[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 3708 Introduced in Senate (IS)]

111th CONGRESS
  2d Session
                                S. 3708

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.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 5, 2010

Mr. Schumer (for himself, Mr. Kerry, Mr. Lautenberg, Mr. Menendez, Mr. 
  Casey, Mrs. Gillibrand, Mr. Franken, Mr. Harkin, and Ms. Klobuchar) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

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

SEC. 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 
        this section by program instruction or otherwise.
            (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).

SEC. 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).
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