,,ii  #aaeth ,,congress  #ast ,session  
,s4 #bjei  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,november #b1  
#bjag,mr4 ,thune 7for himself1 ,mr4     
,alexander1 ,mr4 ,burr1 ,mr4 ,enzi1 ,mr4
 ,roberts1 and ,mr4 ,cassidy7 introduced
 the following bill2 which was read     
twice and referred to the ,committee on 
,finance  ,a ,,bill  ,to amend title    
,,xviii of the ,social ,security ,act to
 provide for a #ij-;day period for the  
determination of whether a ,,mips       
eligible professional or eligible       
hospital is a meaningful ,,ehr user and 
to remove the all-or-nothing approach to
 meaningful use1 and for other purposes4
  #a4 ,short title ,this ,act may be    
cited as the ,,ehr ,regulatory ,relief  
,act4  #b4 #ij-;day period for          
determination of whether a ,,mips       
eligible professional or an eligible    
hospital is a meaningful ,,ehr user  7a7
 ,inclusion of #ij-;,day performance    
period for advancing care information   
performance category under ,,mips       

,section #ahdh7q77#d7 of the ,social    
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7q77#d77 is amended by adding  
at the end the following new sentence3  
,for purposes of determining a          
performance period for the performance  
category described in paragraph         
7#b77;,a77iv71 and for purposes of the  
performance period described in         
subsection 7o77#b77;,d71 such term shall
 also include a continuous #ij-;day     
period 7as specified by the ,secretary  
in rulemaking71 in addition to any other
 period 7or periods7 specified by the   
,secretary44  7b7 ,for an eligible      
hospital for the #bjag ,,ehr reporting  
period and subsequent reporting periods 
and payment adjustments for fiscal year 
#bjai and subsequent fiscal years       
,section #ahhf7;b77#c77;,b77ix77,,iv7 of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acieww7b77#c77;,b77ix77,,iv77
 is amended by adding at the end the    
following new sentence3 ,for the ,,ehr  
reporting period with respect to fiscal 

year #bjai and each subsequent fiscal   
year1 such term shall also include any  
continuous #ij-;day period 7as specified
 by the ,secretary in rulemaking71 in   
addition to any other period 7or        
periods7 specified by the ,secretary44  
#c4 ,removing the all-or-nothing        
approach to meaningful use  7a7         
,ensuring flexibility for advancing care
 information performance category score 
,the ,secretary of ,health and ,human   
,services shall take into consideration 
any findings or recommendations of the  
,comptroller ,general of the ,united    
,states in the report under section     
#aja7;c77#b77;,a7 of the ,medicare      
,access and ,,chip ,reauthorization ,act
 of #bjae 7,public ,law #aad-aj7 with   
respect to ensuring flexibility in      
assessing the performance of ,,mips     
eligible professionals under the        
,merit-based ,incentive ,payment ,system
 under section #ahdh7q7 of the ,social  
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7q77 for the performance       

category described in paragraph         
7#b77;,a77iv7 of such section1 as       
applicable and appropriate4  7b7 ,for   
eligible hospitals ,section #ahhf7n77#c7
 of the ,social ,security ,act 7#db     
,u4,s4,c4 #acieww7n77#c77 is amended by 
adding at the end the following new     
paragraph3  7,d7 ,flexibility for       
meaningful use determinations for       
eligible hospitals ,in applying clauses 
7i71 7ii71 and 7iii7 of subparagraph    
7,a71 for purposes of subsection        
7b77#c77;,b77ix7 for an ,,ehr reporting 
period under such subsection with       
respect to fiscal years after #bjai1 the
 ,secretary shall determine that an     
eligible hospital is a meaningful ,,ehr 
user for the ,,ehr reporting period for 
such fiscal years using a methodology   
specified by the ,secretary through     
rulemaking based on performance with    
respect to objectives and measures      
established by the ,secretary that are  
met by an eligible hospital4 ,such      
methodology shall allow an eligible     

hospital to be a meaningful ,,ehr user  
if they achieve #gj percent 7or a       
portion between #ej and #gj percent7 of 
such measures or if they achieve a      
composite score 7as determined by the   
,secretary through rulemaking7 based on 
such measures4  4  #d4 ,reducing volume 
of future ,,ehr-related significant     
hardship requests ,the last sentence of 
sections #ahdh7o77#b77;,a7 and          
#ahhf7n77#c77;,a7 of the ,social        
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7o77#b77;,a71                  
#acieww7n77#c77;,a77 are each amended by
 striking by and all that follows before
 the period at the end4  #e4 ,extending 
flexibility in applying hardship        
exception for meaningful use for an     
eligible hospital for the #bjag ,,ehr   
reporting period and payment adjustment 
for fiscal year #bjai  ,section         
#ahhf7;b77#c77;,b77ix7 of the ,social   
,security ,act 7#db ,u4,s4,c4           
#acieww7b77#c77;,b77ix77 is amended--   
7#a7 in the first sentence of subclause 

7,,ii7-- 7,a7 by striking fiscal year   
#bjag and inserting each of fiscal years
 #bjag and #bjai2 and  7,b7 by striking 
,april #a1 #bjaf and inserting the      
applicable date 7as defined in subclause
 7,v772 and  7#b7 by adding at the end  
the following new subclause3  7,v7 ,for 
purposes of this clause1 the term       
applicable date means-- 7aa7 with       
respect to the payment reduction under  
subclause 7,i7 for fiscal year #bjag1   
,april #a1 #bjaf2 and  7bb7 with respect
 to the payment reduction under         
subclause 7,i7 for fiscal year #bjai1   
,april #a1 #bjah4  4