[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4889 Reported in House (RH)]

                                                 Union Calendar No. 468
107th CONGRESS
  2d Session
                                H. R. 4889

                      [Report No. 107-714, Part I]

To amend title XI of the Social Security Act to improve patient safety.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              June 6, 2002

Mrs. Johnson of Connecticut (for herself, Mr. Thomas, Mr. Houghton, Mr. 
    Fletcher, Mrs. Morella, Mr. Hayworth, Mr. Weller, and Mr. Camp) 
 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

                            October 1, 2002

    Reported from the Committee on Ways and Means with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

                            October 1, 2002

Referral to the Committee on Energy and Commerce extended for a period 
                 ending not later than October 4, 2002

                            October 4, 2002

Referral to the Committee on Energy and Commerce extended for a period 
                 ending not later than October 11, 2002

                            October 11, 2002

 Additional sponsors: Mr. Herger, Mr. Lewis of Kentucky, Mr. English, 
                Mr. Smith of New Jersey, and Mr. Portman

                            October 11, 2002

Committee on Energy and Commerce discharged; committed to the Committee 
 of the Whole House on the State of the Union and ordered to be printed
[For text of introduced bill, see copy of bill as introduced on June 6, 
                                 2002]

_______________________________________________________________________

                                 A BILL


 
To amend title XI of the Social Security Act to improve patient safety.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Patient Safety 
Improvement Act of 2002''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Patient safety improvements.

                 ``Part D--Patient Safety Improvements

        ``Sec. 1181. Voluntary reporting of patient safety data; 
                            definitions.
        ``Sec. 1182. Confidentiality and peer review protections.
        ``Sec. 1183. Center for Quality Improvement and Patient Safety.
        ``Sec. 1184. Interoperability standards for health care 
                            information technology systems.
        ``Sec. 1185. Voluntary adoption of methods to improve patient 
                            safety.
        ``Sec. 1186. Evaluation and report.
Sec. 3. Medical Information Technology Advisory Board.

SEC. 2. PATIENT SAFETY IMPROVEMENTS.

    Title XI of the Social Security Act is amended by adding at the end 
the following new part:

                 ``Part D--Patient Safety Improvements

       ``voluntary reporting of patient safety data; definitions

    ``Sec. 1181. (a) Collection and Voluntary Reporting of Patient 
Safety Data.--In order to improve patient safety and the quality of 
health care delivery, a health care provider (as defined in subsection 
(d)) may voluntarily collect and develop patient safety data (as 
defined in subsection (e)) and report such data to one or more patient 
safety organizations (as defined in subsection (f)) in a manner that is 
confidential and privileged (as described in section 1182).
    ``(b) Use of Patient Safety Data by Patient Safety Organizations.--
Patient safety organizations shall analyze the patient safety data 
reported and develop (and report back to health care providers) 
information to improve patient safety and the quality of health care 
delivery and shall submit non-identifiable information derived from 
such data in a uniform manner to the Center for Quality Improvement and 
Patient Safety (for inclusion in the Patient Safety Database, if 
applicable). Such non-identifiable information may be disclosed and 
shared with other patient safety organizations. Identifiable patient 
safety data may be disclosed to other patient safety organizations with 
the explicit authorization for each such disclosure by the reporting 
provider involved.
    ``(c) Functions of Center.--The Center for Quality Improvement and 
Patient Safety conducts patient safety activities consistent with 
section 1183.
    ``(d) Health Care Providers Covered.--For purposes of this part, 
the term `health care provider' means--
            ``(1) a provider of services (as defined in section 1861(u) 
        and including a hospital, skilled nursing facility, home health 
        agency, and hospice program) that provides services for which 
        payment may be made under part A of title XVIII and the 
        provider's employees;
            ``(2) a health care entity or individual that furnishes 
        medical or other health services (as defined in section 
        1861(s)), other services described in section 1832(a)(2), or 
        other items and services for which payment may be made under 
        such title, including a physician (as defined in section 
        1861(r)); and
            ``(3) an organization offering a plan under part C of title 
        XVIII.
    ``(e) Patient Safety Data Covered.--
            ``(1) In general.--For purposes of this part, the term 
        `patient safety data' means any data, reports, records, 
        memoranda, analyses, deliberative work, statements, or root 
        cause analyses that are collected or developed to improve 
        patient safety or health care quality and that--
                    ``(A) are collected or developed by a health care 
                provider for the purpose of reporting to a patient 
                safety organization and that are reported on a timely 
                basis to such an organization;
                    ``(B) are collected or developed by a patient 
                safety organization or by (or on behalf of) the Center 
                for Quality Improvement and Patient Safety, regardless 
                of whether the data are transmitted to the health care 
                provider that reported the original data; or
                    ``(C) describes corrective actions taken by a 
                health care provider in response to the provider's 
                reporting of data to that organization, regardless of 
                whether the organization has transmitted under 
                subsection (f)(2) information to the health care 
                provider that reported the original data, and that are 
                reported on a timely basis to such an organization.
            ``(2) Construction regarding use of data.--
                    ``(A) Internal use permitted to improve patient 
                safety, quality, and efficiency.--Nothing in this part 
                shall be construed to limit or discourage a health care 
                provider from developing and using patient safety data 
                within the provider to improve patient safety, health 
                care quality, or administrative efficiency of the 
                provider.
                    ``(B) Treatment.--Information that is collected or 
                developed as patient safety data is not disqualified 
                from being treated as patient safety data because of 
                its development or use for the purposes described in 
                subparagraph (A) and such development or use shall not 
                constitute a waiver of any privilege or protection 
                established under section 1182 or under State law.
    ``(f) Qualifications of Patient Safety Organizations.--
            ``(1) In general.--For purposes of this part, the term 
        `patient safety organization' means a private or public 
        organization that conducts activities to improve patient safety 
        and the quality of health care delivery by assisting health 
        care providers that report to such organizations and that has 
        been certified by the Secretary as--
                    ``(A) performing each of the activities described 
                in paragraph (2); and
                    ``(B) meets the other requirements of paragraphs 
                (3) through (5).
            ``(2) Activities described.--The activities referred to in 
        paragraph (1)(A) are the following:
                    ``(A) The collection and analysis of patient safety 
                data that are voluntarily reported by more than one 
                health care provider on a local, regional, State, or 
                national basis.
                    ``(B) The development and dissemination of 
                information to health care providers and other patient 
                safety organizations with respect to improving patient 
                safety, such as recommendations, protocols, or 
                information regarding best practices.
                    ``(C) The utilization of patient safety data to 
                carry out activities under this paragraph to improve 
                patient safety and to provide assistance to health care 
                providers to minimize patient risk.
            ``(3) Conduct of activities.--In conducting activities 
        under paragraph (2), a patient safety organization shall--
                    ``(A) maintain confidentiality with respect to 
                individually identifiable health information;
                    ``(B) submit non-identifiable information to the 
                Center for Quality Improvement and Patient Safety in a 
                format established by the Secretary; and
                    ``(C) maintain appropriate security measures with 
                respect to patient safety data.
            ``(4) Organization requirements.--The requirements of this 
        paragraph for an organization are that--
                    ``(A) the organization is managed, controlled, and 
                operated independently from health care providers which 
                report patient safety data to it under this part;
                    ``(B) if the organization no longer qualifies as a 
                patient safety organization, with respect to any 
                patient safety data that it received from a health care 
                provider, the organization shall do one of the 
                following:
                            ``(i) with the approval of the provider and 
                        another patient safety organization, transfer 
                        such data to such other organization;
                            ``(ii) if practicable, return the data to 
                        the provider; or
                            ``(iii) destroy the patient safety data;
                    ``(C) if the organization charges a fee for the 
                activities it performs with respect to health care 
                providers, the fee shall be uniform among all classes 
                or types of health care providers (taking into account 
                the size of the health care provider);
                    ``(D) the organization seeks to collect data from 
                health care providers in a standardized manner that 
                permits valid comparisons of similar cases among 
                similar health care providers; and
                    ``(E) the organization meets such other 
                requirements as the Secretary may by regulation 
                require.
        For purposes of subparagraph (A), an organization is controlled 
        by a health care provider if the provider is able to 
        significantly influence or direct the actions or policies of 
        the organization.
            ``(5) Limitation on use of patient safety data by patient 
        safety organizations.--A patient safety organization may not 
        use patient safety data reported by a health care provider in 
        accordance with this part to take regulatory or enforcement 
        actions it otherwise performs (or is responsible for 
        performing) in relation to such provider.
            ``(6) Technical assistance.--The Secretary may provide 
        technical assistance to patient safety organizations in 
        providing recommendations and advice to health care providers 
        reporting patient safety data under this part. Such assistance 
        shall include advice with respect to methodology, 
        communication, dissemination of information, data collection, 
        security, and confidentiality concerns.
    ``(g) Construction.--Nothing in this part shall be construed to 
limit or discourage the reporting of information relating to patient 
safety within a health care provider.

             ``confidentiality and peer review protections

    ``Sec. 1182. (a) In General.--Notwithstanding any other provision 
of law, patient safety data shall be privileged and confidential in 
accordance with this section.
    ``(b) Scope of Privilege.--Subject to the succeeding provisions of 
this section, such data shall not be--
            ``(1) subject to a civil or administrative subpoena;
            ``(2) subject to discovery in connection with a civil or 
        administrative proceeding;
            ``(3) disclosed pursuant to section 552 of title 5, United 
        States Code (commonly known as the Freedom of Information Act) 
        or any other similar Federal or State law; or
            ``(4) admitted as evidence or otherwise disclosed in any 
        civil or administrative proceeding.
    ``(c) Clarification of Scope.--The privilege established by this 
section with respect to patient safety data described in section 
1181(e)(1)(A) shall apply to information, such as records of a 
patient's medical diagnosis and treatment, other primary health care 
information, and other information, to the extent that such information 
was collected or developed for the purpose specified in such section 
and is reported in accordance with such section. Such privilege shall 
not apply to information merely by reason of its inclusion, or the fact 
of its submission, in a report under such section. Information 
available from sources other than a report made under such section may 
be discovered or admitted in a civil or administrative proceeding, if 
discoverable or admissible under applicable state law.
    ``(d) Information Not Subject to Privilege.--The privilege 
established by this section shall not apply to one or more of the 
following:
            ``(1) Medical records and other primary health records.--
        Records of a patient's medical diagnosis and treatment and 
        other primary health records of a health care provider. Such 
        privilege shall not apply to such information by reason of its 
        inclusion within patient safety data.
            ``(2) FDA.--Relevant information disclosed by a health care 
        provider or patient safety organization to the Food and Drug 
        Administration, or to a person that is subject to the 
        jurisdiction of such Administration, with respect to an 
        Administration-regulated product or activity for which that 
        entity has responsibility, for the purposes of activities 
        related to quality, safety, or effectiveness of such 
        Administration-regulated product or activity, subject to 
        section 520(c) of the Federal Food, Drug, and Cosmetic Act.
            ``(3) Non-identifiable information used by database.--Non-
        identifiable information from a patient safety organization to 
        the Patient Safety Database and the further disclosure of such 
        data by the Center for Quality Improvement and Patient Safety.
    ``(e) Reporter Protection.--
            ``(1) In general.--A health care provider may not use 
        against an individual in an adverse employment action described 
        in paragraph (2) the fact that the individual in good faith 
        reported--
                    ``(A) to the provider with the intention of having 
                it reported to a patient safety organization, or
                    ``(B) directly to a patient safety organization,
        information that would constitute patient safety data under 
        section 1181(e)(1)(A) if the provider were to have submitted it 
        on a timely basis to a patient safety organization in 
        accordance with such section.
            ``(2) Adverse employment action.--For purposes of this 
        subsection, an `adverse employment action' includes--
                    ``(A) the failure to promote an individual or 
                provide any other employment-related benefit for which 
                the individual would otherwise be eligible;
                    ``(B) an evaluation or decision made in relation to 
                accreditation, certification, credentialing or 
                licensing of the individual; and
                    ``(C) a personnel action that is adverse to the 
                individual concerned.
            ``(3) Remedies.--The provisions of the first sentence of 
        section 1128A(a) shall apply with respect to a health care 
        provider's violation of paragraph (1) in the same manner as 
        they apply to an act referred to in section 1128A(a)(7).
    ``(f) Penalty.--It is unlawful for any person to disclose any 
patient safety data in violation of the provisions of this section. Any 
person violating such provisions shall be subject to the same sanctions 
under section 1160(c) (relating to, upon conviction, a fine of not more 
than $1,000, imprisonment for not more than 6 months, or both, per 
disclosure and payment of the costs of prosecution) as a person who 
discloses any information described in section 1160(a).
    ``(g) Rules of Construction.--
            ``(1) No limitation of other privileges.--Subject to 
        paragraph (2), nothing in this section shall be construed as 
        affecting other privileges that are available under Federal or 
        State laws that provide greater peer review or confidentiality 
        protections than the peer review and confidentiality 
        protections provided for in this section.
            ``(2) No effect on state mandatory reporting 
        requirements.--Nothing in this part shall be construed as 
        preempting or otherwise affecting any State law mandatory 
        reporting requirement for health care providers.
    ``(h) Application of Privacy Regulations.--For purposes of applying 
the regulations promulgated pursuant to section 264(c) of the Health 
Insurance Portability and Accountability Act of 1996 (Public Law 104-
191; 110 Stat. 2033)--
            ``(1) patient safety organizations shall be treated as 
        business associates;
            ``(2) activities of such organizations described in section 
        1181(f)(2)(A) in relation to a health care provider are deemed 
        to be health care operations of the provider; and
            ``(3) the disclosure of identifiable information under the 
        voluntary program under this part by such an organization shall 
        be treated as necessary for the proper management and 
        administration of the organization.
Nothing in this section shall be construed to alter or affect the 
implementation of such regulation or such section 264(c).
    ``(i) Waivers.--Nothing in this part shall be construed as 
precluding a health care provider from waiving the privilege or 
confidentiality protections under this section. Disclosure of patient 
safety data under subsection (d)(2) shall not constitute a waiver of 
any privilege or protection established under this section or under 
State law.
    ``(j) Continuation of Privilege.--Patient safety data of an 
organization that is certified as a patient safety organization shall 
continue to be privileged and confidential, in accordance with this 
section, if the organization's certification is terminated or revoked 
or if the organization otherwise ceases to qualify as a patient safety 
organization until the data are otherwise disposed of in accordance 
with section 1181(f)(4).
    ``(k) Survey and Report.--
            ``(1) Survey.--The Comptroller General of the United States 
        shall conduct a survey of State laws that relate to patient 
        safety data peer review systems, including laws that establish 
        an evidentiary privilege applicable to data developed in such 
        systems, and shall review the manner in which such laws have 
        been interpreted by the courts and the effectiveness of such 
        laws in promoting patient safety.
            ``(2) Report.--Not later than 9 months after the date of 
        enactment of this section, the Comptroller General shall 
        prepare and submit to Congress a report concerning the results 
        of the survey conducted under paragraph (1).

          ``center for quality improvement and patient safety

    ``Sec. 1183. (a) In General.--The Secretary, acting through the 
Director of the Agency for Healthcare Research and Quality, shall 
ensure that the Center for Quality Improvement and Patient Safety (in 
this section referred to as the `Center') supports public and private 
sector initiatives to improve patient safety for items and services 
furnished through health care providers.
    ``(b) Duties.--
            ``(1) In general.--The Secretary, acting through the 
        Director, shall ensure that the Center carries out the 
        following duties:
                    ``(A) Provide for the certification and 
                recertification of patient safety organizations in 
                accordance with subsection (d).
                    ``(B) Collect and disseminate information related 
                to patient safety.
                    ``(C) Establish a Patient Safety Database to 
                collect, support, and coordinate the analysis of non-
                identifiable information submitted to the Database in 
                accordance with subsection (e).
                    ``(D) Facilitate the development of consensus among 
                health care providers, patients, and other interested 
                parties concerning patient safety and recommendations 
                to improve patient safety.
                    ``(E) Provide technical assistance to States that 
                have (or are developing) medical errors reporting 
                systems, assist States in developing standardized 
                methods for data collection, and collect data from 
                State reporting systems for inclusion in the Patient 
                Safety Database.
            ``(2) Consultation.--In carrying out the duties under 
        paragraph (1) (including the establishment of the Database), 
        the Secretary shall consult with and develop partnerships, as 
        appropriate, with health care organizations, health care 
        providers, public and private sector entities, patient safety 
        organizations, health care consumers, and other relevant 
        experts to improve patient safety.
    ``(c) Certification and Recertification Process.--
            ``(1) In general.--The initial certification and 
        recertification of a patient safety organization under 
        subsection (b)(1)(A) shall be made under a process that is 
        approved by the Secretary and is consistent with criteria 
        published by the Secretary.
            ``(2) Revocation.--Such a certification or recertification 
        may be revoked by the Secretary upon a showing of cause 
        (including the disclosure of data in violation of section 
        1182).
            ``(3) Termination.--Such a certification provided for a 
        patient safety organization shall terminate (subject to 
        recertification) on the earlier of--
                    ``(A) the date that is 3 years after the date on 
                which such certification was provided; or
                    ``(B) the date on which the Secretary revokes the 
                certification.
    ``(d) Implementation and Consultation.--In carrying out subsection 
(c)(1), the Secretary shall--
            ``(1) facilitate the development of patient safety goals 
        and track the progress made in meeting those goals; and
            ``(2) ensure that data submitted by a patient safety 
        organization to the Patient Safety Database, as provided for 
        under subsection (e), are comparable and useful for research 
        and analysis and that the research findings and patient safety 
        alerts that result from such analyses are presented in clear 
        and consistent formats that enhance the usefulness of such 
        alerts.
    ``(e) Patient Safety Database.--
            ``(1) In general.--The Secretary, acting through the 
        Director, shall--
                    ``(A) establish a Patient Safety Database to 
                collect non-identifiable information concerning patient 
                safety that is reported on a voluntary basis; and
                    ``(B) establish common formats for the voluntary 
                reporting of data under subparagraph (A), including the 
                establishment of necessary data elements, common and 
                consistent definitions, and a standardized computer 
                interface for the processing of such data.
            ``(2) Database.--In carrying out this subsection, the 
        Secretary--
                    ``(A) shall establish and modify as necessary 
                criteria to determine the organizations that may 
                voluntarily contribute to, and the data that comprises, 
                the Patient Safety Database;
                    ``(B) shall ensure that the Patient Safety Database 
                is only used by qualified entities or individuals as 
                determined appropriate by the Secretary in accordance 
                with criteria applied by the Secretary; and
                    ``(C) may enter into contracts for the 
                administration of the Database with private and public 
                entities with experience in the administration of 
                similar databases.
            ``(3) Non-identifiable information.--For purposes of this 
        part, the term `non-identifiable information' means information 
        that is presented in a form and manner that prevents the 
        identification of any health care provider, patient, and the 
        reporter of the information.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary for each fiscal year to 
carry out this section.

  ``interoperability standards for health care information technology 
                                systems

    ``Sec. 1184. (a) In General.--By not later than 2 years after the 
date of the enactment of this part, the Secretary shall develop or 
adopt (and shall periodically review and update) voluntary, national 
standards that promote the interoperability of health care information 
technology systems across all health care settings. In promulgating 
regulations to carry out this section, the Secretary shall take into 
account the cost that meeting such standards would have on providing 
health care in the United States and the increased efficiencies in 
providing such care achieved under the standards.
    ``(b) Consultation and Coordination.--The Secretary shall develop 
and update such standards in consultation with (and with coordination 
between)--
            ``(1) the National Committee for Vital and Health 
        Statistics, and
            ``(2) the Medical Information Technology Advisory Board 
        (established under section 3 of the Patient Safety Improvement 
        Act of 2002).
    ``(c) Dissemination.--The Secretary shall provide for the 
dissemination of the standards developed and updated under this 
section.
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary for each fiscal year to 
carry out this section.

       ``voluntary adoption of methods to improve patient safety

    ``Sec. 1185. The Secretary shall encourage health care providers to 
adopt appropriate evidence-based methods to improve patient safety. 
Such methods shall not constitute national practice guidelines.

                        ``evaluation and report

    ``Sec. 1186. (a) Evaluation.--The Comptroller General of the United 
States shall conduct a comprehensive evaluation of the implementation 
of this part. Such evaluation shall include an examination of the 
following:
            ``(1) The health care providers that reported patient 
        safety data under this part and the patient safety 
        organizations to which they reported the information.
            ``(2) What types of events were so reported on.
            ``(3) The usefulness of the analyses, information, and 
        recommendations provided by patient safety organizations in 
        response to such reported information.
            ``(4) The response of health care providers to such 
        analyses, information, and recommendations, including a survey 
        of providers to obtain estimates of the percentage of providers 
        by category who have adopted specific error-reduction methods 
        and, if applicable, reasons for not adopting specific 
        practices.
            ``(5) The effectiveness of the program under this part in 
        reducing medical errors.
    ``(b) Report.--Not later than 5 years after the date the provisions 
of this part are first implemented, the Comptroller General shall 
submit to Congress a report on the evaluation conducted under 
subsection (a).''.

SEC. 3. MEDICAL INFORMATION TECHNOLOGY ADVISORY BOARD.

    (a) Establishment.--
            (1) In general.--Not later than 3 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 an advisory board to be known as the ``Medical 
        Information Technology Advisory Board'' (in this section 
        referred to as the ``MITAB'').
            (2) Chairman.--The Secretary shall designate one member as 
        chairman. The chairman shall be an individual affiliated with 
        an organization having expertise creating American National 
        Standards Institute (ANSI) accepted standards in health care 
        information technology and a member of the National Committee 
        for Vital and Health Statistics.
    (b) Composition.--
            (1) In general.--The MITAB shall consist of not more than 
        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 staff experts from each of the 
                following: the Centers for Medicare & Medicaid 
                Services, the Agency for Healthcare Research and 
                Quality, and the Institute of Medicine of the National 
                Academy of Sciences;
                    (C) representatives of private organizations with 
                expertise in medical infomatics;
                    (D) a representative of a teaching hospital; and
                    (E) one or more representatives of the health care 
                information technology industry.
            (2) Terms of appointment.--The term of any appointment 
        under paragraph (1) to the MITAB shall be for the life of the 
        MITAB.
            (3) Meetings.--The MITAB shall meet at the call of its 
        chairman or a majority of its members.
            (4) Vacancies.--A vacancy on the MITAB shall be filled in 
        the same manner in which the original appointment was made not 
        later than 30 days after the MITAB is given notice of the 
        vacancy and shall not affect the power of the remaining members 
        to execute the duties of the MITAB.
            (5) Compensation.--Members of the MITAB shall receive no 
        additional pay, allowances, or benefits by reason of their 
        service on the MITAB.
            (6) Expenses.--Each member of the MITAB shall receive 
        travel expenses and per diem in lieu of subsistence in 
        accordance with sections 5702 and 5703 of title 5, United 
        States Code.
    (c) Duties.--
            (1) In general.--The MITAB shall on an ongoing basis 
        advise, and make recommendations to, the Secretary regarding 
        medical information technology, including the following:
                    (A) The best current practices in medical 
                information technology.
                    (B) Methods for the adoption (not later than 2 
                years after the date of the enactment of this section) 
                of a uniform health care information system interface 
                between and among old and new computer systems.
                    (C) Recommendations for health care vocabulary, 
                messaging, and other technology standards (including a 
                common lexicon for computer technology) necessary to 
                achieve the interoperability of health care information 
                systems for the purposes described in subparagraph (E).
                    (D) Methods of implementing--
                            (i) health care information technology 
                        interoperability standardization; and
                            (ii) records security.
                    (E) Methods to promote information exchange among 
                health care providers so that long-term compatibility 
                among information systems is maximized, in order to do 
                one or more of the following:
                            (i) To maximize positive outcomes in 
                        clinical care--
                                    (I) by providing decision support 
                                for diagnosis and care; and
                                    (II) by assisting in the emergency 
                                treatment of a patient presenting at a 
                                facility where there is no medical 
                                record for the patient.
                            (ii) 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, and to 
                        assist in minimizing the need for new and 
                        different records as patients move from 
                        provider to provider.
                            (iii) To reduce or eliminate the need for 
                        redundant records, paperwork, and the 
                        repetitive taking of patient histories and 
                        administering of tests.
                            (iv) To minimize medical errors, such as 
                        administration of contraindicated drugs.
                            (v) 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.
            (2) Reports.--
                    (A) Initial report.--No later than 18 months after 
                the date of the enactment of this Act, the MITAB shall 
                submit to Congress and the Secretary an initial report 
                concerning the matters described in paragraph (1). The 
                report shall include--
                            (i) the practices described in paragraph 
                        (1)(A), including the status of health care 
                        information technology standards being 
                        developed by private sector and public-private 
                        groups;
                            (ii) recommendations for accelerating the 
                        development of common health care terminology 
                        standards;
                            (iii) recommendations for completing 
                        development of health care information system 
                        messaging standards; and
                            (iv) progress toward meeting the deadline 
                        described in paragraph (1)(B) for adoption of 
                        methods described in such paragraph.
                    (B) Subsequent reports.--During each of the 2 years 
                after the year in which the report is submitted under 
                subparagraph (A), the MITAB shall submit to Congress 
                and the Secretary an annual report relating to 
                additional recommendations, best practices, results of 
                information technology improvements, analyses of 
                private sector efforts to implement the 
                interoperability standards established in section 1184 
                of the Social Security Act, and such other matters as 
                may help ensure the most rapid dissemination of best 
                practices in health care information technology.
    (d) Staff and Support Services.--
            (1) Executive director.--
                    (A) Appointment.--The Chairman shall appoint an 
                executive director of the MITAB.
                    (B) Compensation.--The executive director shall be 
                paid the rate of basic pay for level V of the Executive 
                Schedule.
            (2) Staff.--With the approval of the MITAB, the executive 
        director may appoint such personnel as the executive director 
        considers appropriate.
            (3) Applicability of civil service laws.--The staff of the 
        MITAB shall be appointed without regard to the provisions of 
        title 5, United States Code, governing appointments in the 
        competitive service, and shall be paid without regard to the 
        provisions of chapter 51 and subchapter III of chapter 53 of 
        such title (relating to classification and General Schedule pay 
        rates).
            (4) Experts and consultants.--With the approval of the 
        MITAB, the executive director may procure temporary and 
        intermittent services under section 3109(b) of title 5, United 
        States Code.
    (e) Powers.--
            (1) Hearings and other activities.--For the purpose of 
        carrying out its duties, the MITAB may hold such hearings and 
        undertake such other activities as the MITAB determines to be 
        necessary to carry out its duties.
            (2) Detail of federal employees.--Upon the request of the 
        MITAB, the head of any Federal agency is authorized to detail, 
        without reimbursement, any of the personnel of such agency to 
        the MITAB to assist the MITAB in carrying out its duties. Any 
        such detail shall not interrupt or otherwise affect the civil 
        service status or privileges of the Federal employee.
            (3) Technical assistance.--Upon the request of the MITAB, 
        the head of a Federal agency shall provide such technical 
        assistance to the MITAB as the MITAB determines to be necessary 
        to carry out its duties.
            (4) Obtaining information.--The MITAB may secure directly 
        from any Federal agency information necessary to enable it to 
        carry out its duties, if the information may be disclosed under 
        section 552 of title 5, United States Code. Upon request of the 
        Chairman of the MITAB, the head of such agency shall furnish 
        such information to the MITAB.
    (f) Termination.--The MITAB shall terminate 30 days after the date 
of submission of its final report under subsection (c)(2)(B).
    (g) Applicability of FACA.--The provisions of the Federal Advisory 
Committee Act (5 U.S.C. App.) shall apply to the MITAB.
    (h) Authorization of Appropriations.--There are authorized to be 
appropriated to the Secretary of Health and Human Services such sums as 
are necessary to carry out this section.




                                                 Union Calendar No. 468

107th CONGRESS

  2d Session

                               H. R. 4889

                      [Report No. 107-714, Part I]

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                                 A BILL

To amend title XI of the Social Security Act to improve patient safety.

_______________________________________________________________________

                            October 11, 2002

Committee on Energy and Commerce discharged; committed to the Committee 
 of the Whole House on the State of the Union and ordered to be printed