text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``E-Centives Act of 2009''.
  
  SEC. 2. INCREASED MATCHING PAYMENTS UNDER MEDICAID FOR HEALTH 
                INFORMATION TECHNOLOGY.
  
      Section 1903 of the Social Security Act (42 U.S.C. 1396b) is 
  amended--
              (1) in subsection (a)(3)(E), by inserting ``(other than 
          costs attributable to programs described in subsection (bb))'' 
          after ``costs incurred during such quarter''; and
              (2) by adding at the end the following new subsections:
      ``(aa) Enhanced Payments for Certified Health Information 
  Technology Incentives.--
              ``(1) In general.--The Secretary shall provide for payments 
          to each State that provides incentive payments to physicians, 
          hospitals, community health centers, rural health clinics, and 
          community mental health centers that exhibit meaningful use of 
          health information technology certified under this subsection, 
          as determined by the measures for meaningful use of health 
          information technology under paragraph (5). No payment may be 
          made to a State for incentive payments made by a State for 
          meaningful use of health information technology that occurs 
          before January 1, 2010.
              ``(2) Application.--To qualify for payments under paragraph 
          (1), a State shall submit an application in a time and manner 
          specified by the Secretary and containing the following:
                      ``(A) A description of the incentive payments.
                      ``(B) A description of the method the State will 
                  use to allocate such incentive payments among 
                  physicians, hospitals, community health centers, rural 
                  health clinics, and community mental health centers, 
                  including how the State will prioritize payments to 
                  providers serving a high percentage of Medicaid, SCHIP, 
                  and uninsured patients.
                      ``(C) A time line for implementing such payment 
                  incentives.
                      ``(D) A plan for disseminating information to 
                  physicians, hospitals, community health centers, rural 
                  health clinics, and community mental health centers 
                  about the availability of such payment incentives.
                      ``(E) An assessment of the current level of use of 
                  health information technology by physicians, hospitals, 
                  community health centers, rural health clinics, and 
                  community mental health centers in the State, using a 
                  standard assessment form developed by the Secretary.
                      ``(F) Any other information required by the 
                  Secretary.
              ``(3) Amount of payments to states.--
                      ``(A) In general.--Subject to subparagraph (B), the 
                  payment made to a State under this subsection for a 
                  quarter, with respect to sums expended by such State 
                  during such quarter that are attributable to providing 
                  incentive payments under paragraph (1), shall be in an 
                  amount equal to the following:
                              ``(i) For any quarter in 2010, the enhanced 
                          FMAP (as defined in section 2105(b)) of such 
                          sums.
                              ``(ii) For any quarter in 2011 or 2012, 
                          such sums multiplied by a percentage equal to 
                          such enhanced FMAP minus 1.5 percentage points.
                              ``(iii) For any quarter in 2013 or 2014, 
                          such sums multiplied by a percentage equal to 
                          such enhanced FMAP minus 3 percentage points.
                              ``(iv) For any quarter beginning after 
                          2014, 0.
                      ``(B) Limitation.--
                              ``(i) Fiscal year limitation.--The total 
                          amount of payments made under this subsection 
                          shall not exceed $500,000,000 for any fiscal 
                          year.
                              ``(ii) Allocation.--If the amounts 
                          otherwise payable under this subsection for a 
                          fiscal year exceed the amount specified in 
                          clause (i), the Secretary shall reduce the 
                          amounts payable under this subsection, in a 
                          manner specified by the Secretary, to comply 
                          with the limitation under such clause.
                              ``(iii) Duplicative payments prohibited.--
                          No payment shall be made under any other 
                          provision of this title for expenditures for 
                          which payment is made under this subsection.
                      ``(C) Manner of payment.--Payment to a State under 
                  this subsection shall be made in the same manner as 
                  payments under subsection (a).
              ``(4) Certification requirements for health information 
          technology.--
                      ``(A) In general.--The Secretary, in consultation 
                  with the Office of the National Coordinator for Health 
                  Information Technology and the Certification Commission 
                  of Health Information Technology, shall determine the 
                  requirements for certification of health information 
                  technology under this subsection.
                      ``(B) Interim certification requirements.--During 
                  any period in which the Secretary has not determined 
                  such certification requirements, the Secretary, for 
                  purposes of this subsection, shall use the 
                  certification requirements for health information 
                  technology established by the Certification Commission 
                  for Health Information Technology.
              ``(5) Measures for meaningful use of health information 
          technology.--
                      ``(A) In general.--For purposes of this subsection, 
                  the Secretary shall publish standard measures of 
                  meaningful use of health information technology to be 
                  used by providers to demonstrate meaningful use of 
                  certified health information technology. Such measures 
                  may include--
                              ``(i) self-certification of operational use 
                          of such technology;
                              ``(ii) the submission of (or ability to 
                          submit), in a form and manner specified by the 
                          Secretary, such information on clinical 
                          measures and data (that do not include 
                          individually identifiable health information) 
                          from such technology as indicates a meaningful 
                          utilization of such technology; and
                              ``(iii) such other means as the Secretary 
                          may specify.
                      ``(B) Alternative measures.--The Secretary may 
                  establish and apply different measures based on the 
                  stage of implementation or adoption of the certified 
                  health information technology involved.
      ``(bb) Payments for Electronic Information and Eligibility Systems 
  and Patient Registries.--
              ``(1) In general.--In addition to the payments provided 
          under subsection (a), the Secretary shall provide for payments 
          to each State that establishes a program to--
                      ``(A) design, develop, install, maintain, and 
                  operate--
                              ``(i) electronic information and 
                          eligibility systems; and
                              ``(ii) patient registries for the purpose 
                          of disease screening;
                      ``(B) coordinate benefits and services under this 
                  title and under title XVIII for individuals under the 
                  State plan who are full-benefit dual eligible 
                  individuals.
                      ``(C) train providers in the use of such systems 
                  and registries.
              ``(2) Application.--To qualify for payments under paragraph 
          (1), a State shall submit an application in such time and 
          manner as required by the Secretary and containing such 
          information as the Secretary specifies and include, at a 
          minimum, a description of the electronic information and 
          eligibility systems and patient registries covered by the 
          program described in paragraph (1).
              ``(3) Amount of payments to states.--
                      ``(A) In general.--The payments made a State under 
                  this subsection shall be an amount equal to--
                              ``(i) 90 percent of so much of the sums 
                          expended by such State during any quarter 
                          commencing on or after January 1, 2010, as are 
                          attributable to--
                                      ``(I) the design, development, or 
                                  installation of electronic information 
                                  and eligibility systems and patient 
                                  registries under paragraph (1); and
                                      ``(II) training staff employed by 
                                  providers on the use of such system or 
                                  registry during the three-year period 
                                  beginning on the date such system or 
                                  registry is installed; and
                              ``(ii) 75 percent of so much of the sums 
                          expended by such State during any quarter 
                          commencing on or after January 1, 2010, as are 
                          attributable to--
                                      ``(I) the maintenance of such 
                                  systems and registries; and
                                      ``(II) training for staff employed 
                                  by providers on the use of a system or 
                                  registry that occurs after the last day 
                                  of the end of the period described in 
                                  clause (i)(II).
                      ``(B) Manner of payment.--Payment to a State under 
                  this subsection shall be made in the same manner as 
                  payments under subsection (a).
              ``(4) Electronic information and eligibility system 
          defined.--For purposes of this subsection, the term `electronic 
          information and eligibility system' means a system for 
          determining eligibility and exchanging information that meets 
          such requirements as the Secretary shall specify. Such 
          requirements for a system shall include a requirement that the 
          system--
                      ``(A) be interconnected and interoperable with 
                  other electronic systems and registries, including--
                              ``(i) systems administered by the Centers 
                          for Disease Control for disease reporting 
                          purposes;
                              ``(ii) systems that exist for the purpose 
                          of determining eligibility for the Medicare 
                          program under title XVIII; and
                              ``(iii) systems that exist for the purpose 
                          of determining eligibility for the Temporary 
                          Assistance for Needy Families program under 
                          title IV, free and reduced price lunches under 
                          the Richard B. Russell National School Lunch 
                          Act (42 U.S.C. 1751 et seq.), or other 
                          federally funded programs targeted to low-
                          income populations; and
                      ``(B) can be used to automatically send, receive, 
                  and integrate data (including laboratory results and 
                  medical histories) from systems and registries 
                  administered by other providers or organizations or 
                  through a health information exchange.''.
  
  SEC. 3. MEDICAID TRANSFORMATION PAYMENTS REPORT.
  
      (a) In General.--Not later than June 30, 2009, the Secretary of 
  Health and Human Services shall submit to Congress a report on Medicaid 
  transformation payments under section 1903(z) of the Social Security 
  Act (42 U.S.C. 1396b(z)).
      (b) Contents.--The report under subsection (a) shall include--
              (1) a description--
                      (A) of the financial costs and benefits of the 
                  Medicaid transformation payments;
                      (B) of the entities to which such costs and 
                  benefits accrue; and
                      (C) of any reduction in duplicative or unnecessary 
                  care resulting from methods adopted by States and 
                  funded by such payments; and
              (2) an analysis of the information contained in the reports 
          submitted to the Secretary by States under section 
          1903(z)(3)(C) of the Social Security Act during the two-year 
          period ending on December 31, 2008, including--
                      (A) the impact of the methods funded by the 
                  payments on--
                              (i) health care quality and safety; and
                              (ii) the privacy and security of 
                          identifiable health information;
                      (B) the effect of such methods on furthering 
                  interconnectedness between--
                              (i) providers and State Medicaid programs; 
                          and
                              (ii) State Medicaid programs and other 
                          programs for low-income populations 
                          administered by State and Federal entities;
                      (C) the extent to which such methods reduce the 
                  administrative burden on such programs; and
                      (D) the contribution of the payments to the goals 
                  of public health and public health reporting.
target: E-Centives Act of 2009 - Amends title XIX (Medicaid) of the Social Security Act to direct the Secretary of Health and Human Services to provide for payments to each state that provides incentive payments to physicians, hospitals, community health centers, rural health clinics, and community mental health centers that exhibit meaningful use of certified health information technology.
  
  Directs the Secretary to provide for payments to each state that establishes a program to: (1) design, develop, install, maintain, and operate electronic information and eligibility systems and patient registries for the purpose of disease screening; (2) coordinate benefits and services under Medicare and Medicaid for full-benefit dual eligible individuals under the state plan; and (3) train providers in the use of such systems and registries.
  
  Directs the Secretary of Health and Human Services to submit to Congress a report on Medicaid transformation payments to states for the adoption of innovative methods to improve effectiveness and efficiency in providing medical assistance.
feat_title: A bill to amend title XIX of the Social Security Act to encourage the use of certified health information technology by providers in the Medicaid program and the Children's Health Insurance Program, and for other purposes.