II 113th CONGRESS 1st Session S. 1286 IN THE SENATE OF THE UNITED STATES July 11, 2013 Mr. Rockefeller (for himself, Mr. Whitehouse , and Mr. Franken ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To encourage the adoption and use of certified electronic health record technology by safety net providers and clinics.

1. Short title This Act may be cited as the Medicaid Information Technology to Enhance Community Health Act of 2013 or the MITECH Act . 2. Incentives for adoption and use of EHR Technology by safety net clinics and providers Section 1903(t) of the Social Security Act ( 42 U.S.C. 1396b(t) ) is amended— (1) in paragraph (2)— (A) in subparagraph (A)— (i) in clause (i), by inserting or QSNC-based after hospital-based ; (ii) in clause (ii)— (I) by inserting or QSNC-based after hospital-based ; and (II) by striking and at the end and inserting or ; and (iii) in clause (iii), by striking who practices predominantly in a Federally qualified health center or rural health clinic and inserting subject to paragraph (11)(C), who practices predominantly in a Federally qualified health center, rural health clinic, or qualified safety net clinic ; and (B) in subparagraph (B)— (i) in clause (i), by striking or ; (ii) in clause (ii), by striking the period at the end and inserting , or ; and (iii) by adding at the end the following new clause: (iii) subject to paragraph (11), a qualified safety net clinic (as defined in paragraph (3)(G)). ; (2) in paragraph (3)— (A) in subparagraph (B)(v), by striking rural health clinic and all that follows through the period and inserting rural health clinic, Federally qualified health center, or qualified safety net clinic that is led by a physician assistant. ; and (B) by adding at the end the following new subparagraphs: (G) The term qualified safety net clinic means a clinic or network of clinics that is operated by a private non-profit or public entity and that has at least 30 percent of its patient volume (as estimated in accordance with a methodology established by the Secretary) attributable to needy individuals (as defined in subparagraph (F)). (H) The term QSNC-based means, with respect to an eligible professional, an individual who furnishes substantially all of their professional services in a qualified safety net clinic and through the use of the facilities and equipment, including qualified electronic health records, of the clinic. The determination of whether an eligible professional is a QSNC-based eligible professional shall be made on the basis of the site of service (as defined by the Secretary) and without regard to any employment or billing arrangement between the eligible professional and any other provider. ; (3) in paragraph (5)— (A) in subparagraph (A), by inserting clause (i) or (ii) of before paragraph (2)(B) ; and (B) by adding at the end the following new subparagraph: (E) For purposes of payments described in paragraph (1)(B) to a Medicaid provider described in paragraph (2)(B)(iii), the Secretary shall establish a methodology for determining the maximum amount of payment permitted for each such provider. ; and (4) by adding at the end the following new paragraph: (11) (A) Not later than January 1, 2015, the Secretary, in consultation with States and other relevant stakeholders, shall promulgate regulations to establish a procedure through which a qualified safety net clinic may demonstrate meaningful use of certified EHR technology by such clinic for purposes of satisfying the requirement described in paragraph (6)(C)(i)(II). (B) A qualified safety net clinic shall not be eligible to receive payments described in paragraph (1)(B) before the date on which the Secretary establishes the procedure described in subparagraph (A). On and after that date, a qualified safety net clinic may receive such payments if the qualified safety net clinic notifies the Secretary that the qualified safety net clinic elects to receive such payments in lieu of the Secretary making payments described in paragraph (1)(A) to the eligible professionals who practice predominately in the qualified safety net clinic. (C) On or after the date that the Secretary establishes the procedure described in subparagraph (A), an eligible professional who practices predominately in a qualified safety net clinic, as described in paragraph (2)(A)(iii), shall not be eligible to receive payments described in paragraph (1)(A) if the qualified safety net clinic receives payments described in paragraph (1)(B). .