ing period for 2015 in a physician practice 
that is a solo practice.’’. 
(b) EXCEPTION FOR CERTAIN PHYSICIANS NEAR RE-
TIREMENT
AGE.—Subparagraph 
(F) 
of 
section 
1848(a)(7) of the Social Security Act (42 U.S.C. 1395w– 
4(a)(7)), as added by subsection (a), is amended— 
(1) in clause (i), in the first and third sen-
tences, by striking ‘‘clause (ii)’’ and inserting 
‘‘clause (ii) or (iii)’’; and 
(2) by adding at the end the following new 
clause: 
‘‘(iii) ELIGIBLE
PROFESSIONALS
AT 
OR NEAR RETIREMENT AGE.—An eligible 
professional described in this clause is an 
eligible professional who as of the last day 
of 2015 has attained early retirement age 
(as defined in section 216(l)(2)) or who 
will attain such age during the 5-year pe-
riod following such day.’’. 
(c) NOTIFICATION OF ELIGIBILITY FOR EXCEPTIONS 
FROM PAYMENT ADJUSTMENT.—Section 1848(a)(7) of 
the Social Security Act (42 U.S.C. 1395w–4(a)(7)), as 
amended by subsection (a), is further amended by adding 
at the end the following new subparagraph: 
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‘‘(G) NOTIFICATION.—Not later than 30 
days after the date on which the Secretary de-
termines an eligible professional is exempt, pur-
suant to subparagraph (F), from the applica-
tion of the payment adjustment under subpara-
graph (A), the Secretary shall provide such eli-
gible professional notice of such determina-
tion.’’. 
SEC. 3. SHORTENING EHR REPORTING PERIOD FOR APPLI-
CATION OF MEDICARE EHR PAYMENT AD-
JUSTMENT TO ELIGIBLE PROFESSIONALS. 
(a) IN GENERAL.—Section 1848(a)(7)(E)(ii) of the 
Social Security Act (42 U.S.C. 1395w–4(a)(7)(E)(ii)) is 
amended by inserting ‘‘, so long as all of such period (or 
periods) occurs during the year in which the corresponding 
adjustment, if any, under this paragraph would be applied 
to the eligible professional involved’’ after ‘‘a period (or 
periods) specified by the Secretary’’. 
(b) REBATES.—Section 1848(a)(7)(A) of the Social 
Security Act (42 U.S.C. 1395w–4(a)(7)(A)) is amended 
by adding at the end the following new clause: 
‘‘(iv) SPECIAL RULE.—The Secretary 
shall establish a process under which if for 
a calendar year, beginning with 2015, an 
adjustment is made under this paragraph 
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with respect to covered professional serv-
ices furnished by an eligible professional 
and then during such calendar year the eli-
gible professional meets the criteria for es-
tablishing meaningful use of certified EHR 
technology, the Secretary shall provide to 
the eligible professional a rebated amount 
such that the total amount of payment 
that the provider receives under this sub-
section for such services for such year is 
the fee schedule amount that would other-
wise apply to such services under this sub-
section without application of this para-
graph.’’. 
(c) 
CONFORMING
AMENDMENT.—Section 
1848(o)(5)(B) of the Social Security Act is amended by 
adding at the end the following new sentence: ‘‘Such term, 
as used under this subsection with respect to subsection 
(a)(7) and a year beginning with 2015, shall have the 
meaning given such term under subsection (a)(7)(E)(ii).’’. 
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SEC. 4. ADDITIONAL EXCEPTIONS TO APPLICATION OF 
MEDICARE PAYMENT ADJUSTMENT FOR CER-
TAIN MEDICAID AND HOSPITAL-BASED ELIGI-
BLE PROFESSIONALS NOT DEMONSTRATING 
EHR MEANINGFUL USE. 
(a) ELIGIBLE PROFESSIONALS PARTICIPATING
IN 
MEDICAID
EHR 
INCENTIVE
PROGRAM.—Section 
1848(a)(7) of the Social Security Act (42 U.S.C. 1395w– 
4(a)(7)), as amended by section 2, is further amended— 
(1) in subparagraph (A)(i), by striking ‘‘(D), 
and (F)’’ and inserting ‘‘(D), (F), and (G)’’; 
(2) by redesignating subparagraph (G) as sub-
paragraph (H); and 
(3) by inserting after subparagraph (F) the fol-
lowing new subparagraph: 
‘‘(G) ADDITIONAL EXCEPTIONS FOR CER-
TAIN MEDICAID PROVIDERS PARTICIPATING IN 
MEDICAID EHR INCENTIVE PROGRAM.—In the 
case of an eligible professional who is a Med-
icaid 
provider 
described 
in 
section 
1903(t)(2)(A), the Secretary shall exempt such 
eligible professional from the application of the 
Medicare payment adjustment under subpara-
graph (A), with respect to a year, if such year 
is the first year that such professional received 
payment under section 1903(t).’’. 
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(b) HOSPITAL-BASED ELIGIBLE PROFESSIONALS.— 
Section 1848(a)(7)(D) of the Social Security Act (42 
U.S.C. 1395w–4(a)(7)(D)) is amended by adding at the 
end the following new sentence: ‘‘In applying the definition 
under subsection (o)(1)(C)(ii) for purposes of the previous 
sentence, the reference to ‘substantially all’ under such 
subsection shall mean 90 percent or more and a deter-
mination described in such subsection, with respect to an 
eligible professional, may only be made by the Secretary 
pursuant to a request of the professional that is submitted 
to the Secretary before 2015, and shall be effective for 
such professional for 2015 and each subsequent year.’’. 
(c) APPLICATION
OF
NOTIFICATION
REQUIRE-
MENT.—Subparagraph (H) of section 1848(a)(7) of the 
Social Security Act (42 U.S.C. 1395w–4(a)(7)), as added 
by section 2(c) and redesignated by subsection (a)(2), is 
amended by striking ‘‘subparagraph (F)’’ and inserting 
‘‘subparagraph (B), (D), (F), or (G)’’. 
SEC. 5. ALTERNATE MEANINGFUL USE CRITERIA FOR ELI-
GIBLE 
PROFESSIONALS 
UTILIZING 
ELEC-
TRONIC HEALTH RECORDS AND SPECIALTY 
REGISTRY SYSTEMS. 
Section 1848(o)(2) of the Social Security Act (42 
U.S.C. 1395w–4(o)(2)) is amended— 
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