Health Industry Washington Watch : Washington DC Healthcare Industry Law Firm : Reed Smith : Health Industry Washington Watch : Regulations, Medicare/Medicaid, Governmental Organizations

This post was written by Jacqueline B. Penrod.

On March 10, 2010, the Office of the National Coordinator for Health Information Technology (ONC) published a proposed rule to establish certification programs for health information technology (HIT). The rule follows the publication of two other rules on January 13, 2010 that addressed the adoption of certification standards and criteria and established a proposed definition of “meaningful use” that will be applied to determine the initial incentive payments to providers pursuant to the American Recovery and Reinvestment Act of 2009. The March 10 proposed rule describes two certification programs. The first program would establish a temporary certification process so that organizations will be able to test and certify complete electronic health records (EHR) and/or EHR modules; the second program would be more comprehensive and is designed to replace the temporary program with a permanent one. The purpose for proposing a temporary program initially is to assure the availability of certified EHR technology before providers must demonstrate meaningful use in order to be eligible to receive payments under the Medicare and Medicaid EHR Incentives Program. It is anticipated that there will be a separate final rule issued for each of these programs. Comments on the temporary certification program must be submitted by April 9, 2010; comments on the permanent certification program are due May 10, 2010.

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The HHS Office of Civil Rights (OCR) has indicated that the agency will be delaying enforcement of the HITECH Act provisions under which Business Associates are required to directly comply with the HIPAA Privacy and Security Rules.  Although the statutory compliance date for the Business Associate requirement is February 17, 2010, Adam Greene, an OCR attorney, "unofficially" indicated in a recent speech that HHS will be exercising its enforcement discretion to not enforce the new provision until after a proposed and final rule on this subject have been promulgated.

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On February 18, 2010, the Department of Health and Human Services (HHS) announced that it will be providing states with an additional $4.3 billion in federal funding to offset the cost of Medicare Part D prescription drug coverage for individuals eligible for both Medicare and Medicaid. The increased aid results from HHS applying the temporary enhanced Federal Medical Assistance Percentage (FMAP) payments authorized by the American Recovery and Reinvestment Act (ARRA) to state “clawback” payments (state payments designed to offset the added expense to Medicare Part D for assuming drug costs for dual eligibles). The temporary adjustment in the clawback payments will apply for the period of October 1, 2008 through December 31, 2010. 

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The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the ARRA, requires covered entities to report to HHS within 60 days of discovery any breaches of protected health information that affect 500 or more individuals. The HHS Office for Civil Rights (OCR) has posted a list of covered entities that have reported such breaches of protected health information, and OCR will continue to update the list as it receives new reports. 

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The Obama Administration has released its proposed federal budget for fiscal year (FY) 2011. In its budget documents, the Administration reaffirms its commitment to enacting health reform legislation, and it assumes $150 billion in federal savings attributable to health reform over the 2011-2020 period. The document states that the budget “supports health insurance reform” by expanding patient-centered health research on treatment effectiveness; increasing investment in health information technology, prevention, and wellness activities; and initiating Medicare payment reform demonstrations. Nevertheless, the budget does not outline comprehensive reform plans, nor does it repeat the sweeping Medicare and Medicaid budget savings proposals included in the Administration’s proposed FY 2010 budget. In other health policy areas, the budget would: expand funding for biomedical research, health centers for the medically underserved, and HIV/AIDS prevention and treatment; provide a six-month, $25.5 billion extension of the American Recovery and Reinvestment Act (ARRA) temporary increase in federal Medicaid matching funds; expand Medicare and Medicaid anti-fraud efforts; address high-risk billing activity associated with the Medicaid drug benefit; expand Food and Drug Administration (FDA) user fees; and fund an FDA to “provide regulatory pathways for new technologies such as biosimilars.”  A separate FDA press release on the budget proposal announces that the Administration is seeking $4.03 billion for the FDA in FY 2011, which is a 23% increase over the agency’s current $3.28 billion budget.  The following initiatives are the major components of the FDA's FY 2011 budget increase:  transforming food safety ($318.3 million); Protecting Patients Initiative ($100.8 million); advancing regulatory science ($25.0 million); and tobacco-related initiatives ($215.0 million).  Note that many provisions of the proposed budget would require Congressional approval to implement. To that end, Congress is holding a series of hearings on the proposal, including Senate Finance and House Energy and Commerce Committee hearings focusing on the health policy provisions of the budget. Several other budget hearings scheduled for the week of February 8 were postponed due to extreme weather conditions in the Washington, D.C. area.

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HHS published a notice February 2, 2010 announcing the adjusted Federal Medical Assistance Percentage (FMAP) rates, as provided under the ARRA, for the first quarter of FY 2010 (which began October 1, 2009).

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This post was written by Jacqueline B. Penrod.

On January 13, 2010, the Office of the National Coordinator for Health Information Technology (ONC) published an interim final rule (the “Standards Rule”) to adopt an initial set of standards, implementation specifications, and certification criteria for health information technology. Designed to be “the first step in an incremental approach . . . to enhance the interoperability, functionality, utility and security of health information technology and to support its meaningful use,” the Standards Rule outlines capability requirements for electronic health records (EHR) systems and establishes standards for the exchange of information between systems. It also provides guidance with respect to maintaining the privacy and security of patient data and adherence to the requirements of the HIPAA Privacy Rule.   The rule is effective February 12, 2010, although comments will be accepted until March 15, 2010. Also on January 13, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule (the “Incentive Rule”) implementing the EHR incentive payments provided for in the American Recovery and Reinvestment Act of 2009 (ARRA). Under the ARRA, hospitals and eligible professionals (EP) may qualify to receive incentive payments under the Medicare fee-for-service, Medicare Advantage, and Medicaid programs if they adopt and meaningfully use certified electronic health technology. Beginning in 2015, hospitals and EPs that do not adopt and meaningfully use such technology will have downward payment adjustments. The Incentive Rule sets forth a broad outline of the manner in which providers will be eligible for EHR incentive payments. It includes the long-awaited initial criteria to determine whether a hospital or EP is a “meaningful user” of certified EHR technology, as well as the methods which will be used to calculate the payments and adjustments. Functionality and clinical quality measures for each type of provider are proposed for each program. The Incentive Rule proposes a three-stage approach to assessing meaningful use of EHR technology, with progressive reliance on and use of electronic medical records. While the criteria for Stage 1 are set forth in detail, the criteria for the remaining two stages are expected to be developed later, taking into account progress in technology and within the health industry. The meaningful use criteria will be updated on a biennial basis; proposed criteria for Stages 2 and 3 are anticipated to be released in 2011 and 2013, respectively. The significant impact that the meaningful use criteria may have on reimbursement for providers warrants close scrutiny. The proposed rule is posted here. CMS will accept comments on the proposed rule until March 15, 2010. Reed Smith is preparing a client bulletin summarizing the Incentive Rule.

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The House has approved a temporary extension of enhanced Medicaid matching funds as part of legislation designed to spur job creation. H.R. 2847, passed on December 16, 2009, would provide $23.5 billion to extend higher federal Medicaid matching fund levels under the American Recovery and Reinvestment Act of 2009 (ARRA) through June 2011. The bill also would provide $12.3 billion to extend from nine to 15 months the 65% COBRA health insurance subsidy for individuals who have lost their jobs. The bill, the “Jobs For Main Street Act of 2010,” now moves to the Senate, where the outlook is questionable given that chamber’s current focus on health reform legislation. 

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HHS has published a notice finalizing the methodology for calculating the higher FMAP amounts available to states under the ARRA. The adjusted FMAPs are applicable to the third and fourth quarters of FY 2009.

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On August 24, 2009, the Department of Health and Human Services (HHS) issued an interim final rule with comment period to implement an American Recovery and Reinvestment Act of 2009 provision requiring notification of breaches of unsecured protected health information. For purposes of determining what information is “unsecured protected health information,” HHS also is updating its guidance specifying the technologies and methodologies that render protected health information unusable, unreadable, or indecipherable to unauthorized individuals. The interim final rule is effective September 23, 2009. HHS will accept comments on the interim final rule until October 23, 2009, while comments on information collection requirements associated with the rule are due by September 8, 2009. In a related development, on August 25, 2009, the Federal Trade Commission (FTC) published a final rule that requires vendors of personal health records and related entities to notify consumers when the security of their individually identifiable health information has been breached, in compliance with the ARRA. The FTC rule is effective September 24, 2009, and full compliance is required by February 22, 2010. A Reed Smith analysis of the FTC rule is posted here, and a summary of the HHS rule is available here.   

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On August 4, 2009, HHS published a notice with comment period describing the methodology for calculating the higher federal matching funds available under the American Recovery and Reinvestment Act of 2009 (ARRA). Specifically, the ARRA provides for temporary increases in the Federal Medical Assistance Percentage (FMAP) rates to provide fiscal relief to states and to protect and maintain state Medicaid programs in a period of economic downturn. The increased FMAP rates apply during a recession adjustment period (October 1, 2008 through December 31, 2010). The percentages listed in the rule are for the third quarter of FY 2009, beginning April 1, 2009 and ending June 30, 2009. HHS will accept comments on the rule through August 19, 2009. 

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CMS has recently issued guidance to state survey agencies on a number of issues, including: Interpretive Guidelines for Long-Term Care Facilities (infection control programs); Surveying Facilities That Use Electronic Health Records; EMTALA Requirements and Options for Hospitals in a Disaster; Clarification of Ambulatory Surgical Center Interpretive Guidelines; Initial Surveys of CAH Distinct Part Units Changed to Tier 4 Priority Status; and Priority Order of Quality Indicator Survey National Implementation in States. In addition, CMS has issued guidance to State Medicaid Directors on the ARRA “prompt pay” requirements.

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The Agency for Healthcare Research and Quality (AHRQ) has announced the availability of funding for the development of a clinical registry of orthopedic devices, drugs, and procedures, with an initial focus on hip and knee replacements.  The initiative seeks to enable comparative effectiveness and safety studies regarding various orthopedic procedures and devices.

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The American Recovery and Reinvestment Act (ARRA) included a major expansion of federal efforts to compare the effectiveness of different medical treatments, including more than $1 billion in funding for comparative effectiveness research (CER). Two federal panels recently released reports on CER priorities under the ARRA. First, the Federal Coordinating Council for Comparative Effectiveness Research issued its recommendations for a strategic framework for CER activity and investments. The Council recommended that the primary investment for CER funding should be data infrastructure (e.g., linking current data sources to enable answering CER questions, development of distributed electronic data networks and patient registries, and partnerships with the private sector). Other key areas for research identified by the Council are:

• Medical and assistive devices (e.g., comparing rehabilitative devices).
• Procedures and surgery (e.g., evaluating surgical options or surgery versus medical management).
• Diagnostic Testing (e.g. comparing imaging modalities for evaluating certain types of cancer).
• Behavioral change (e.g., developing and assessing smoking cessation programs).
• Delivery system strategies (e.g., testing two different discharge process care models on readmission rates or testing two different medical home models on preventing hospital admissions and improving quality of life).
• Prevention (e.g., comparing two interventions to prevent or decrease obesity, comparing strategies for reaching populations that do not access the health care system with prevention efforts).

Separately, on June 30, 2009, the Institute of Medicine (IOM) released its ARRA-mandated report on "Initial National Priorities for Comparative Effectiveness Research," which identifies 100 heath topics that should get priority attention and funding under federal comparative effectiveness efforts. Priority topics include health delivery, health disparities, cardiovascular care, geriatrics, psychiatry, endocrinology, and oncology/hematology, among many others. The IOM cautions, however that comparative effectiveness research “will not yield real improvements unless the results are adopted by health care providers and organizations and integrated into clinical practice.”   A Washington Legal Foundation “Critical Legal Issues Working Paper Series” article by Reed Smith attorneys Areta Kupchyk and Kathleen McGuan entitled “Comparative Effectiveness: Refining the Standards for FDA Approval & CMS Coverage,” is available here.   

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On June 17, 2009, CMS issued guidance to state Medicaid directors on implementation of the American Recovery and Reinvestment Act of 2009 (ARRA) Medicaid and Children’s Health Insurance Program provisions, including details on payments that should not be counted for purposes of eligibility for federal programs. 

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CMS is working with states to implement a new survey process to promote better infection control practices in ambulatory surgical centers (ASCs). Specifically, $10 million of ARRA funding is being made available to states in FYs 2009 and 2010 to implement a new survey process and increase the frequency of inspections for ASCs. In addition to remedying current infection control lapses and preventing future healthcare-associated infections, the funds will help states avoid otherwise planned layoffs or furloughs and/or recruit additional surveyors to inspect more ASCs.  

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CMS has announced a website dedicated to information on the health information technology provisions in the American Recovery and Reinvestment Act of 2009, including information on Medicare and Medicaid incentives for electronic health records adoption. 

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On June 16, 2009, the federal Health Information Technology (HIT) Policy Committee met to begin defining what constitutes "meaningful use" of electronic health records (EHRs) under the American Recovery and Reinvestment Act, which authorizes Medicare and Medicaid incentive payments to eligible health care providers who demonstrate "meaningful use" of a certified EHR.  At the June 16, 2009 meeting, the Committee received recommendations from its Meaningful Use Workgroup on the definition of meaningful use, and the Committee is accepting comments on the Workgroup’s update until June 26, 2009. The Centers for Medicare & Medicaid Services (CMS) expects to issue a proposed rule later this year on the incentive program and the definition of meaningful use, and the public will have another opportunity to comment at that time.

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A Department of Health and Human Services (HHS) Office of Inspector General (OIG) audit found that HHS correctly calculated temporary increases in Medicaid’s Federal Medical Assistance Percentages (FMAP) in accordance with Recovery Act requirements.

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On June 10, 2009, the Federal Coordinating Council for Comparative Effectiveness Research is holding a meeting in Washington D.C. to hear public comments on the Council's efforts to coordinate research and guide investments in comparative effectiveness research funded by the American Recovery and Reinvestment Act of 2009 (ARRA). The Council is soliciting comments on:

• What types of investments in infrastructure for comparative effectiveness research should the Coordinating Council consider?
• What criteria should the Coordinating Council consider when evaluating different investment options?
• What federal government activities in the area of comparative effectiveness research should the Coordinating Council focus its attention on?
• How can the Coordinating Council best foster integration of these activities across the programs managed by the Departments of Health and Human Services, Defense, and Veterans Affairs?
• What steps should the Coordinating Council consider to help ensure that public- and private-sector efforts in the area of comparative effectiveness research are mutually supportive?
• What information on the Coordinating Council’s activities would be most useful?

Individuals seeking to participate should register by June 8. In addition, the meeting will be web cast and individuals may participate by audioconference. 

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On May 28, 2009, the HHS Office of the National Coordinator for Health Information Technology (ONC) published a notice announcing a draft description of a program establishing regional extension centers to assist providers seeking to adopt and become meaningful users of health information technology, as required under the American Recovery and Reinvestment Act of 2009 (ARRA). While actual ARRA funding awarded per center Is expected to vary based on the number and types of providers proposed to be served and the amount of matching funds proposed by each regional center, the ONC anticipates an average award value on the order of $1 million to $2 million per center, with a maximum award of $10 million. Comments on the draft plan will be accepted until June 11, 2009.

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HHS has released a series of American Recovery and Reinvestment Act (ARRA) Implementation Plans, detailing how the department is addressing key aspects of the legislation. Specifically, the plans highlight the following areas: Improving and Preserving Health Care (including increases in the Medicaid Federal Medical Assistance Percentage); Accelerating the Adoption of Health Information Technology; Strengthening Scientific Research and Facilities; Improving Children and Community Services; Strengthening Community Healthcare Services; Supporting Comparative Effectiveness Research; Promoting Prevention and Wellness; and Improving Accountability and Information Technology Security. The updates include funding tables and discussions of objectives and planned activities, among other features.

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The HHS Office of Inspector General (OIG) has posted its first Monthly Recovery Update Report providing an accounting of steps the OIG is taking to safeguard ARRA funding, such as review of HHS agency spending plans and development of grant audit guides. It also outlines planned OIG activities, including audits of state use of increased Federal Medical Assistance Percentage spending and audits of agency grant award processes.

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The Office of the National Coordinator for Health Information Technology has announced the first meeting of the HIT Policy Committee on May 11, 2009. In addition, the first meeting of the HIT Standards Committee is scheduled for May 15, 2009. Both Committees were established by the ARRA to help guide the expansion of federal health IT efforts.

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On April 29, 2009, the Obama Administration released a report on HHS progress over the first 100 days of the Obama Administration. The report addresses implementation of the American Recovery and Reinvestment Act of 2009, efforts to promote health reform, regulatory review initiatives, and release of the President's proposed budget, among other things.

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To promote transparency, HHS has established a new searchable database of communications with registered lobbyists on ARRA issues. HHS is reporting verbal and written communications within three business days of their occurrence.  

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HHS has recalculated the Federal Medical Assistance Percentages (FMAPs) for the first two quarters of fiscal year (FY) 2009 pursuant to the American Recovery and Reinvestment Act (ARRA). The new percentages are effective from October 1, 2008 through March 31, 2009.

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CMS issued a letter to State Survey Agency Directors on April 17, 2009 regarding ARRA provisions that expand the exceptions to the three-year moratorium on LTCH or LTCH satellites previously enacted in the Medicare, Medicaid, and SCHIP Extension Act. The new exception permits an increase in the number of beds in an existing LTCH or LTCH satellite when the bed increase was authorized under a Certificate of Need issued within a specified timeframe. CMS is amending its previous guidance to state survey agencies to reflect this statutory change. CMS Regional Offices will determine whether a facility qualifies for the new exception to the moratorium.  

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The NIH is highlighting a new funding opportunity under the ARRA that will support approximately $200 million in large-scale research projects that have a high likelihood of enabling growth and investment in biomedical research and development, public health, and health care delivery. The purpose of this new program, the Research and Research Infrastructure "Grand Opportunities" (GO), is to support high-impact ideas that lend themselves to short-term funding and may lay the foundation for new fields of scientific inquiry. Grant applicants may propose to address either a specific research question or the creation of a unique infrastructure/resource designed to accelerate scientific progress in the future.   NIH examples of the types of projects that could be funded under this program include the identification and validation of biomarkers in human genetics and biology that indicate the risk for disease or that could serve as a marker of disease progression and/or responsiveness to treatment, or research on information technology to enable physicians to share radiological images across health care institutions.  

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In January 2009, CMS published a notice delaying for 60 days the effective date of a November 25, 2008 final rule designed to provide state Medicaid agencies with increased flexibility to impose premium and cost sharing requirements on certain Medicaid recipients. On March 27, 2009, CMS further delayed the effective date until December 31, 2009. In addition, CMS reopened the comment period on the November rule until April 27, 2009. CMS is especially interested in comments on the effect of certain provisions of the American Recovery and Reinvestment Act of 2009 (ARRA or Recovery Act) involving premiums and cost sharing on the CMS policy. 

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The GAO has announced the appointment of 13 members to the Health Information Technology Policy Committee, a new advisory body established by the ARRA. The panel is charged with making recommendations on creating a policy framework for the development and adoption of a nationwide health information technology infrastructure, including standards for the exchange of patient medical information. Note that additional members will be appointed by HHS, Congress, and the President. 

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The OIG has added a new “Recovery Act Fund Oversight” section to its website. The OIG is responsible for assessing whether HHS is using $135 billion in American Recovery and Reinvestment Act (ARRA) funds in accordance with legal and administrative requirements and is meeting the Office of Management and Budget's accountability objectives. The new section of the website outlines the OIG's initial plans and provides links to related websites. For instance, the web site notes that the OIG will be examining CMS's plan for temporarily increasing the Medicaid Federal Medical Assistance Percentage and the controls in place to ensure that the increase is implemented as intended by the ARRA.

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The Government Accountability Office (GAO) is requesting the public’s help in identifying waste, fraud, abuse, or mismanagement associated with ARRA funds. Specifically, the GAO is urging private citizens, government workers, contractors, and others to report ARRA-related concerns to FraudNet, a hotline that processes allegations about federal agencies and federally funded programs. The ARRA requires GAO to issue bimonthly reviews of how selected states and localities are using funds. 

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On March 19, 2009, HHS announced the members of the Federal Coordinating Council for Comparative Effectiveness Research. The Council was authorized by the American Recovery and Reinvestment Act (ARRA) as part of a major expansion of federal efforts to compare the effectiveness of different medical treatments, including both infrastructure changes and an infusion of $1 billion in funding for comparative effectiveness research. The Council is charged with helping to coordinate and guide investments in comparative effectiveness research, advising the President and Congress on federal comparative effectiveness research infrastructure needs, and reviewing federal agency organizational expenditures for comparative effectiveness research. The Council must report to the President and Congress by June 30, 2009 on current federal comparative effectiveness research and recommendations for research conducted under ARRA funding. The members of the Council are as follows:

• Anne Haddix, chief policy officer, Office of Strategy and Innovation, Centers for Disease Control and Prevention;
• Thomas Valuck, Medical Officer and Senior Adviser, CMS Center for Medicare Management;
• Peter Delany, Director, Office of Applied Studies, Substance Abuse and Mental Health Services Administration;
• Carolyn Clancy, Director, Agency for Healthcare Research and Quality;
• Deborah Parham Hopson, Associate Administrator, HIV/AIDS Bureau, Health Resources and Services Administration;
• David Hunt, Chief Medical Officer, Office of the National Coordinator for Health Information Technology;
• James Scanlon, Acting Assistant Secretary for Planning and Evaluation, HHS;
• Elizabeth Nabel, Director, National Heart, Lung, and Blood Institute, National Institutes of Health;
• Garth Graham, Deputy Assistant Secretary for Minority Health, Office of Minority Health, HHS;
• Jesse Goodman, Acting Chief Medical Officer, Food and Drug Administration, and Director, FDA Center for Biologics Evaluation and Research;
• Michael Marge, Acting Director, Office on Disability, HHS;
• Neera Tanden, Counselor, Office of the Secretary, HHS;
• Joel Kupersmith, Chief Research and Development Officer, Department of Veterans Affairs;
• Michael Kilpatrick, Director of Strategic Communications for the Military Health System, Department of Defense; and
• Ezekiel Emanuel, Special Advisor for Health Policy, Office of Management and Budget

In a related development, the Institute of Medicine is accepting public comments on priorities for comparative effectiveness research under the ARRA.  Stakeholders can submit answers to a questionnaire through March 27, 2009.

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On March 20, 2009, HHS announced the selection of David Blumenthal, M.D., M.P.P. as the Obama Administration's choice for National Coordinator for Health Information Technology. As the National Coordinator, Dr. Blumenthal will lead the implementation of a nationwide interoperable, privacy-protected health information technology infrastructure, as called for in the American Recovery and Reinvestment Act. Dr. Blumenthal most recently served as a physician and director of the Institute for Health Policy at the Massachusetts General Hospital/Partners HealthCare System in Boston.

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HHS has announced the creation of the Office of Recovery Act Coordination to help ensure the timely and transparent distribution of an estimated $137 billion in American Recovery and Reinvestment Act (ARRA) funds managed by HHS. Dennis Williams will lead the new office and serve as the HHS Deputy Assistant Secretary for Recovery Act Coordination. As of March 11, 2009, HHS has distributed $3 billion in ARRA funds to support a variety of policies and programs, including community health centers and state Medicaid programs. In a related development, NIH has announced the availability of $1.5 billion in ARRA grants to fund scientific research, construction and improvement of research facilities, and the purchase of scientific equipment. 

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The National Advisory Council for Healthcare Research and Quality will meet on April 3, 2009 to discuss Agency for Healthcare Research and Quality (AHRQ) initiatives, including the AHRQ budget for FY 2009, comparative effectiveness, and AHRQ activities under the American Recovery and Reinvestment Act (ARRA).

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On March 12, 2009, HHS published a notice soliciting nominations of members for the HIT Standards Committee and HIT Policy Committee, both of which are established by the American Recovery and Reinvestment Act of 2009.  The HIT Standards Committee is charged with making recommendations to the National Coordinator for Health Information Technology on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information for purposes of health information technology adoption.  The HIT Policy Committee makes recommendations to the National Coordinator on the implementation of a nationwide health information technology infrastructure. Nominations for both committees are due by March 16, 2009.

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This post was written by Karl A. Thallner, Jr., Carol C. Loepere, Debra A. McCurdy, Brad M. Rostolsky, Jacqueline B. Penrod, and Amie E. Schaadt.

On February 17, 2009, President Obama signed into law H.R. 1, the American Recovery and Reinvestment Act (the “ARRA”). The sweeping $790 billion economic stimulus package includes a number of health care policy provisions. Reed Smith's Health Care Memorandum summarizes the major health policy provisions of the Act.

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On February 13, 2009, the House and Senate approved the conference report to accompany H.R. 1, the American Recovery and Reinvestment Act.  President Obama signed the bill into law on February 17, 2009.  The $790 billion economic stimulus package includes a number of health care policy provisions.  Among other things, the final agreement includes:

• $19 billion to accelerate the adoption of health information technology systems;
• Strengthened federal privacy and security provisions to protect personally-identifiable health information;
• Approximately $87 billion in additional federal matching funds over two years to help states maintain their Medicaid programs in the face of state budget shortfalls;
• $1.1 billion to support comparative effectiveness research;
• $1 billion for a new Prevention and Wellness Fund; and
• Provisions to help unemployed workers maintain health insurance coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA) law.
• A provision blocking a fiscal year 2009 reduction in Medicare payments to teaching hospitals related to capital payments for indirect medical education;
• A provision blocking a fiscal year 2009 Medicare payment cut to hospice providers related to a wage index payment add-on;
• Technical corrections to the Medicare, Medicaid, and SCHIP Extension Act of 2007 related to Medicare payments for long-term care hospitals;
• A temporary increase in states’ annual disproportionate share hospital allotments;
• An extension of moratoria on Medicaid regulations for targeted case management, provider taxes, and school-based administration and transportation services through June 30, 2009, and a new moratorium on a Medicaid regulation related to hospital outpatient services through June 30, 2009;
• An extension of Transitional Medical Assistance and the Qualified Individual program; and
• Medicaid prompt payment requirements for nursing facilities and hospitals.

Information on the versions of the measure approved earlier by the House and Senate is available here.    

Update:  On February 17, 2009, President Obama signed into law H.R. 1, the American Recovery and Reinvestment Act (the “ARRA”).  Reed Smith's Health Care Memorandum summarizes the major health policy provisions of the Act.

 

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