I 
113TH CONGRESS 
1ST SESSION H. R. 1309 
To amend titles XVIII and XIX of the Social Security Act to exclude patholo-
gists from incentive payments and penalties under Medicare and Medicaid 
relating to the meaningful use of electronic health records. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 21, 2013 
Mr. PRICE of Georgia (for himself and Mr. KIND) introduced the following 
bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committee on Ways and Means, 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 exclude pathologists from incentive payments and pen-
alties under Medicare and Medicaid relating to the mean-
ingful use of electronic health records. 
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 ‘‘Health Information 
Technology Reform Act’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
VerDate Mar 15 2010 
07:28 Mar 23, 2013
Jkt 029200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H1309.IH
H1309
rfrederick on DSK6VPTVN1PROD with BILLS
(1) Under the American Recovery and Reinvest-
ment Act of 2009, physicians are eligible to receive 
Federal funding to promote the adoption of elec-
tronic health records if meaningful use standards 
are met. 
(2) Beginning in 2015, certain physicians who 
do not meet such meaningful use standards face 
penalties in the form of reductions in Medicare pay-
ments. 
(3) Pathologists and their laboratories have 
been on the front lines of electronic health informa-
tion, utilizing computerized Laboratory Information 
Systems and Anatomic Pathology Information Sys-
tems to support the work of analyzing patient speci-
mens and generating test results. These laboratory 
information systems exchange laboratory and pathol-
ogy data with electronic health records and enter-
prise-wide clinical information systems. 
(4) Current regulations implementing electronic 
health record meaningful use standards largely re-
flect physician office-based practices and thus, are 
not applicable to the practice of pathology and lab-
oratory medicine. Furthermore, since pathologists 
use Laboratory Information Systems and Anatomic 
Pathology Information Systems, maintenance of cer-
VerDate Mar 15 2010 
07:28 Mar 23, 2013
Jkt 029200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H1309.IH
H1309
rfrederick on DSK6VPTVN1PROD with BILLS
tain patient health information in a certified elec-
tronic health record is not applicable. 
(5) This lack of alignment between regulation 
and pathology practice makes it nearly impossible 
for pathologists to satisfy meaningful use standards, 
putting them at risk for payment penalties under 
Medicare. 
(6) Through their role in appropriate test selec-
tion and personalized medicine, and with access to 
the patient’s electronic health record, pathologists 
can play a key role in furthering Congress’ goals of 
reducing costs and improving health care quality. 
(7) However, imposing payment penalties on 
pathologists for failing to meet electronic health 
record meaningful use standards that do not apply 
to their practice and typical interaction with pa-
tients, will not help advance quality care and ac-
countability. 
SEC. 3. EXCLUDING PATHOLOGISTS FROM MEDICARE AND 
MEDICAID INCENTIVE PAYMENTS AND PEN-
ALTIES RELATING TO THE MEANINGFUL USE 
OF ELECTRONIC HEALTH RECORDS. 
(a) MEDICARE.— 
(1) EXCLUSION
FROM
PENALTIES.—Section 
1848(a)(7)(E)(iii) of the Social Security Act (42 
VerDate Mar 15 2010 
07:28 Mar 23, 2013
Jkt 029200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H1309.IH
H1309
rfrederick on DSK6VPTVN1PROD with BILLS
U.S.C. 1395w–4(a)(7)(E)(iii)) is amended by insert-
ing ‘‘, except such term does not include a patholo-
gist, as identified by enrollment under this title with 
a specialty code of 22 or 69’’ after ‘‘section 
1861(r)’’. 
(2) EXCLUSION FROM INCENTIVE PAYMENTS.— 
Section 1848(o)(5)(C) of such Act (42 U.S.C. 
1395w–4(o)(5)(C)) is amended by inserting ‘‘, ex-
cept such term does not include a pathologist, as 
identified by enrollment under this title with a spe-
cialty code of 22 or 69’’ after ‘‘section 1861(r)’’. 
(b) MEDICAID.—Section 1903(t)(3)(B)(i) of the So-
cial Security Act (42 U.S.C. 1396b(t)(3)(B)(i)) is amend-
ed by inserting ‘‘other than a pathologist, as identified by 
enrollment under title XVIII with a specialty code of 22 
or 69 or by the applicable equivalent State identification 
number for pathology or independent laboratory’’ after 
‘‘physician’’. 
Æ 
VerDate Mar 15 2010 
07:28 Mar 23, 2013
Jkt 029200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6301
E:\BILLS\H1309.IH
H1309
rfrederick on DSK6VPTVN1PROD with BILLS