I 
113TH CONGRESS 
1ST SESSION H. R. 1331 
To amend certain requirements and penalties implemented under the Medicare 
and Medicaid programs by the HITECH Act of 2009, which would 
otherwise impede eligible professionals from adopting electronic health 
records to improve patient care. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 21, 2013 
Mrs. BLACK (for herself, Mr. CHABOT, Mr. GRIMM, Mr. HARRIS, and Mrs. 
BLACKBURN) 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 subsequently 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 certain requirements and penalties implemented 
under the Medicare and Medicaid programs by the 
HITECH Act of 2009, which would otherwise impede 
eligible professionals from adopting electronic health 
records to improve patient care. 
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 
‘‘Electronic Health Records Improvement 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. 
Sec. 2. Exception for certain eligible professionals from application of Medicare 
payment adjustment for not demonstrating EHR meaningful 
use. 
Sec. 3. Shortening EHR reporting period for application of Medicare EHR pay-
ment adjustment to eligible professionals. 
Sec. 4. Additional exceptions to application of Medicare payment adjustment 
for certain Medicaid and hospital-based eligible professionals 
not demonstrating EHR meaningful use. 
Sec. 5. Alternate meaningful use criteria for eligible professionals utilizing elec-
tronic health records and specialty registry systems. 
Sec. 6. Enhancing Medicare EHR meaningful use among eligible professionals 
who are rural health care providers. 
Sec. 7. Improving EHR meaningful use under Medicare by eligible professionals 
who practice in ambulatory surgical centers. 
Sec. 8. Exemption from certain EHR meaningful use requirements for certain 
eligible professionals for purposes of Medicare payment adjust-
ment. 
Sec. 9. Additional administrative provisions relating to Medicare eligible profes-
sionals’ EHR incentives. 
Sec. 10. Non-application of provisions and amendments to eligible professional 
Medicare incentives for certain MA organizations and Medicaid 
incentives for adoption and meaningful use of certified EHR 
technology. 
SEC. 2. EXCEPTION FOR CERTAIN ELIGIBLE PROFES-
SIONALS FROM APPLICATION OF MEDICARE 
PAYMENT 
ADJUSTMENT 
FOR 
NOT 
DEM-
ONSTRATING EHR MEANINGFUL USE. 
(a) EXCEPTION
FOR CERTAIN SMALL PHYSICIAN 
PRACTICES.—Section 1848(a)(7) of the Social Security 
Act (42 U.S.C. 1395w–4(a)(7)) is amended— 
(1) in subparagraph (A)(i), by striking ‘‘sub-
paragraphs (B) and (D)’’ and inserting ‘‘subpara-
graphs (B), (D), and (F)’’; and 
(2) by adding at the end the following new sub-
paragraph: 
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‘‘(F) 3-YEAR EXCEPTION FOR CERTAIN EL-
IGIBLE PROFESSIONALS.— 
‘‘(i) IN
GENERAL.—The Secretary 
shall exempt an eligible professional whom 
the Secretary determines is described in 
clause (ii) from the application of the pay-
ment adjustment under subparagraph (A) 
for each of the payment years 2015 
through 2017. The Secretary shall make a 
determination under the previous sentence, 
with respect to such an exemption for an 
eligible professional, only if such eligible 
professional submits a request for such ex-
emption. The Secretary shall determine 
whether or not an eligible professional is 
described in clause (ii) not later than 30 
days after the date such eligible profes-
sional submits a request pursuant to the 
previous sentence. 
‘‘(ii) ELIGIBLE
PROFESSIONALS
IN 
SMALL PHYSICIAN PRACTICES.—An eligible 
professional described in this clause is an 
eligible professional furnishing covered pro-
fessional services during the EHR report-
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