The House and the Senate met last week in conference to agree on a final version of the “American Recovery and Reinvestment Act” (also known as the Stimulus Package). On Friday, February 13, 2009 the U.S. House of Representatives approved the bill by a 246–183 vote and the Senate approved it by a vote of 60-38.

The stimulus package was signed by President Obama on Tuesday, February 17, 2009. The final version of the legislation includes provisions addressing Health Information Technology (Health IT), Comparative Effectiveness Research (CER) and funding of medical research.

Summary of the Health-Related Provisions

Health Information Technology (Health IT)

• The legislation provides incentive payments to physicians who adopt and utilize Electronic Medical Health Records (EHR). The bonus payments are tied to the reporting of quality date
  • Physicians who have a certified EhR and who are reporting Medicare quality measures (PQRI) by 2011 or 2012 are eligible for a total bonus payment of $44,000 over five years
  • Physicians who don’t adopt the technology in 2011 or 2012 but comply with the bill language before 2015 can receive a total bonus payment of $41,000 over five years
• The incentive payments for physician will end in 2016 and the penalties will begin in 2015. In 2015, penalties will be a 2 percent decrease of the allowed charges if the eligible professional does not e-prescribe
• The bill establishes a broadband technology opportunities program to provide, among other items, education, awareness, access, equipment and support to medical and health care providers. The legislation codifies the Office of National Coordinator for Health IT (ONCHIT), which is in charge of the development and nationwide implementation of an interoperable health information technology infrastructure
• The first set of standards, including implementation specifications and certification criteria, should be adopted by the Secretary of the U.S. Department of Health and Human Services (HHS) through the rule making process no later then December 31, 2009
• $ 19 billion dollars are allocated to Health IT. ONCHIT receives $2 billion to fulfill its mission, and the remaining $17 billion will pay the bonus incentives to healthcare providers
• The Secretary of HHS is required to submit an annual report to Congress beginning in 2011 to explain the actions taken by the government to encourage the adoption of HIT, to describe the barriers to the Health IT implementation, and provide recommendations about the nationwide adoption program

Comparative Effectiveness Research

• The language established the Federal Coordinating Council for Comparative Effectiveness Research (CER). This council will coordinate CER and will advise Congress and the President on strategies regarding the infrastructure needs for CER within the federal government
• The legislation provides $1.1 billion for CER. This amount includes $400 million for the HHS to conduct comparative effectiveness research, $300 million goes directly to the Agency for Healthcare Research and Quality (AHRQ) and $400 million to National Institute of Health
• The Final stimulus language uses the term “Ccmparative effectiveness.” The Society had previously expressed concerns about the term “comparative effectiveness” — the term “comparative clinical effectiveness” would have been preferred. However, the report language that accompanies the bill specifies that this research is not intended to be used to mandate coverage or any other public/private payer policies, but rather is used to evaluate and compare the clinical outcomes, effectiveness, and risk and benefits of two or more medical treatments

National Institue of Health

• The language provides $10 billion, including $8.4 billion for biomedical research to study diseases such as Alzheimer’s, Parkinson’s, cancer and heart diseases. $1 billion was added for the renovation of the university research facilities and $500 million to renovate the NIH research buildings