[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3309 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 3309

To amend titles XVIII and XIX of the Social Security Act to improve the 
 electronic health records meaningful use programs under the Medicare 
             and Medicaid programs, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 29, 2015

Mrs. Ellmers of North Carolina introduced the following bill; which was 
 referred to the Committee on Energy and Commerce, and in addition to 
   the Committee on Ways and Means, 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 improve the 
 electronic health records meaningful use programs under the Medicare 
             and Medicaid programs, and for other purposes.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Further 
Flexibility in HIT Reporting and Advancing Interoperability Act'' or 
the ``Flex-IT 2 Act''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
    TITLE I--ALIGNMENT OF MEANINGFUL USE RULEMAKING TO MERIT-BASED 
                  INCENTIVE PAYMENT SYSTEM RULEMAKING

Sec. 101. Pausing meaningful use rulemaking.
                   TITLE II--IMPROVING MEANINGFUL USE

Sec. 201. Removing the pass-fail approach of the Medicare and Medicaid 
                            meaningful use program.
Sec. 202. Aligning quality reporting in the Medicare and Medicaid 
                            meaningful use program.
Sec. 203. Expanding the hardship exception to the Medicare EHR payment 
                            adjustments.
Sec. 204. Promoting interoperability through EHR certification process.
Sec. 205. Improving the timing of the adoption of more stringent 
                            measures of meaningful use under the 
                            Medicare and Medicaid meaningful use 
                            program.
Sec. 206. Three-month EHR reporting periods for the Medicare and 
                            Medicaid EHR incentive payment programs.
Sec. 207. Providing eligible professionals and eligible hospitals the 
                            option to meet a more advanced stage of 
                            meaningful use.

    TITLE I--ALIGNMENT OF MEANINGFUL USE RULEMAKING TO MERIT-BASED 
                  INCENTIVE PAYMENT SYSTEM RULEMAKING

SEC. 101. PAUSING MEANINGFUL USE RULEMAKING.

    (a) Sense of the Congress.--It is the sense of Congress that the 
Secretary of Health and Human Services (in this section referred to as 
the ``Secretary'') should not finalize the proposed rules relating to 
Stage 3 criteria for the meaningful use of certified EHR technology (as 
defined in section 3000 of the Public Health Service Act (42 U.S.C. 
300jj)) and the issuance of 2015 EHR certification criteria and should 
instead encourage interoperability, usability, and improved outcomes 
with respect to electronic health records.
    (b) No Issuance of Stage 3 Criteria or of EHR Certification 
Criteria Before 2017 Unless Conditions Met.--Unless one of the 
conditions described in subsection (c) has been met, the Secretary 
shall not issue, prior to January 1, 2017--
            (1) any proposed or final rule that would modify the 
        definition of the term ``Meaningful EHR user'' under section 
        495.4 of title 42, Code of Federal Regulations (or any 
        successor regulation), by adding Stage 3 criteria for eligible 
        professionals or eligible hospitals; or
            (2) any proposed or final rule that would add new 
        certification criteria for certified EHR technology under part 
        170 of title 45, Code of Federal Regulations.
    (c) Conditions.--The conditions described in this subsection are 
the following:
            (1) The Secretary certifies that 75 percent of both 
        eligible hospitals and eligible professionals have successfully 
        attested to the Stage 2 criteria established under section 
        495.6 of title 42, Code of Federal Regulations.
            (2) The Secretary promulgates a final rule to implement the 
        Merit-Based Incentive Payment System established under section 
        1848(q) of the Social Security Act (42 U.S.C. 1395w-4(q)).
    (d) Flexibility To Adjust Existing Meaningful Use and Certification 
Criteria.--Nothing in this section shall be construed as affecting the 
authority of the Secretary to change, modify, suspend, or revoke 
meaningful use and certification criteria effective on the date of the 
enactment of this Act, including the Stage 2 criteria established under 
section 495.6 of title 42, Code of Federal Regulations, and the 2014 
Edition certified health record criteria under subpart C, part 170 of 
title 45, Code of Federal Regulations, for any of the following 
reasons:
            (1) The change, modification, suspension, or revocation 
        relates to the recommendations for achieving widespread 
        interoperability made by the Secretary pursuant to section 106 
        of the Medicare Access and CHIP Reauthorization Act of 2015.
            (2) The criteria may negatively impact the quality of care 
        for, or may risk harm to, a patient.
            (3) The change, modification, suspension, or revocation is 
        necessary to reflect advances in science or technology, or to 
        improve transparency.

                   TITLE II--IMPROVING MEANINGFUL USE

SEC. 201. REMOVING THE PASS-FAIL APPROACH OF THE MEDICARE AND MEDICAID 
              MEANINGFUL USE PROGRAM.

    (a) Eligible Professionals.--
            (1) In general.--Section 1848(o)(2) of the Social Security 
        Act (42 U.S.C. 1395w-4(o)(2)) is amended by adding at the end 
        the following new subparagraph:
                    ``(E) Consideration of technological and cost 
                barriers.--In applying clauses (i), (ii), and (iii) of 
                subparagraph (A) to determine whether a professional is 
                using certified EHR technology in a meaningful manner 
                for a period described in such subparagraph for a year 
                after 2015, the Secretary--
                            ``(i) may not require that the 
                        professional, in order to be considered a 
                        meaningful EHR user for such period, meet every 
                        requirement or objective specified pursuant to 
                        such clauses but instead shall apply a linear 
                        scale;
                            ``(ii) shall establish a method to 
                        determine if an eligible professional is a 
                        partial meaningful user consistent with such 
                        linear scale; and
                            ``(iii) shall consider differences among 
                        professionals (such as differences in the 
                        specialties and patient populations of 
                        professionals) as well as technological and 
                        cost barriers in determining which of the 
                        requirements or objectives must be met by the 
                        professional during such period in order for 
                        the professional to be so considered.''.
            (2) Incentive payment.--Section 1848(o)(1)(A)(i) of the 
        Social Security Act (42 U.S.C. 1395w-4(o)(1)(A)(i)) is 
        amended--
                    (A) by inserting ``or, for 2016, partial meaningful 
                EHR user'' after ``meaningful EHR user''; and
                    (B) by inserting ``(or, for 2016, in accordance 
                with the linear scale applied pursuant to paragraph 
                (2)(E), equal to not more than)'' after ``equal to''.
            (3) Payment adjustment.--Section 1848(a)(7)(A)(i) of the 
        Social Security Act (42 U.S.C. 1395w-4(a)(7)(A)(i)) is 
        amended--
                    (A) by inserting ``or, for such a year after 2015, 
                partial meaningful EHR user'' after ``meaningful EHR 
                user''; and
                    (B) by inserting ``(or, for such a year after 2015, 
                in accordance with the linear scale applied pursuant to 
                paragraph (2)(E), equal to at least)'' after ``equal 
                to''.
    (b) Eligible Hospitals.--
            (1) In general.--Section 1886(n)(3) of the Social Security 
        Act (42 U.S.C. 1395ww(n)(3)) is amended by adding at the end 
        the following new subparagraph:
                    ``(D) Consideration of technological and cost 
                barriers.--In applying clauses (i), (ii), and (iii) of 
                subparagraph (A) to determine whether a hospital is 
                using certified EHR technology in a meaningful manner 
                for an EHR reporting period for a fiscal year after 
                fiscal year 2015, the Secretary--
                            ``(i) may not require that the hospital, in 
                        order to be considered a meaningful EHR user 
                        for such period, meet every such requirement or 
                        objective specified pursuant to such clauses 
                        but instead shall apply a linear scale;
                            ``(ii) shall establish a method to 
                        determine if an eligible professional is a 
                        partial meaningful user consistent with such 
                        linear scale; and
                            ``(iii) shall consider differences among 
                        hospitals (such as differences in the type of 
                        hospital, specialties available at and patient 
                        populations of hospitals) in determining which 
                        of the requirements or objectives must be met 
                        by the hospital during such period in order for 
                        the hospital to be so considered.''.
            (2) Incentive payment.--Section 1886(n)(1) of the Social 
        Security Act (42 U.S.C. 1395ww(n)(1)) is amended--
                    (A) by inserting ``or, for a fiscal year after 
                fiscal year 2015, partial meaningful EHR user'' after 
                ``meaningful EHR user''; and
                    (B) by inserting ``(or, for a fiscal year after 
                fiscal year 2015, in accordance with the linear scale 
                applied pursuant to paragraph (2)(D), equal to not more 
                than)'' after ``equal to''.
            (3) Payment adjustment.--Section 1886(b)(3)(B)(ix)(I) of 
        the Social Security Act (42 U.S.C. 1395ww(b)(3)(B)(ix)(I)) is 
        amended--
                    (A) in subclause (I)--
                            (i) by inserting ``or, for a fiscal year 
                        after fiscal year 2015, partial meaningful EHR 
                        user'' after ``meaningful EHR user''; and
                            (ii) by inserting ``(or, for a fiscal year 
                        after fiscal year 2015, in accordance with the 
                        linear scale applied pursuant to section 
                        1886(n)(2)(D), equal to at least)'' after 
                        ``equal to''; and
                    (B) in subclause (III), by inserting ``or, for a 
                fiscal year after fiscal year 2015, partial meaningful 
                EHR user'' after ``meaningful EHR user''.
    (c) Application Under Medicaid.--Section 1903(t)(8) of the Social 
Security Act (42 U.S.C. 1396b(t)(8)) is amended by inserting after the 
second sentence the following: ``In doing so, the Secretary shall 
ensure that the provisions of subparagraph (E) of section 1848(o)(2) 
and subparagraph (D) of section 1886(n)(3) apply under this title with 
respect to demonstrating meaningful use in a similar manner as such 
provisions apply under title XVIII.''.
    (d) Application to Medicare Advantage.--Section 1853 of the Social 
Security Act (42 U.S.C. 1395w-23) is amended--
            (1) in subsection (l)--
                    (A) in paragraph (1), by inserting ``or, for a year 
                after 2015, partial meaningful EHR users,'' after 
                ``meaningful EHR users'';
                    (B) in paragraph (4)(A), by inserting ``(or, for a 
                year after 2015, in accordance with the linear scale 
                applied pursuant to section 1848(o)(2)(E), equal to at 
                least)'' after ``equal to''; and
                    (C) in paragraph (6), in each of subparagraphs (A) 
                and (B), by inserting ``or, for a year after 2015, 
                partial meaningful EHR user,'' after ``meaningful EHR 
                user''; and
            (2) in subsection (m)--
                    (A) in paragraph (1), by inserting ``or, for a 
                fiscal year after fiscal year 2015, partial meaningful 
                EHR users,'' after ``meaningful EHR users''; and
                    (B) in paragraph (4)(A), by inserting ``or, for a 
                fiscal year after fiscal year 2015, partial meaningful 
                EHR users,'' after ``meaningful EHR users''.
    (e) Application to Critical Access Hospitals.--Section 1814(l) of 
the Social Security Act (42 U.S.C. 1395f(l)) is amended--
            (1) in paragraph (3)(A), by inserting ``or, for a fiscal 
        year after 2015, partial meaningful EHR user,'' after 
        ``meaningful EHR user'';
            (2) in paragraph (3)(A)(ii)(I), by inserting ``(or, for a 
        fiscal year after fiscal year 2015, in accordance with the 
        linear scale applied pursuant to section 1886(n)(2)(D), equal 
        to not more than)'' after ``equal to''; and
            (3) in paragraph (4)--
                    (A) in subparagraph (A), by inserting ``or, for a 
                fiscal year after 2015, partial meaningful EHR user,'' 
                after ``meaningful EHR user''; and
                    (B) in subparagraph (B), by inserting ``(or, for a 
                fiscal year after fiscal year 2015, in accordance with 
                the linear scale applied pursuant to section 
                1886(n)(2)(D), a percent equal to at least the 
                applicable percent)'' after ``applicable percent''.

SEC. 202. ALIGNING QUALITY REPORTING IN THE MEDICARE AND MEDICAID 
              MEANINGFUL USE PROGRAM.

    (a) Eligible Professionals.--
            (1) Testing of measures.--Section 1848(k)(2)(C) of the 
        Social Security Act (42 U.S.C. 1395w-4(k)(2)(C)) is amended by 
        adding at the end the following new clause:
                            ``(iii) Testing.--After December 31, 2015, 
                        the Secretary may only specify a clinical 
                        quality measure under this subparagraph if the 
                        Secretary has demonstrated, through field tests 
                        among multiple and varied eligible 
                        professionals, that it is feasible for such 
                        professionals to electronically submit valid 
                        and accurate information on the measure.''.
            (2) Deemed compliance if satisfy pqrs.--Section 
        1848(o)(2)(B)(iii) of the Social Security Act (42 U.S.C. 1395w-
        4(o)(2)(B)(iii)) is amended by adding at the end the following:
    ``In implementing the preceding sentence, the Secretary shall treat 
an eligible professional who, for a period under subsection (k) for 
covered professional services furnished in a year after 2015, satisfies 
the requirements of clauses (i) or (ii) of subsection (k)(2)(C), or who 
satisfactorily participates in a qualified clinical data registry for a 
reporting period (as defined in subsection (m)(6)(C)) as determined by 
the Secretary pursuant to subsection (k)(2)(C) and subsection 
(m)(3)(D), as satisfying the requirement of subparagraph (A) for the 
corresponding period described in such subparagraph for such year.''.
    (b) Eligible Hospitals.--
            (1) Testing of measures.--Section 1886(n)(3)(B)(i) of the 
        Social Security Act (42 U.S.C. 1395ww(n)(3)(B)(i)) is amended 
        by adding at the end the following new subclause:
                                    ``(III) After September 30, 2015, 
                                the Secretary may only select a 
                                clinical quality measure under this 
                                subparagraph if the Secretary has 
                                demonstrated, through field tests in 
                                multiple and varied hospitals, that it 
                                is feasible for such hospitals to 
                                electronically submit valid and 
                                accurate information on the measure.''.
            (2) Deemed compliance if satisfy hospital inpatient quality 
        reporting requirements.--Section 1886(n)(3)(B)(iii) of the 
        Social Security Act (42 U.S.C. 1395ww(n)(3)(B)(iii)) is amended 
        by adding at the end the following: ``In implementing the 
        preceding sentence, the Secretary shall treat an eligible 
        hospital that, for a period under subsection (b)(3)(B)(viii) 
        for a fiscal year after fiscal year 2015, satisfies the 
        requirements of such subsection as satisfying the requirement 
        of subparagraph (A) for the corresponding reporting period for 
        such fiscal year.''.
    (c) Application Under Medicaid.--Section 1903(t)(8) of the Social 
Security Act (42 U.S.C. 1396b(t)(8)), as amended by section 201(c), is 
further amended in the third sentence--
            (1) by inserting ``and the last sentence of subparagraph 
        (B)(iii)'' after ``subparagraph (E)''; and
            (2) by inserting ``and the last sentence of subparagraph 
        (B)(i)(III)'' after ``subparagraph (D)''.

SEC. 203. EXPANDING THE HARDSHIP EXCEPTION TO THE MEDICARE EHR PAYMENT 
              ADJUSTMENTS.

    (a) Eligible Professionals.--Section 1848(a)(7)(B) of the Social 
Security Act (42 U.S.C. 1395w-4(a)(7)(B)) is amended to read as 
follows:
                    ``(B) Significant hardship exception.--
                            ``(i) In general.--Subject to clause (ii), 
                        the Secretary may, on a case-by-case basis, 
                        exempt an eligible professional from the 
                        application of the payment adjustment under 
                        subparagraph (A) if the Secretary determines, 
                        subject to annual renewal, that compliance with 
                        the requirement for being a meaningful EHR user 
                        would result in a significant hardship, such as 
                        in the case of an eligible professional who 
                        practices in a rural area without sufficient 
                        Internet access.
                            ``(ii) Required exception.--Subject to 
                        clause (iii), beginning for 2015, the Secretary 
                        shall, on a case-by-case basis, exempt an 
                        eligible professional from the application of 
                        the payment adjustment under subparagraph (A) 
                        if the Secretary determines, subject to annual 
                        renewal, the eligible professional--
                                    ``(I) encounters unforeseen 
                                circumstances (including technological 
                                difficulties and other disruptive 
                                situations) that present barriers to 
                                compliance with the requirement for 
                                being a meaningful EHR user;
                                    ``(II) changes certified EHR 
                                technology vendors, or changes from 
                                self-developed electronic health 
                                records to certified EHR technology 
                                from a vendor;
                                    ``(III) is an anesthesiologist, 
                                radiologist, pathologist, hospitalist, 
                                or is in any other physician specialty 
                                or subspecialty identified through 
                                rulemaking as a specialty or 
                                subspecialty that presents physicians 
                                in the specialty or subspecialty with 
                                unique difficulties in complying with 
                                such requirement;
                                    ``(IV) is at or near retirement age 
                                (as defined by the Secretary); or
                                    ``(V) is not able to be in 
                                compliance with any such requirement 
                                because the certified EHR technology 
                                used by such professional is not 
                                capable of sending, receiving, and 
                                seamlessly incorporating data from 
                                other certified EHR technology.
                            ``(iii) Limitation.--In no case may an 
                        eligible professional be granted an exemption 
                        under this subparagraph for more than 5 
                        years.''.
    (b) Eligible Hospitals.--Section 1886(b)(3)(B)(ix)(II) of the 
Social Security Act (42 U.S.C. 1395ww(b)(3)(B)(ix)(II)) is amended to 
read as follows:
                                    ``(II)(aa) Subject to item (cc), 
                                the Secretary may, on a case-by-case 
                                basis, exempt a subsection (d) hospital 
                                from the application of subclause (I) 
                                with respect to a fiscal year if the 
                                Secretary determines, subject to annual 
                                renewal, that requiring such hospital 
                                to be a meaningful EHR user during such 
                                fiscal year would result in a 
                                significant hardship, such as in the 
                                case of a hospital in a rural area 
                                without sufficient Internet access.
                                    ``(bb) Subject to item (cc), 
                                beginning for fiscal year 2015, the 
                                Secretary shall, on a case-by-case 
                                basis, exempt a subsection (d) hospital 
                                from the application of subclause (I) 
                                with respect to a fiscal year if the 
                                Secretary determines, subject to annual 
                                renewal, that the hospital encounters 
                                unforeseen circumstances (including 
                                technological difficulties and other 
                                disruptive situations) that present 
                                barriers to compliance with the 
                                requirement for such hospital to be a 
                                meaningful EHR user during such fiscal 
                                year, changes certified EHR technology 
                                vendors, changes from self-developed 
                                electronic health records to certified 
                                EHR technology from a vendor, or is not 
                                able to be in compliance with any such 
                                requirement because the certified EHR 
                                technology used by such hospital is not 
                                capable of sending, receiving, and 
                                seamlessly incorporating data from 
                                other certified EHR technology.
                                    ``(cc) In no case may a hospital be 
                                granted an exemption under this 
                                subclause for more than 5 years.''.

SEC. 204. PROMOTING INTEROPERABILITY THROUGH EHR CERTIFICATION PROCESS.

    Section 3004(a)(1) of the Public Health Service Act (42 U.S.C. 
300jj-14(a)(1)) is amended by adding at the end the following new 
sentence: ``The Secretary may not propose adoption of such standards, 
implementation specifications, or certification criteria unless such 
standards, implementation specifications, or certification criteria, 
respectively, have been successfully tested for widespread use by end 
users for at least a one-year period.''.

SEC. 205. IMPROVING THE TIMING OF THE ADOPTION OF MORE STRINGENT 
              MEASURES OF MEANINGFUL USE UNDER THE MEDICARE AND 
              MEDICAID MEANINGFUL USE PROGRAM.

    (a) Eligible Professionals.--Section 1848(o)(2) of the Social 
Security Act (42 U.S.C. 1395w-4(o)(2)), as amended by section 201(a), 
is further amended--
            (1) in subparagraph (A), in the matter following clause 
        (iii), by striking ``shall seek'' and inserting ``shall, in 
        accordance with subparagraph (F), seek''; and
            (2) by adding at the end the following new subparagraph:
                    ``(F) Provisions relating to increased stringency 
                of measures.--The Secretary shall implement the last 
                sentence of subparagraph (A) (relating to requirements 
                for more stringent measures of meaningful use selected 
                under this paragraph) in accordance with the following:
                            ``(i) Ensuring predictability.--Subject to 
                        clause (ii), in the case that the Secretary 
                        selects measures of meaningful use, including 
                        any objectives associated with such measures, 
                        the Secretary may not change or modify such 
                        selection for a period of three years.
                            ``(ii) Flexibility to adjust certain 
                        measures.--
                                    ``(I) Permissible reason for 
                                changes or modifications to measures.--
                                The Secretary may change or modify a 
                                measure of meaningful use before the 
                                end of the three-year period described 
                                in clause (i) if the Secretary makes 
                                one or more of the following 
                                determinations:
                                            ``(aa) The measure may 
                                        negatively impact the quality 
                                        of care for, or may risk harm 
                                        to, a patient.
                                            ``(bb) There is a new 
                                        hardship demonstrated by 
                                        eligible professionals specific 
                                        to the measure.
                                            ``(cc) An adjustment to the 
                                        measure is necessary to reflect 
                                        advances in science or 
                                        technology.
                                    ``(II) Request for review of 
                                clinical quality measures.--The 
                                Secretary shall establish a process 
                                under which stakeholders may, in the 
                                case that new information is available 
                                with respect to a clinical quality 
                                measure selected by the Secretary for 
                                quality reporting under subparagraph 
                                (A)(iii), request that the Secretary 
                                change or modify such measure for a 
                                reason described in subclause (I).''.
    (b) Eligible Hospitals.--Section 1886(n)(3) of the Social Security 
Act (42 U.S.C. 1395ww(n)(3)), as amended by section 201(b), is further 
amended--
            (1) in subparagraph (A), in the matter following clause 
        (iii), by striking ``shall seek'' and inserting ``shall, in 
        accordance with subparagraph (E), seek''; and
            (2) by adding at the end the following new subparagraph:
                    ``(E) Provisions relating to increased stringency 
                of measures.--The Secretary shall implement the last 
                sentence of subparagraph (A) (relating to requirements 
                for more stringent measures of meaningful use selected 
                under this paragraph) in accordance with the following:
                            ``(i) Ensuring predictability.--Subject to 
                        clause (ii), in the case that the Secretary 
                        selects measures of meaningful use, including 
                        any objectives associated with such measures, 
                        the Secretary may not change or modify such 
                        selection for a period of three years.
                            ``(ii) Flexibility to adjust certain 
                        measures.--
                                    ``(I) Permissible reason for 
                                adjustments to measures.--The Secretary 
                                may change or modify a measure of 
                                meaningful use before the end of the 
                                three-year period described in clause 
                                (i) if the Secretary makes one or more 
                                of the following determinations:
                                            ``(aa) The measure may 
                                        negatively impact the quality 
                                        of care for, or may risk harm 
                                        to, a patient.
                                            ``(bb) There is a new 
                                        hardship demonstrated by 
                                        eligible hospitals specific to 
                                        the measure.
                                            ``(cc) An adjustment to the 
                                        measure is necessary to reflect 
                                        advances in science or 
                                        technology.
                                    ``(II) Request for review of 
                                clinical quality measures.--The 
                                Secretary shall establish a process 
                                under which stakeholders may, in the 
                                case that new information is available 
                                with respect to a clinical quality 
                                measure selected by the Secretary for 
                                quality reporting under subparagraph 
                                (A)(iii), request that the Secretary 
                                change or modify such measure for a 
                                reason described in subclause (I).''.
    (c) Application Under Medicaid.--Section 1903(t)(8) of the Social 
Security Act (42 U.S.C. 1396b(t)(8)), as amended by sections 201(c) and 
202(c), is further amended in the third sentence--
            (1) by striking ``and the last sentence of subparagraph 
        (B)(iii)'' and inserting ``, the last sentence of subparagraph 
        (B)(iii), and subparagraph (F)''; and
            (2) by striking ``and the last sentence of subparagraph 
        (B)(i)(III)'' and inserting ``, the last sentence of 
        subparagraph (B)(i)(III), and subparagraph (E)''.

SEC. 206. THREE-MONTH EHR REPORTING PERIODS FOR THE MEDICARE AND 
              MEDICAID EHR INCENTIVE PAYMENT PROGRAMS.

    (a) EHR Reporting Period.--
            (1) Eligible professionals.--Section 1848(a)(7)(E)(ii) of 
        the Social Security Act (42 U.S.C. 1395w-4(a)(7)(E)(ii)) is 
        amended by adding at the end the following: ``Such period (or 
        periods) shall consist of a three-month reporting period, 
        without regard to the payment year or the stage criteria (as 
        established under section 495.6 of title 42, Code of Federal 
        Regulations) involved.''.
            (2) Eligible hospitals.--Subsections (b)(3)(B)(ix)(IV) and 
        (n)(6)(A) of section 1886 of the Social Security Act (42 U.S.C. 
        1395ww) are each amended by adding at the end the following: 
        ``Such period (or periods) shall consist of a three-month 
        reporting period, without regard to the payment year or the 
        stage criteria (as established under section 495.6 of title 42, 
        Code of Federal Regulations) involved.''.
            (3) Application under medicaid.--Section 1903(t)(8) of the 
        Social Security Act (42 U.S.C. 1396b(t)(8)), as amended by 
        sections 201(c), 202(c), and 205(c), is further amended by 
        adding at the end the following new sentence: ``Such reporting 
        periods shall consist of a three-month reporting period, 
        without regard to payment year or the stage criteria (as 
        established under section 495.6 of title 42, Code of Federal 
        Regulations).''.
    (b) Regulations.--Not later than 3 months after the date of 
enactment of this Act, the Secretary of Health and Human Services shall 
promulgate regulations to carry out the amendments made by subsection 
(a). Such regulations shall apply beginning with the 2016 EHR reporting 
period.

SEC. 207. PROVIDING ELIGIBLE PROFESSIONALS AND ELIGIBLE HOSPITALS THE 
              OPTION TO MEET A MORE ADVANCED STAGE OF MEANINGFUL USE.

    (a) Meaningful EHR User.--A ``meaningful EHR user'', as defined 
under section 495.4 of title 24, Code of Federal Regulations, shall 
include eligible professionals and eligible hospitals who demonstrate 
meaningful use of certified EHR technology by meeting the applicable 
objectives and associated measures of either of the following:
            (1) The stage of meaningful use that the eligible 
        professional or eligible hospital is scheduled to meet during 
        the applicable ``EHR reporting period'', as such term is 
        defined under section 495.4 of title 24, Code of Federal 
        Regulations.
            (2) Any other stage of meaningful use, provided that such 
        stage of meaningful use selected by the eligible professional 
        or eligible hospital is more advanced than the stage of 
        meaningful use that the eligible professional or eligible 
        hospital is scheduled to meet during the applicable EHR 
        reporting period.
    (b) Definition.--In this subparagraph, the term ``stage of 
meaningful use'' means the stage criteria established by the Secretary 
of Health and Human Services under section 495.6 of title 42, Code of 
Federal Regulations.
                                 <all>