I 

113TH CONGRESS 

1ST SESSION H. R. 2676 

To amend title XIX of the Social Security Act to encourage the adoption 

and use of certified electronic health record technology by safety net 

providers and clinics under the Medicaid program. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 11, 2013 

Mrs. CAPPS introduced the following bill; which was referred to the Committee 

on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to encourage 

the adoption and use of certified electronic health record 

technology by safety net providers and clinics under the 

Medicaid program. 

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 

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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 para15 graph (1)(B) to a Medicaid provider described in para16 graph (2)(B)(iii), the Secretary shall establish a method17 ology for determining the maximum amount of payment 

18 permitted for each such provider.’’; and 

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

20 paragraph: 

21 ‘‘(11)(A) Not later than January 1, 2015, the Sec22 retary, in consultation with States and other relevant 

23 stakeholders, shall promulgate regulations to establish a 

24 procedure through which a qualified safety net clinic may 

25 demonstrate meaningful use of certified EHR technology 

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1 by such clinic for purposes of satisfying the requirement 

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

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

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

5 the date on which the Secretary establishes the procedure 

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

7 a qualified safety net clinic may receive such payments 

8 if the qualified safety net clinic notifies the Secretary that 

9 the qualified safety net clinic elects to receive such pay10 ments in lieu of the Secretary making payments described 

11 in paragraph (1)(A) to the eligible professionals who prac12 tice predominately in the qualified safety net clinic. 

13 ‘‘(C) On or after the date that the Secretary estab14 lishes the procedure described in subparagraph (A), an eli15 gible professional who practices predominately in a quali16 fied safety net clinic, as described in paragraph (2)(A)(iii), 

17 shall not be eligible to receive payments described in para18 graph (1)(A) if the qualified safety net clinic receives pay19 ments described in paragraph (1)(B).’’. 

Æ 

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