clarification of application of wrongful disclosure criminal penalties and improved enforcement of the laws. The HITECH Act addresses the privacy and security concerns associated with the electronic transmission of health information, through several provisions that strengthen the civil and criminal enforcement of the HIPAA rules. [2]

REFERENCES (1) American Health information Management Association "Analysis of Health Care Confidentiality, Privacy, and Security Provisions of The American Recovery and Reinvestment Act of 2009, Public Law 111-5" (2009).

The Health Information Technology for Economic and Clinical Health Act came in to existence as part of the American Recovery and Reinvestment Act of 2009. It imposes certain requirements on vendors of personal health records (and other related entities) in the event of certain security breaches relating to protected health information.

In February 2009, President Obama signed the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of his overall economic stimulus plan. The HITECH Act continues the effort of the Health Insurance Portability and Accountability Act (HIPAA) to encourage movement to electronic patient records and to deliver stricter data protection regulations for more secure patient privacy.


Enhanced breach notification requirements have major impact on providers, insurance companies and other EPs and their 'business associates':

Breach Notification Final Rule Update

The Interim Final Rule for Breach Notification for Unsecured Protected Health Information, issued pursuant to the Health Information Technology for Economic and Clinical Health (HITECH) Act, was published in the Federal Register on August 24, 2009, and became effective on September 23, 2009. During the 60-day public comment period on the Interim Final Rule, HHS received approximately 120 comments. [2]

HHS reviewed the public comment on the interim rule and developed a final rule, which was submitted to the Office of Management and Budget (OMB) for Executive Order 12866 regulatory review on May 14, 2010. [2] At this time, however, HHS is withdrawing the breach notification final rule from OMB review to allow for further consideration, given the Department’s experience to date in administering the regulations. This is a complex issue and the Administration is committed to ensuring that individuals’ health information is secured to the extent possible to avoid unauthorized uses and disclosures, and that individuals are appropriately notified when incidents do occur. We intend to publish a final rule in the Federal Register in the coming months.

Until such time as a new final rule is issued, the Interim Final Rule that became effective on September 23, 2009, remains in effect.


Health Resources and Services Administration (HRSA)

Community Health Centers Construction, Renovation, Equipment, and Health IT

Types of Available Grant Money:

  • Capital Improvement Grants- $850 million (for use on capital improvements, including EHR adoption) * WILL BE SPENT IN FY09
  • Health Information Technology Systems/Networks Grants- $125 million *WILL BE SPENT IN FY09
  • Facility Investment Grants- $512.5 million * WILL BE SPENT IN FY10
  • TOTAL: $1.5 billion

HRSA Objectives:

  • preserve and create jobs
  • promote economic recovery
  • all capital funding opportunities will support health center efforts to modernize facilities and systems, and in turn improve access to quality, comprehensive, culturally competent and affordable primary and preventive health care for medically underserved populations.

HRSA Delivery Schedule:

  • Capital Improvement Program Awards
  • Guidance Released: May 1, 2009
  • Application Phase: May 1 – June 2, 2009
  • Award Date: July 1, 2009
  • Project Period: July 1, 2009 – June 30, 2011
  • First Quarterly Report: October 1, 2009
  • HIT Systems/Networks Awards:
  • Guidance Released: FY 2009
  • Application Phase: FY 2009
  • Review Phase: FY 2009
  • Award Date: FY 2009
  • Project Period: FY 2009 – FY 2010
  • First Quarterly Report: October 1, 2009
  • Facility Investment Awards
  • Guidance Released: FY 2009
  • Application Phase: FY 2009
  • Review Phase: FY 2010
  • Award Date: FY 2010
  • Project Period: FY 2010 – FY 2011
  • First Quarterly Report: January 1, 2010

HRSA Achievement Metrics

HRSA will issue Quarterly reports on indicating the number of community health centers that have either adopted a certified Electronic Health Record, or have upgraded/expanded a current certified Electronic Health Record

Indian Health Service (IHS) Implementation Plan for Health IT Adoption

IHS Funding:

  • Certified Electronic Health Record Adoption

o $61.7 million (34.8 in FY09 and 26.9 in FY10)

  • CPOE
  • Clinical Decision Support
  • Quality Reporting
  • Health Information Exchange
  • Certification
  • Deployment
  • Personal Health Record Adoption

o$2.5 million ($1.7 million in FY09 and $0.8 million in FY10)

  • Telehealth and Network Infrastructure

o$16.7 million ($12.7 million in FY09 and $4.0 million in FY10)

  • Administration Costs- $4.1 million

IHS Objectives:

  • Deploy enhanced electronic health information technology to expand services, improve patient care quality, decrease service disparities, and expand access by Indians to out‐of‐network services and reimbursements.
  • Modernize and enhance network hardware and software capacity so that all Indian health care sites enhance the delivery of care and benefit from new health care information tools and security

IHS Delivery Schedule:

  • Certified EHR-Comprehensive Health Information

o Contract Supplements-April-June 2009

o New Awards- October-December 2010

o Work Milestones

  • Acquire Practice Management Solution
  • EHR Web Interface (2011)

oDelivery- July-September 2011

* Certified EHR-CPOE

oContract Supplements-April-June 2009

oNew Awards- October-December 2010

oWork Milestones

  • Pharmacy Drug File Enhancement
  • Consolidated Mail Outpatient Pharmacy

o Delivery- January-March 2011

* Certified EHR- Clinical Decision Support

o Contract Supplements-April-June 2009

o New Awards-None

o Work Milestones

  • Care Management Functionality (June 2010)
  • ER Dashboard Application (March 2010)

o Delivery- September 2010

* Certified EHR- Quality and Performance Reporting

oContract Supplements-April-June 2009

oNew Awards-None

o Work Milestones

  • Add 2 performance measures to Clinical Reporting System’s Select Measures Report

oDelivery- July 2010

* Certified EHR- Health Information Exchange

oContract Supplements (April-June 2009)

oNew Awards (October 2010)

oWork Milestones

  • Deploy Master Patient Index (January-March 2010)
  • Complete NHIN Connection (March 2010)

oDelivery- September 2010

Certified EHR- Certification

  • Contract Supplements-April-June 2009
  • New Awards (October 2010)
  • Work Milestones
  • Complete DHR Inpatient Certification
  • Delivery-(July 2010)
  • athenaClinicals Versions 0.27 and 10.6 from Athenahealth were certified in the CCHIT Certified 2006 and 2008 programs respectively.

Certified EHR- Deployment

  • Contract Supplements-April-June 2009
  • New Awards: None
  • Work Milestones
  • Implement use of 80 RPMS in Alaskan Villages (July 2011)
  • Delivery- September 2011

Personal Health Record Adoption

  • Contract Supplements-April-June 2009
  • New Awards: (October 2010)
  • Work Milestones
  • Complete Requirements for Initial PHR (December 2010)

oDelivery- (April-June 2010)

Telehealth and Network Infrastructure

  • Contract Supplements-April-June 2009
  • New Awards: (July-September 2009)
  • Delivery- (April-June 2010)
  • Progress reports will be posted Quarterly on

== HHS, AHRQ, and NIH Comparative Effectiveness Research

Comparative Effectiveness Research Types of Funding Available ==

  • HHS Discretionary Funding- $400 million
  • AHRQ- $300 million
  • NIH- $400 million

Comparative Effectiveness Research Objectives

  • Comparative effectiveness research is the conduct and synthesis of systematic research comparing different interventions and strategies to prevent, diagnose, treat and monitor health conditions.
  • The purpose of this research is to inform patients, providers, and decision-makers, responding to their expressed needs, about which interventions are most effective for which patients under specific circumstances.
  • Research will include medications, procedures, medical and assistive devices and technologies, behavioral change strategies, and delivery system interventions.

Comparative Effectiveness Research Delivery Schedule

  • HHS will release delivery schedule before June 30, 2009

Comparative Effectiveness Research Achievement Metrics

  • The Comparative Effectiveness Research Council will meet 14 times in FY09 and 6 times in FY10 to direct the research effort.

HHS Information Technology Security

HHS IT Security Types of Funding

  • HHS Information Technology Security-$50 million ($31.9 million in FY09, $18.1 million in FY10)

HHS IT Security Objectives

  • provide the ability to rapidly determine the enterprise security risk posture of operational IT systems and computer networks throughout HHS by funding the following areas:

oSecurity Incident Response & Coordination

  • OPDIV Security Engineering and Technical Staff Support
  • Enterprise-wide Security Situational Awareness
  • Endpoint (Desktop Computer) Protection, Internet Content Web Security Filtering, and Data Loss Prevention
  • Enhanced OPDIV Security Architecture, Engineering and Implementation

HHS IT Security Achievement Metrics

  • Percentage of HHS laptops and desktops secured with encryption
  • Percentage of HHS enterprise network infrastructure monitored by the CSIRC with automated intrusion detection systems
  • Percentage of HHS IT systems protected with advanced Internet content filtering and anti-malware solutions
  • Percentage of HHS critical IT systems audit logs reviewed by CSIRC and OPDIV

This policy was enacted in 2009 to mandate implementation of EMR technology across the country. The mandate encouraged health care providers to invest in EMR technology and provides financial incentives to providers who participate. United States American Reinvestment Act of 2009, which is a complex economic stimulus package written during the administration of George W Bush (43rd President of the United States of America) and signed into law by Barack H Obama (44th President of the United States of America) is the funding and legislative vehicle to instigate economic development, job creation and address the implementation of EMR electronic medical record (EMR) technology that has not been implemented to this point.

The Congressional Budget Office (CBO), in its paper on Evidence on the costs and Benefits of health information technology points out that President Bush, in 2004, through an Executive Order, first tasked the nation with a 10 year mandate to embrace EMRs and also created the Office of the National Coordinator (ONC) to oversee this massive initiative (May 2008). [3]


The legislation consists of two (2) parts. (1) To preserve and create jobs and promote economic recovery. (2) To assist those most impacted by the recession. (3) To provide investments needed to increase economic efficiency by spurring technological advances in science and health. (4) To invest in transportation, environmental protection, and other infrastructure that will provide long-term economic benefits. (5) To stabilize State and local government budgets, in order to minimize and avoid reductions in essential services and counterproductive state and local tax increases


Agriculture, Rural Development, Food And Drug Administration, and Related Agencies, Commerce, Justice, Science, And Related Agencies, Department Of Defense, Energy And Water Development, Financial Services And General Government, Department Of Homeland Security Interior, Environment, And Related Agencies Departments Of Labor, Health And Human Services, And Education, And Related Agencies, Legislative Branch, Military Construction And Veterans Affairs And Related, Agencies, State, Foreign Operations, And Related Programs, Transportation, Housing And Urban Development, And Related Agencies, Health Information Technology, State Fiscal Stabilization Fund, Accountability And Transparency, General Provisions—This Act


Division 'B' Tax provisions—Assistance for unemployed workers and struggling families —Premium assistance for COBRA benefits. —Medicare and Medicaid health information technology; Miscellaneous Medicare provisions. —State fiscal relief. —Broadband technology opportunities program —Limits on Executive compensation.

Title IV: Medicare and Medicaid Health Information Technology, Miscellaneous Medicare

The integral portion of the legislation to implement EMR technology is Meaningful Use (MU). MU is the legislative vehicle to fund HITECH, which gives incentive payments through Medicare and Medicaid to clinicians and hospitals when they use EHRs privately and securely to achieve the goals of MU.

The Purpose of Meaningful Use:

  1. Improve quality, safety, efficiency, and reduce health disparities.
  2. Engage patients and families.
  3. Improve care coordination.
  4. Ensure adequate privacy and security protections for personal health information.
  5. Improve population and public health.

Some of the Core Objectives for Meaningful Use (Stage 1) are as follows (these are three out of thirteen core objectives needed to be met by eligible professionals):

  1. Use Computerized Provider Order Entry ([CPOE]) for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per State, local, and

professional guideline [4]

Record all of the following demographics:

  1. Preferred language
  2. Gender
  3. Race
  4. Ethnicity
  5. Date of birth
  6. Date and preliminary cause of death in the event of mortality in the eligible hospital or CAH

Record and chart changes in the following vital signs:

  1. Height
  2. Weight
  3. Blood pressure
  4. Calculate and display body mass index (BMI)
  5. Plot and display growth charts for children 2–20 years, including BMI

It is noteworthy to add that eligible professionals and hospitals have a different amount of core objectives and menu objectives that must be met in the Stage 1 of meaningful use. Eligible professionals must meet a total of 13 core objectives and 5 menu measures for a total of 18 objectives while eligible hospitals and Critical Access Hospitals must meet 11 core objectives and 5 menu measures for a total of 16 objectives to meet. Stage 2 of meaningful use Eligible providers must meet 17 core objectives and 3 menu measures for a total of 20 objectives while eligible hospitals must meet 16 core objectives and 3 menu measures for a total of 19 objectives. Stage 3 objectives is still being finalized and should be released in March of 2015.

Meaningful use stage 1

The first stage of meaningful use, it seemed as if the government wanted eligible providers and hospitals to focus on implementation of EHR systems and collect certain patient data. Many hospitals and providers were still documenting on paper with little or no adoption of electronic health information implemented. Stage 2 of meaningful use seems to focus on how the data that is being collected is being used and disseminated. For instance, patients must now be able to view, transmit and download information regarding their hospital visit through a patient portal. This measure is all about patient involvement with their health information. Another focus for Stage 2 is intraoperability and the sharing of information with follow up providers. Many times when patients are admitted to a hospital their outside providers are never notified.

In essence, for ease of use and reference, it will be a good idea to summarize the various stages of Meaningful Use (MU) as, Stage-I - "Adoption" (of Electronic Medical Records), Stage-II "Exchange" (of data across EMR systems to make them interoperable) and Stage-III "Use of that data" (for Clinical Decision Support).

Total health care spending: $155.1 billion.

In her article dated 1/5/2015, on, a daily publication of California Health Foundation, "12 experts weigh in on HIT progress, disappointments in 2014 and hopes for 2015", Kate Ackerman, Editor in Chief points out that: [5]

"Incentive payments for eligible hospitals and professionals participating in the meaningful use program reached $25.7 B in 2014".

She goes on to add:

"According to ONC, more than 93% of eligible hospitals and 76% of eligible professionals now meaningfully use Health IT". [5] Although the 10 year Presidential mandate has included all three stages, we can reasonably infer that Stage-I - "Adoption" has been successful.

She also states that:

"However, at the end of the year, CMS announced that more than 257,000 eligible professionals will be penalized in 2015 for failing to meet Medicare meaningful use requirements". [5]

This is a clear indication that, the Government, while willing and able to provide financial incentives for those that comply with this mandate, will also not hesitate to penalize those that don't comply, thereby making it both affordable and necessary for the well being of the society.

Health Information Technology

Medicare and Medicaid EHR Incentive Program will provide incentive payments to eligible professionals (EP), eligible hospitals (EH) and critical access hospitals (CAH) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.

$25.8 billion for health information technology investments and incentive payments to physicians, hospitals and health care providers.

As enacted in 2009, mental health treatment facilities were excluded from the financial incentives available to most hospitals. The Behavioral Health Information Technology Act of 2011 extended the HITECH definition of “provider” and “facility” to include those for behavioral and mental health care. This incentivized proliferation of interoperable health information technology across psychiatric and primary health where continuity is vital. [2]

old references

old References

  1. Economic Stimulus for the Healthcare IT Industry [3]
  2. Summary of HHS Recovery Operational Plan - May 2009 [4]

old References

  1. "Public Law 111-5 [5] (retrieved 2/28/2010)
  2. "Title IV-Health Information for Economic and Clinical Health Act" [6] (retrieved 2/28/2010)
  3. Full text of ARRA [7]


  1. Cassidy, Bonnie S; King, Elaine; Wheatley, Vicki. "ARRA’s Impact on HIM." Journal of AHIMA 81, no.2 (February 2010): 48-49; 56.
  2. 2.0 2.1 2.2 U.S. Department of Health & Human Services: HITECH Act Enforcement Interim Final Rule
  3. Evidence on the Costs and Benefits of Health Information Technology. (2008). Congress of the United States Congressional Budget Office.
  4. Eligible Professional Meaningful Use Core Measures, Stage 1.
  5. 5.0 5.1 5.2 12 Experts Weigh In on Health IT Progress, Disappointment in 2014 & Hopes for 2015. January 5, 2015.