The U.S. Department of Health and Human Services (USDHHS) published two sets of rules on December 30 to implement the "HITECH" provisions of the American Recovery and Reinvestment Act of 2009 (ARRA). USHHS will open the public comment periods on both sets of rules officially on January 13.  These rules include:

• Proposed rules developed by the Centers for Medicare and Medicaid Services (CMS) on adoption and meaningful use of electronic health records (EHRs) that hospitals, physicians, and other practitioners must meet to qualify for over $20 billion in new Medicare/Medicaid payment incentives over the next ten years;
• "Interim final" rules developed the USDHHS Office of the National Coordinator for Health Information Technology (ONCHIT) on EHR technology standards, specifications, and certification criteria to be applied by private organizations in evaluating health IT products.

The CMS proposed rules define meaningful use in terms of clinical objectives such as e-prescribing, care coordination, and quality assurance activities relying on EHRs, and set forth attestation and verification procedures related to three phases of meaningful use to be incrementally rigorous over the period 2011-2013.  ONCHIT had a key role in developing these requirements.  The rules also interpret ARRA provisions on determining Medicare payment incentives for hospitals, to be implemented through Medicare fiscal intermediaries as soon as October 2010, Medicare payment incentives for physicians and other practitioners, to be implemented by Medicare carriers in January 2011, and Medicaid payment incentives as a state plan option, qualifying for 100% Federal financial participation, to be set by each state within parameters in the rules.       

The ONCHIT "interim final" rules seek to ensure accuracy, reliability, consistency in EHR formats and terminology, and security in the transfer of patients' health information over the internet via health IT products to be certified as interoperable - able to function efficiently across a wide range of providers, payers, quality improvement organizations, and government agencies.    ONCHIT will publish additional rules on certification organizations and procedures.