On Feb. 13, 2009, Congress passed the American Recovery and Reinvestment Act of 2009 at the urging of President Obama, who signed it into law four days later. A direct response to the economic crisis, the Recovery Act has three immediate goals:

• Create new jobs and save existing ones
• Spur economic activity and invest in long-term growth
• Foster unprecedented levels of accountability and transparency in government spending

The Recovery Act intends to achieve those goals by:

• Providing $288 billion in tax cuts and benefits for millions of working families and businesses
• Increasing federal funds for education and health care as well as entitlement programs (such as extending unemployment benefits) by $224 billion
• Making $275 billion available for federal contracts, grants and loans
• Requiring recipients of Recovery funds to report quarterly on how they are using the money. All the data is posted on Recovery.gov so the public can track the Recovery funds.
*Recovery.gov

Certification Commission for Healthcare Information Technology - To develop criteria and evaluation processes for certifying EHRs and the infrastructure or network components through which they interoperate.

Centers for Medicare & Medicaid Services
• Organization to ensure effective, up-to-date health care coverage and to promote quality care for beneficiaries.
*CMS Website

An EHR (electronic health record) is a real-time patient health record with access to evidence-based decision support tools that can be used to aid clinicians in decision making. The EHR can automate and streamline a clinician's workflow, ensuring that all clinical information is communicated. It can also prevent delays in response that result in gaps in care. The EHR can also support the collection of data for uses other than clinical care, such as billing, quality management, outcome reporting, and public health disease surveillance and reporting. (ONC)

An EMR (electronic medical record) is a real-time patient health record with access to evidence-based decision support tools that can be used to aid clinicians in decision making. The EMR can automate and streamline a clinician's workflow, ensuring that all clinical information is communicated. It can also prevent delays in response that result in gaps in care. The EMR can also support the collection of data for uses other than clinical care, such as billing, quality management, outcome reporting, and public health disease surveillance and reporting. (ONC)

Eligible Professionals:
Medicare
• Doctor of Medicine or Osteopathy
• Doctor of Dental Surgery or Dental Medicine
• Doctor of Podiatric Medicine
• Doctor of Optometry
• Chiropractor * (Spine Subluxation)
Medicaid
• Physician
• Dentist
• Certified Nurse Mid-wife
• Nurse Practitioner
• Physician Assistant (Rural Health Clinic/ FQHC)

Two regulations have been released, one of which defines the “meaningful use” objectives that providers must meet to qualify for the bonus payments, and the other which identifies the technical capabilities required for certified EHR technology.

•Incentive Program for Electronic Health Records: Issued by the Centers for Medicare & Medicaid Services (CMS), this final rule defines the minimum requirements that providers must meet through their use of certified EHR technology in order to qualify for the payments.

•Standards and Certification Criteria for Electronic Health Records: Issued by the Office of the National Coordinator for Health Information Technology, this rule identifies the standards and certification criteria for the certification of EHR technology, so eligible professionals and hospitals may be assured that the systems they adopt are capable of performing the required functions.

The Medicaid EHR Incentive Program will provide incentive payments to eligible professionals, eligible hospitals, and CAHs as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology in their first year of participation and demonstrate meaningful use for up to five remaining participation years.
• The Medicaid EHR Incentive Program is voluntarily offered by individual states and territories and may begin as early as 2011, depending on the state.
• Eligible professionals can receive up to $63,750 over the six years that they choose to participate in the program.
• Eligible hospital incentive payments may begin as early as 2011, depending on when the state begins its program. The last year a Medicaid eligible hospital may begin the program is 2016. Hospital payments are based on a number of factors, beginning with a $2 million base payment.
Protected by the Medicare Trust Fund, the Medicare and Medicaid funds for Meaningful Use incentives are not subject to changes in annual appropriations and are therefore protected for disbursement under this program. Medicare and Medicaid funds for Meaningful Use are administered by the Centers for Medicare and Medicaid Services (CMS).

The Medicare EHR Incentive Program will provide incentive payments to eligible professionals, eligible hospitals, and CAHs that demonstrate meaningful use of certified EHR technology.
• Participation can begin as early as 2011.
• Eligible professionals can receive up to $44,000 over five years under the Medicare EHR Incentive Program. There's an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area (HSPA).
• To get the maximum incentive payment, Medicare eligible professionals must begin participation by 2012.
• Incentive payments for eligible hospitals and CAHs may begin as early as 2011 and are based on a number of factors, beginning with a $2 million base payment.
• Important! For 2015 and later, Medicare eligible professionals, eligible hospitals, and CAHs that do not successfully demonstrate meaningful use will have a payment adjustment in their Medicare reimbursement.
Protected by the Medicare Trust Fund, the Medicare and Medicaid funds for Meaningful Use incentives are not subject to changes in annual appropriations and are therefore protected for disbursement under this program. Medicare and Medicaid funds for Meaningful Use are administered by the Centers for Medicare and Medicaid Services (CMS).

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administration’s health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care. ONC is organizationally located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS).