About legislation (H.R. 1):

President Obama signed the American Recovery and Economic Reinvestment Act into law on Feb 17. The bill, commonly referred to as the economic stimulus package, contains more than $787 billion in federal spending. These funds go to a variety of programs, including health care. Here is a look at how health care stimulus funds are allocated:

Health information technology (IT) allows medical records to be stored electronically and transmitted through an interoperable IT network. Health IT will require funds to initialize, but is expected to save lives and cut costs once it's fully implemented. The stimulus package allocates money to two parts of health IT:

• The Office of the National Coordinator will receive $2 billion to lay down health IT infrastructure; $300 million of this money must be spent on regional efforts.
• $20.8 billion in net direct spending over 10 years goes to Medicare and Medicaid incentives for physicians to invest in health IT. The core funding will be divided so that about 60 percent goes to Medicare and 40 percent to Medicaid.

The Health Insurance Portability and Accountability Act (HIPAA), signed into law in 1996, lays out protections for the privacy and confidentiality of personal health information. Amended in 2005, HIPAA includes rules for who can have access to an individual's health information, how such information can be accessed and how the information can be used. The stimulus package tweaks HIPAA to tighten privacy requirements, strengthen consumers' roles in deciding who can access information about pre-existing conditions and restrict the sale of health information.

Medicare and Medicaid are the two main federal health insurance programs. Medicare is operated by the federal government and serves people 65 and older, as well as people with disabilities. Medicaid is operated by each state and serves people with low incomes and people with disabilities. The stimulus package puts off some scheduled cuts to Medicare and increases the amount of money the federal government pays to the states to operate Medicaid. In order to get some of this additional $680 million in Medicaid funds, states must agree to promptly reimburse providers, with 99 percent of claims handled within 90 days of receipt. The stimulus bill also extends Medicaid coverage for transition periods in which a beneficiary might be dropped due to increased income level.

The stimulus package increases federal spending on several health care programs:

• Community health centers serve many people who otherwise might not have access to health care. The stimulus allocates $2 billion to build and equip new community health centers.
• Health profession training programs educate future medical professionals. These programs receive $500 million in the stimulus package, with $300 million going to the National Health Service Corps and $200 million to existing health professions and nurse education programs.
• The National Institutes of Health (NIH), the largest funder of medical research in the world, receives all its money from the federal government.
• The stimulus package awards an additional $10.5 billion to NIH; $7.4 million of which goes directly to medical research grants for projects that must be completed within two years. The the rest funds construction, with $1 billion set aside for non-federal research facilities.
• The National Science Foundation (NSF) is the federal agency responsible for promoting science and engineering programs. The stimulus package gives NSF $2.5 billion, with $2 billion for research programs, $300 million for instrumentation programs and $200 million for grants to universities.
• The Prevention and Wellness Fund, dedicated to promoting a healthier America, receives $1 billion in the stimulus package. Of that, $300 million goes to Centers for Disease Control health promotion programs, $50 million for health-associated infection reduction, and $650 million for clinical and community-based programs to combat chronic disease rates.
• Comparative effectiveness research aims to cut costs and improve the quality of health care by identifying the most effective treatments for a particular condition. Comparative effectiveness efforts receive $1.1 billion in the stimulus package, with $400 million to be spent at the discretion of the secretary of Health and Human Services, $400 million transferred to the director of NIH and $300 million going to the Agency for Healthcare Research and Quality.