I 

111TH CONGRESS 

2D SESSION H. R. 6072 

To amend titles XVIII and XIX of the Social Security Act to clarify the 

application of EHR payment incentives in cases of multi-campus hospitals. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 30, 2010 

Mr. SPACE (for himself, Mr. STARK, Mr. PALLONE, Mr. LEVIN, Mr. WAXMAN, 

Mr. DINGELL, Mr. BURGESS, Mr. ENGEL, Mrs. BLACKBURN, Mr. BOUCHER, Mr. BUTTERFIELD, Mrs. CAPPS, Ms. CASTOR of Florida, Mr. 

CROWLEY, Mr. DAVIS of Illinois, Mr. DOGGETT, Mr. GONZALEZ, Mr. 

GENE GREEN of Texas, Mr. HIGGINS, Mr. LEWIS of Georgia, Mr. 

MCDERMOTT, Mr. MEEK of Florida, Mr. NEAL of Massachusetts, Mr. 

PASCRELL, Mr. POMEROY, Mr. RANGEL, Ms. SCHWARTZ, Ms. SUTTON, 

Mr. THOMPSON of California, Mr. VAN HOLLEN, and Mr. WEINER) introduced the following bill; which was referred to the Committee on Ways 

and Means, and in addition to the Committee on Energy and Commerce, 

for a period to be subsequently determined by the Speaker, in each case 

for consideration of such provisions as fall within the jurisdiction of the 

committee concerned 

A BILL 

To amend titles XVIII and XIX of the Social Security Act 

to clarify the application of EHR payment incentives 

in cases of multi-campus hospitals. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Electronic Health 

3 Record Incentives for Multi-Campus Hospitals Act of 

4 2010’’. 

5 SEC. 2. CLARIFICATION OF INCENTIVES FOR MULTI-CAM6 PUS HOSPITALS FOR ADOPTION AND MEAN7 INGFUL USE OF CERTIFIED ELECTRONIC 

8 HEALTH RECORDS. 

9 (a) SPECIAL RULE FOR APPLYING MEDICARE EHR 

10 INCENTIVE PAYMENTS TO REMOTE INPATIENT LOCA11 TIONS OF A HOSPITAL.—Section 1886(n) of the Social Se12 curity Act (42 U.S.C. 1395ww(n)) is amended— 

13 (1) in paragraph (2), by adding at the end the 

14 following new subparagraph: 

15 ‘‘(H) SPECIAL RULE FOR REMOTE INPA16 TIENT LOCATIONS OF A HOSPITAL.— 

17 ‘‘(i) IN GENERAL.—In the case of an 

18 eligible hospital that consists of a qualified 

19 main provider and one or more qualified 

20 remote inpatient locations, the hospital 

21 may elect (in such form and manner as 

22 specified by the Secretary) for all applica23 ble payment years to— 

24 ‘‘(I) substitute the base amount 

25 alternative described in clause (ii) for 


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1 the base amount described in subpara2 graph (A)(i)(I); or 

3 ‘‘(II) substitute the discharge re4 lated amount alternative described in 

5 clause (iii) for the discharge related 

6 amount described in subparagraph 

7 (A)(i)(II). 

8 The election described in the previous sen9 tence, with respect to an eligible hospital, 

10 shall be made once for such hospital and 

11 shall apply to such hospital for all applica12 ble payment years. 

13 ‘‘(ii) BASE AMOUNT ALTERNATIVE.— 

14 The base amount alternative described in 

15 this clause with respect to an eligible hos16 pital is the product of— 

17 ‘‘(I) the base amount specified in 

18 subparagraph (B); and 

19 ‘‘(II) the total number of all 

20 qualified component facilities of the 

21 hospital. 

22 An election to substitute the base amount 

23 alternative described in this clause shall 

24 not affect the computation of the discharge 


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1 related amount specified in subparagraph 

2 (C) for the eligible hospital. 

3 ‘‘(iii) DISCHARGE RELATED AMOUNT

4 ALTERNATIVE.—The discharge related 

5 amount alternative described in this clause 

6 with respect to an eligible hospital for a 

7 12-month period is determined as follows: 

8 ‘‘(I) First, compute the amount 

9 under subparagraph (C) as if the 

10 phrase ‘estimated based upon total 

11 discharges for the eligible hospital (re12 gardless of any source of payment) for 

13 the period divided by the total number 

14 of all component facilities of the hos15 pital’ were substituted for the phrase 

16 ‘estimated based upon total discharges 

17 for the eligible hospital (regardless of 

18 any source of payment) for the pe19 riod’. 

20 ‘‘(II) Then multiply the amount 

21 computed under subclause (I) by the 

22 total number of all qualified compo23 nent facilities of such hospital. 

24 ‘‘(iv) DEFINITIONS.—For purposes of 

25 this subsection: 


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1 ‘‘(I) APPLICABLE PAYMENT

2 YEAR.—The term ‘applicable payment 

3 year’ means the first payment year 

4 for which a hospital makes an election 

5 described in clause (i) and each subse6 quent payment year applicable to such 

7 hospital. 

8 ‘‘(II) COMPONENT FACILITY; 

9 QUALIFIED COMPONENT FACILITY.— 

10 The term ‘component facility’ means, 

11 with respect to an eligible hospital, 

12 the main provider or any remote inpa13 tient location of such hospital. The 

14 term ‘qualified component facility’ 

15 means, with respect to a main pro16 vider, a qualified main provider and, 

17 with respect to a remote inpatient lo18 cation, a qualified remote inpatient lo19 cation. 

20 ‘‘(III) MAIN PROVIDER; QUALI21 FIED MAIN PROVIDER.—The term 

22 ‘main provider’, with respect to an eli23 gible hospital, has the meaning given 

24 such term in section 413.65(a)(2) of 

25 title 42, Code of Federal Regulations. 


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1 The term ‘qualified main provider’ 

2 means a main provider that is a 

3 meaningful EHR user for the report4 ing period involved. 

5 ‘‘(IV) REMOTE INPATIENT LOCA6 TION; QUALIFIED REMOTE INPATIENT

7 LOCATION.—The term ‘remote inpa8 tient location’ means, with respect to 

9 an eligible hospital, a remote location 

10 of a hospital, as defined in and ap11 plied under section 413.65 of title 42, 

12 Code of Federal Regulations, that 

13 provides inpatient hospital services 

14 that are paid for under subsection (d). 

15 The term ‘qualified remote inpatient 

16 location’ means, with respect to an eli17 gible hospital, a location for which the 

18 eligible hospital has submitted to the 

19 Secretary, for the reporting period in20 volved, an attestation (in such form 

21 and manner as specified by the Sec22 retary) that certifies that the location 

23 is a remote inpatient location and a 

24 meaningful EHR user for such pe25 riod.’’; and 


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1 (2) in paragraph (4)(A)— 

2 (A) at the end of clause (ii), by striking 

3 ‘‘and’’; 

4 (B) at the end of clause (iii), by striking 

5 the period and inserting a semicolon; and 

6 (C) by adding at the end the following new 

7 clauses: 

8 ‘‘(iv) the methodology and standards 

9 for determining a remote inpatient loca10 tion, a qualified remote inpatient location, 

11 a component facility, a qualified compo12 nent facility, a main provider, and a quali13 fied main provider, as such terms are de14 fined in paragraph (2)(H)(iv), and which 

15 such locations, facilities, and providers are 

16 qualified remote inpatient locations, quali17 fied component facilities, and qualified 

18 main providers, as such terms are defined 

19 in such paragraph; and 

20 ‘‘(v) the methodology and standards 

21 for the election described in paragraph 

22 (2)(H).’’. 

23 (b) IMPLEMENTATION AND ADMINISTRATION.— 

24 (1) IMPLEMENTATION.—Notwithstanding any 

25 other provision of law, the Secretary of Health and 


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1 Human Services may implement by program instruc2 tion or otherwise this section. 

3 (2) ADMINISTRATION.—Chapter 35 of title 44, 

4 United States Code, shall not apply to the collection 

5 of information to carry out the amendments made 

6 by this section. 

7 (c) EFFECTIVE DATE.—The amendments made by 

8 this section shall apply as if included in the enactment 

9 of the American Recovery and Reinvestment Act of 2009 

10 (Public Law 111–5). 

11 SEC. 3. CLARIFICATION FOR MEDICAID EHR PAYMENT IN12 CENTIVES. 

13 (a) IN GENERAL.—Section 1903(t)(5) of the Social 

14 Security Act (42 U.S.C. 1396b(t)(5)) is amended— 

15 (1) by adding at the end the following new sub16 paragraph: 

17 ‘‘(E) For purposes of determining the applicable 

18 amounts specified in subparagraph (A) of section 

19 1886(n)(2), as applied by the first sentence of subpara20 graph (B)— 

21 ‘‘(i) the provisions of subparagraph (H) of such 

22 section shall apply to a Medicaid provider described 

23 in paragraph (2)(B) consisting of a qualified main 

24 provider and one or more qualified remote inpatient 

25 locations (as such terms are defined in clause (iv) of 


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1 such subparagraph (H)) in the same manner and to 

2 the same extent that such subparagraph applies to 

3 an eligible hospital described in clause (i) of such 

4 subparagraph, except that— 

5 ‘‘(I) in applying the second sentence of 

6 clause (iv)(IV) of such subparagraph, with re7 spect to a Medicaid provider described in para8 graph (2)(B), in lieu of certifying that a remote 

9 inpatient location is a meaningful EHR user, 

10 the Medicaid provider shall certify that the re11 mote inpatient location is described in para12 graph (2)(B) and is in compliance with para13 graph (6)(C) of this subsection for the year of 

14 payment involved; and 

15 ‘‘(II) the first sentence of clause (iv)(IV) of 

16 such subparagraph shall be applied in the case 

17 of a Medicaid provider described in paragraph 

18 (2)(B)(i) without regard to the requirement 

19 that inpatient hospital services provided are 

20 paid for under section 1886(d); and 

21 ‘‘(ii) an election made under subparagraph (H) 

22 of such section by an eligible hospital described in 

23 clause (i) of such subparagraph that is a Medicaid 

24 provider described in paragraph (2)(B), shall apply. 


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1 The Secretary may make appropriate adjustments to the 

2 overall hospital EHR amount under subparagraph (B), 

3 with respect to a Medicaid provider described in paragraph 

4 (2)(B), to take into account the provisions of this subpara5 graph.’’; and 

6 (2) in the first sentence of subparagraph (B), 

7 by inserting ‘‘and subject to subparagraph (E)’’ 

8 after ‘‘For purposes of this paragraph’’. 

9 (b) EFFECTIVE DATE.—The amendments made by 

10 this section shall apply as if included in the enactment 

11 of the American Recovery and Reinvestment Act of 2009 

12 (Public Law 111–5). 

Æ 


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