I 
112TH CONGRESS 
1ST SESSION H. R. 2500 
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 12, 2011 
Mr. BURGESS (for himself, Mr. ENGEL, Mr. BRADY of Texas, Mr. RANGEL, 
Mr. GRIMM, Mr. SESSIONS, Mrs. MALONEY, Mrs. CAPITO, Mr. HINCHEY, 
Mr. SCALISE, Mr. GERLACH, Mr. KING of New York, Mr. GENE GREEN 
of Texas, Mr. HIGGINS, Mr. CROWLEY, Mrs. BLACKBURN, Mr. KIND, Mr. 
LEWIS of Georgia, Mr. GONZALEZ, Mr. OLSON, Mr. ACKERMAN, Mr. 
STIVERS, Mr. BUCSHON, Mrs. LOWEY, Mrs. ELLMERS, Mr. BRADY of 
Pennsylvania, Ms. CLARKE of New York, Mr. MARINO, Mr. PASCRELL, 
Mr. FRANK of Massachusetts, Mr. STARK, Mr. PETRI, Mr. LATOURETTE, 
Mr. SHUSTER, Mr. FARR, Mr. TIBERI, Mr. POMPEO, Mr. LEVIN, Mr. 
HANNA, Mr. BOSWELL, Mr. RUNYAN, Mr. NEAL, Mr. MCGOVERN, Mr. 
NADLER, Mr. BUTTERFIELD, Mr. HEINRICH, Mr. BECERRA, Mr. 
MCDERMOTT, Ms. BERKLEY, Mr. SCHOCK, Mr. MARCHANT, Ms. JACK-
SON LEE of Texas, and Mr. CANSECO) introduced the following bill; 
which was referred to the Committee on Ways and Means, and in addi-
tion to the Committee on Energy and Commerce, for a period to be sub-
sequently 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Equal Access and Par-
ity for Multi-Campus Hospitals Act’’. 
SEC. 2. CLARIFICATION OF INCENTIVES FOR MULTI-CAM-
PUS HOSPITALS FOR ADOPTION AND MEAN-
INGFUL USE OF CERTIFIED ELECTRONIC 
HEALTH RECORDS. 
(a) SPECIAL RULE FOR APPLYING MEDICARE EHR 
INCENTIVE PAYMENTS
TO REMOTE INPATIENT LOCA-
TIONS OF A HOSPITAL.—Section 1886(n) of the Social Se-
curity Act (42 U.S.C. 1395ww(n)) is amended— 
(1) in paragraph (2), by adding at the end the 
following new subparagraph: 
‘‘(H) SPECIAL RULE FOR REMOTE INPA-
TIENT LOCATIONS OF A HOSPITAL.— 
‘‘(i) IN GENERAL.—In the case of an 
eligible hospital that consists of a qualified 
main provider and one or more qualified 
remote inpatient locations, the hospital 
may elect (in such form and manner as 
specified by the Secretary) for all applica-
ble payment years to— 
‘‘(I) substitute the base amount 
alternative described in clause (ii) for 
the base amount described in subpara-
graph (A)(i)(I); or 
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‘‘(II) substitute the discharge re-
lated amount alternative described in 
clause (iii) for the discharge related 
amount described in subparagraph 
(A)(i)(II). 
The election described in the previous sen-
tence, with respect to an eligible hospital, 
shall be made once for such hospital and 
shall apply to such hospital for all applica-
ble payment years. 
‘‘(ii) BASE AMOUNT ALTERNATIVE.— 
The base amount alternative described in 
this clause with respect to an eligible hos-
pital is the product of— 
‘‘(I) the base amount specified in 
subparagraph (B); and 
‘‘(II) the total number of all 
qualified component facilities of the 
hospital. 
An election to substitute the base amount 
alternative described in this clause shall 
not affect the computation of the discharge 
related amount specified in subparagraph 
(C) for the eligible hospital. 
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‘‘(iii) DISCHARGE RELATED AMOUNT 
ALTERNATIVE.—The 
discharge 
related 
amount alternative described in this clause 
with respect to an eligible hospital for a 
12-month period is determined as follows: 
‘‘(I) First, compute the amount 
under subparagraph (C) as if the 
phrase ‘estimated based upon total 
discharges for the eligible hospital (re-
gardless of any source of payment) for 
the period divided by the total number 
of all component facilities of the hos-
pital’ were substituted for the phrase 
‘estimated based upon total discharges 
for the eligible hospital (regardless of 
any source of payment) for the pe-
riod’. 
‘‘(II) Then multiply the amount 
computed under subclause (I) by the 
total number of all qualified compo-
nent facilities of such hospital. 
‘‘(iv) DEFINITIONS.—For purposes of 
this subsection: 
‘‘(I) 
APPLICABLE
PAYMENT 
YEAR.—The term ‘applicable payment 
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year’ means the first payment year 
for which a hospital makes an election 
described in clause (i) and each subse-
quent payment year applicable to such 
hospital. 
‘‘(II) 
COMPONENT
FACILITY; 
QUALIFIED
COMPONENT
FACILITY.— 
The term ‘component facility’ means, 
with respect to an eligible hospital, 
the main provider or any remote inpa-
tient location of such hospital. The 
term ‘qualified component facility’ 
means, with respect to a main pro-
vider, a qualified main provider and, 
with respect to a remote inpatient lo-
cation, a qualified remote inpatient lo-
cation. 
‘‘(III) MAIN
PROVIDER; QUALI-
FIED
MAIN
PROVIDER.—The term 
‘main provider’, with respect to an eli-
gible hospital, has the meaning given 
such term in section 413.65(a)(2) of 
title 42, Code of Federal Regulations. 
The term ‘qualified main provider’ 
means a main provider that is a 
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meaningful EHR user for the report-
ing period involved. 
‘‘(IV) REMOTE INPATIENT LOCA-
TION; QUALIFIED REMOTE INPATIENT 
LOCATION.—The term ‘remote inpa-
tient location’ means, with respect to 
an eligible hospital, a remote location 
of a hospital, as defined in and ap-
plied under section 413.65 of title 42, 
Code of Federal Regulations, that 
provides inpatient hospital services 
that are paid for under subsection (d). 
The term ‘qualified remote inpatient 
location’ means, with respect to an eli-
gible hospital, a location for which the 
eligible hospital has submitted to the 
Secretary, for the reporting period in-
volved, an attestation (in such form 
and manner as specified by the Sec-
retary) that certifies that the location 
is a remote inpatient location and a 
meaningful EHR user for such pe-
riod.’’; and 
(2) in paragraph (4)(A)— 
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(A) at the end of clause (ii), by striking 
‘‘and’’; 
(B) at the end of clause (iii), by striking 
the period and inserting a semicolon; and 
(C) by adding at the end the following new 
clauses: 
‘‘(iv) the methodology and standards 
for determining a remote inpatient loca-
tion, a qualified remote inpatient location, 
a component facility, a qualified compo-
nent facility, a main provider, and a quali-
fied main provider, as such terms are de-
fined in paragraph (2)(H)(iv), and which 
such locations, facilities, and providers are 
qualified remote inpatient locations, quali-
fied component facilities, and qualified 
main providers, as such terms are defined 
in such paragraph; and 
‘‘(v) the methodology and standards 
for the election described in paragraph 
(2)(H).’’. 
(b) IMPLEMENTATION AND ADMINISTRATION.— 
(1) IMPLEMENTATION.—Notwithstanding any 
other provision of law, the Secretary of Health and 
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Human Services may implement by program instruc-
tion or otherwise this section. 
(2) ADMINISTRATION.—Chapter 35 of title 44, 
United States Code, shall not apply to the collection 
of information to carry out the amendments made 
by this section. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply as if included in the enactment 
of the American Recovery and Reinvestment Act of 2009 
(Public Law 111–5). 
SEC. 3. CLARIFICATION FOR MEDICAID EHR PAYMENT IN-
CENTIVES. 
(a) IN GENERAL.—Section 1903(t)(5) of the Social 
Security Act (42 U.S.C. 1396b(t)(5)) is amended— 
(1) by adding at the end the following new sub-
paragraph: 
‘‘(E) For purposes of determining the ap-
plicable amounts specified in subparagraph (A) 
of section 1886(n)(2), as applied by the first 
sentence of subparagraph (B)— 
‘‘(i) the provisions of subparagraph 
(H) of such section shall apply to a Med-
icaid provider described in paragraph 
(2)(B) consisting of a qualified main pro-
vider and one or more qualified remote in-
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vided are paid for under section 
1886(d); and 
‘‘(ii) an election made under subpara-
graph (H) of such section by an eligible 
hospital described in clause (i) of such sub-
paragraph that is a Medicaid provider de-
scribed in paragraph (2)(B), shall apply. 
The Secretary may make appropriate adjust-
ments to the overall hospital EHR amount 
under subparagraph (B), with respect to a 
Medicaid provider described in paragraph 
(2)(B), to take into account the provisions of 
this subparagraph.’’; and 
(2) in the first sentence of subparagraph (B), 
by inserting ‘‘and subject to subparagraph (E)’’ 
after ‘‘For purposes of this paragraph’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply as if included in the enactment 
of the American Recovery and Reinvestment Act of 2009 
(Public Law 111–5). 
Æ 
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