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Reimbursement Use HITECH as directed

Healthcare practitioners who want to take advantage of funds made available by ARRA must focus on the transition to EHR technology now.

By Frederick Turner T

he ability of American medicine to deliver high- quality care at affordable rates will depend, in part, on the ability of healthcare practitioners to incorporate high technology into their practices. One area where

federal law envisions the effi ciencies that accompany technology is the electronic management of medical records. This article examines the federal law which supports the funding of health information technology (HIT) and provides strategic suggestions for contracting for HIT and ultimately receiving federal funds. On Feb. 17, 2009, President Obama signed the American

Frederick Turner is a partner in the law fi rm of Turner & Turner, located in Tarrytown, N.Y., where his technology practice involves telecommunications and technology-related agreements. He wishes to thank David L. Snyder, Esq., managing partner of Snyder & Snyder, LLP, for his assistance with this article. Turner can be reached at FWTurner@

Recovery and Reinvestment Act (ARRA) into law. The new law is an enormous and unprecedented initiative to stimulate the U.S. economy and simultaneously promote certain policy objectives; by now most healthcare providers are aware that among the many provisions of ARRA is a concerted effort to improve the delivery of healthcare services by promoting the meaningful use of HIT. One area of HIT that holds particular promise for both improving the quality of care and producing increased ef- fi ciencies is the use of electronic health records (EHRs). The Health Information

Technology for Economic and Clinical Health (HITECH) Act,

enacted as part of ARRA, was signed into law to promote the adoption of HIT by authorizing incentive payments, through Medicare and Medicaid, to physicians and hospitals that demonstrate meaningful use of certifi ed EHRs – provided this technology is procured and introduced in accordance with a prescribed timeline.

The pool of federal HITECH funds has, understandably, spawned an army of vendors promoting a vast array of tech- nologies designed to fulfi ll the HITECH vision of integrating advanced technology into the delivery of healthcare services. But the window to qualify for the maximum incentive pay- ments is closing and will soon expire, leaving latecomers eligible for lesser (and progressively diminishing) fi nancial rewards and late-latecomers subject to penalties.

Many practitioners have focused on EHR as the key area of medical technology that should be part of any modern medical practice. The complexity of securing reimbursement for EHR

24 October 2011

investment, however, combined with the fi xed timeline for in- centive eligibility, has created an unfortunate air of urgency about selecting EHR technology. Adding to the overall uncertainty and anxiety about making a large capital investment is the undeniable fact that HITECH funding is subject to the shifting political winds that blow through Washington. This article presents a brief overview of the HITECH Act and offers healthcare provid- ers wrestling with EHR technology options some advice: Use HITECH only as directed, and consider consulting an attorney before committing to a course of treatment.


Only a small fraction of physicians presently use any EHR system, despite years of widespread availability and ample pro- motion. The reluctance to adopt is understandable: Healthcare providers are leery of incurring large setup and maintenance costs – disrupting existing, established routines – and are unsure that the fi nancial benefi ts will justify the cost. HITECH is designed to break through these real and perceived fears by providing suffi cient incentives – and ultimately penalties – to motivate individual practitioners and institutions to overcome inertia and skepticism and ride a great wave of adoption. Under HITECH, eligible professions (EP) will be eligible for up to $44,000 in reimbursements from Medicare and $65,000 from Medicaid for meaningful use of a certifi ed EHR starting in 2011. To qualify for these payments and other incentives, an EP must comply with and follow certain regulatory criteria that defi ne meaningful use and certifi ed EHRs, as well as a host of other key terms. In the short space provided here, the focus will be on the timeline for Medicare practitioners seeking the maximum incentive payments under HITECH, the necessity of selecting a certifi ed EHR provider to qualify for incentive pay- ments and the status of the meaningful-use standards required for monetary reimbursement. Finally this article discusses some of the many pitfalls that a healthcare provider will want to avoid in contracting with an EHR provider.

Healthcare professionals with Medicare patients who meet the requirements for meaningful use of a certifi ed EHR are eligible to receive up to 75 percent of the allowable Medicare reimbursement.

Medicare providers must act by no later than 2012 to claim the full incentive; given the lead times required to investigate and compare the many competing EHR systems, select a spe- cifi c technology, install the hardware and train personnel, time


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