I 
114TH CONGRESS 
1ST SESSION H. R. 3309 
To amend titles XVIII and XIX of the Social Security Act to improve 
the electronic health records meaningful use programs under the Medi-
care and Medicaid programs, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 29, 2015 
Mrs. ELLMERS of North Carolina introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committee on Ways and Means, for a period to be subsequently de-
termined 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 improve the electronic health records meaningful use 
programs under the Medicare and Medicaid programs, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Further Flexibility in HIT Reporting and Advancing 
Interoperability Act’’ or the ‘‘Flex-IT 2 Act’’. 
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(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—ALIGNMENT OF MEANINGFUL USE RULEMAKING TO 
MERIT-BASED INCENTIVE PAYMENT SYSTEM RULEMAKING 
Sec. 101. Pausing meaningful use rulemaking. 
TITLE II—IMPROVING MEANINGFUL USE 
Sec. 201. Removing the pass-fail approach of the Medicare and Medicaid mean-
ingful use program. 
Sec. 202. Aligning quality reporting in the Medicare and Medicaid meaningful 
use program. 
Sec. 203. Expanding the hardship exception to the Medicare EHR payment ad-
justments. 
Sec. 204. Promoting interoperability through EHR certification process. 
Sec. 205. Improving the timing of the adoption of more stringent measures of 
meaningful use under the Medicare and Medicaid meaningful 
use program. 
Sec. 206. Three-month EHR reporting periods for the Medicare and Medicaid 
EHR incentive payment programs. 
Sec. 207. Providing eligible professionals and eligible hospitals the option to 
meet a more advanced stage of meaningful use. 
TITLE I—ALIGNMENT OF MEAN-
INGFUL USE RULEMAKING TO 
MERIT-BASED 
INCENTIVE 
PAYMENT 
SYSTEM 
RULE-
MAKING 
SEC. 101. PAUSING MEANINGFUL USE RULEMAKING. 
(a) SENSE OF THE CONGRESS.—It is the sense of 
Congress that the Secretary of Health and Human Serv-
ices (in this section referred to as the ‘‘Secretary’’) should 
not finalize the proposed rules relating to Stage 3 criteria 
for the meaningful use of certified EHR technology (as 
defined in section 3000 of the Public Health Service Act 
(42 U.S.C. 300jj)) and the issuance of 2015 EHR certifi-
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cation criteria and should instead encourage interoper-
ability, usability, and improved outcomes with respect to 
electronic health records. 
(b) NO ISSUANCE OF STAGE 3 CRITERIA OR OF EHR 
CERTIFICATION CRITERIA BEFORE 2017 UNLESS CONDI-
TIONS MET.—Unless one of the conditions described in 
subsection (c) has been met, the Secretary shall not issue, 
prior to January 1, 2017— 
(1) any proposed or final rule that would mod-
ify the definition of the term ‘‘Meaningful EHR 
user’’ under section 495.4 of title 42, Code of Fed-
eral Regulations (or any successor regulation), by 
adding Stage 3 criteria for eligible professionals or 
eligible hospitals; or 
(2) any proposed or final rule that would add 
new certification criteria for certified EHR tech-
nology under part 170 of title 45, Code of Federal 
Regulations. 
(c) CONDITIONS.—The conditions described in this 
subsection are the following: 
(1) The Secretary certifies that 75 percent of 
both eligible hospitals and eligible professionals have 
successfully attested to the Stage 2 criteria estab-
lished under section 495.6 of title 42, Code of Fed-
eral Regulations. 
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(2) The Secretary promulgates a final rule to 
implement the Merit-Based Incentive Payment Sys-
tem established under section 1848(q) of the Social 
Security Act (42 U.S.C. 1395w–4(q)). 
(d) FLEXIBILITY TO ADJUST EXISTING MEANING-
FUL USE AND CERTIFICATION CRITERIA.—Nothing in 
this section shall be construed as affecting the authority 
of the Secretary to change, modify, suspend, or revoke 
meaningful use and certification criteria effective on the 
date of the enactment of this Act, including the Stage 2 
criteria established under section 495.6 of title 42, Code 
of Federal Regulations, and the 2014 Edition certified 
health record criteria under subpart C, part 170 of title 
45, Code of Federal Regulations, for any of the following 
reasons: 
(1) The change, modification, suspension, or 
revocation relates to the recommendations for 
achieving widespread interoperability made by the 
Secretary pursuant to section 106 of the Medicare 
Access and CHIP Reauthorization Act of 2015. 
(2) The criteria may negatively impact the 
quality of care for, or may risk harm to, a patient. 
(3) The change, modification, suspension, or 
revocation is necessary to reflect advances in science 
or technology, or to improve transparency. 
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TITLE II—IMPROVING 
MEANINGFUL USE 
SEC. 201. REMOVING THE PASS-FAIL APPROACH OF THE 
MEDICARE AND MEDICAID MEANINGFUL USE 
PROGRAM. 
(a) ELIGIBLE PROFESSIONALS.— 
(1) IN GENERAL.—Section 1848(o)(2) of the 
Social Security Act (42 U.S.C. 1395w–4(o)(2)) is 
amended by adding at the end the following new 
subparagraph: 
‘‘(E) CONSIDERATION OF TECHNOLOGICAL 
AND COST BARRIERS.—In applying clauses (i), 
(ii), and (iii) of subparagraph (A) to determine 
whether a professional is using certified EHR 
technology in a meaningful manner for a period 
described in such subparagraph for a year after 
2015, the Secretary— 
‘‘(i) may not require that the profes-
sional, in order to be considered a mean-
ingful EHR user for such period, meet 
every requirement or objective specified 
pursuant to such clauses but instead shall 
apply a linear scale; 
‘‘(ii) shall establish a method to deter-
mine if an eligible professional is a partial 
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meaningful user consistent with such linear 
scale; and 
‘‘(iii) shall consider differences among 
professionals (such as differences in the 
specialties and patient populations of pro-
fessionals) as well as technological and cost 
barriers in determining which of the re-
quirements or objectives must be met by 
the professional during such period in 
order for the professional to be so consid-
ered.’’. 
(2) 
INCENTIVE
PAYMENT.—Section 
1848(o)(1)(A)(i) of the Social Security Act (42 
U.S.C. 1395w–4(o)(1)(A)(i)) is amended— 
(A) by inserting ‘‘or, for 2016, partial 
meaningful EHR user’’ after ‘‘meaningful EHR 
user’’; and 
(B) by inserting ‘‘(or, for 2016, in accord-
ance with the linear scale applied pursuant to 
paragraph (2)(E), equal to not more than)’’ 
after ‘‘equal to’’. 
(3) 
PAYMENT
ADJUSTMENT.—Section 
1848(a)(7)(A)(i) of the Social Security Act (42 
U.S.C. 1395w–4(a)(7)(A)(i)) is amended— 
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(A) by inserting ‘‘or, for such a year after 
2015, partial meaningful EHR user’’ after 
‘‘meaningful EHR user’’; and 
(B) by inserting ‘‘(or, for such a year after 
2015, in accordance with the linear scale ap-
plied pursuant to paragraph (2)(E), equal to at 
least)’’ after ‘‘equal to’’. 
(b) ELIGIBLE HOSPITALS.— 
(1) IN GENERAL.—Section 1886(n)(3) of the 
Social Security Act (42 U.S.C. 1395ww(n)(3)) is 
amended by adding at the end the following new 
subparagraph: 
‘‘(D) CONSIDERATION OF TECHNOLOGICAL 
AND COST BARRIERS.—In applying clauses (i), 
(ii), and (iii) of subparagraph (A) to determine 
whether a hospital is using certified EHR tech-
nology in a meaningful manner for an EHR re-
porting period for a fiscal year after fiscal year 
2015, the Secretary— 
‘‘(i) may not require that the hospital, 
in order to be considered a meaningful 
EHR user for such period, meet every such 
requirement or objective specified pursuant 
to such clauses but instead shall apply a 
linear scale; 
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‘‘(ii) shall establish a method to deter-
mine if an eligible professional is a partial 
meaningful user consistent with such linear 
scale; and 
‘‘(iii) shall consider differences among 
hospitals (such as differences in the type of 
hospital, specialties available at and pa-
tient populations of hospitals) in deter-
mining which of the requirements or objec-
tives must be met by the hospital during 
such period in order for the hospital to be 
so considered.’’. 
(2) INCENTIVE PAYMENT.—Section 1886(n)(1) 
of the Social Security Act (42 U.S.C. 1395ww(n)(1)) 
is amended— 
(A) by inserting ‘‘or, for a fiscal year after 
fiscal year 2015, partial meaningful EHR user’’ 
after ‘‘meaningful EHR user’’; and 
(B) by inserting ‘‘(or, for a fiscal year 
after fiscal year 2015, in accordance with the 
linear scale applied pursuant to paragraph 
(2)(D), equal to not more than)’’ after ‘‘equal 
to’’. 
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(3) 
PAYMENT
ADJUSTMENT.—Section 
1886(b)(3)(B)(ix)(I) of the Social Security Act (42 
U.S.C. 1395ww(b)(3)(B)(ix)(I)) is amended— 
(A) in subclause (I)— 
(i) by inserting ‘‘or, for a fiscal year 
after fiscal year 2015, partial meaningful 
EHR user’’ after ‘‘meaningful EHR user’’; 
and 
(ii) by inserting ‘‘(or, for a fiscal year 
after fiscal year 2015, in accordance with 
the linear scale applied pursuant to section 
1886(n)(2)(D), equal to at least)’’ after 
‘‘equal to’’; and 
(B) in subclause (III), by inserting ‘‘or, for 
a fiscal year after fiscal year 2015, partial 
meaningful EHR user’’ after ‘‘meaningful EHR 
user’’. 
(c) 
APPLICATION
UNDER
MEDICAID.—Section 
1903(t)(8) of the Social Security Act (42 U.S.C. 
1396b(t)(8)) is amended by inserting after the second sen-
tence the following: ‘‘In doing so, the Secretary shall en-
sure that the provisions of subparagraph (E) of section 
1848(o)(2) and subparagraph (D) of section 1886(n)(3) 
apply under this title with respect to demonstrating mean-
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SEC. 202. ALIGNING QUALITY REPORTING IN THE MEDI-
CARE AND MEDICAID MEANINGFUL USE PRO-
GRAM. 
(a) ELIGIBLE PROFESSIONALS.— 
(1) 
TESTING
OF
MEASURES.—Section 
1848(k)(2)(C) of the Social Security Act (42 U.S.C. 
1395w–4(k)(2)(C)) is amended by adding at the end 
the following new clause: 
‘‘(iii) TESTING.—After December 31, 
2015, the Secretary may only specify a 
clinical quality measure under this sub-
paragraph if the Secretary has dem-
onstrated, through field tests among mul-
tiple and varied eligible professionals, that 
it is feasible for such professionals to elec-
tronically submit valid and accurate infor-
mation on the measure.’’. 
(2) DEEMED COMPLIANCE IF SATISFY PQRS.— 
Section 1848(o)(2)(B)(iii) of the Social Security Act 
(42 U.S.C. 1395w–4(o)(2)(B)(iii)) is amended by 
adding at the end the following: 
‘‘In implementing the preceding sentence, the Sec-
retary shall treat an eligible professional who, for a period 
under subsection (k) for covered professional services fur-
nished in a year after 2015, satisfies the requirements of 
clauses (i) or (ii) of subsection (k)(2)(C), or who satisfac-
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torily participates in a qualified clinical data registry for 
a reporting period (as defined in subsection (m)(6)(C)) as 
determined by the Secretary pursuant to subsection 
(k)(2)(C) and subsection (m)(3)(D), as satisfying the re-
quirement of subparagraph (A) for the corresponding pe-
riod described in such subparagraph for such year.’’. 
(b) ELIGIBLE HOSPITALS.— 
(1) 
TESTING
OF
MEASURES.—Section 
1886(n)(3)(B)(i) of the Social Security Act (42 
U.S.C. 1395ww(n)(3)(B)(i)) is amended by adding 
at the end the following new subclause: 
‘‘(III) After September 30, 2015, 
the Secretary may only select a clin-
ical quality measure under this sub-
paragraph if the Secretary has dem-
onstrated, through field tests in mul-
tiple and varied hospitals, that it is 
feasible for such hospitals to electroni-
cally submit valid and accurate infor-
mation on the measure.’’. 
(2) DEEMED
COMPLIANCE
IF
SATISFY
HOS-
PITAL
INPATIENT
QUALITY
REPORTING
REQUIRE-
MENTS.—Section 1886(n)(3)(B)(iii) of the Social 
Security Act (42 U.S.C. 1395ww(n)(3)(B)(iii)) is 
amended by adding at the end the following: ‘‘In im-
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plementing the preceding sentence, the Secretary 
shall treat an eligible hospital that, for a period 
under subsection (b)(3)(B)(viii) for a fiscal year 
after fiscal year 2015, satisfies the requirements of 
such subsection as satisfying the requirement of sub-
paragraph (A) for the corresponding reporting pe-
riod for such fiscal year.’’. 
(c) 
APPLICATION
UNDER
MEDICAID.—Section 
1903(t)(8) of the Social Security Act (42 U.S.C. 
1396b(t)(8)), as amended by section 201(c), is further 
amended in the third sentence— 
(1) by inserting ‘‘and the last sentence of sub-
paragraph (B)(iii)’’ after ‘‘subparagraph (E)’’; and 
(2) by inserting ‘‘and the last sentence of sub-
paragraph (B)(i)(III)’’ after ‘‘subparagraph (D)’’. 
SEC. 203. EXPANDING THE HARDSHIP EXCEPTION TO THE 
MEDICARE EHR PAYMENT ADJUSTMENTS. 
(a) 
ELIGIBLE
PROFESSIONALS.—Section 
1848(a)(7)(B) of the Social Security Act (42 U.S.C. 
1395w–4(a)(7)(B)) is amended to read as follows: 
‘‘(B) 
SIGNIFICANT
HARDSHIP
EXCEP-
TION.— 
‘‘(i) IN GENERAL.—Subject to clause 
(ii), the Secretary may, on a case-by-case 
basis, exempt an eligible professional from 
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the application of the payment adjustment 
under subparagraph (A) if the Secretary 
determines, subject to annual renewal, that 
compliance with the requirement for being 
a meaningful EHR user would result in a 
significant hardship, such as in the case of 
an eligible professional who practices in a 
rural area without sufficient Internet ac-
cess. 
‘‘(ii) REQUIRED EXCEPTION.—Subject 
to clause (iii), beginning for 2015, the Sec-
retary shall, on a case-by-case basis, ex-
empt an eligible professional from the ap-
plication of the payment adjustment under 
subparagraph (A) if the Secretary deter-
mines, subject to annual renewal, the eligi-
ble professional— 
‘‘(I) encounters unforeseen cir-
cumstances (including technological 
difficulties and other disruptive situa-
tions) that present barriers to compli-
ance with the requirement for being a 
meaningful EHR user; 
‘‘(II) 
changes 
certified 
EHR 
technology vendors, or changes from 
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self-developed 
electronic 
health 
records to certified EHR technology 
from a vendor; 
‘‘(III) is an anesthesiologist, ra-
diologist, pathologist, hospitalist, or is 
in any other physician specialty or 
subspecialty identified through rule-
making as a specialty or subspecialty 
that presents physicians in the spe-
cialty or subspecialty with unique dif-
ficulties in complying with such re-
quirement; 
‘‘(IV) is at or near retirement 
age (as defined by the Secretary); or 
‘‘(V) is not able to be in compli-
ance with any such requirement be-
cause the certified EHR technology 
used by such professional is not capa-
ble 
of 
sending, 
receiving, 
and 
seamlessly incorporating data from 
other certified EHR technology. 
‘‘(iii) LIMITATION.—In no case may 
an eligible professional be granted an ex-
emption under this subparagraph for more 
than 5 years.’’. 
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(b) 
ELIGIBLE
HOSPITALS.—Section 
1886(b)(3)(B)(ix)(II) of the Social Security Act (42 
U.S.C. 1395ww(b)(3)(B)(ix)(II)) is amended to read as 
follows: 
‘‘(II)(aa) Subject to item (cc), 
the Secretary may, on a case-by-case 
basis, exempt a subsection (d) hos-
pital from the application of subclause 
(I) with respect to a fiscal year if the 
Secretary determines, subject to an-
nual renewal, that requiring such hos-
pital to be a meaningful EHR user 
during such fiscal year would result in 
a significant hardship, such as in the 
case of a hospital in a rural area with-
out sufficient Internet access. 
‘‘(bb) Subject to item (cc), begin-
ning for fiscal year 2015, the Sec-
retary shall, on a case-by-case basis, 
exempt a subsection (d) hospital from 
the application of subclause (I) with 
respect to a fiscal year if the Sec-
retary determines, subject to annual 
renewal, that the hospital encounters 
unforeseen circumstances (including 
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technological difficulties and other dis-
ruptive situations) that present bar-
riers to compliance with the require-
ment for such hospital to be a mean-
ingful EHR user during such fiscal 
year, changes certified EHR tech-
nology vendors, changes from self-de-
veloped electronic health records to 
certified EHR technology from a ven-
dor, or is not able to be in compliance 
with any such requirement because 
the certified EHR technology used by 
such hospital is not capable of send-
ing, receiving, and seamlessly incor-
porating data from other certified 
EHR technology. 
‘‘(cc) In no case may a hospital 
be granted an exemption under this 
subclause for more than 5 years.’’. 
SEC. 204. PROMOTING INTEROPERABILITY THROUGH EHR 
CERTIFICATION PROCESS. 
Section 3004(a)(1) of the Public Health Service Act 
(42 U.S.C. 300jj–14(a)(1)) is amended by adding at the 
end the following new sentence: ‘‘The Secretary may not 
propose adoption of such standards, implementation speci-
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fications, or certification criteria unless such standards, 
implementation specifications, or certification criteria, re-
spectively, have been successfully tested for widespread 
use by end users for at least a one-year period.’’. 
SEC. 205. IMPROVING THE TIMING OF THE ADOPTION OF 
MORE STRINGENT MEASURES OF MEANING-
FUL USE UNDER THE MEDICARE AND MED-
ICAID MEANINGFUL USE PROGRAM. 
(a) ELIGIBLE PROFESSIONALS.—Section 1848(o)(2) 
of the Social Security Act (42 U.S.C. 1395w–4(o)(2)), as 
amended by section 201(a), is further amended— 
(1) in subparagraph (A), in the matter fol-
lowing clause (iii), by striking ‘‘shall seek’’ and in-
serting ‘‘shall, in accordance with subparagraph (F), 
seek’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(F) 
PROVISIONS
RELATING
TO
IN-
CREASED
STRINGENCY
OF
MEASURES.—The 
Secretary shall implement the last sentence of 
subparagraph (A) (relating to requirements for 
more stringent measures of meaningful use se-
lected under this paragraph) in accordance with 
the following: 
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‘‘(i) ENSURING
PREDICTABILITY.— 
Subject to clause (ii), in the case that the 
Secretary selects measures of meaningful 
use, including any objectives associated 
with such measures, the Secretary may not 
change or modify such selection for a pe-
riod of three years. 
‘‘(ii) FLEXIBILITY
TO
ADJUST
CER-
TAIN MEASURES.— 
‘‘(I) PERMISSIBLE
REASON
FOR 
CHANGES
OR
MODIFICATIONS
TO 
MEASURES.—The 
Secretary 
may 
change or modify a measure of mean-
ingful use before the end of the three- 
year period described in clause (i) if 
the Secretary makes one or more of 
the following determinations: 
‘‘(aa) The measure may neg-
atively impact the quality of care 
for, or may risk harm to, a pa-
tient. 
‘‘(bb) There is a new hard-
ship demonstrated by eligible 
professionals 
specific 
to 
the 
measure. 
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‘‘(cc) An adjustment to the 
measure is necessary to reflect 
advances in science or tech-
nology. 
‘‘(II) REQUEST FOR REVIEW OF 
CLINICAL
QUALITY
MEASURES.—The 
Secretary shall establish a process 
under which stakeholders may, in the 
case that new information is available 
with respect to a clinical quality meas-
ure selected by the Secretary for qual-
ity reporting under subparagraph 
(A)(iii), request that the Secretary 
change or modify such measure for a 
reason described in subclause (I).’’. 
(b) ELIGIBLE HOSPITALS.—Section 1886(n)(3) of 
the Social Security Act (42 U.S.C. 1395ww(n)(3)), as 
amended by section 201(b), is further amended— 
(1) in subparagraph (A), in the matter fol-
lowing clause (iii), by striking ‘‘shall seek’’ and in-
serting ‘‘shall, in accordance with subparagraph (E), 
seek’’; and 
(2) by adding at the end the following new sub-
paragraph: 
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‘‘(E) 
PROVISIONS
RELATING
TO
IN-
CREASED
STRINGENCY
OF
MEASURES.—The 
Secretary shall implement the last sentence of 
subparagraph (A) (relating to requirements for 
more stringent measures of meaningful use se-
lected under this paragraph) in accordance with 
the following: 
‘‘(i) ENSURING
PREDICTABILITY.— 
Subject to clause (ii), in the case that the 
Secretary selects measures of meaningful 
use, including any objectives associated 
with such measures, the Secretary may not 
change or modify such selection for a pe-
riod of three years. 
‘‘(ii) FLEXIBILITY
TO
ADJUST
CER-
TAIN MEASURES.— 
‘‘(I) PERMISSIBLE
REASON
FOR 
ADJUSTMENTS
TO
MEASURES.—The 
Secretary may change or modify a 
measure of meaningful use before the 
end of the three-year period described 
in clause (i) if the Secretary makes 
one or more of the following deter-
minations: 
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‘‘(aa) The measure may neg-
atively impact the quality of care 
for, or may risk harm to, a pa-
tient. 
‘‘(bb) There is a new hard-
ship demonstrated by eligible 
hospitals specific to the measure. 
‘‘(cc) An adjustment to the 
measure is necessary to reflect 
advances in science or tech-
nology. 
‘‘(II) REQUEST FOR REVIEW OF 
CLINICAL
QUALITY
MEASURES.—The 
Secretary shall establish a process 
under which stakeholders may, in the 
case that new information is available 
with respect to a clinical quality meas-
ure selected by the Secretary for qual-
ity reporting under subparagraph 
(A)(iii), request that the Secretary 
change or modify such measure for a 
reason described in subclause (I).’’. 
(c) 
APPLICATION
UNDER
MEDICAID.—Section 
1903(t)(8) of the Social Security Act (42 U.S.C. 
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1396b(t)(8)), as amended by sections 201(c) and 202(c), 
is further amended in the third sentence— 
(1) by striking ‘‘and the last sentence of sub-
paragraph (B)(iii)’’ and inserting ‘‘, the last sen-
tence of subparagraph (B)(iii), and subparagraph 
(F)’’; and 
(2) by striking ‘‘and the last sentence of sub-
paragraph (B)(i)(III)’’ and inserting ‘‘, the last sen-
tence of subparagraph (B)(i)(III), and subparagraph 
(E)’’. 
SEC. 206. THREE-MONTH EHR REPORTING PERIODS FOR 
THE MEDICARE AND MEDICAID EHR INCEN-
TIVE PAYMENT PROGRAMS. 
(a) EHR REPORTING PERIOD.— 
(1) 
ELIGIBLE
PROFESSIONALS.—Section 
1848(a)(7)(E)(ii) of the Social Security Act (42 
U.S.C. 1395w–4(a)(7)(E)(ii)) is amended by adding 
at the end the following: ‘‘Such period (or periods) 
shall consist of a three-month reporting period, with-
out regard to the payment year or the stage criteria 
(as established under section 495.6 of title 42, Code 
of Federal Regulations) involved.’’. 
(2) 
ELIGIBLE
HOSPITALS.—Subsections 
(b)(3)(B)(ix)(IV) and (n)(6)(A) of section 1886 of 
the Social Security Act (42 U.S.C. 1395ww) are 
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each amended by adding at the end the following: 
‘‘Such period (or periods) shall consist of a three- 
month reporting period, without regard to the pay-
ment year or the stage criteria (as established under 
section 495.6 of title 42, Code of Federal Regula-
tions) involved.’’. 
(3) APPLICATION
UNDER
MEDICAID.—Section 
1903(t)(8) of the Social Security Act (42 U.S.C. 
1396b(t)(8)), as amended by sections 201(c), 
202(c), and 205(c), is further amended by adding at 
the end the following new sentence: ‘‘Such reporting 
periods shall consist of a three-month reporting pe-
riod, without regard to payment year or the stage 
criteria (as established under section 495.6 of title 
42, Code of Federal Regulations).’’. 
(b) REGULATIONS.—Not later than 3 months after 
the date of enactment of this Act, the Secretary of Health 
and Human Services shall promulgate regulations to carry 
out the amendments made by subsection (a). Such regula-
tions shall apply beginning with the 2016 EHR reporting 
period. 
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SEC. 207. PROVIDING ELIGIBLE PROFESSIONALS AND ELI-
GIBLE HOSPITALS THE OPTION TO MEET A 
MORE ADVANCED STAGE OF MEANINGFUL 
USE. 
(a) MEANINGFUL EHR USER.—A ‘‘meaningful EHR 
user’’, as defined under section 495.4 of title 24, Code 
of Federal Regulations, shall include eligible professionals 
and eligible hospitals who demonstrate meaningful use of 
certified EHR technology by meeting the applicable objec-
tives and associated measures of either of the following: 
(1) The stage of meaningful use that the eligi-
ble professional or eligible hospital is scheduled to 
meet during the applicable ‘‘EHR reporting period’’, 
as such term is defined under section 495.4 of title 
24, Code of Federal Regulations. 
(2) Any other stage of meaningful use, provided 
that such stage of meaningful use selected by the eli-
gible professional or eligible hospital is more ad-
vanced than the stage of meaningful use that the eli-
gible professional or eligible hospital is scheduled to 
meet during the applicable EHR reporting period. 
(b) DEFINITION.—In this subparagraph, the term 
‘‘stage of meaningful use’’ means the stage criteria estab-
lished by the Secretary of Health and Human Services 
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under section 495.6 of title 42, Code of Federal Regula-
tions. 
Æ 
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