,,ii #aad? ,,congress #b;d ,session ,s4 #cagc ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,july #ac1 #bjaf ,mr4 ,?une 7= himself1 ,mr4 ,alex&]1 ,mr4 ,burr1 ,mr4 ,enzi1 ,mr4 ,rob]ts1 & ,mr4 ,cassidy7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to provide = a #ij-;day ,,ehr report+ p]iod = ! det]m9ation ( :e!r an eligible pr(essional or eligible hospital is a mean+ful ,,ehr us] & to remove ! all-or-no?+ approa* to mean+ful use1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,,ehr ,regulatory ,relief ,act4 #b4 #ij-;day ,,ehr report+ p]iod = det]m9ation ( :e!r an eligible pr(essional or eligible hospital is a mean+ful ,,ehr us] 7a7 ,= an eligible pr(essional = ! #bjaf ,,ehr report+ p]iod = ! #bjah paym5t adju/m5t ,section #ahdh7;a77#g77;,e77ii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7;a77#g77;,e77ii77 is am5d$ by add+ at ! end ! foll[+ new s5t5ce3 ,= ! ,,ehr report+ p]iod ) respect to #bjah or additional ye>s1 su* t]m %all also include a #ij-;day ,,ehr report+ p]iod1 9 addition to any p]iod 7or p]iods7 specifi$ by ! ,secret>y44 7b7 ,cont9uation ( #ij-;,day ,,ehr report+ p]iod "u ,,mips ,section #ahdh7o77#e77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7o77#e77;,b77 is am5d$ by add+ at ! end ! foll[+ new s5t5ce3 ,= purposes ( det]m9+ a p]=mance p]iod "u subsection 7q77#d7 ) respect to ! p]=mance category describ$ 9 subsection 7q77#b77;,a77iv71 & = purposes ( ! p]=mance p]iod describ$ 9 p>agraph 7#b77;,d71 = ye>s z ! ,secret>y det]m9es appropriate1 su* t]m %all also include a #ij-;day ,,ehr p]=mance p]iod1 9 addition to any p]iod 7or p]iods7 specifi$ by ! ,secret>y44 7c7 ,= an eligible hospital = ! #bjaf ,,ehr report+ p]iod & subsequ5t report+ p]iods & paym5t adju/m5ts = fiscal ye> #bjah & subsequ5t fiscal ye>s ,section #ahhf7;b77#c77;,b77ix77,,iv7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieww7b77#c77;,b77ix77,,iv77 is am5d$ by add+ at ! end ! foll[+ new s5t5ce3 ,= ! ,,ehr report+ p]iod ) respect to fiscal ye> #bjah & ea* subsequ5t fiscal ye>1 su* t]m %all also include a #ij-;day ,,ehr report+ p]iod 7or p]iods7 specifi$ by ! ,secret>y44 #c4 ,remov+ ! all-or-no?+ approa* to mean+ful use 7a7 ,= an eligible pr(essional ,section #ahdh7o77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7o77#b77 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,e7 ,flexibility = mean+ful use det]m9ations = eligible pr(essionals ,9 apply+ clauses 7i71 7ii71 & 7iii7 ( subp>agraph 7,a71 ! ,secret>y may det]m9e t an eligible pr(essional is a mean+ful ,,ehr us] = ! ,,ehr report+ p]iod = #bjah or additional ye>s z det]m9$ by ! ,secret>y if su* eligible pr(essional meets at lea/ #gj p]c5t 7or a portion betwe5 #ej & #gj p]c5t7 ( ! measures e/abli%$ by ! ,secret>y4 4 7b7 ,= an eligible hospital ,section #ahhf7n77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieww7n77#c77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7,d7 ,flexibility = mean+ful use det]m9ations = eligible hospitals ,9 apply+ clauses 7i71 7ii71 & 7iii7 ( subp>agraph 7,a71 = purposes ( subsection 7b77#c77;,b77ix7 = an ,,ehr report+ p]iod "u su* subsection ) respect to fiscal ye>s aft] #bjah1 ! ,secret>y %all det]m9e t an eligible hospital is a mean+ful ,,ehr us] = ! ,,ehr report+ p]iod = su* fiscal ye>s us+ a me?odology specifi$ by ! ,secret>y ?r\gh rulemak+ bas$ on p]=mance ) respect to objectives & measures e/abli%$ by ! ,secret>y t is met by an eligible hospital4 ,su* me?odology %all all[ an eligible hospital to be a mean+ful ,,ehr us] if !y a*ieve #gj p]c5t 7or a portion betwe5 #ej & #gj p]c5t7 ( su* measures or if !y a*ieve a composite score 7z det]m9$ by ! ,secret>y ?r\gh rulemak+7 bas$ on su* measures4 4 7c7 ,con=m+ am5dm5ts ,! la/ s5t5ce ( ea* ( sections #ahdh7o77#b77;,a7 & #ahhf7n77#c77;,a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7o77#b77;,a71 #acieww7n77#c77;,a77 are am5d$ by /rik+ by & all t foll[s be=e ! p]iod at ! end4 #d4 ,ext5d+ flexibility 9 apply+ h>d%ip exception = mean+ful use 7a7 ,= an eligible pr(essional = ! #bjaf ,,ehr report+ p]iod = ! #bjah paym5t adju/m5t ,section #ahdh7;a77#g77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7;a77#g77;,b77 is am5d$-- 7#a7 by /rik+ exception4--,! ,secret>y & ins]t+ 8exception4-- 7i7 ,9 g5]al ,! ,secret>y 2 7#b7 9 ! fir/ s5t5ce ( clause 7i71 z add$ by p>agraph 7#a7-- 7,a7 by /rik+ #bjag & ins]t+ ea* ( #bjag & #bjah2 & 7,b7 by /rik+ ,m>* #ae1 #bjaf & ins]t+ ! applicable date 7z def9$ 9 clause 7ii772 & 7#c7 by add+ at ! end ! foll[+ new clause3 7ii7 ,applicable date def9$ ,9 ?is subp>agraph1 ! t]m applicable date means-- 7,i7 ) respect to ! paym5t adju/m5t "u subp>agraph 7,a7 = #bjag1 ,m>* #ae1 #bjaf2 & 7,,ii7 ) respect to ! paym5t adju/m5t "u subp>agraph 7,a7 = #bjah1 ,m>* #ae1 #bjag4 4 7b7 ,= an eligible hospital = ! #bjaf & #bjag ,,ehr report+ p]iods & paym5t adju/m5ts = fiscal ,ye>s #bjah & #bjai ,section #ahhf7;b77#c77;,b77ix7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieww7b77#c77;,b77ix77 is am5d$-- 7#a7 9 ! fir/ s5t5ce ( subclause 7,,ii7-- 7,a7 by /rik+ fiscal ye> #bjag & ins]t+ ea* ( fiscal ye>s #bjag ?r\gh #bjai2 & 7,b7 by /rik+ ,april #a1 #bjaf & ins]t+ ! applicable date 7z def9$ 9 subclause 7,v772 & 7#b7 by add+ at ! end ! foll[+ new subclause3 7,v7 ,= purposes ( ?is clause1 ! t]m applicable date means-- 7aa7 ) respect to ! paym5t r$uction "u subclause 7,i7 = fiscal ye> #bjag1 ,april #a1 #bjaf2 7bb7 ) respect to ! paym5t r$uction "u subclause 7,i7 = fiscal ye> #bjah1 ,april #a1 #bjag2 & 7cc7 ) respect to ! paym5t r$uction "u subclause 7,i7 = fiscal ye> #bjai1 ,april #a1 #bjah4 4