I 
113TH CONGRESS 
1ST SESSION 
H. R. 986 
To amend title XVIII of the Social Security Act to ensure the eligibility 
of eligible professionals practicing in rural health clinics for electronic 
health records and quality improvement incentives under Medicare, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 6, 2013 
Mr. SCHOCK (for himself, Mr. BRALEY of Iowa, Mr. HUIZENGA of Michigan, 
Mrs. MCMORRIS RODGERS, and Mr. WALDEN) 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 title XVIII of the Social Security Act to ensure 
the eligibility of eligible professionals practicing in rural 
health clinics for electronic health records and quality 
improvement incentives under Medicare, 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. 
This Act may be cited as the ‘‘Rural Health Clinic 
Fairness Act of 2013’’. 
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SEC. 2. EXTENSION OF MEDICARE EHR INCENTIVES TO ELI-
GIBLE 
PROFESSIONALS 
PRACTICING 
IN 
RURAL HEALTH CLINICS. 
(a) IN GENERAL.—Section 1848(o)(5)(A) of the So-
cial Security Act (42 U.S.C. 1395w(o)(5)(A)) is amended 
by inserting before the period at the end the following: 
‘‘and, with respect to payment years after 2013, includes 
rural health clinic services (as defined in section 
1861(aa)(1)) furnished by an eligible professional’’. 
(b) 
OFFSETTING
REDUCTION.—Section 
1848(o)(1)(B) of the Social Security Act (42 U.S.C. 
1395w–4(o)(1)(B)) is amended— 
(1) in clause (ii), by striking ‘‘clauses (iii) 
through (v)’’ and inserting ‘‘the succeeding clauses’’; 
and 
(2) by adding at the end the following new 
clause: 
‘‘(iv) BUDGET NEUTRALITY ADJUST-
MENT.—The Secretary shall reduce the ap-
plicable amounts that would otherwise be 
determined under this subparagraph with 
respect to 2014 and each succeeding year 
by an amount that the Secretary estimates 
would ensure that estimated aggregate 
payments under this subsection for such 
year is not increased as a result of the 
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amendment made by section 2(a) of the 
Rural Health Clinic Fairness Act of 
2013.’’. 
SEC. 3. EXTENSION OF MEDICARE ERX AND QUALITY RE-
PORTING INCENTIVES TO RURAL HEALTH 
CLINICS. 
(a) IN GENERAL.—Section 1848(m)(6)(A) of the So-
cial Security Act (42 U.S.C. 1395w(m)(6)(A)) is amended 
by inserting before the period at the end the following: 
‘‘, except that the term ‘covered professional services’ 
shall, with respect to reporting periods for 2014 or a sub-
sequent year, include rural health clinic services (as de-
fined in section 1861(aa)(1)) furnished by an eligible pro-
fessional’’. 
(b) OFFSETTING REDUCTION.—Section 1848(m)(1) 
of such Act (42 U.S.C. 1395w(m)(1)) is amended— 
(1) in subparagraph (B), by striking ‘‘For pur-
poses’’ and inserting ‘‘Subject to subparagraph (C), 
for purposes’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(C) 
BUDGET
NEUTRALITY
ADJUST-
MENT.—The Secretary shall reduce the applica-
ble quality percent that would otherwise be de-
termined under subparagraph (B) for 2014 by 
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