[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3292 Introduced in House (IH)]
107th CONGRESS
1st Session
H. R. 3292
To establish an informatics grant program for hospitals and skilled
nursing facilities and to encourage health care providers to make major
information technology advances by establishing a Medical Information
Technology Advisory Board that will develop and disseminate standards
for the electronic sharing of medical information.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 14, 2001
Mr. Houghton (for himself and Mrs. Thurman) introduced the following
bill; which was referred to the Committee on Ways and Means, and in
addition to the Committee on Energy and Commerce, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To establish an informatics grant program for hospitals and skilled
nursing facilities and to encourage health care providers to make major
information technology advances by establishing a Medical Information
Technology Advisory Board that will develop and disseminate standards
for the electronic sharing of medical information.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medication Errors Reduction Act of
2001''.
SEC. 2. INFORMATICS SYSTEMS GRANT PROGRAM FOR HOSPITALS AND SKILLED
NURSING FACILITIES.
(a) Grants.--
(1) In general.--The Secretary of Health and Human Services
(in this section referred to as the ``Secretary'') shall
establish a program to make grants to eligible entities that
have submitted applications in accordance with subsection (b)
for the purpose of assisting such entities in offsetting the
costs related to purchasing, leasing, developing, and
implementing standardized clinical health care informatics
systems designed to improve patient safety and reduce adverse
events and health care complications resulting from medication
errors.
(2) Duration.--The authority of the Secretary to make
grants under this section shall terminate on September 30,
2011.
(3) Costs defined.--For purposes of this section, the term
``costs'' shall include total expenditures incurred for--
(A) purchasing, leasing, and installing computer
software and hardware, including handheld computer
technologies;
(B) making improvements to existing computer
software and hardware;
(C) purchasing or leasing communications
capabilities necessary for clinical data access,
storage, and exchange; and
(D) providing education and training to eligible
entity staff on computer patient safety information
systems.
(4) Eligible entity defined.--For purposes of this section,
the term ``eligible entity'' means the following entities:
(A) Hospital.--A hospital (as defined in section
1861(e) of the Social Security Act (42 U.S.C.
1395x(e))).
(B) Skilled nursing facility.--A skilled nursing
facility (as defined in section 1819(a) of such Act (42
U.S.C. 1395i-3(e))).
(b) Application.--An eligible entity seeking a grant under this
section shall submit an application to the Secretary at such time, in
such form and manner, and containing such information as the Secretary
specifies.
(c) Special Considerations and Rural Hospital Reserve.--
(1) Special consideration for eligible entities that serve
a large number of medicare, medicaid, and schip eligible
individuals.--In awarding grants under this section, the
Secretary shall give special consideration to eligible entities
in which individuals that are eligible for benefits under the
medicare program under title XVIII of the Social Security Act,
the medicaid program under title XIX of such Act, or under the
State children's health insurance program under title XXI of
such Act make up a high percentage of the total patient
population of the entity.
(2) Reserve 20 percent of grant funds for rural
hospitals.--
(A) In general.--Subject to subparagraph (C), the
Secretary shall ensure that at least 20 percent of the
funds available for making grants under this section
are used for making grants to eligible entities that
are rural hospitals.
(B) Rural hospital defined.--For purposes of
subparagraph (A), the term ``rural hospital'' means a
hospital that--
(i) is located in a rural area (as such
term is defined for purposes of section 1886(d)
of the Social Security Act (42 U.S.C.
1395ww(d)));
(ii) is located in an area designated by
any law or regulation of the State as a rural
area; or
(iii) is designated by the State as a rural
hospital.
(C) Availability of reserve funds if limited number
of rural hospitals apply for grants.--If the Secretary
estimates that the amount of funds reserved under
subparagraph (A) for hospitals described in such
subparagraph exceeds the maximum amount of funds
permitted for such hospitals under subsection (d), the
Secretary may reduce the amount reserved for such
hospitals by an amount equal to such excess and use
such funds for awarding grants to other eligible
entities.
(3) Special consideration for compliance with recommended
standards.--In awarding grants under this section, the
Secretary shall give special consideration to eligible entities
for grants that are intended to comply with the requirements
referred to in paragraph (1)(B) of section 3(c) (relating to
interoperability standardization, common medical technology (lexicon),
and records security) that are recommended under such section.
(d) Limitation on Amount of Grant.--
(1) In general.--A grant awarded under this section may not
exceed the lesser of--
(A) an amount equal to the applicable percentage of
the costs incurred by the eligible entity for the
project for which the entity is seeking funding under
this section; or
(B) in the case of a grant made to a--
(i) hospital, $750,000; or
(ii) skilled nursing facility, $200,000.
(2) Applicable percentage.--For purposes of paragraph
(1)(A), the term ``applicable percentage'' means, with respect
to an eligible entity, the percentage of total net revenues for
such period as determined appropriate by the Secretary for the
entity that consists of net revenues from the medicare and
medicaid programs or the State children's health insurance
program under titles XVIII, XIX, and XXI of the Social Security
Act.
(e) Eligible Entity Required To Furnish Secretary With
Information.--An eligible entity receiving a grant under this section
shall furnish the Secretary with such information as the Secretary may
require to--
(1) evaluate the project for which the grant is made; and
(2) ensure that funding provided under the grant is
expended for the purposes for which it is made.
(f) Reports.--
(1) Interim reports.--
(A) In general.--The Secretary shall submit, at
least annually, a report to the Committee on Ways and
Means of the House of Representatives and the Committee
on Finance of the Senate on the grant program
established under this section.
(B) Contents.--A report submitted pursuant to
subparagraph (A) shall include information on--
(i) the number of grants made;
(ii) the nature of the projects for which
funding is provided under the grant program;
(iii) the geographic distribution of grant
recipients; and
(iv) such other matters as the Secretary
determines appropriate.
(2) Final report.--Not later than 180 days after the
completion of all of the projects for which a grant is made
under this section, the Secretary shall submit a final report
to the committees referred to in paragraph (1)(A) on the grant
program established under this section, together with such
recommendations for legislation and administrative action as
the Secretary determines appropriate.
(g) Authorization of Appropriations.--
(1) Authorization.--
(A) Hospitals.--There are authorized to be
appropriated from the Federal Hospital Insurance Trust
Fund under section 1817 of the Social Security Act (42
U.S.C. 1395i) $93,000,000, for each of the fiscal years
2002 through 2011, for the purpose of making grants
under this section to eligible entities that are
hospitals.
(B) Skilled nursing facilities.--There are
authorized to be appropriated from the Federal Hospital
Insurance Trust Fund under section 1817 of the Social
Security Act (42 U.S.C. 1395i) $4,500,000, for each of
the fiscal years 2002 through 2011, for the purpose of
making grants under this section to eligible entities
that are skilled nursing facilities.
(2) Availability.--Any amounts appropriated pursuant to the
authority contained in subparagraph (A) or (B) of paragraph (1)
shall remain available, without fiscal year limitation, through
September 30, 2011.
SEC. 3. MEDICAL INFORMATION TECHNOLOGY ADVISORY BOARD.
(a) Establishment.--No later than three months after the date of
the enactment of this Act, the Secretary of Health and Human Services
(in this section referred to as the ``Secretary'') shall appoint a
board to be known as the ``Medical Information Technology Advisory
Board'' (in this section referred to as the ``MITAB''). The Secretary
shall designate one member as chairman and one as vice chairman.
(b) Composition.--
(1) In general.--The MITAB shall consist of 17 members that
include--
(A) experts from the fields of medical information,
information technology, medical continuous quality
improvement, medical records security and privacy,
individual and institutional health care clinical
providers, health researchers, and health care
purchasers;
(B) one or more Members of the National Committee
on Vital and Health Statistics and one or more Members
of the Medicare Payment Advisory Commission or its
staff; and
(C) one or more staff experts from the National
Library of Medicine, the Centers for Medicare &
Medicaid Services, and the Agency for Healthcare
Research and Quality.
(2) Terms; etc.--The provisions of paragraphs (3) through
(8) of section 4021(c) of the Balanced Budget Act of 1997 shall
apply to the MITAB in the same manner as they applied to the
National Bipartisan Commission on the Future of Medicare.
(c) Duties.--
(1) Initial report.--No later than 30 months after the date
of the enactment of this Act, the MITAB shall submit to
Congress a report on the following:
(A) The best current practices in medical
information technology.
(B) The requirements to be established (after
appropriate development and testing) for--
(i) health care information technology
interoperability standardization,
(ii) common medical terminology (lexicon),
and
(iii) records security.
(C) Certification of compliance with MITAB
requirements, so that the goal of confidential
information exchange among health care providers may be
promoted and so that long-term compatibility among
information systems is maximized, in order to promote
one or more of the goals described in subsection (d).
(2) Subsequent reports.--During the 6 years after the year
in which the report is submitted under paragraph (1), the MITAB
shall submit to Congress reports, every 24 months, relating to
additional recommendations, best practices, results of
information technology improvements financed under grants under
section 2, and such other matters as may help ensure the most
rapid dissemination of best practices in health care
information technology.
(d) Goals.--The goals described in this subsection are the
following:
(1) To maximize positive outcomes in clinical care--
(A) by providing decision support for diagnosis and
care; and
(B) by assisting in the emergency treatment of a
patient presenting at a facility where there is no
medical record of the patient.
(2) To contribute to (and be consistent with) the
development of the patient assessment instrument provided for
under section 545 of the Medicare, Medicaid, and SCHIP Benefits
Improvement and Protection Act of 2000 (as enacted into law by
section 1(a)(6) of Public Law 106-554), and to assist in
minimizing the need for new and different records as patients
move from provider to provider.
(3) To reduce or eliminate the need for redundant records,
paperwork, and the repetitive taking of patient histories and
administering of tests.
(4) To minimize medical errors, such as administration of
contraindicated drugs.
(5) To promote and ensure access to best practices of
medicine through support of research across institutions.
(6) To provide a compatible information technology
architecture that facilitates future quality and cost-saving
needs and that avoids the financing and development of
information technology systems that are not readily compatible.
(e) Staff and Administration.--The provisions of section 4021(d) of
the Balanced Budget Act of 1997 shall apply to the MITAB in the same
manner as they applied to the National Bipartisan Commission on the
Future of Medicare.
(f) Powers.--The provisions of section 4021(e) of the Balanced
Budget Act of 1997 shall apply to the MITAB in the same manner as they
applied to the National Bipartisan Commission on the Future of
Medicare.
(g) Termination.--The MITAB shall terminate 30 days after the date
of submission of its final report under subsection (c)(2).
(h) Authorization of Appropriations.--There are authorized to be
appropriated $2,500,000 in fiscal year 2002, $8,000,000 in fiscal year
2003, and $9,500,000 in fiscal year 2004 to carry out this section. The
full amount of such appropriation shall be payable from the Federal
Hospital Insurance Trust Fund under section 1817 of the Social Security
Act (42 U.S.C. 1395i). Funding for the reports provided under
subsection (c)(2) shall be from funds appropriated for the
administrative budget of the Centers for Medicare & Medicaid Services.
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