On February 17, 2009, President Obama signed the American Recovery and Reinvestment Act (ARRA) into law. The $790 billion economic stimulus package includes many health care policy provisions. For example, ARRA provides:
- Almost $20 billion in funding for nation-wide health information technology;
- Additional HIPAA federal privacy and security provisions;
- Help for unemployed workers to maintain health insurance coverage under COBRA;
- A reversal of a Medicare payment cut to hospice providers;
- Certain corrections to the Medicare, Medicaid, and SCHIP related to Medicare payments for long-term care hospitals;
- $1.1 billion to support comparative effectiveness research;
- $1 billion for a new Prevention and Wellness Fund;
- An increase in states’ disproportionate share hospital allotments;
- $87 billion in additional federal matching funds over two years to help states maintain their Medicaid programs in light of state budget shortfalls; and
- Medicaid prompt payment requirements for nursing facilities and hospitals.
Title XIII of ARRA, the Health Information Technology for Economic and Clinical Health Act (HITECH Act) addresses health information technology (HIT). The HITECH Act includes approximately $20 billion allocated to health information technology (HIT) projects. Projects include investment in HIT infrastructure, a nationwide health information network, and Medicare and Medicaid reimbursement incentives to assist physicians and hospitals in implementing electronic health record (EHR) technology.
The Office of the National Coordinator of Health Information Technology (ONCHIT), a unit of the Department of Health and Human Services (DHHS) is charged with adoption and implementation of HIT standards. ARRA also establishes the Federal Coordinating Council for Comparative Effectiveness Research to improve the quality of health care.
ARRA directs ONCHIT, in consultation with other federal agencies, to update “The ONC-Coordinated Federal Health IT Strategic Plan.” ARRA further directs DHHS to establish by December 31, 2009 an “initial set of standards, implementation specifications, and certification criteria” for national interoperability HIT standards. DHHS may use any existing national interoperability HIT standards that DHHS has already recognized, such as the six HITSP interoperability specifications, in meeting its December 31, 2009 rulemaking deadline.