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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicaid Information 
Technology to Enhance Community Health Act of 2013’’ 
or the ‘‘MITECH Act’’. 
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SEC. 2. INCENTIVES FOR ADOPTION AND USE OF EHR 
TECHNOLOGY BY SAFETY NET CLINICS AND 
PROVIDERS. 
Section 1903(t) of the Social Security Act (42 U.S.C. 
1396b(t)) is amended— 
(1) in paragraph (2)— 
(A) in subparagraph (A)— 
(i) in clause (i), by inserting ‘‘or 
QSNC-based’’ after ‘‘hospital-based’’; 
(ii) in clause (ii)— 
(I) by inserting ‘‘or QSNC- 
based’’ after ‘‘hospital-based’’; and 
(II) by striking ‘‘and’’ at the end 
and inserting ‘‘or’’; and 
(iii) in clause (iii), by striking ‘‘who 
practices predominantly in a Federally 
qualified health center or rural health clin-
ic’’ and inserting ‘‘subject to paragraph 
(11)(C), who practices predominantly in a 
Federally qualified health center, rural 
health clinic, or qualified safety net clinic’’; 
and 
(B) in subparagraph (B)— 
(i) in clause (i), by striking ‘‘or’’; 
(ii) in clause (ii), by striking the pe-
riod at the end and inserting ‘‘, or’’; and 
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(iii) by adding at the end the fol-
lowing new clause: 
‘‘(iii) subject to paragraph (11), a qualified 
safety net clinic (as defined in paragraph (3)(G)).’’; 
(2) in paragraph (3)— 
(A) in subparagraph (B)(v), by striking 
‘‘rural health clinic’’ and all that follows 
through the period and inserting ‘‘rural health 
clinic, Federally qualified health center, or 
qualified safety net clinic that is led by a physi-
cian assistant.’’; and 
(B) by adding at the end the following new 
subparagraphs: 
‘‘(G) The term ‘qualified safety net clinic’ 
means a clinic or network of clinics that is operated 
by a private non-profit or public entity and that has 
at least 30 percent of its patient volume (as esti-
mated in accordance with a methodology established 
by the Secretary) attributable to needy individuals 
(as defined in subparagraph (F)). 
‘‘(H) The term ‘QSNC-based’ means, with re-
spect to an eligible professional, an individual who 
furnishes substantially all of their professional serv-
ices in a qualified safety net clinic and through the 
use of the facilities and equipment, including quali-
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fied electronic health records, of the clinic. The de-
termination of whether an eligible professional is a 
QSNC-based eligible professional shall be made on 
the basis of the site of service (as defined by the 
Secretary) and without regard to any employment or 
billing arrangement between the eligible professional 
and any other provider.’’; 
(3) in paragraph (5)— 
(A) in subparagraph (A), by inserting 
‘‘clause (i) or (ii) of’’ before ‘‘paragraph 
(2)(B)’’; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(E) For purposes of payments described in para-
graph (1)(B) to a Medicaid provider described in para-
graph (2)(B)(iii), the Secretary shall establish a method-
ology for determining the maximum amount of payment 
permitted for each such provider.’’; and 
(4) by adding at the end the following new 
paragraph: 
‘‘(11)(A) Not later than January 1, 2015, the Sec-
retary, in consultation with States and other relevant 
stakeholders, shall promulgate regulations to establish a 
procedure through which a qualified safety net clinic may 
demonstrate meaningful use of certified EHR technology 
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