Page:United States Statutes at Large Volume 123.djvu/510

 123STA T .490PUBLIC LA W 111 –5—FE B.1 7, 2009 ‘ ‘ (A)toMedica id pr o v ider s descri b edi n para g rap h ( 2 )(A) notine x cess o f85 percent of net average a l lo w able costs (as defined in paragraph ( 3 )( E )) for certified E HR technolog y (and s u pport services including m aintenance and training that is for, or is necessary for the adoption and operation of, such technology) with respect to such providers and ‘‘( B ) to Medicaid providers described in paragraph (2)(B) not in excess of the maximum amount permitted under para - graph (5) for the provider involved . ‘‘(2) I n this subsection and subsection (a)(3)( F ), the term ‘Med- icaid provider ’ means — ‘‘(A) an eligible professional (as defined in paragraph (3)(B))— ‘‘(i) who is not hospital-based and has at least 3 0 percent of the professional’s patient volume (as estimated in accordance with a methodology established by the S ec- retary) attributable to individuals who are receiving med- ical assistance under this title; ‘‘(ii) who is not described in clause (i), who is a pediatri- cian, who is not hospital-based, and who has at least 20 percent of the professional’s patient volume (as estimated in accordance with a methodology established by the Sec- retary) attributable to individuals who are receiving med- ical assistance under this title; and ‘‘(iii) who practices predominantly in a Federally q uali- fied health center or rural health clinic and has at least 30 percent of the professional’s patient volume (as esti- mated in accordance with a methodology established by the Secretary) attributable to needy individuals (as defined in paragraph (3)(F)); and ‘‘(B)(i) a children’s hospital, or ‘‘(ii) an acute-care hospital that is not described in clause (i) and that has at least 1 0 percent of the hospital’s patient volume (as estimated in accordance with a methodology estab- lished by the Secretary) attributable to individuals who are receiving medical assistance under this title. An eligible professional shall not qualify as a Medicaid provider under this subsection unless any right to payment under sections 18 4 8(o) and 1853(l) with respect to the eligible professional has been waived in a manner specified by the Secretary. For purposes of calculating patient volume under subparagraph (A)(iii), insofar as it is related to uncompensated care, the Secretary may require the ad j ustment of such uncompensated care data so that it would be an appropriate proxy for charity care, including a downward adjustment to eliminate bad debt data from uncompensated care. In applying subparagraphs (A) and (B)(ii), the methodology estab- lished by the Secretary for patient volume shall include individuals enrolled in a Medicaid managed care plan (under section 1 9 03(m) or section 1932). ‘‘(3) In this subsection and subsection (a)(3)(F) ‘‘(A) T he term ‘certified EHR technology’ means a qualified electronic health record (as defined in 3000(13) of the P ublic Health Service Act) that is certified pursuant to section 3001(c)(5) of such Act as meeting standards adopted under section 3004 of such Act that are applicable to the type of record involved (as determined by the Secretary, such as an Defin i t i o n s.Ap p l i cab ilit y . Definition.