Endocrine Insider
February 19, 2009

The economic stimulus bill passed by Congress and signed this week by President Obama includes provisions important to physicians and researchers. The American Recovery and Reinvestment Act of 2009 creates and promotes the widespread adoption of health information technology (HIT) and provides funds for biomedical research.

For Practitioners: The law allocates approximately $19 billion for Medicare and Medicaid HIT incentives over a five year period, including direct incentive payments for the adoption and meaningful use of an HIT system. The total amount a physician could receive under the program would be capped and would decrease over time. As reported in the last issue of Endocrine Insider, beginning in 2011, eligible physicians could receive up to $15,000 in the first year, with reduced payments in subsequent years. Physicians who are early adopters, defined as having an HIT system in place by 2012, will be eligible for an initial larger payment of up to $18,000. Eligible professionals in rural areas could receive a 10 percent increase in their incentive payments. The maximum amount a physician can collect in HIT bonuses is $44,000. Physicians who do not adopt a certified HIT system will face a reduction in their Medicare fee schedule payments of -1 percent in 2015, -2 percent in 2016, and -3 percent in 2017 and beyond. Exceptions will be made on a case by case basis for significant hardships. Details on certified systems and eligibility requirements are not yet available and will be determined by the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology.

For Researchers: The National Institutes of Health also received a significant boost in funding in the economic stimulus bill.  Of the $10 billion included in the package for the NIH, $8.2 billion will be allocated to the Office of the Director, with $7.4 billion designated for transfer to the Institutes, Centers, and Common Fund, and $800 million retained for the Office of the Director (see associated story below for further details on how the NIH funds will be spent).  The $10 billion was included in the package passed by the Senate, and was a result of an amendment offered by Senator Tom Harkin (D-IA) to add $6.5 billion to the $3.5 billion already in the package.  The inclusion of the funds in the final package can be largely attributed to the efforts of the NIH’s champions, Senators Harkin and Specter (R-PA) and The Endocrine Society lauds the senators for their efforts.

In addition to HIT provisions and the research funding, the approved stimulus bill contains positive changes to graduate medical education funding. The bill extends a moratorium through June 30, 2009 on regulations related to graduate medical education payments. The law also retroactively reverses a $191 million cut to capital Medicare Indirect Medical Education payments.