II 

113TH CONGRESS 

1ST SESSION S. 1286 

To encourage the adoption and use of certified electronic health record 

technology by safety net providers and clinics. 

IN THE SENATE OF THE UNITED STATES 

JULY 11, 2013 

Mr. ROCKEFELLER (for himself, Mr. WHITEHOUSE, and Mr. FRANKEN) introduced the following bill; which was read twice and referred to the Committee on Finance 

A BILL 

To encourage the adoption and use of certified electronic 

health record technology by safety net providers and clinics. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicaid Information 

5 Technology to Enhance Community Health Act of 2013’’ 

6 or the ‘‘MITECH Act’’. 


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1 SEC. 2. INCENTIVES FOR ADOPTION AND USE OF EHR 

2 TECHNOLOGY BY SAFETY NET CLINICS AND 

3 PROVIDERS. 

4 Section 1903(t) of the Social Security Act (42 U.S.C. 

5 1396b(t)) is amended— 

6 (1) in paragraph (2)— 

7 (A) in subparagraph (A)— 

8 (i) in clause (i), by inserting ‘‘or 

9 QSNC-based’’ after ‘‘hospital-based’’; 

10 (ii) in clause (ii)— 

11 (I) by inserting ‘‘or QSNC12 based’’ after ‘‘hospital-based’’; and 

13 (II) by striking ‘‘and’’ at the end 

14 and inserting ‘‘or’’; and 

15 (iii) in clause (iii), by striking ‘‘who 

16 practices predominantly in a Federally 

17 qualified health center or rural health clin18 ic’’ and inserting ‘‘subject to paragraph 

19 (11)(C), who practices predominantly in a 

20 Federally qualified health center, rural 

21 health clinic, or qualified safety net clinic’’; 

22 and 

23 (B) in subparagraph (B)— 

24 (i) in clause (i), by striking ‘‘or’’; 

25 (ii) in clause (ii), by striking the pe26 riod at the end and inserting ‘‘, or’’; and 


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1 (iii) by adding at the end the fol2 lowing new clause: 

3 ‘‘(iii) subject to paragraph (11), a qualified 

4 safety net clinic (as defined in paragraph (3)(G)).’’; 

5 (2) in paragraph (3)— 

6 (A) in subparagraph (B)(v), by striking 

7 ‘‘rural health clinic’’ and all that follows 

8 through the period and inserting ‘‘rural health 

9 clinic, Federally qualified health center, or 

10 qualified safety net clinic that is led by a physi11 cian assistant.’’; and 

12 (B) by adding at the end the following new 

13 subparagraphs: 

14 ‘‘(G) The term ‘qualified safety net clinic’ 

15 means a clinic or network of clinics that is operated 

16 by a private non-profit or public entity and that has 

17 at least 30 percent of its patient volume (as esti18 mated in accordance with a methodology established 

19 by the Secretary) attributable to needy individuals 

20 (as defined in subparagraph (F)). 

21 ‘‘(H) The term ‘QSNC-based’ means, with re22 spect to an eligible professional, an individual who 

23 furnishes substantially all of their professional serv24 ices in a qualified safety net clinic and through the 

25 use of the facilities and equipment, including qualiVerDate Mar 15 2010 22:17 Jul 11, 2013 Jkt 029200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1286.IS S1286

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1 fied electronic health records, of the clinic. The de2 termination of whether an eligible professional is a 

3 QSNC-based eligible professional shall be made on 

4 the basis of the site of service (as defined by the 

5 Secretary) and without regard to any employment or 

6 billing arrangement between the eligible professional 

7 and any other provider.’’; 

8 (3) in paragraph (5)— 

9 (A) in subparagraph (A), by inserting 

10 ‘‘clause (i) or (ii) of’’ before ‘‘paragraph 

11 (2)(B)’’; and 

12 (B) by adding at the end the following new 

13 subparagraph: 

14 ‘‘(E) For purposes of payments described in 

15 paragraph (1)(B) to a Medicaid provider described 

16 in paragraph (2)(B)(iii), the Secretary shall estab17 lish a methodology for determining the maximum 

18 amount of payment permitted for each such pro19 vider.’’; and 

20 (4) by adding at the end the following new 

21 paragraph: 

22 ‘‘(11)(A) Not later than January 1, 2015, the Sec23 retary, in consultation with States and other relevant 

24 stakeholders, shall promulgate regulations to establish a 

25 procedure through which a qualified safety net clinic may 


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1 demonstrate meaningful use of certified EHR technology 

2 by such clinic for purposes of satisfying the requirement 

3 described in paragraph (6)(C)(i)(II). 

4 ‘‘(B) A qualified safety net clinic shall not be eligible 

5 to receive payments described in paragraph (1)(B) before 

6 the date on which the Secretary establishes the procedure 

7 described in subparagraph (A). On and after that date, 

8 a qualified safety net clinic may receive such payments 

9 if the qualified safety net clinic notifies the Secretary that 

10 the qualified safety net clinic elects to receive such pay11 ments in lieu of the Secretary making payments described 

12 in paragraph (1)(A) to the eligible professionals who prac13 tice predominately in the qualified safety net clinic. 

14 ‘‘(C) On or after the date that the Secretary estab15 lishes the procedure described in subparagraph (A), an eli16 gible professional who practices predominately in a quali17 fied safety net clinic, as described in paragraph (2)(A)(iii), 

18 shall not be eligible to receive payments described in para19 graph (1)(A) if the qualified safety net clinic receives pay20 ments described in paragraph (1)(B).’’. 

Æ 


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