Senate Bill to Expand Medicaid Eligibility for HITECH

MITECH Act Introduced in Senate

Senator John Kerry from Massachusetts has introduced the Medicaid Information Technology to Enhance Community Health (MITECH) Act in Senate bill 3539. The bill is to “encourage the adoption and use of certified electronic health record technology by safety net providers and clinics”. Since eligibility for HITECH Act incentive money is defined and controlled by law, to add or change eligibility to the program amendments must be made to the original law – the HITECH Act.

Currently a subset of providers, although servicing lower income patient populations, are not eligible for Medicaid incentives. It defines safety net providers as a clinic or network of clinics that is operated by a private non-profit or public entity and that has at least 30 percent of its patient volume (as estimated in accordance with a methodology established by the Secretary) attributable to needy individuals. In his Senate floor speech introducing the bill, Senator Kerry said, “Given that Medicaid eligibility levels are so low in many states, it is difficult for many safety-net providers to meet the 30% Medicaid threshold required to participate in the Medicaid EHR incentive program even though their patients are predominately low-income”.

The term ‘QSNC-based’ is also defined in the bill – with respect to an eligible professional, an individual who furnishes substantially all of their professional services in a qualified safety net clinic and through the use of the facilities and equipment, including qualified electronic health records, of the clinic. The determination of whether an eligible professional is a QSNC-based eligible professional shall be made on the basis of the site of service (as defined by the Secretary) and without regard to any employment or billing arrangement between the eligible professional and any other provider.”

The bill also gives the Secretary of HHS the ability to develop methodologies to expand eligibility to the clinics as an entity, similar to the current process that exists for hospitals.

MITECH has been referred to the Committee on Finance. Track the bill on