I 111th CONGRESS 2d Session H. R. 6072 IN THE HOUSE OF REPRESENTATIVES July 30, 2010 Mr. Space (for himself, Mr. Stark, Mr. Pallone, Mr. Levin, Mr. Waxman, Mr. Dingell, Mr. Burgess, Mr. Engel, Mrs. Blackburn, Mr. Boucher, Mr. Butterfield, Mrs. Capps, Ms. Castor of Florida, Mr. Crowley, Mr. Davis of Illinois, Mr. Doggett, Mr. Gonzalez, Mr. Gene Green of Texas, Mr. Higgins, Mr. Lewis of Georgia, Mr. McDermott, Mr. Meek of Florida, Mr. Neal of Massachusetts, Mr. Pascrell, Mr. Pomeroy, Mr. Rangel, Ms. Schwartz, Ms. Sutton, Mr. Thompson of California, Mr. Van Hollen, and Mr. Weiner) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals.

1.

Short title

This Act may be cited as the Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010.

2.

Clarification of incentives for multi-campus hospitals for adoption and meaningful use of certified electronic health records

(a)

Special rule for applying Medicare EHR incentive payments to remote inpatient locations of a hospital

Section 1886(n) of the Social Security Act (42 U.S.C. 1395ww(n)) is amended— (1)in paragraph (2), by adding at the end the following new subparagraph: (H)

Special rule for remote inpatient locations of a hospital

(i)

In general

In the case of an eligible hospital that consists of a qualified main provider and one or more qualified remote inpatient locations, the hospital may elect (in such form and manner as specified by the Secretary) for all applicable payment years to— (I)substitute the base amount alternative described in clause (ii) for the base amount described in subparagraph (A)(i)(I); or (II)substitute the discharge related amount alternative described in clause (iii) for the discharge related amount described in subparagraph (A)(i)(II). The election described in the previous sentence, with respect to an eligible hospital, shall be made once for such hospital and shall apply to such hospital for all applicable payment years.(ii)

Base amount alternative

The base amount alternative described in this clause with respect to an eligible hospital is the product of— (I)the base amount specified in subparagraph (B); and (II)the total number of all qualified component facilities of the hospital. An election to substitute the base amount alternative described in this clause shall not affect the computation of the discharge related amount specified in subparagraph (C) for the eligible hospital.(iii)

Discharge related amount alternative

The discharge related amount alternative described in this clause with respect to an eligible hospital for a 12-month period is determined as follows: (I)First, compute the amount under subparagraph (C) as if the phrase estimated based upon total discharges for the eligible hospital (regardless of any source of payment) for the period divided by the total number of all component facilities of the hospital were substituted for the phrase estimated based upon total discharges for the eligible hospital (regardless of any source of payment) for the period. (II)Then multiply the amount computed under subclause (I) by the total number of all qualified component facilities of such hospital. (iv)

Definitions

For purposes of this subsection: (I)

Applicable payment year

The term applicable payment year means the first payment year for which a hospital makes an election described in clause (i) and each subsequent payment year applicable to such hospital. (II)

Component facility; qualified component facility

The term component facility means, with respect to an eligible hospital, the main provider or any remote inpatient location of such hospital. The term qualified component facility means, with respect to a main provider, a qualified main provider and, with respect to a remote inpatient location, a qualified remote inpatient location. (III)

Main provider; qualified main provider

The term main provider, with respect to an eligible hospital, has the meaning given such term in section 413.65(a)(2) of title 42, Code of Federal Regulations. The term qualified main provider means a main provider that is a meaningful EHR user for the reporting period involved. (IV)

Remote inpatient location; qualified remote inpatient location

The term remote inpatient location means, with respect to an eligible hospital, a remote location of a hospital, as defined in and applied under section 413.65 of title 42, Code of Federal Regulations, that provides inpatient hospital services that are paid for under subsection (d). The term qualified remote inpatient location means, with respect to an eligible hospital, a location for which the eligible hospital has submitted to the Secretary, for the reporting period involved, an attestation (in such form and manner as specified by the Secretary) that certifies that the location is a remote inpatient location and a meaningful EHR user for such period. ; and (2)in paragraph (4)(A)— (A)at the end of clause (ii), by striking and; (B)at the end of clause (iii), by striking the period and inserting a semicolon; and (C)by adding at the end the following new clauses: (iv)the methodology and standards for determining a remote inpatient location, a qualified remote inpatient location, a component facility, a qualified component facility, a main provider, and a qualified main provider, as such terms are defined in paragraph (2)(H)(iv), and which such locations, facilities, and providers are qualified remote inpatient locations, qualified component facilities, and qualified main providers, as such terms are defined in such paragraph; and (v)the methodology and standards for the election described in paragraph (2)(H). . (b)

Implementation and administration

(1)

Implementation

Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement by program instruction or otherwise this section. (2)

Administration

Chapter 35 of title 44, United States Code, shall not apply to the collection of information to carry out the amendments made by this section. (c)

Effective date

The amendments made by this section shall apply as if included in the enactment of the American Recovery and Reinvestment Act of 2009 (Public Law 111–5).

3.

Clarification for Medicaid EHR payment incentives

(a)

In general

Section 1903(t)(5) of the Social Security Act (42 U.S.C. 1396b(t)(5)) is amended— (1)by adding at the end the following new subparagraph: (E)For purposes of determining the applicable amounts specified in subparagraph (A) of section 1886(n)(2), as applied by the first sentence of subparagraph (B)— (i)the provisions of subparagraph (H) of such section shall apply to a Medicaid provider described in paragraph (2)(B) consisting of a qualified main provider and one or more qualified remote inpatient locations (as such terms are defined in clause (iv) of such subparagraph (H)) in the same manner and to the same extent that such subparagraph applies to an eligible hospital described in clause (i) of such subparagraph, except that— (I)in applying the second sentence of clause (iv)(IV) of such subparagraph, with respect to a Medicaid provider described in paragraph (2)(B), in lieu of certifying that a remote inpatient location is a meaningful EHR user, the Medicaid provider shall certify that the remote inpatient location is described in paragraph (2)(B) and is in compliance with paragraph (6)(C) of this subsection for the year of payment involved; and (II)the first sentence of clause (iv)(IV) of such subparagraph shall be applied in the case of a Medicaid provider described in paragraph (2)(B)(i) without regard to the requirement that inpatient hospital services provided are paid for under section 1886(d); and (ii)an election made under subparagraph (H) of such section by an eligible hospital described in clause (i) of such subparagraph that is a Medicaid provider described in paragraph (2)(B), shall apply. The Secretary may make appropriate adjustments to the overall hospital EHR amount under subparagraph (B), with respect to a Medicaid provider described in paragraph (2)(B), to take into account the provisions of this subparagraph.; and (2)in the first sentence of subparagraph (B), by inserting and subject to subparagraph (E) after For purposes of this paragraph. (b)

Effective date

The amendments made by this section shall apply as if included in the enactment of the American Recovery and Reinvestment Act of 2009 (Public Law 111–5).