Page:United States Statutes at Large Volume 123.djvu/513

 123STA T .49 3 PUBLIC LA W 111 –5—FE B.1 7, 2 0 09 underthis tit l e a nd w h o are not des c ri b ed in section 18 8 6( n ) ( 2 )( D )(i) .I nco mp utin g inpatient - bed-da y s under the pre v ious sentence , the S ecretary shall ta k e into account inpatient-bed-days attributable to inpatient-bed-days that are paid f or individuals enrolled in a M edicaid managed care plan (under section 1 903 (m) or section 1932). ‘ ‘(D) In no case may the payments described in paragraph (1)( B ) with respect to a Medicaid provider described in paragraph (2)(B) be paid — ‘‘(i) for any year beginning after 2016 unless the provider has been provided payment under paragraph (1)(B) for the previous year and ‘‘(ii) over a period of more than 6 years of payment. ‘‘(6) P ayments described in paragraph (1) are not in accordance with this subsection unless the following re q uirements are met ‘‘( A )(i) T he State provides assurances satisfactory to the Secretary that amounts received under subsection (a)(3)( F ) with respect to payments to a Medicaid provider are paid, sub j ect to clause (ii), directly to such provider (or to an employer or facility to which such provider has assigned payments) with- out any deduction or rebate. ‘‘(ii) Amounts described in clause (i) may also be paid to an entity promoting the adoption of certified EHR technology, as designated by the State, if participation in such a payment arrangement is voluntary for the eligible professional involved and if such entity does not retain more than 5 percent of such payments for costs not related to certified EHR technology (and support services including maintenance and training) that is for, or is necessary for the operation of, such technology. ‘‘(B) A Medicaid provider described in paragraph (2)(A) is responsible for payment of the remaining 15 percent of the net average allowable cost. ‘‘( C )(i) Subject to clause (ii), with respect to payments to a Medicaid provider— ‘‘(I) for the first year of payment to the Medicaid pro- vider under this subsection, the Medicaid provider dem- onstrates that it is engaged in efforts to adopt, implement, or upgrade certified EHR technology; and ‘‘(II) for a year of payment, other than the first year of payment to the Medicaid provider under this subsection, the Medicaid provider demonstrates meaningful use of cer- tified EHR technology through a means that is approved by the State and acceptable to the Secretary, and that may be based upon the methodologies applied under section 18 4 8(o) or 1886(n). ‘‘(ii) In the case of a Medicaid provider who has completed adopting, implementing, or upgrading such technology prior to the first year of payment to the Medicaid provider under this subsection, clause (i)(I) shall not apply and clause (i)(II) shall apply to each year of payment to the Medicaid provider under this subsection, including the first year of payment. ‘‘(D) To the e x tent specified by the Secretary, the certified EHR technology is compatible with State or Federal administra- tive management systems. For purposes of subparagraph (B), a Medicaid provider described in paragraph (2)(A) may accept payments for the costs described