The American Recovery Stimulus Act 2009: Let s Talk Healthcare

Transcription

1 The American Recovery Stimulus Act 2009: Let s Talk Healthcare Learning How to Identify and Capture Funded State and Local Healthcare Technology Opportunities.

2 Agenda Healthcare Funding Update Ron Sheps, Vertical Markets Manager, Westcon Group Healthcare Reform Act Political Overview Jeff W. Smith, President True Upside Consulting Federal ARRA Update: So Where Are the Opportunities? Stu Schwartzreich, Director, Westcon Federal Westcon Community Demo Lou Ordorica, Community Manager, Westcon Group

3 The American Recovery & Reinvestment Act, Westcon, and You. Healthcare Funding Update

4 Healthcare Industry Update HIPAA Oversight to Change Hands A big announcement from HHS this summer was the decision by HHS Secretary Sebelius to transfer HIPAA Privacy and Security oversight to the HHS Office of Civil Rights (OCR). Since the early days of the HIPAA regulations, HIPAA Security regulations and enforcement have been the responsibility of the Centers for Medicare and Medicaid Services. As outlined in August s Federal Register, consolidation of the responsibilities into OCR streamlines the enforcement and administrative requirements of personal health information. CMS will retain responsibility for administrative handling of healthcare consumer complaints related to Transactions and Code Sets and Unique Provider Identifiers.

5 The HITECH Act of 2009 As the national dialogue on healthcare reform continues, health IT and health information exchange (HIE) have emerged as critical means to ensuring a healthcare system that is affordable, effective, safe and transparent. A new report from the State Alliance for e-health, Preparing to Implement HiTech: A State Guide for Electronic Health Information Exchange, aims to help states lead the way in using health IT and HIE. The HITECH Act, enacted as part of the American Recovery and Reinvestment Act of 2009, expands the role of states in fostering health information exchange and adoption of electronic health records over the next five years. The Act set a goal of 2014 to increase dramatically the number of healthcare providers who have, and effectively use EHRs and HIE. The report recommends actions states should begin undertaking now to successfully implement the HITECH Act, including: Preparing or updating the state plan for HIE adoption; Engaging stakeholders; Establishing a state leadership office to manage the implementation; Preparing state agencies to participate; Implementing privacy strategies and reforms; Determining the HIE business model; Creating a communications strategy; Establishing opportunities for health IT training and education.

6 Grants for State-Level HIE Efforts The legislation provides for grants to states to promote HIE. The grants may be awarded directly to states or to their qualified designated entities. Funding will be provided for both state planning and state implementation grants. To receive an implementation grant, a state must have a state plan approved by the Department of Health and Human Services (HHS). Specific guidance for state plan requirements and for the grant programs has not yet been released, but the law specifies that the grants would cover state actions that: Increase participation in the use and exchange of electronic health information; Provide assistance, and remove barriers, to support exchange that improves quality; Support initiatives and infrastructure for intra- and interstate exchange; and Provide resources for underserved communities to support EHR adoption and exchange. Under a separate program, the legislation also allows HHS to establish a loan program for certified EHR technology purchase and implementation costs. The intent of this competitive program is to provide selected states or other grantees with funds to make guaranteed loans available to providers for the purchase and implementation expenses associated with adopting certified EHRs. Because training and workflow analysis and design are known to be critical to successful adoption, the loans could also cover some of the indirect costs, including staff training and maintenance. Details on both of the grant programs are forthcoming. There is no deadline for the release of the grants, but if the loan program is implemented, it cannot begin until 2010.

7 Medicare and Medicaid Incentive Program HIPAA Oversight to Change Hands The HITECH Act provides incentive payments under Medicare or Medicaid for eligible providers who have adopted certified EHR systems and who meet statutory requirements for meaningful use. To be eligible for Medicaid incentive payments, a certain percentage of the provider s patient caseload must be enrolled in Medicaid. The threshold in this area is generally 30 percent of patients for physicians (20 percent for pediatricians) and 10 percent for hospitals. Meaningful use of an HER system, as defined in the law, includes three key components: The EHR system must be certified and include e-prescribing capabilities. The technology must provide for EHR exchange with other systems (interoperability). The system must produce reports using various yet-to-be-defined clinical and quality metrics. Medicare will also establish a definition for meaningful use. Funds to support enhanced payment incentives could become under Medicare as early as October 1, 2010, for hospitals and other providers starting January 1, Medicaid payments could begin sooner.

8 Standards Adoption, Certification, & Other Federal Actions HHS must adopt standards for health IT systems by the end of The legislation calls on HHS to form a Health IT Policy Committee and a Health IT Standards Committee to generate recommendations for certification criteria and technology standards for EHRs and other relevant systems and software. The policy committee will make recommendations to the national coordinator for health IT. All technology implemented through the programs named above must conform to these standards. The HITECH Act codifies the existence of the ONC and gives it responsibility for moving toward a nationwide system of information exchange. Several pathways are outlined, and the office is required to submit a plan for achieving the requirements of the act. The act calls for the appointment a new chief privacy officer within ONC and *makes several changes to the Health Insurance Portability and Accountability Act (HIPAA), including extending HIPAA requirements to business associates and authorizing state attorneys general enforce HIPAA provisions. *These provisions went into effect September 23, All HIPAA regulations affecting healthcare providers are now extended to all peripheral businesses relating to healthcare, and carry equal legal penalties for noncompliance.

9 HITECH Breach Notification Interim Final Rule

10 HITECH Breach Notification Interim Final Rule

11 Who Is Affected by Current HIPAA Regulations? Providers Hospitals, medical groups, physicians LLPs, clinics, Emergency care facilities, teaching universities as well as others Health Plans Processing of health information Other Entities Plans that provide for or pay for medical care Employers that self-insure Clearinghouses Public or private organizations that process or facilitate health care services Employers that want to utilize medical information for data mining Pharmaceutical companies conducting clinical research Departments within an affected Organization can include: Marketing Legal/Compliance Risk Management Enrollment Internal Audits Reimbursement Claims Processing Human Resources Research Utilization Management Security Information Technology Quality Management Facilities Management Underwriting Provider Contracting Accounting/Finance Customer Service Contract Compliance Record Keeping

12 Extending HIPAA to Business Associates Some of the many types of Business partners now liable under HIPAA, effective September 23, 2009 Lab Provider Office Insurance Carrier Employer Members Hospital Bank Pharmacy Electronic Connectivity Specialist Credit Card Company Consultant Medical Library Pharmaceutical Company Government New Players Third Party Administrator

13 Regional Extension Centers and the TOP Program HITECH also provides federal funding for Regional Extension Centers, to offer health care providers technical assistance and best practices in implementing and using health IT. The act also provides direct funding to community health centers for infrastructure improvements, including health IT. Although states may not directly manage these efforts, they must be aware of them and determine ways to incorporate and coordinate initiatives. Finally, the American Recovery and Reinvestment Act (ARRA) provides significant federal funding for broadband infrastructure and deployment. A total of $7.2 billion is provided for activities such as infrastructure, mapping of broadband availability, training, and education to spur broadband use in rural, unserved, and underserved communities. Of that amount, $2.5 billion will flow through the Rural Utilities Services Distance Learning, Telemedicine, and Broadband Program (RUS) of the U.S. Department of Agriculture, and $4.7 billion will flow through the *U.S. Department of Commerce, National Telecommunications and Information Administration (NTIA) Broadband Technology Opportunities Program (TOP). Broadband mapping support ($350 million) is available to the states through the NTIA funding. States are eligible to apply for some of the competitive grants as well. It is important for states to consider how broadband availability would affect health information exchange and what type of broadband projects might help increase HIE coverage. HIE cannot become a reality without broadband access, and the grants could provide valuable transmission capabilities. Educating those in the broadband sector about the sea change that is sought in health care is vital; linking telehealth, broadband, and HIE investments is strategic for states with rural or frontier areas and unserved or underserved populations. *This is great news for Westcon partners who have been learning how to apply for TOP Grant funding since 1997! If you would like further information on TOP, visit our website at

14 Is Healthcare IT ready to move? Is Incentive of Increased Medicare Payments Sufficient for Organizations To Begin Making Investments? More than half of respondents believe that a combination of increased Medicare payments for providers that demonstrate meaningful use, combined with the threat of reduced Medicare Market Basket Adjustments for providers who don t meet the requirements will be sufficient for professionals and hospitals to begin to make investments in EHR technology.

15 Using Public Sector Web Resources for Finding Leads

16 As Predicted, Money Is Flowing Slowly to HCR

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24 Our new Public Sector Web Site* Federal Market State and Local Market Education Market Economic Stimulus Act *with a bridge to our new Healthcare site 10/7/

25 Our new Public Sector Web Site* Federal Market State and Local Market Education Market Economic Stimulus Act *with a bridge to our new Healthcare site 10/7/

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28 Thank You for Your Business Where Can I Go For Further Help? Ronald Sheps, Vertical Markets Westcon Group North America 520 White Plains Road Tarrytown, New York rsheps@westcon.com Visit our web sites at:

29 Healthcare Reform Act Political Overview Jeff W. Smith President and Senior Principle Consultant True Upside Consulting

30 Presentation Summary Some Interesting Recent Quotes Political Climate Overview What we Know Today What we Anticipate for Tomorrow

31 Healthcare Reform Act- Recent Quotes It will provide more security and stability to those who have health insurance. It will provide insurance to those who don t. And it will lower the cost of health care for our families, our businesses, and our government." PRESIDENT BARACK OBAMA These State by State Census numbers only serve to further confirm a reality that far too many American families live without insurance every day, said Secretary Sebelius. Our health care system has reached a breaking point. The status quo is unsustainable, and continuing to delay reform is not an option. - Health and Human Services Secretary Kathleen Sebelius

32 Health Care Reform Act- Current Political Climate This is a truly polarizing issue Misinformation abounds Media coverage has been less than stellar Facts are our Friends Very little waffling Obama Administration precarious Singular substantive legislative focus currently

33 Healthcare Reform Act- What We Know The bill will most likely not pass this year Liberal Democrats will not vote for it without a public option Conservative Democrats will not vote for it with a public option Republicans will not vote for it with a public option or at all in many cases Obama does not have even close to the 60 votes he needs in the Senate to get it through There is strong belief on the Hill that if a public option is not included to provide competition for the insurance providers that the bill makes little sense Pharmaceutical companies are pretty safe either way Providers are in a precarious state as the competition that would come from a public option has quite an unknown/uncertain impact on their ability to provide care profitably The devil you know syndrome exists here

34 Healthcare Reform Act- What We Know The bill will probably be in the ~$900 billion range without a public option It would entail a 10 year period and probably a ramp of funding I.T. impact is believed to be in the 10-15% range of the total amount spent by year This is Less than a 1% impact on the overall Federal I.T. budget Many opportunities still abound for the nimble The Healthcare Reform Act is a political slugfest The Healthcare Reform Act put pressure and distractions on getting the 2010 budget finalized which effected 2009 buying season spend marginally D.O.D. specifically

35 Healthcare Reform Act- What We Anticipate The Public Option will not go away Look for concessions but not surrender The Insurance companies will take a material impact Many Caps and Loopholes will be eliminated Most Small Businesses have a short window to afford the escalating costs of Insurance as an employee benefit Costs efficiencies abound from the current model healthcarereform.gov is a terrific resource I.T. Efficiency Solutions will prevail I.T. Spend will be morphed over time 2010 will still be a year of very robust spending

36 Federal ARRA Update So Where Are the Opportunities? Stu Schwartzreich

37 ARRA Funded Opportunities Bid: Cisco routers, switches, and related equipment. Bid Number: W9115U09T0013 Sector: Federal Owner: ATEC Contracting Activity Buyer: Matthew Mason Buyer Phone:(254) Fax: Department: Title: Bid At Glance Publication Date: 9/11/2009 Submittal Date:9/21/ :00:00 AM Onvia Reference Number: Location:TX BELLCategory:IT - Computer Hardware, FSC 59 - Electrical and Electronic Equipment Components Bid Description FEDERAL ECONOMIC RECOVERY SPENDING 59--Cisco routers, switches, and related equipment. Solicitation Number: W9115U09T0013 Agency: Department of the Army Office: U.S. Army Test & Evaluation Command Location: U.S. Army ATEC Contracting Activity General Information Posted Date: Sep 10, 2009 Response Date: September 21, 2009 Original Set Aside: N/A Set Aside: N/A Classification Code: Electrical and electronic equipment components NAICS Code: Computer and Electronic Product Manufacturing/ Telephone Apparatus Manufacturing Contracting Office Address: US Army ATEC Contracting Activity, ATTN: CSTE- CA, P.O. Box Y, Fort Hood, TX Place of Performance: USA OTC BLDG Fort Hood TX US Solicitation Number: W9115U09T0013 Notice Type: Combined Synopsis/Solicitation Synopsis: Added: Sep 10, :57 pm This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. This solicitation document incorporates provisions and clauses in effect through Federal Acquisition Circular and Defense Federal Acquisition Regulation Supplement The government intends to compete a firm-fixed price procurement. This procurement is set aside for Service Disabled Veteran Owned Business in NAICS code with a size standard of 1000 employees. Quotes in response to this solicitation must be signed and dated and submitted no later than 10:00 a.m. CST, September 21, Quotes may be submitted by to matthew.w.mason@us.army.mil or by fax to Vendors are responsible for verifying the receipt of any quotes submitted. Any contract resulting will be firm fixed price (FFP) supply contract. Delivery shall be on or before 30 October Please note that vendors must be currently registered in the Central Contractor Registration (CCR) Database and Online Registration and Certification Application (ORCA). Requirement: (4) CISCO 2811-SEC 64F/256 (CS1-CISCO 2811-SEC/K) (4) CISCO PT 10/100 Etherswitch (CISNM-16ESW) (2) CISCO E SFP LC Connector SX (CIS-GLC-SX-MM) (3) CISCO CAT /100/1000t-4 SFP (CIS-WS-C3750G-24TS-E1U) Ship/Delivery to: USA OTC Bldg Ft. Hood, TX Contract Line Items: CLIN 001: (4) CISCO 2811-SEC 64F/256 (CS1-CISCO 2811-SEC/K) CLIN 002: (4) CISCO PT 10/100 Etherswitch (CISNM-16ESW) CLIN 003: (2) CISCO E SFP LC Connector SX (CIS-GLC-SX-MM) CLIN 004: (3) CISCO CAT /100/1000t-4 SFP (CIS-WS- C3750G-24TS-E1U) The following FAR provisions and clauses apply to this solicitation, are incorporated by reference, and will be incorporated into any contract resulting from this notice: , Central Contractor Registration (Apr 2008) , Annual Representations and Certifications (Feb 2009) , Instructions to Offerors - Commercial Items , Offeror Representations and Certification Commercial Items , Contract Terms and Conditions - Commercial Items , Electronic Bid Submission , Buy American Act - Supplies , Buy American Act Certificate , Availability of Funds , Subcontracts for Commercial Items (MAR 2009) , Alt II Contract Terms and Conditions Required to Implement Statutes or Executive Orders - Commercial Items The following clauses are checked as being applicable in : Restrictions on Subcontractor Sales to the Government, Alt Whistleblower Protections under the American Recovery and Reinvestment Act of , Notice to Total Small Business Set Aside , Utilization of Small Business Concerns (MAY 2004) , Post Award Small Business Program Representation , Convict Labor (JUNE 2003) , Child Labor - Cooperation with Authorities and Remedies (FEB 2008) (E.O ) , Prohibition of Segregated Facilities (FEB 1999) , Payment by Electronic Funds Transfer-Central Contract Registration The following Defense FAR Supplement (DFARS) provisions and clauses apply to this solicitation and are incorporated by reference: Central Contractor Registration ( ) Alt A (SEP 2007) Contract Terms and Conditions Required to Implement Statutes or Executive Orders Applicable to Defense Acquisitions of Commercial Items (Jan 2009) Electronic Submission of Payment Requests and Receiving Reports (MAR 2008) TO QUOTE: At a minimum, submitted quotes shall include the following: * A priced quote sheet for all CLINS, with authorized signature * Companys Address * Duns/CAGE Numbers Additional Info: AMSCA Website Point of Contact(s): Matthew W Mason, US Army ATEC Contracting Activity

38 ARRA Funded Awarded Opps! Federal Award: Recovery Act - CISCO Equipment Bid Number: RFQ Sector: Federal Owner: US Department of Health and Human Services, Program Support Center Buyer: Camille Timmerman Buyer Phone: (301) Fax:(301) camille.timmerman@psc.hhs.gov Department: Title: Contract Specialist Federal Award At A Glance Publication Date:9/23/2009Onvia Reference Number: Award Number:HHSP GAward Value:$6,677.00Location:ROCKVILLE, MD MONTGOMERYCategory:IT - Computer Hardware, FSC 70 - Automatic Data Processing Equipment, Software, Supplies & Support Equipment Federal Award Description FEDERAL ECONOMIC RECOVERY SPENDING Recovery Act - Dell & CISCO Equipment Solicitation Number: RFQ Agency: Department of Health and Human Services Office: Program Support Center Location: Division of Acquisition Management General Information Original Posted Date: August 14, 2009 Posted Date: Sep 23, 2009 Original Response Date: Aug 21, :00 pm Eastern Original Set Aside: N/A Set Aside: N/A Classification Code: General purpose information technology equipment NAICS Code: Merchant Wholesalers, Durable Goods/ Computer and Computer Peripheral Equipment and Software Merchant Wholesalers Contracting Office Address: Parklawn Building Room Fishers Lane Rockville, Maryland Solicitation Number: RFQ Notice Type: Award Notice Contract Award Date: September 22, 2009 Contract Award Number: HHSP G Contract Award Dollar Amount: $6, Contractor Awarded Name: STELL CO, INC. Contractor Awarded Address: 1085 Williamette Falls Drive West Linn, Oregon United States Synopsis: Added: Sep 23, :35 pm The subject solicitation was made available on the GSA ebuy website at An award was made to STELL CO, Inc. in the amount of $6, The brand name justification is included below. The following product was purchased: Cisco 2811 Router including Smartnet Maintenance The contract file was documented with the following rationale for restricting competition to a brand name. Indian Health Service (IHS) uses Cisco Network router equipment for approximately 90% of its existing hardware in order to provide consistent agency operation, mission, and patient care. CISCO routers are used for routing all network traffic as well as for user authentication. It is imperative that all routers be standardized in order to maintain adequate technical support, maintenance and staffing. Standardization to existing hardware makes the installation, setup and deployment of new hardware manageable and meets the security standards of DHHS and IHS. Cisco brand network equipment is required to ensure consistency among the hardware and software configurations for IHS systems administrators to maintain and support. Primary Point of Contact.: Camille M. Timmerman, Contract Specialist camille.timmerman@psc.hhs.gov Phone: Fax: Secondary Point of Contact: Marie L. Sunday, Contracting Officer MARIE.SUNDAY@PSC.HHS.GOV Phone: Fax:

39 Next Steps! Join our Federal Program and Form a Strategic Partnership with Westcon to Help Grow your Federal Business! Join our GSA Strategy Utilize our Federal Market Intelligence Services Utilize our Federal Market Intelligence Services Register at our website us.federal.westcon.com

40 Thank You for Your Business Where Can I Go For Further Help? Stu Schwartzreich Director, Federal sschwartzreich@westcon.com

41 Westcon Community Demo Lou Ordorica

42 Questions Contact Information Stu Schwartzreich Director, Federal Lou Ordorica Community Manager, Westcon Ronald Sheps Vertical Markets Westcon Group North America Jeff W Smith President, True Upside Consulting