Sec. 802. Extension of eligibility for Medicare and Medicaid health information technology implementation assistance
1,773 words·~8 min read·
/bill/113/hr/4574/ih/section-802·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 ) is amended— in subsection (a)(7)— in subparagraph (E), by adding at the end the following new clause: The term additional eligible professional means a clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)). ; and by adding at the end the following new subparagraph: The Secretary shall apply the provisions of this paragraph with respect to an additional eligible professional in the same manner as such provisions apply to an eligible professional, except in applying subparagraph (A)— in clause (i), the reference to 2015 shall be deemed a reference to 2019; in clause (ii), the references to 2015, 2016, and 2017 shall be deemed references to 2019, 2020, and 2021, respectively; and in clause (iii), the reference to 2018 shall be deemed a reference to 2022. ; and in subsection (o)— in paragraph (5), by adding at the end the following new subparagraph:
The term additional eligible professional means a clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)). ; and by adding at the end the following new paragraph: The Secretary shall apply the provisions of this subsection with respect to an additional eligible professional in the same manner as such provisions apply to an eligible professional, except in applying— paragraph (1)(A)(ii), the reference to 2016 shall be deemed a reference to 2020; paragraph (1)(B)(ii), the references to 2011 and 2012 shall be deemed references to 2015 and 2016, respectively; paragraph (1)(B)(iii), the references to 2013 shall be deemed references to 2017; paragraph (1)(B)(v), the references to 2014 shall be deemed references to 2018; and paragraph (1)(E), the reference to 2011 shall be deemed a reference to 2015. .
Section 1886 of the Social Security Act ( 42 U.S.C. 1395ww ) is amended— in subsection (b)(3)(B)(ix), by adding at the end the following new subclause: The Secretary shall apply the provisions of this subsection with respect to an additional eligible hospital (as defined in subsection (n)(6)(C)) in the same manner as such provisions apply to an eligible hospital, except in applying— subclause (I), the references to 2015, 2016, and 2017 shall be deemed references to 2019, 2020, and 2021, respectively; and subclause (III), the reference to 2015 shall be deemed a reference to 2019. ; and in subsection (n)— in paragraph (6), by adding at the end the following new subparagraph:
The term additional eligible hospital means an inpatient hospital that is a psychiatric hospital (as defined in section 1861(f)). ; and by adding at the end the following new paragraph: The Secretary shall apply the provisions of this subsection with respect to an additional eligible hospital in the same manner as such provisions apply to an eligible hospital, except in applying paragraph (2)— the Secretary shall adjust the base amount specified in subparagraph
(B)of such paragraph, in a manner specified by the Secretary, to reflect the smaller size of such additional eligible hospitals relative to eligible hospitals; the Secretary shall adjust the discharge related amount specified in subparagraph
(C)of such paragraph for each 12-month period selected by the Secretary under such subparagraph, in a manner specified by the Secretary, to reflect the smaller size such additional hospitals relative to eligible hospitals, including by adjusting the ranges of discharges specified in such subparagraph and the amount specified in such subparagraph for each discharge within such a specified range; the references in subparagraph (E)(ii) of such paragraph to 2013 and 2015 shall be deemed references to 2017 and 2019, respectively; and the reference in subparagraph (G)(i) of such paragraph to 2011 shall be deemed a reference to 2015. . Section 1903(t) of the Social Security Act ( 42 U.S.C. 1396b(t) ) is amended— in paragraph (2)(B)— in clause (i), by striking , or and inserting a semicolon; in clause (ii), by striking the period and inserting a semicolon; and by adding after clause
(ii)the following new clauses: a public hospital that is principally a psychiatric hospital (as defined in section 1861(f)); a private hospital that is principally a psychiatric hospital (as defined in section 1861(f)) and that has at least 10 percent of its patient volume (as estimated in accordance with a methodology established by the Secretary) attributable to individuals receiving medical assistance under this title; a community mental health center meeting the criteria specified in section 1913(c) of the Public Health Service Act; or a residential or outpatient mental health or substance abuse treatment facility that— is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Commission on Accreditation of Rehabilitation Facilities, the Council on Accreditation, or any other national accrediting agency recognized by the Secretary; and has at least 10 percent of its patient volume (as estimated in accordance with a methodology established by the Secretary) attributable to individuals receiving medical assistance under this title. ; in paragraph (3)(B)— in clause (iv), by striking and after the semicolon; in clause (v), by striking the period and inserting ; and ; and by adding at the end the following new clause: clinical psychologist providing qualified psychologist services (as defined in section 1861(ii)), if such clinical psychologist is practicing in an outpatient clinic that— is led by a clinical psychologist; and is not otherwise receiving payment under paragraph
(1)as a Medicaid provider described in paragraph (2)(B). ; and in paragraph (5)(B), by adding at the end the following new sentence: For purposes of this subparagraph in computing the amounts under section 1886(n)(2)(C) for payment years after 2015, with respect to a Medicaid provider described in clause (iii), (iv), (v), or
(vi)of paragraph (2)(B), in order to reflect the smaller size of Medicaid providers described in such clauses relative to Medicaid providers described in clauses
(i)and
(ii)of such paragraph (2)(B), the Secretary shall, in a manner specified by the Secretary, adjust the base amount specified in subparagraph
(B)of section 1886(n)(2) and the discharge related amount calculated under subparagraph
(C)of such section, including by adjusting the ranges of discharges specified in such subparagraph
(C)and the amount specified in such subparagraph
(C)for each discharge within such a specified range. . Section 1853 of the Social Security Act ( 42 U.S.C. 1395w–23 ) is amended— in subsection (l)— in paragraph (1)— by inserting or additional eligible professionals (as described in paragraph (9)) after paragraph
(2); and by inserting and additional eligible professionals before under such sections ; in paragraph (3)(B)— in clause
(i)in the matter preceding subclause (I), by inserting or an additional eligible professional described in paragraph
(9)after paragraph
(2); and in clause (ii)— in the matter preceding subclause (I), by inserting or an additional eligible professional described in paragraph
(9)after paragraph
(2); and in subclause (I), by inserting or an additional eligible professional, respectively, after eligible professional ; in paragraph (3)(C), by inserting and additional eligible professionals after all eligible professionals ; in paragraph (4)(D), by adding at the end the following new sentence: In the case that a qualifying MA organization attests that not all additional eligible professionals of the organization are meaningful EHR users with respect to an applicable year, the Secretary shall apply the payment adjustment under this paragraph based on the proportion of all such additional eligible professionals of the organization that are not meaningful EHR users for such year. ; in paragraph (6)(A), by inserting and, as applicable, each additional eligible professional described in paragraph
(9)after paragraph
(2); in paragraph (6)(B), by inserting and, as applicable, each additional eligible hospital described in paragraph
(9)after subsection (m)(1) ; in paragraph (7)(A), by inserting and, as applicable, additional eligible professionals after eligible professionals ; in paragraph (7)(B), by inserting and, as applicable, additional eligible professionals after eligible professionals ; in paragraph (8)(B), by inserting and additional eligible professionals described in paragraph
(9)after paragraph
(2); and by adding at the end the following new paragraph: With respect to a qualifying MA organization, an additional eligible professional described in this paragraph is an additional eligible professional (as defined for purposes of section 1848(o)) who— is employed by the organization; or is employed by, or is a partner of, an entity that through contract with the organization furnishes at least 80 percent of the entity’s Medicare patient care services to enrollees of such organization; and furnishes at least 80 percent of the professional services of the additional eligible professional covered under this title to enrollees of the organization; and furnishes, on average, at least 20 hours per week of patient care services. ; and in subsection (m)— in paragraph (1)— by inserting or additional eligible hospitals (as described in paragraph (7)) after paragraph
(2); and by inserting and additional eligible hospitals before under such sections ; in paragraph (3)(A)(i), by inserting or additional eligible hospital after eligible hospital ; in paragraph (3)(A)(ii), by inserting or an additional eligible hospital after eligible hospital in each place it occurs; in paragraph (3)(B)— in clause (i), by inserting or an additional eligible hospital described in paragraph
(7)after paragraph
(2); and in clause (ii)— in the matter preceding subclause (I), by inserting or an additional eligible hospital described in paragraph
(7)after paragraph
(2); and in subclause (I), by inserting or an additional eligible hospital, respectively, after eligible hospital ; in paragraph (4)(A), by inserting or one or more additional eligible hospitals (as defined in section 1886(n)), as appropriate, after section 1886(n)(6)(A)) ; in paragraph (4)(D), by adding at the end the following new sentence: In the case that a qualifying MA organization attests that not all additional eligible hospitals of the organization are meaningful EHR users with respect to an applicable period, the Secretary shall apply the payment adjustment under this paragraph based on the methodology specified by the Secretary, taking into account the proportion of such additional eligible hospitals, or discharges from such hospitals, that are not meaningful EHR users for such period. ; in paragraph (5)(A), by inserting and, as applicable, each additional eligible hospital described in paragraph
(7)after paragraph
(2); in paragraph (5)(B), by inserting and additional eligible hospitals, as applicable, after eligible hospitals ; in paragraph (6)(B), by inserting and additional eligible hospitals described in paragraph
(7)after paragraph
(2); and by adding at the end the following new paragraph: With respect to a qualifying MA organization, an additional eligible hospital described in this paragraph is an additional eligible hospital (as defined in section 1886(n)(6)(C)) that is under common corporate governance with such organization and serves individuals enrolled under an MA plan offered by such organization. .
Connectionstraces to 2
Traces to 2 documents
2 references not yet in our index
- 42 USC 1395w–4
- 42 USC 1395w–23
Citation graph
cites case law
Sec. 802
Extension of eligibility for Medicare and Medicaid health information technology implementation assistance
Cite42 USC 1395w–4
Cite42 USC 1395w–23
Cites 4Cited by 0 across 0 sources