123STA T .47 2 PUBLIC LA W 111 –5—FE B. 17 , 2 0 0 9numbersofth ee lig ible p rofession a ls w ho are meaningful EHR users an d, as determined appropriate b y the S e c- retary, of group practices recei v ing incentive payments under paragraph (1).‘ ‘( 4 ) CERTIF IE D E H RTE C H NOL O GY DEFINED. —F or purposes of this section, the term ‘certified EHR technology ’ means a q ualified electronic health record (as defined in section 30 00(13) of the P ublic Health Service A ct) 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 ambulatory electronic health record for office-based physi- cians or an inpatient hospital electronic health record for hos- pitals). ‘‘(5) D EFINITION S .—For purposes of this subsection
‘‘(A) CO V ERED P ROFESSION A L SERVICES.— T he term ‘cov- ered professional services’ has the meaning given such term in subsection ( k )(3). ‘‘( B ) EHR REPORTING PERIOD.—The term ‘EHR reporting period’ means, with respect to a payment year, any period (or periods) as specified by the Secretary. ‘‘(C) ELIGI B LE PROFESSIONAL.—The term ‘eligible professional’ means a physician, as defined in section 1 86 1(r).’’. (b) I NCENTIVE PAY M ENT AD JU STMENT.—Section 1848(a) of the Social Security Act (4 2U .S.C. 13 9 5w – 4(a)) is amended by adding at the end the following new paragraph: ‘‘( 7 ) INCENTIVES FOR MEANINGFUL USE OF CERTIFIED EHR TECHNOLOGY.— ‘‘(A) ADJUSTMENT.— ‘‘(i) IN GENERAL.—Sub j ect to subparagraphs (B) and (D), with respect to covered professional services furnished by an eligible professional during 2015 or any subsequent payment year, if the eligible profes- sional is not a meaningful EHR user (as determined under subsection (o)(2)) for an EHR reporting period for the year, the fee schedule amount for such services furnished by such professional during the year (including the fee schedule amount for purposes of determining a payment based on such amount) shall be equal to the applicable percent of the fee schedule amount that would otherwise apply to such services under this subsection (determined after application of paragraph (3) but without regard to this paragraph). ‘‘(ii) APPLICABLE PERCENT.—Subject to clause (iii), for purposes of clause (i), the term ‘applicable percent’ means— ‘‘(I) for 2015, 99 percent (or, in the case of an eligible professional who was subject to the application of the payment adjustment under sec- tion 1848(a)(5) for 2014, 98 percent)
‘‘(II) for 2016, 98 percent; and ‘‘(III) for 2017 and each subsequent year, 97 percent. ‘‘(iii) AUTHORITY TO DECREASE APPLICABLE PERCENTAGE FOR 2018 AND SUBSE Q UENT YEARS.—For 2018 and each subsequent year, if the Secretary finds
