,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #acca  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #ba1 #bjac ,mrs4 
,black 7= h]self1 ,mr4 ,*abot1 ,mr4     
,grimm1 ,mr4 ,h>ris1 & ,mrs4 ,blackburn7
 introduc$ ! foll[+ bill2 :i* 0 ref]r$  
to ! ,committee on ,en]gy & ,comm]ce1 & 
9 addition to ! ,committee on ,ways &   
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d c]ta9 requirem5ts &   
p5alties implem5t$ "u ! ,m$ic>e &       
,m$icaid programs by ! ,,hite* ,act (   
#bjji1 :i* w\ld o!rwise imp$e eligible  
pr(essionals f adopt+ electronic heal?  
records to improve pati5t c>e4  #a4     
,%ort title2 table ( cont5ts  7a7 ,%ort 
title ,?is ,act may be cit$ z !         
,electronic ,heal? ,records ,improvem5t 
,act4  7b7 ,table ( cont5ts ,! table (  
cont5ts ( ?is ,act is z foll[s3  ,sec4  
#a4 ,%ort title2 table ( cont5ts4 ,sec4 
#b4 ,exception = c]ta9 eligible         

pr(essionals f application ( ,m$ic>e    
paym5t adju/m5t = n demon/rat+ ,,ehr    
mean+ful use4 ,sec4 #c4 ,%ort5+ ,,ehr   
report+ p]iod = application ( ,m$ic>e   
,,ehr paym5t adju/m5t to eligible       
pr(essionals4 ,sec4 #d4 ,additional     
exceptions to application ( ,m$ic>e     
paym5t adju/m5t = c]ta9 ,m$icaid &      
hospital-bas$ eligible pr(essionals n   
demon/rat+ ,,ehr mean+ful use4 ,sec4 #e4
 ,alt]nate mean+ful use crit]ia =       
eligible pr(essionals utiliz+ electronic
 heal? records & specialty regi/ry      
sy/ems4 ,sec4 #f4 ,enhanc+ ,m$ic>e ,,ehr
 mean+ful use among eligible            
pr(essionals :o are rural heal? c>e     
provid]s4 ,sec4 #g4 ,improv+ ,,ehr      
mean+ful use "u ,m$ic>e by eligible     
pr(essionals :o practice 9 ambulatory   
surgical c5t]s4 ,sec4 #h4 ,exemption f  
c]ta9 ,,ehr mean+ful use requirem5ts =  
c]ta9 eligible pr(essionals = purposes (
 ,m$ic>e paym5t adju/m5t4 ,sec4 #i4     
,additional adm9i/rative provisions     
relat+ to ,m$ic>e eligible pr(essionals'

 ,,ehr inc5tives4 ,sec4 #aj4            
,non-application ( provisions & am5dm5ts
 to eligible pr(essional ,m$ic>e        
inc5tives = c]ta9 ,,ma organizations &  
,m$icaid inc5tives = adoption & mean+ful
 use ( c]tifi$ ,,ehr te*nology4  #b4    
,exception = c]ta9 eligible pr(essionals
 f application ( ,m$ic>e paym5t adju/m5t
 = n demon/rat+ ,,ehr mean+ful use  7a7 
,exception = c]ta9 small physician      
practices ,section #ahdh7;a77#g7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7;a77#g77 is am5d$--  7#a7 9   
subp>agraph 7,a77i71 by /rik+           
subp>agraphs 7,b7 & 7,d7 & ins]t+       
subp>agraphs 7,b71 7,d71 & 7,f72 &  7#b7
 by add+ at ! end ! foll[+ new          
subp>agraph3  7,f7 #c-ye> exception =   
c]ta9 eligible pr(essionals  7i7 ,9     
g5]al ,! ,secret>y %all exempt an       
eligible pr(essional :om ! ,secret>y    
det]m9es is describ$ 9 clause 7ii7 f !  
application ( ! paym5t adju/m5t "u      
subp>agraph 7,a7 = ea* ( ! paym5t ye>s  
#bjae ?r\gh #bjag4 ,! ,secret>y %all    

make a det]m9ation "u ! previ\s s5t5ce1 
) respect to su* an exemption = an      
eligible pr(essional1 only if su*       
eligible pr(essional submits a reque/ = 
su* exemption4 ,! ,secret>y %all det]m9e
 :e!r or n an eligible pr(essional is   
describ$ 9 clause 7ii7 n lat] ?an #cj   
days aft] ! date su* eligible           
pr(essional submits a reque/ pursuant to
 ! previ\s s5t5ce4  7ii7 ,eligible      
pr(essionals 9 small physician practices
 ,an eligible pr(essional describ$ 9 ?is
 clause is an eligible pr(essional      
furni%+ cov]$ pr(essional s]vices dur+ !
 ,,ehr report+ p]iod = #bjae 9 a        
physician practice t is a solo practice4
  4  7b7 ,exception = c]ta9 physicians  
ne> retirem5t age ,subp>agraph 7,f7 (   
section #ahdh7;a77#g7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;a77#g771 z add$ by subsection
 7a71 is am5d$--  7#a7 9 clause 7i71 9 !
 fir/ & ?ird s5t5ces1 by /rik+ clause   
7ii7 & ins]t+ clause 7ii7 or 7iii72 &   
7#b7 by add+ at ! end ! foll[+ new      

clause3  7iii7 ,eligible pr(essionals at
 or ne> retirem5t age ,an eligible      
pr(essional describ$ 9 ?is clause is an 
eligible pr(essional :o z ( ! la/ day ( 
#bjae has atta9$ e>ly retirem5t age 7z  
def9$ 9 section #baf7l77#b77 or :o w    
atta9 su* age dur+ ! #e-ye> p]iod foll[+
 su* day4  4  7c7 ,notification (       
eligibility = exceptions f paym5t       
adju/m5t ,section #ahdh7;a77#g7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7;a77#g771 z am5d$ by          
subsection 7a71 is fur!r am5d$ by add+  
at ! end ! foll[+ new subp>agraph3  7,g7
 ,notification ,n lat] ?an #cj days aft]
 ! date on :i* ! ,secret>y det]m9es an  
eligible pr(essional is exempt1 pursuant
 to subp>agraph 7,f71 f ! application ( 
! paym5t adju/m5t "u subp>agraph 7,a71 !
 ,secret>y %all provide su* eligible    
pr(essional notice ( su* det]m9ation4  4
  #c4 ,%ort5+ ,,ehr report+ p]iod =     
application ( ,m$ic>e ,,ehr paym5t      
adju/m5t to eligible pr(essionals  7a7  
,9 g5]al ,section #ahdh7;a77#g77;,e77ii7

 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciew-#d7;a77#g77;,e77ii77 is
 am5d$ by ins]t+ 1 s long z all ( su*   
p]iod 7or p]iods7 occurs dur+ ! ye> 9   
:i* ! correspond+ adju/m5t1 if any1 "u  
?is p>agraph w\ld be appli$ to !        
eligible pr(essional involv$ aft] a     
p]iod 7or p]iods7 specifi$ by !         
,secret>y4  7b7 ,rebates ,section       
#ahdh7;a77#g77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#aciew-#d7;a77#g77;,a77 is am5d$ by add+
 at ! end ! foll[+ new clause3  7iv7    
,special rule ,! ,secret>y %all e/abli% 
a process "u :i* if = a cal5d> ye>1     
beg9n+ ) #bjae1 an adju/m5t is made "u  
?is p>agraph ) respect to cov]$         
pr(essional s]vices furni%$ by an       
eligible pr(essional & !n dur+ su*      
cal5d> ye> ! eligible pr(essional meets 
! crit]ia = e/abli%+ mean+ful use (     
c]tifi$ ,,ehr te*nology1 ! ,secret>y    
%all provide to ! eligible pr(essional a
 rebat$ am\nt su* t ! total am\nt (     
paym5t t ! provid] receives "u ?is      

subsection = su* s]vices = su* ye> is ! 
fee s*$ule am\nt t w\ld o!rwise apply to
 su* s]vices "u ?is subsection )\t      
application ( ?is p>agraph4  4  7c7     
,con=m+ am5dm5t ,section                
#ahdh7o77#e77;,b7 ( ! ,social ,security 
,act is am5d$ by add+ at ! end ! foll[+ 
new s5t5ce3 ,su* t]m1 z us$ "u ?is      
subsection ) respect to subsection      
7a77#g7 & a ye> beg9n+ ) #bjae1 %all h !
 mean+ giv5 su* t]m "u subsection       
7a77#g77;,e77ii744  #d4 ,additional     
exceptions to application ( ,m$ic>e     
paym5t adju/m5t = c]ta9 ,m$icaid &      
hospital-bas$ eligible pr(essionals n   
demon/rat+ ,,ehr mean+ful use  7a7      
,eligible pr(essionals p>ticipat+ 9     
,m$icaid ,,ehr inc5tive program ,section
 #ahdh7;a77#g7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciew-#d7;a77#g771 
z am5d$ by section #b1 is fur!r am5d$-- 
7#a7 9 subp>agraph 7,a77i71 by /rik+    
7,d71 & 7,f7 & ins]t+ 7,d71 7,f71 &     
7,g72  7#b7 by r$esignat+ subp>agraph   
7,g7 z subp>agraph 7,h72 &  7#c7 by     

ins]t+ aft] subp>agraph 7,f7 ! foll[+   
new subp>agraph3  7,g7 ,additional      
exceptions = c]ta9 ,m$icaid provid]s    
p>ticipat+ 9 ,m$icaid ,,ehr inc5tive    
program ,9 ! case ( an eligible         
pr(essional :o is a ,m$icaid provid]    
describ$ 9 section #aijc7t77#b77;,a71 ! 
,secret>y %all exempt su* eligible      
pr(essional f ! application ( ! ,m$ic>e 
paym5t adju/m5t "u subp>agraph 7,a71 )  
respect to a ye>1 if su* ye> is ! fir/  
ye> t su* pr(essional receiv$ paym5t "u 
section #aijc7t74  4  7b7               
,hospital-,bas$ eligible pr(essionals   
,section #ahdh7;a77#g77;,d7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;a77#g77;,d77 is am5d$ by add+
 at ! end ! foll[+ new s5t5ce3 ,9 apply+
 ! def9ition "u subsection              
7o77#a77;,c77ii7 = purposes ( ! previ\s 
s5t5ce1 ! ref]5ce to sub/antially all "u
 su* subsection %all mean #ij p]c5t or m
 & a det]m9ation describ$ 9 su*         
subsection1 ) respect to an eligible    
pr(essional1 may only be made by !      

,secret>y pursuant to a reque/ ( !      
pr(essional t is submitt$ to ! ,secret>y
 be=e #bjae1 & %all be effective = su*  
pr(essional = #bjae & ea* subsequ5t     
ye>44  7c7 ,application ( notification  
requirem5t ,subp>agraph 7,h7 ( section  
#ahdh7;a77#g7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciew-#d7;a77#g771 z   
add$ by section #b7;c7 & r$esignat$ by  
subsection 7a77#b71 is am5d$ by /rik+   
subp>agraph 7,f7 & ins]t+ subp>agraph   
7,b71 7,d71 7,f71 or 7,g74  #e4         
,alt]nate mean+ful use crit]ia =        
eligible pr(essionals utiliz+ electronic
 heal? records & specialty regi/ry      
sy/ems ,section #ahdh7o77#b7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciew-#d7o77#b77 is am5d$--  7#a7 9    
subp>agraph 7,a77iii71 by /rik+ ,subject
 to & ins]t+ ,= su* p]iod1 ! eligible   
pr(essional satisfactorily uses a       
qualifi$ national specialty regi/ry     
sy/em t measures quality improvem5t or  
improves pati5t safety 7z describ$ 9    
subp>agraph 7,d771 or1 subject to2 &    

7#b7 by add+ at ! end ! foll[+ new      
subp>agraph3  7,d7 ,qualifi$ national   
specialty regi/ries  7i7 ,n lat] ?an    
,janu>y #a1 #bjae1 ! ,secret>y %all     
specify1 pursuant to rulemak+1 crit]ia =
 det]m9+--  7,i7 if a national          
speciality regi/ry sy/em is a qualifi$  
national speciality regi/ry sy/em1 =    
purposes ( ?is p>agraph2 &  7,,ii7 if an
 eligible pr(essional has demon/rat$    
satisfactory use 7z det]m9$ by !        
,secret>y7 ( a qualifi$ national        
speciality regi/ry sy/em = a p]iod4     
7ii7 ,= purposes ( ?is p>agraph1 ! t]m  
qualifi$ national specialty regi/ry     
sy/em means1 ) respect to a m$ical      
speciality1 a nationally available      
regi/ry--  7,i7 t is adm9i/]$ or endors$
 by a national m$ical specialty society2
  7,,ii7 t collects cl9ical data =      
purposes ( measur+ quality improvem5t or
 improv+ pati5t safety relat$ to ! type 
( c>e provid$ or conditions treat$ by ! 
types ( eligible pr(essionals t are     
typically "p su* national m$ical        

specialty society2 &  7,,iii7 t is      
det]m9$ to be a qualifi$ national       
speciality regi/ry sy/em by ! ,secret>y 
"u clause 7ii74  4  #f4 ,enhanc+ ,m$ic>e
 ,,ehr mean+ful use among eligible      
pr(essionals :o are rural heal? c>e     
provid]s  7a7 ,ext5sion ( ,m$ic>e ,,ehr 
inc5tives to eligible pr(essionals      
practic+ 9 rural heal? cl9ics  7#a7     
,,ehr paym5t adju/m5t ,section          
#ahdh7;a77#g77;,e77i7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;a77#g77;,e77i77 is am5d$ by  
ins]t+ be=e ! p]iod at ! end ! foll[+3  
&1 ) respect to paym5t ye>s aft] #bjad1 
includes rural heal? cl9ic s]vices 7z   
def9$ 9 section #ahfa7;aa77#a77 furni%$ 
by an eligible pr(essional4  7#b7 ,,ehr 
increas$ paym5ts ,section               
#ahdh7o77#e77;,a7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4                     
#aciew-#d7o77#e77;,a77 is am5d$ by      
ins]t+ be=e ! p]iod at ! end ! foll[+3  
&1 ) respect to paym5t ye>s aft] #bjad1 
includes rural heal? cl9ic s]vices 7z   

def9$ 9 section #ahfa7;aa77#a77 furni%$ 
by an eligible pr(essional4  7b7        
,ext5sion ( ,m$ic>e e,rx & quality      
report+ inc5tives to rural heal? cl9ics 
,section #ahdh7m77#f77;,a7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7m77#f77;,a77 is am5d$ by      
ins]t+ be=e ! p]iod at ! end ! foll[+3  
except t ! t]m cov]$ pr(essional s]vices
 %all1 ) respect to report+ p]iods =    
#bjae or a subsequ5t ye>1 include rural 
heal? cl9ic s]vices 7z def9$ 9 section  
#ahfa7;aa77#a77 furni%$ by an eligible  
pr(essional4  #g4 ,improv+ ,,ehr        
mean+ful use "u ,m$ic>e by eligible     
pr(essionals :o practice 9 ambulatory   
surgical c5t]s  7a7 #c-,ye> exemption f 
enc\nt]s calculation ,to demon/rate     
,,ehr mean+ful use = purposes ( paym5t  
adju/m5t ,section #ahdh7o77#b7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7o77#b771 z am5d$ by section   
#e1 is fur!r am5d$ by add+ at ! end !   
foll[+ new subp>agraph3  7,e7 ,treatm5t 
( pati5t enc\nt]s at ambulatory surgical

 c5t]s  7i7 ,9 g5]al ,subject to clause 
7ii71 9 apply+ ?is p>agraph = purposes (
 subsection 7a77#g71 any submissions (  
claims = items or s]vices furni%$ by an 
eligible pr(essional at an ambulatory   
surgical c5t] dur+ p]=mance ye>s = !    
#bjae1 #bjaf1 or #bjag paym5t           
det]m9ations %all n be includ$ 9 ! data 
us$ to det]m9e if su* eligible          
pr(essional is a mean+ful ,,ehr us]4    
7ii7 ,rule ( con/ruction ,no?+ 9 clause 
7i7 %all prohibit an eligible           
pr(essional f receiv+ an additional     
paym5t "u p>agraph 7#a7 ) respect to    
cov]$ pr(essional s]vices furni%$ 9 a   
paym5t ye> if ! eligible pr(essional is 
det]m9$ to be a mean+ful ,,ehr us] "u   
?is p>agraph = ! report+ p]iod = su*    
ye>4  7iii7 ,limitation ( paym5t        
adju/m5t ,9 apply+ clause 7i7 = purposes
 ( subsection 7a77#g7 & a ye>1 if an    
eligible pr(essional is n a mean+ful    
,,ehr us] pursuant to su* clause = an   
,,ehr report+ p]iod = ! ye>1 any        
adju/m5t "u su* subsection %all n apply 

to ! fee s*$ule am\nt = cov]$           
pr(essional s]vices furni%$ by su*      
eligible pr(essional dur+ ! ye> 9 an    
ambulatory surgical c5t]4  4  7b7       
,re9/atem5t ( bat*+ process ,subp>agraph
 7,e7 ( section #ahdh7o77#b7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciew-#d7o77#b771 z add$ by subsection 
7a71 is am5d$ by add+ at ! end ! foll[+ 
new clause3  7iv7 ,use ( bat*+ process  
,9 apply+ ?is p>agraph = purposes (     
subsection 7a77#g7 & ) respect to a     
pati5t enc\nt] occurr+ at an ambulatory 
surgical c5t]1 if an eligible           
pr(essional creates a record ( su*      
pati5t enc\nt] )\t us+ c]tifi$ ,,ehr    
te*nology at ! ambulatory surgical c5t] 
& subsequ5tly inputs ! in=mation ( su*  
record ( su* enc\nt] into c]tifi$ ,,ehr 
te*nology at a diff]5t location1 c]tifi$
 ,,ehr te*nology %all be treat$ z be+   
available at su* pati5t enc\nt]4  4  #h4
 ,exemption f c]ta9 ,,ehr mean+ful use  
requirem5ts = c]ta9 eligible            
pr(essionals = purposes ( ,m$ic>e paym5t

 adju/m5t ,section #ahdh7o77#b7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7o77#b771 z am5d$ by section   
#g1 is fur!r am5d$ by add+ at ! end !   
foll[+ new subp>agraph3  7,f7           
,exceptions = c]ta9 eligible            
pr(essionals ,9 apply+ ?is p>agraph =   
purposes ( subsection 7a77#g71 ! foll[+ 
%all apply3  7i7 ,9 ! case ( an eligible
 pr(essional :o is an ane/hesiologi/ or 
physician ( any o!r specialty or        
subspecialty id5tifi$ ?r\gh rulemak+ z n
 conduct+ traditional (fice visits1 9   
ord] to be treat$ z a mean+ful ,,ehr us]
 = an ,,ehr report+ p]iod "u su*        
subsection = a ye> su* eligible         
pr(essional %all n be requir$ to--  7,i7
 provide cl9ical summ>ies to pati5ts2 or
  7,,ii7 provide pati5ts1 ^u reque/1 )  
an electronic copy ( ! heal? in=mation (
 su* pati5ts 7includ+ diagno/ic te/     
results1 problem li/s1 m$ication li/s1 &
 m$ication all]gies74  7ii7 ,9 ! case ( 
an eligible pr(essional :o is an        
ane/hesiologi/ or physician ( any o!r   

specialty t does n traditionally ord]   
prescription drugs be=e adm9i/ration (  
su* drugs1 z specifi$ ?r\gh rulemak+1 9 
ord] to be treat$ z a mean+ful ,,ehr us]
 = an ,,ehr report+ p]iod "u su*        
subsection = a ye> su* eligible         
pr(essional %all n be requir$ to utilize
 ,,ehr te*nology t provides = *ecks on  
prescription drug int]actions until     
,,ehr te*nology is available to         
accommodate *ecks on int]actions betwe5 
prescription drugs adm9i/]$ 9 op]at+    
rooms or o!r ane/hetiz+ locations4  ,!  
,secret>y %all provide notice to ea*    
eligible pr(essional to :om clause 7i7  
or 7ii7 applies ( ! application ( su*   
clause4  4  #i4 ,additional adm9i/rative
 provisions relat+ to ,m$ic>e eligible  
pr(essionals' ,,ehr inc5tives  7a7      
,appeals process ,section #ahdh7o77#c7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciew-#d7o77#c77 is am5d$--  7#a7 9   
subp>agraph 7,c71 by /rik+ ,!re %all be 
no & ins]t+ ,except z provid$ "u        
subp>agraph 7,e71 !re %all be no2 &     

7#b7 by add+ at ! end ! foll[+ new      
subp>agraph3  7,e7 ,appeals process be=e
 application ( p5alties ,! ,secret>y    
%all1 by n lat] ?an ,janu>y #a1 #bjae1  
e/abli% & h 9 place a process = eligible
 pr(essionals to seek1 be=e application 
( a paym5t adju/m5t "u subsection       
7a77#g77;,a7 ) respect to su* an        
eligible pr(essional1 a review ( !      
det]m9ation t ! eligible pr(essional did
 n qualify z a mean+ful ,,ehr us] "u    
p>agraph 7#b74  4  7b7 ,semi-,annual    
progress report  7#a7 ,9 g5]al ,n lat]  
?an six mon?s aft] ! date ( ! enactm5t (
 ?is ,act & e six mon?s !reaft] until ! 
date specifi$ 9 p>agraph 7#c71 !        
,secret>y ( ,heal? & ,human ,s]vices1   
?r\gh ! ,adm9i/rator ( ! ,c5t]s =       
,m$ic>e  ,m$icaid ,s]vices1 %all submit 
to ,congress a report t conta9s ! foll[+
 in=mation3  7,a7 ,improvem5ts t h be5  
made 9 /reaml9+ requirem5ts among v>i\s 
programs "u ! ,m$ic>e program "u title  
,,xviii ( ! ,social ,security ,act      
reg>d+ simil> in=mation 7su* z =        

purposes ( mean+ful use ( c]tifi$ ,,ehr 
te*nology1 physician quality report+1 & 
electronic prescrib+74  7,b7            
,improvem5ts c]tifi$ ,,ehr te*nology    
v5dors h made 9 int]op]ability4  7,c7 ,!
 progress ( ! adoption ( c]tifi$ ,,ehr  
te*nology by physician specialty gr\ps &
 ! p]c5tage ( eligible pr(essionals 7z  
def9$ 9 section #ahdh7;a77#g77;,e7 ( !  
,social ,security ,act7 :o are eligible 
= inc5tive paym5ts "u ! ,m$ic>e program 
= mean+ful use ( c]tifi$ ,,ehr          
te*nology4  7,d7 ,! report+ capabilities
 ( qualifi$ national specialty report+  
sy/ems 7z def9$ 9 section #ahdh7o77#b7 (
 ! ,social ,security ,act1 z add$ by    
section #e7 & recomm5dations = mak+ su* 
regi/ries m int]active ) ,,ehr          
te*nology4  7,e7 ,! results ( ! mo/     
rec5t survey conduct$ "u p>agraph 7#b74 
7#b7 ,physician survey ,n lat] ?an six  
mon?s aft] ! date ( ! enactm5t ( ?is    
,act & e six mon?s !reaft] until ! date 
specifi$ 9 p>agraph 7#c71 ! ,secret>y ( 
,heal? & ,human ,s]vices1 ?r\gh !       

,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices1 %all conduct a survey
 ( physicians to id5tify b>ri]s enc\nt]$
 by physicians 9 a*iev+ /age #c (       
mean+ful use ( c]tifi$ ,,ehr te*nology4 
7#c7 ,date specifi$ ,= purposes (       
p>agraphs 7#a7 & 7#b71 ! date specifi$ 9
 ?is p>agraph is ! date on :i* #ge p]c5t
 ( all eligible pr(essionals 7z def9$ 9 
section #ahdh7o77#e7 ( ! ,social        
,security ,act7 h satisfi$ ! requirem5ts
 ( /age #b ( mean+ful use ( c]tifi$     
,,ehr te*nology 7z def9$ by ! ,secret>y 
( ,heal? & ,human ,s]vices74  #aj4      
,non-application ( provisions & am5dm5ts
 to eligible pr(essional ,m$icaid       
inc5tives = adoption & mean+ful use (   
c]tifi$ ,,ehr te*nology ,section        
#aijc7t7 ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #acif;b7t77 is am5d$ by add+ 
at ! end ! foll[+ new p>agraph3  7#aa7  
,! provisions (1 includ+ ! am5dm5ts made
 by1 ! ,electronic ,heal? ,records      
,improvem5t ,act 7o!r ?an section #aj ( 
su* ,act7 %all n apply = purposes ( ?is 

subsection or subsection 7a77#c77;,f74  
4