(A) by inserting ‘‘or specified claim (as de-
fined in subsection (r)(6))’’ after ‘‘district 
where the claim’’; 
(B) by inserting ‘‘(or, with respect to a 
person described in subsection (o), the person)’’ 
after ‘‘claimant’’; 
(C) by inserting ‘‘that are not received by 
the Inspector General of the Department of 
Health and Human Services under subsection 
(q) as reimbursement’’ after ‘‘amounts recov-
ered’’; and 
(D) by inserting ‘‘(or, in the case of a pen-
alty or assessment under subsection (o), by a 
specified State agency (as defined in subsection 
(r)(7))’’ after ‘‘or a State agency’’. 
SEC. 303. AUTHORIZING A BLANKET MEANINGFUL USE SIG-
NIFICANT HARDSHIP EXCEPTION. 
(a) PHYSICIANS’ SERVICES.—Section 1848(a)(7)(B) 
of the Social Security Act (42 U.S.C. 1395w–4(a)(7)(B)) 
is amended by inserting ‘‘(or through a blanket exception 
with respect to the payment adjustment for 2017, but only 
if a request for such exception is filed no later than June 
30, 2016)’’ after ‘‘on a case-by-case basis’’. 
(b) 
HOSPITAL
SERVICES.—Section 
1886(b)(3)(B)(ix)(II) of the Social Security Act (42 
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U.S.C. 1395ww(b)(3)(B)(ix)(II)) is amended by inserting 
‘‘(or through a blanket exception with respect to the pay-
ment adjustment for fiscal year 2017, but only if a request 
for such exception is filed no later than June 30, 2016)’’ 
after ‘‘on a case-by-case basis’’. 
(c) IMPLEMENTATION AUTHORITY.—The Secretary 
of Health and Human Services may implement the amend-
ments made by this section by interim final rule with com-
ment period. 
SEC. 304. LIMITING FEDERAL MEDICAID REIMBURSEMENT 
TO STATES FOR DURABLE MEDICAL EQUIP-
MENT (DME) TO MEDICARE PAYMENT RATES. 
Section 1903(i)(27) of the Social Security Act (42 
U.S.C. 1396b(i)(27)), as added by section 503(a)(1) of di-
vision O of the Consolidated Appropriations Act, 2016, is 
amended by striking ‘‘January 1, 2019’’ and inserting 
‘‘October 1, 2018’’. 
SEC. 305. TREATMENT OF PATIENT ENCOUNTERS IN AMBU-
LATORY 
SURGICAL 
CENTERS 
IN 
DETER-
MINING MEANINGFUL EHR USE. 
Section 1848(o)(2) of the Social Security Act (42 
U.S.C. 1395w–4(o)(2)) is amended by adding at the end 
the following new subparagraph: 
‘‘(E) TREATMENT
OF
PATIENT
ENCOUN-
TERS AT AMBULATORY SURGICAL CENTERS.— 
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‘‘(i) IN GENERAL.—Subject to clause 
(ii), with respect to a payment adjustment 
applied under subsection (a)(7)(A), for 
2017 or a subsequent year, any patient en-
counter of an eligible professional occur-
ring at an ambulatory surgical center (de-
scribed in section 1833(i)(1)(A)) shall not 
be treated as a patient encounter in deter-
mining whether an eligible professional 
qualifies as a meaningful EHR user. Not-
withstanding any other provision of law, 
the Secretary may implement this clause 
by program instruction or otherwise. 
‘‘(ii) SUNSET.—Clause (i) shall no 
longer apply as of the first payment year 
that begins more than 3 years after the 
date the Secretary determines, through no-
tice and comment rulemaking, that cer-
tified EHR technology is applicable to the 
ambulatory surgical center setting.’’. 
Æ 
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