,,ii  #aae? ,,congress  #a/ ,session    
,s4 #bjei  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,novemb] #b1 #bjag,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 p]iod = !          
det]m9ation ( :e!r a ,,mips 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 p]iod =     
det]m9ation ( :e!r a ,,mips eligible    
pr(essional or an eligible hospital is a
 mean+ful ,,ehr us]  7a7 ,inclusion (   
#ij-;,day p]=mance p]iod = advanc+ c>e  
in=mation p]=mance category "u ,,mips   
,section #ahdh7q77#d7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7q77#d77 is am5d$ by add+ at ! 

end ! foll[+ new s5t5ce3 ,= purposes (  
det]m9+ a p]=mance p]iod = ! p]=mance   
category describ$ 9 p>agraph            
7#b77;,a77iv71 & = purposes ( ! p]=mance
 p]iod describ$ 9 subsection            
7o77#b77;,d71 su* t]m %all also include 
a cont9u\s #ij-;day p]iod 7z specifi$ by
 ! ,secret>y 9 rulemak+71 9 addition to 
any o!r p]iod 7or p]iods7 specifi$ by ! 
,secret>y44  7b7 ,= an eligible hospital
 = ! #bjag ,,ehr report+ p]iod &        
subsequ5t report+ p]iods & paym5t       
adju/m5ts = fiscal ye> #bjai & 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> #bjai & ea* subsequ5t fiscal 
ye>1 su* t]m %all also include any      
cont9u\s #ij-;day p]iod 7z specifi$ by !
 ,secret>y 9 rulemak+71 9 addition to   
any o!r p]iod 7or p]iods7 specifi$ by ! 
,secret>y44  #c4 ,remov+ ! all-or-no?+  

approa* to mean+ful use  7a7 ,ensur+    
flexibility = advanc+ c>e in=mation     
p]=mance category score ,! ,secret>y (  
,heal? & ,human ,s]vices %all take into 
consid]ation any f9d+s or recomm5dations
 ( ! ,comptroll] ,g5]al ( ! ,unit$      
,/ates 9 ! report "u section            
#aja7;c77#b77;,a7 ( ! ,m$ic>e ,access & 
,,*ip ,reau?orization ,act ( #bjae      
7,public ,law #aad-aj7 ) respect to     
ensur+ flexibility 9 assess+ ! p]=mance 
( ,,mips eligible pr(essionals "u !     
,m]it-bas$ ,inc5tive ,paym5t ,sy/em "u  
section #ahdh7q7 ( ! ,social ,security  
,act 7#db ,u4,s4,c4 #aciew-#d7q77 = !   
p]=mance category describ$ 9 p>agraph   
7#b77;,a77iv7 ( su* section1 z          
applicable & appropriate4  7b7 ,=       
eligible hospitals ,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] #bjai1 !    
,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 are 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  #d4 ,r$uc+ volume ( future
 ,,ehr-relat$ significant h>d%ip reque/s
 ,! la/ s5t5ce ( sections               
#ahdh7o77#b77;,a7 & #ahhf7n77#c77;,a7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#aciew-#d7o77#b77;,a71                  
#acieww7n77#c77;,a77 are ea* am5d$ by   

/rik+ by & all t foll[s be=e ! p]iod at 
! end4  #e4 ,ext5d+ flexibility 9 apply+
 h>d%ip exception = mean+ful use = an   
eligible hospital = ! #bjag ,,ehr       
report+ p]iod & paym5t adju/m5t = fiscal
 ye> #bjai  ,section                    
#ahhf7;b77#c77;,b77ix7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acieww7b77#c77;,b77ix77 is am5d$--     
7#a7 9 ! fir/ s5t5ce ( subclause        
7,,ii7-- 7,a7 by /rik+ fiscal ye> #bjag 
& ins]t+ ea* ( fiscal ye>s #bjag &      
#bjai2 &  7,b7 by /rik+ ,april #a1 #bjaf
 & ins]t+ ! applicable date 7z def9$ 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> #bjai1      
,april #a1 #bjah4  4