Page:United States Statutes at Large Volume 123.djvu/511

 123STA T .49 1 PUBLIC LA W 111 –5—FE B.1 7, 2 0 09 ambul a torye le c tro ni c h ealth recor df or office - ba s ed p hysicians or an inpatient hospital electronic health record for hospitals ).‘ ‘ (B ) T he term ‘eli g ible professional ’ means a — ‘‘(i) physician ‘‘(ii) dentist; ‘‘(iii) certified nurse mid- w ife; ‘‘(i v ) nurse practitioner; and ‘‘(v) physician assistant insofar as the assistant is prac- ticing in a rural health clinic that is led by a physician assistant or is practicing in a F ederally q ualified health center that is so led. ‘‘( C ) The term ‘average allowable costs’ means, with respect to certified EHR technology of M edicaid providers described in paragraph ( 2 )( A ) for— ‘‘(i) the first year of payment with respect to such a provider, the average costs for the purchase and initial implementation or upgrade of such technology (and support services including training that is for, or is necessary for the adoption and initial operation of, such technology) for such providers, as determined by the S ecretary based upon studies conducted under paragraph ( 4 )(C); and ‘‘(ii) a subsequent year of payment with respect to such a provider, the average costs not described in clause (i) relating to the operation, maintenance, and use of such technology for such providers, as determined by the Sec- retary based upon studies conducted under paragraph (4)(C). ‘‘( D ) The term ‘hospital-based’ means, with respect to an eligible professional, a professional (such as a pathologist, anesthesiologist, or emergency physician) who furnishes substantially all of the individual’s professional services in a hospital setting (whether inpatient or outpatient) and through the use of the facilities and equipment, including qualified electronic health records, of the hospital. The determination of whether an eligible professional is a hospital-based eligible professional shall be made on the basis of the site of service (as defined by the Secretary) and without regard to any employ- ment or billing arrangement between the eligible professional and any other provider. ‘‘(E) The term ‘net average allowable costs’ means, with respect to a Medicaid provider described in paragraph (2)(A), average allowable costs reduced by any payment that is made to such Medicaid provider from any other source (other than under this subsection or by a State or local government) that is directly attributable to payment for certified EHR technology or support services described in subparagraph (C). ‘‘(F) The term ‘needy individual’ means, with respect to a Medicaid provider, an individual— ‘‘(i) who is receiving assistance under this title; ‘‘(ii) who is receiving assistance under title X X I ‘‘(iii) who is furnished uncompensated care by the pro- vider; or ‘‘(iv) for whom charges are reduced by the provider on a sliding scale basis based on an individual’s ability to pay. ‘‘(4)(A) W ith respect to a Medicaid provider described in para- graph (2)(A), sub j ect to subparagraph (B), in no case shall—