261 
to make the information described in paragraph 
(5)(C)(I)(i)(bb) available to the public in a manner 
that allows for comparison of price information 
among health information technology products and 
that aids in making informed decisions for pur-
chasing such a product.’’. 
(B) INFORMATION
BLOCKING.—Not later 
than 12 months after the date of the enactment 
of this Act, the National Coordinator shall, 
through rulemaking, implement the provisions 
of this section, and amendments made by this 
section, relating to information blocking. 
(C) HIPAA.—Not later than January 1, 
2017, the National Coordinator shall publish 
guidance to clarify the relationship of the 
HIPAA privacy and security law, as defined in 
section 3009(a)(2) of the Public Health Service 
Act (42 U.S.C. 300jj–19(a)(2)) as such provi-
sions relate to information blocking (as defined 
in section 3010A(f) of such Act, as added by 
paragraph (2), including examples of how such 
provisions may result in information blocking. 
(4) DEMONSTRATION REQUIRED FOR MEANING-
FUL EHR USE INCENTIVES UNDER MEDICARE.— 
(A) INCENTIVES FOR PROFESSIONALS.— 
VerDate Sep 11 2014 
01:31 May 20, 2015
Jkt 049200
PO 00000
Frm 00261
Fmt 6652
Sfmt 6201
E:\BILLS\H6.IH
H6
SSpencer on DSK4SPTVN1PROD with BILLS
262 
(i) 
IN
GENERAL.—Section 
1848(o)(2)(C) of the Social Security Act 
(42 U.S.C. 1395w–4(o)(2)(C)) is amended 
by adding at the end the following new 
clause: 
‘‘(iii) INTEROPERABILITY.—With re-
spect to EHR reporting periods for pay-
ment years beginning with 2018, the 
means described in clause (i) specified by 
the Secretary shall include a demonstra-
tion, through means such as an attesta-
tion, that the professional has not taken 
any action described in subsection (a)(2) of 
section 3010A of the Public Health Service 
Act with respect to which the professional, 
with respect to the use of any certified 
EHR technology.’’. 
(ii) HARDSHIP
EXEMPTION
IN
CASE 
OF DECERTIFIED EHR.—Subparagraph (B) 
of section 1848(a)(7) 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.— 
VerDate Sep 11 2014 
01:31 May 20, 2015
Jkt 049200
PO 00000
Frm 00262
Fmt 6652
Sfmt 6201
E:\BILLS\H6.IH
H6
SSpencer on DSK4SPTVN1PROD with BILLS
263 
‘‘(i) IN
GENERAL.—The Secretary 
may, on a case-by-case basis, exempt an el-
igible professional from the application of 
the payment adjustment under subpara-
graph (A) if the Secretary determines, sub-
ject to annual renewal, that compliance 
with the requirement for being a meaning-
ful 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 access. 
‘‘(ii) DECERTIFICATION.— 
‘‘(I) IN
GENERAL.—The Sec-
retary may, on a case-by-case basis, 
exempt an eligible professional from 
the application of the payment adjust-
ment under subparagraph (A) if the 
Secretary determines that such pro-
fessional was determined to not be a 
meaningful EHR user because the 
qualified electronic health record used 
by such professional was decertified 
under section 3001(c)(5)(C) of the 
Public Health Service Act. An exemp-
tion under the previous sentence may 
VerDate Sep 11 2014 
01:31 May 20, 2015
Jkt 049200
PO 00000
Frm 00263
Fmt 6652
Sfmt 6201
E:\BILLS\H6.IH
H6
SSpencer on DSK4SPTVN1PROD with BILLS
264 
be applied to an eligible professional 
only, subject to subclause (II), during 
the first payment year with respect to 
the first EHR reporting period to 
which such decertification applies. 
‘‘(II) DURATION.— 
‘‘(aa) IN GENERAL.—In no 
case shall an exemption by rea-
son of this clause be for a period 
of less than 12 months. 
‘‘(bb) EXTENSION.—An ex-
emption under this clause may be 
extended for a period of an addi-
tional 12 months subject to the 
limitation described in clause (ii). 
‘‘(iii) LIMITATION.—Subject to clause 
(ii)(II)(aa), in no case may an eligible pro-
fessional be granted an exemption under 
this subparagraph for more than 5 years.’’. 
(B) INCENTIVES FOR HOSPITALS.— 
(i) IN GENERAL.—Section 1886(o)(1) 
of the Social Security Act (42 U.S.C. 
1395ww(o)(1)) is amended— 
(I) in subparagraph (A), by in-
serting before the period at the end 
VerDate Sep 11 2014 
01:31 May 20, 2015
Jkt 049200
PO 00000
Frm 00264
Fmt 6652
Sfmt 6201
E:\BILLS\H6.IH
H6
SSpencer on DSK4SPTVN1PROD with BILLS
265 
the following: ‘‘and, for performance 
periods for fiscal year 2018 or a sub-
sequent fiscal year, that provide a 
demonstration described in subpara-
graph (D) to the Secretary’’; and 
(II) by adding at the end the fol-
lowing new subparagraph: 
‘‘(D) DEMONSTRATION
DESCRIBED.—The 
demonstration described in this subparagraph is 
a demonstration, through means such as an at-
testation, that the hospital has not taken any 
action described in subsection (a)(2) of section 
3010A of the Public Health Service Act with 
respect to which the hospital, with respect to 
the use of any certified EHR technology.’’. 
(ii) HARDSHIP
EXEMPTION
IN
CASE 
OF DECERTIFIED EHR.—Subclause (II) of 
section 1886(b)(3)(B)(ix) of the Social Se-
curity 
Act 
(42 
U.S.C. 
1395ww(b)(3)(B)(ix)) is amended to read 
as follows: 
‘‘(II)(aa) The Secretary may, on 
a case-by-case basis, exempt a sub-
section (d) hospital from the applica-
tion of subclause (I) with respect to a 
VerDate Sep 11 2014 
01:31 May 20, 2015
Jkt 049200
PO 00000
Frm 00265
Fmt 6652
Sfmt 6201
E:\BILLS\H6.IH
H6
SSpencer on DSK4SPTVN1PROD with BILLS
266 
fiscal year if the Secretary deter-
mines, subject to annual renewal, that 
requiring such hospital to be a mean-
ingful EHR user during such fiscal 
year would result in a significant 
hardship, such as in the case of a hos-
pital in a rural area without sufficient 
Internet access. 
‘‘(bb) The Secretary may, on a 
case-by-case basis, exempt a sub-
section (d) hospital from the applica-
tion of subclause (I) with respect to a 
fiscal year if the Secretary deter-
mines, subject to annual renewal, that 
such hospital was determined to not 
be a meaningful EHR user because 
the qualified electronic health record 
used by such hospital was decertified 
under section 3001(c)(5)(C) of the 
Public Health Service Act. An exemp-
tion under the previous sentence may 
be applied to a subsection (d) hospital 
only, subject to items (cc) and (dd), 
during the first payment year with re-
spect to the first EHR reporting pe-
VerDate Sep 11 2014 
01:31 May 20, 2015
Jkt 049200
PO 00000
Frm 00266
Fmt 6652
Sfmt 6201
E:\BILLS\H6.IH
H6
SSpencer on DSK4SPTVN1PROD with BILLS
268 
Health Service Act with respect to which the 
provider knows or should know (as defined in 
section 1128A(i)(7) of the Social Security Act) 
about, with respect to the use of any certified 
EHR technology.’’. 
(f) DEFINITIONS.— 
(1) CERTIFIED EHR TECHNOLOGY.—Paragraph 
(1) of section 3000 of the Public Health Service Act 
(42 U.S.C. 300jj) is amended to read as follows: 
‘‘(1) CERTIFIED EHR TECHNOLOGY.—The term 
‘certified EHR technology’ means a qualified elec-
tronic health record that is certified pursuant to sec-
tion 3001(c)(5) as meeting the certification criteria 
defined in subparagraph (B) of such section that are 
applicable to the type of record involved (as deter-
mined by the Secretary, such as an ambulatory elec-
tronic health record for office-based physicians or an 
inpatient hospital electronic health record for hos-
pitals) including, beginning January 1, 2018, with 
respect to which the vendor or other entity offering 
such technology is in compliance with the require-
ments under section 3001(c)(5)(C)(i).’’. 
(2) WIDESPREAD INTEROPERABILITY.—Section 
3000 of the Public Health Service Act (42 U.S.C. 
VerDate Sep 11 2014 
01:31 May 20, 2015
Jkt 049200
PO 00000
Frm 00268
Fmt 6652
Sfmt 6201
E:\BILLS\H6.IH
H6
SSpencer on DSK4SPTVN1PROD with BILLS