[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2710 Introduced in Senate (IS)]







108th CONGRESS
  2d Session
                                S. 2710

   To amend the Public Health Service Act to improve the quality and 
efficiency of health care delivery through improvements in health care 
            information technology, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 21, 2004

  Mr. Gregg (for himself, Mr. Sessions, and Mr. Frist) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to improve the quality and 
efficiency of health care delivery through improvements in health care 
            information technology, and for other purposes.

    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 ``National Health Information 
Technology Adoption Act''.

SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by 
adding at the end thereof the following:

            ``TITLE XXIX--HEALTH CARE INFORMATION TECHNOLOGY

``SEC. 2901. DEFINITIONS.

    ``In this title:
            ``(1) Coverage area.--The term `coverage area' means the 
        boundaries of a local health information infrastructure.
            ``(2) Demographic data.--The term `demographic data' means 
        data that includes race, ethnicity, socio-economic status, and 
        primary language.
            ``(3) Director.--The term `Director' means the Director of 
        the Office of Health Information Technology.
            ``(4) Health care provider.--The term `health care 
        provider' means a hospital, skilled nursing facility, home 
        health entity, health care clinic, community health center, 
        group practice (as defined in section 1877(h)(4) of the Social 
        Security Act, including practices with only 1 physician), and 
        any other facility or clinician determined appropriate by the 
        Director.
            ``(5) Local health information infrastructures.--The term 
        `local health information infrastructure' means an independent 
        organization of health care entities established for the 
        purpose of linking health information systems to electronically 
        share information. A local health information infrastructure 
        may not be a single business entity.
            ``(6) Office.--The term `Office' means the Office of Health 
        Information Technology established under section 2902.

``SEC. 2902. OFFICE OF HEALTH INFORMATION TECHNOLOGY.

    ``(a) Establishment.--There is established within the Office of the 
Secretary an Office of Health Information Technology. The Office shall 
be headed by a Director to be appointed by the Secretary after 
consultation with the President. The Director shall report directly to 
the Secretary.
    ``(b) Purpose.--It shall be the purpose of the Office to--
            ``(1) improve the quality and increase the efficiency of 
        health care delivery through the use of health information 
        technology;
            ``(2) provide national leadership relating to, and 
        encourage the adoption of, health information technology;
            ``(3) direct all health information technology activities 
        within the Department of Health and Human Services;
            ``(4) act as the lead entity responsible for coordinating 
        the health information technology efforts of the Federal 
        Government; and
            ``(5) facilitate the interaction between the Federal 
        Government and the private sector relating to health 
        information technology development and use.
    ``(c) Duties and Responsibilities.--The Office shall be responsible 
for the following:
            ``(1) Federal leadership.--The Office shall--
                    ``(A) serve as the principle advisor to the 
                Secretary concerning health information technology;
                    ``(B) direct all health information technology 
                activity within the Department of Health and Human 
                Services;
                    ``(C) work with public and private health 
                information technology stakeholders to implement a 
                strategic plan for the establishment of a National 
                Health Information Infrastructure; and
                    ``(D) ensure that health information technology is 
                utilized as fully as practicable in carrying out health 
                surveillance efforts.
            ``(2) Coordination.--The Office shall--
                    ``(A) encourage the development and adoption of 
                clinical, messaging, and decision support health 
                information data standards, pursuant to the 
                requirements of section 2903;
                    ``(B) ensure the maintenance and implementation of 
                the data standards described in subparagraph (A);
                    ``(C) oversee and coordinate the health information 
                technology efforts of the Federal Government;
                    ``(D) ensure the compliance of the Department of 
                Health and Human Services with Federally adopted health 
                information technology data standards;
                    ``(E) serve as the representative of the Department 
                of Health and Human Services with respect to the 
                Consolidated Health Informatics Initiative;
                    ``(F) ensure that the Federal Government consults 
                and collaborates on decision making with respect to 
                health information technology with the private sector 
                and other interested parties; and
                    ``(G) in consultation with private sector, adopt 
                certification and testing criteria to determine if 
                electronic health information systems interoperate.
            ``(3) Communication.--The Office shall--
                    ``(A) act as the point of contact for the private 
                sector with respect to the use of health information 
                technology; and
                    ``(B) work with the private sector to collect and 
                disseminate best health information technology 
                practices.
            ``(4) Evaluation and dissemination.--The Office shall 
        coordinate with the Agency for Health Research and Quality and 
        other Federal agencies to--
                    ``(A) evaluate and disseminate information relating 
                to evidence of the costs and benefits of health 
                information technology and to whom those costs and 
                benefits accrue;
                    ``(B) evaluate and disseminate information on the 
                impact of health information technology on the quality 
                and efficiency of patient care; and
                    ``(C) review Federal payment structures and 
                differentials for health care providers that utilize 
                health information technology systems.
            ``(5) Technical assistance.--The Office shall utilize 
        existing private sector quality improvement organizations to--
                    ``(A) promote the adoption of health information 
                technology among healthcare providers; and
                    ``(B) provide technical assistance concerning the 
                implementation of health information technology to 
                healthcare providers.
    ``(d) Resources.--The Secretary shall make available to the Office, 
the resources, both financial and otherwise, necessary to enable the 
Director to carry out the purposes of, and perform the duties and 
responsibilities of the Office under, this section.
    ``(e) Detail of Federal Employees.--Upon the request of the 
Director, the head of any Federal agency is authorized to detail, 
without reimbursement from the Office, any of the personnel of such 
agency to the Office to assist it in carrying out its duties under this 
section. Any such detail shall not interrupt or otherwise affect the 
civil service status or privileges of the Federal employee.

``SEC. 2903. PROMOTING THE INTEROPERABILITY OF HEALTH CARE INFORMATION 
              TECHNOLOGY SYSTEMS.

    ``(a) Development, and Federal Government Adoption, of Standards.--
            ``(1) Adoption.--
                    ``(A) In general.--Not later than 2 years after the 
                date of the enactment of this title, the Director shall 
                provide for the adoption by the Federal Government of 
                national data and communication health information 
                technology standards that promote the efficient 
                exchange of data between varieties of provider health 
                information technology systems. In carrying out the 
                preceding sentence, the Director may adopt existing 
                standards. Standards adopted under this section shall 
                be voluntary for private sector entities.
                    ``(B) Grants or contracts.--The Director may 
                utilize grants or contracts to provide for the private 
                sector development of standards for adoption by the 
                Federal Government under subparagraph (A).
            ``(2) Requirements.--The standards developed and adopted 
        under paragraph (1) shall be designed to--
                    ``(A) enable health information technology to be 
                used for the collection and use of clinically specific 
                data;
                    ``(B) promote the interoperability of health care 
                information across health care settings; and
                    ``(C) facilitate clinical decision support through 
                the use of health information technology.
            ``(3) Public private partnership.--Consistent with 
        activities being carried out on the date of enactment of this 
        title, including the Consolidated Health Informatics 
        initiative, health information technology standards shall be 
        adopted by the Director under paragraph (1) at the conclusion 
        of a collaborative process that includes consultation between 
        the Federal Government and private sector health care and 
        information technology stakeholders.
            ``(4) Privacy and security.--The regulations promulgated by 
        the Secretary under part C of title XI of the Social Security 
        Act (42 U.S.C. 1320d et seq.) and sections 261, 262, 263, and 
        264 of the Health Insurance Portability and Accountability Act 
        of 1996 (42 U.S.C. 1320d-2 note) with respect to the privacy, 
        confidentiality, and security of health information shall apply 
        to the implementation of programs and activities under this 
        title.
            ``(5) Pilot tests.--To the maximum extent practical, the 
        Director shall pilot test the health information technology 
        data standards developed under paragraph (1) prior to their 
        implementation under this section.
            ``(6) Dissemination.--
                    ``(A) In general.--The Director shall ensure that 
                the standards adopted under paragraph (1) are widely 
                disseminated to interested stakeholders.
                    ``(B) Licensing.--To facilitate the dissemination 
                and implementation of the standards developed and 
                adopted under paragraph (1), the Director may license 
                such standards, or utilize other means, to ensure the 
                widespread use of such standards.
    ``(b) Implementation of Standards.--
            ``(1) Purchase of systems by the secretary.--Effective 
        beginning on the date that is 5 years after the date of 
        enactment of this title, the Secretary shall not purchase any 
        health care information technology system unless such system is 
        in compliance with the standards adopted under subsection (a).
            ``(2) Recipients of federal funds.--Effective on the date 
        described in paragraph (1), the Secretary shall require that 
        funds not appropriated under this title that are designated for 
        Federal health information technology purposes shall be used to 
        purchase health care information technology systems that are in 
        compliance with the standards adopted under subsection (a).
    ``(c) Modification of Standards.--The Director shall provide for 
ongoing oversight of the health information technology standards 
developed under subsection (a) to--
            ``(1) identify gaps or other shortcomings in such 
        standards; and
            ``(2) modify such standards when determined appropriate or 
        develop additional standards, in collaboration with standard 
        setting organizations.

``SEC. 2904. LOAN GUARANTEES FOR THE ADOPTION OF HEALTH INFORMATION 
              TECHNOLOGY.

    ``(a) In General.--The Director shall guarantee payment of the 
principal of and the interest on loans made to eligible entities to 
enable such entities--
            ``(1) to implement local health information infrastructures 
        to facilitate the development of interoperability across health 
        care settings to improve quality and efficiency; or
            ``(2) to facilitate the purchase and adoption of health 
        information technology to improve quality and efficiency.
    ``(b) Eligibility.--To be eligible to receive a loan guarantee 
under subsection (a) an entity shall--
            ``(1) with respect to an entity desiring a loan guarantee--
                    ``(A) under subsection (a)(1), be a coalition of 
                entities that represent an independent consortium of 
                health care stakeholders within a community that--
                            ``(i) includes--
                                    ``(I) physicians (as defined in 
                                section 1881(r)(1) of the Social 
                                Security Act), including physicians 
                                that provide services to low income and 
                                underserved populations;
                                    ``(II) hospitals (including 
                                hospitals that provide services to low 
                                income and underserved populations); 
                                and
                                    ``(III) group health plans or other 
                                health insurance issuers (as such terms 
                                are defined in section 2791); and
                            ``(ii) may include any other health care 
                        providers; or
                    ``(B) under subsection (a)(2) be a health care 
                provider that provides health care services to low-
                income and underserved populations;
            ``(2) to the extent practicable, adopt the national health 
        information technology standards adopted under section 2903; 
        and
            ``(3) prepare and submit to the Director an application at 
        such time, in such manner, and containing such information as 
        the Director may require.
    ``(c) Use of Funds.--Amounts received under a loan guarantee under 
subsection (a) shall be used--
            ``(1) with respect to a loan guarantee described in 
        subsection (a)(1)--
                    ``(A) to develop a plan for the implementation of a 
                local health information infrastructure under this 
                section;
                    ``(B) to establish systems for the sharing of data 
                in accordance with the national health information 
                technology standards developed under section 2903;
                    ``(C) to purchase directly related integrated 
                hardware and software to establish an interoperable 
                health information technology system that is capable of 
                linking to a local health care information 
                infrastructure; and
                    ``(D) to train staff, maintain health information 
                technology systems, and maintain adequate security and 
                privacy protocols;
            ``(2) with respect to a loan or loan guarantee described in 
        subsection (a)(2)--
                    ``(A) to develop a plan for the purchase and 
                installation of health information technology;
                    ``(B) to purchase directly related integrated 
                hardware and software to establish an interoperable 
                health information technology system that is capable of 
                linking to a local health care information 
                infrastructure; and
                    ``(C) to train staff, maintain health information 
                technology systems, and maintain adequate security and 
                privacy protocols; and
            ``(3) to carry out any other activities determined 
        appropriate by the Director.
    ``(d) Special Considerations.--In awarding loan guarantees under 
this section to local health information infrastructures, the Director 
shall give special consideration to eligible entities that--
            ``(1) include at least 50 percent of the patients living in 
        the designated coverage area;
            ``(2) incorporate public health surveillance and reporting 
        into the overall architecture of the proposed infrastructure; 
        and
            ``(3) link local health information infrastructures.
    ``(e) Areas of Specific Interest.--In awarding loan guarantees 
under this section, the Director shall include--
            ``(1) entities with a coverage area that includes an entire 
        State; and
            ``(2) entities with a multi-state coverage area.
    ``(f) Administrative Provisions.--
            ``(1) Aggregate amount.--
                    ``(A) In general.--Except as provided in 
                subparagraph (B), the aggregate amount of principal of 
                loans guaranteed under subsection (a) with respect to 
                an eligible entity may not exceed $5,000,000. In any 
                12-month period the amount disbursed to an eligible 
                entity under this section (by a lender under a 
                guaranteed loan) may not exceed $5,000,000.
                    ``(B) Exception.--The cumulative total of the 
                principal of the loans outstanding at any time to which 
                guarantees have been issued under subsection (a) may 
                not exceed such limitations as may be specified in 
                appropriation Acts.
            ``(2) Protection of federal government.--
                    ``(A) In general.--The Director may not approve an 
                application for a loan guarantee under this section 
                unless the Director determines that--
                            ``(i) the terms, conditions, security (if 
                        any), and schedule and amount of repayments 
                        with respect to the loan are sufficient to 
                        protect the financial interests of the United 
                        States and are otherwise reasonable, including 
                        a determination that the rate of interest does 
                        not exceed such percent per annum on the 
                        principal obligation outstanding as the 
                        Director determines to be reasonable, taking 
                        into account the range of interest rates 
                        prevailing in the private market for loans with 
                        similar maturities, terms, conditions, and 
                        security and the risks assumed by the United 
                        States; and
                            ``(ii) the loan would not be available on 
                        reasonable terms and conditions without the 
                        enactment of this section.
                    ``(B) Recovery.--
                            ``(i) In general.--The United States shall 
                        be entitled to recover from the applicant for a 
                        loan guarantee under this section the amount of 
                        any payment made pursuant to such loan 
                        guarantee, unless the Director for good cause 
                        waives such right of recovery, and, upon making 
                        any such payment, the United States shall be 
                        subrogated to all of the rights of the 
                        recipient of the payments with respect to which 
                        the loan was made.
                            ``(ii) Modification of terms.--Any terms 
                        and conditions applicable to a loan guarantee 
                        under this section may be modified by the 
                        Director to the extent he determines it to be 
                        consistent with the financial interest of the 
                        United States.
            ``(3) Defaults.--The Director may take such action as the 
        Director deems appropriate to protect the interest of the 
        United States in the event of a default on a loan guaranteed 
        under this section, including taking possession of, holding, 
        and using real property pledged as security for such a loan 
        guarantee.
    ``(g) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $50,000,000 for each of fiscal years 
        2005 through 2010.
            ``(2) Availability.--Amounts appropriated under 
        subparagraph (A) shall remain available for obligation until 
        expended.

``SEC. 2905. GRANTS FOR THE PURCHASE OF HEALTH INFORMATION TECHNOLOGY.

    ``(a) In General.--The Director may award competitive grants to 
eligible entities--
            ``(1) to implement local health information infrastructures 
        to facilitate the development of interoperability across health 
        care settings; or
            ``(2) to facilitate the purchase and adoption of health 
        information technology.
    ``(b) Eligibility.--To be eligible to receive a grant under section 
(a) an entity shall--
            ``(1) demonstrate financial need to the Director;
            ``(2) with respect to an entity desiring a grant--
                    ``(A) under subsection (a)(1), represent an 
                independent consortium of health care stakeholders 
                within a community that--
                            ``(i) includes--
                                    ``(I) physicians (as defined in 
                                section 1881(r)(1) of the Social 
                                Security Act), including physicians 
                                that provide services to low income and 
                                underserved populations;
                                    ``(II) hospitals (including 
                                hospitals that provide services to low 
                                income and underserved populations); 
                                and
                                    ``(III) group health plans or other 
                                health insurance issuers (as such terms 
                                are defined in section 2791); and
                            ``(ii) may include any other health care 
                        providers; or
                    ``(B) under subsection (a)(2) be a health care 
                provider that provides health care services to low-
                income and underserved populations;
            ``(3) adopt the national health information technology 
        standards developed under section 2903;
            ``(4) prepare and submit to the Director an application at 
        such time, in such manner, and containing such information as 
        the Director may require; and
            ``(5) agree to provide matching funds in accordance with 
        subsection (d).
    ``(c) Use of Funds.--Amounts received under a grant under 
subsection (a) shall be used to--
            ``(1) with respect to a grant described in subsection 
        (a)(1)--
                    ``(A) to develop a plan for the implementation of a 
                local health information infrastructure under this 
                section;
                    ``(B) to establish systems for the sharing of data 
                in accordance with the national health information 
                technology standards developed under section 2903;
                    ``(C) to implement, enhance, or upgrade a 
                comprehensive, electronic health information technology 
                system; and
                    ``(D) to maintain adequate security and privacy 
                protocols;
            ``(2) with respect to a grant described in subsection 
        (a)(2)--
                    ``(A) to develop a plan for the purchase and 
                installation of health information technology;
                    ``(B) to purchase directly related integrated 
                hardware and software to establish an interoperable 
                health information technology system that is capable of 
                linking to a local health care information 
                infrastructure; and
                    ``(C) to train staff, maintain health information 
                technology systems, and maintain adequate security and 
                privacy protocols;
            ``(3) maintain adequate security and privacy protocols; and
            ``(4) to carry out any other activities determined 
        appropriate by the Director.
    ``(d) Matching Requirement.--
            ``(1) In general.--The Director may not make a grant under 
        this section to an entity unless the entity agrees that, with 
        respect to the costs to be incurred by the entity in carrying 
        out the infrastructure program for which the grant was awarded, 
        the entity will make available (directly or through donations 
        from public or private entities) non-Federal contributions 
        toward such costs in an amount equal to not less than 20 
        percent of such costs ($1 for each $5 of Federal funds provided 
        under the grant).
            ``(2) Determination of amount contributed.--Non-Federal 
        contributions required under paragraph (1) may be in cash or in 
        kind, fairly evaluated, including equipment, technology, or 
        services. Amounts provided by the Federal Government, or 
        services assisted or subsidized to any significant extent by 
        the Federal Government, may not be included in determining the 
        amount of such non-Federal contributions.
    ``(e) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $50,000,000 for each of fiscal years 
        2005 through 2010.
            ``(2) Availability.--Amounts appropriated under paragraph 
        (1) shall remain available for obligation until expended.

``SEC. 2906. REPORTS.

    ``(a) In General.--Not later than 1 year after the date of 
enactment of this title, and annually thereafter, an entity that 
receives a grant or loan guarantee under this title shall submit to the 
Director a report on the activities carried out under the grant or loan 
guarantee involved. Each such report shall include--
            ``(1) a description of the financial costs and benefits of 
        the project involved and of the entities to which such costs 
        and benefits accrue;
            ``(2) a description of the impact of the project on health 
        care quality and safety; and
            ``(3) a description of any reduction in duplicative or 
        unnecessary care as a result of the project involved.
    ``(b) Preference.--In awarding grants and loan guarantees under 
this title, the Director may give a preference to eligible entities 
that agree to electronically submit reports on a daily basis.''.

SEC. 3. STANDARDIZED MEASURES OF QUALITY HEALTH CARE AND DATA 
              COLLECTION.

    Title XIX of the Public Health Service Act, as added by section 2, 
is amended by adding at the end the following:

``SEC. 2907. STANDARDIZED MEASURES OF QUALITY HEALTH CARE.

    ``(a) In General.--
            ``(1) Collaboration.--The Secretary of Health and Human 
        Services, the Secretary of Defense, and the Secretary of 
        Veterans Affairs (referred to in this section as the 
        `Secretaries') shall establish uniform health care quality 
        measures to assess the effectiveness, timeliness, patient self-
        management, efficiency, and safety of care delivered across all 
        federally supported health delivery programs, including those 
        in which health care services are delivered to health disparity 
        populations.
            ``(2) Development of measures.--Relying on earlier work by 
        the Secretary of Health and Human Services or other Federal 
        departments or agencies and with an emphasis on health 
        conditions disproportionately affecting health disparity 
        populations and taking into account health literacy and primary 
        language and cultural factors, the Secretaries shall develop 
        standardized sets of quality measures for--
                    ``(A) 5 common health conditions by not later than 
                January 1, 2006; and
                    ``(B) an additional 10 common health conditions by 
                not later than January 1, 2007.
            ``(3) Pilot testing.--Each federally supported health 
        delivery program may conduct a pilot test of the quality 
        measures developed under paragraph (2) that shall include a 
        collection of patient-level data and a public release of 
        comparative performance reports.
    ``(b) Public Reporting Requirements.--The Secretaries shall work 
collaboratively to establish public reporting requirements for 
clinicians, institutional providers, and health plans in each of the 
federally supported health delivery program described in subsection 
(a).
    ``(c) Full Implementation.--The Secretaries shall work 
collaboratively to implement all sets of quality measures and reporting 
systems developed under subsections (a) and (b) by not later than 
January 1, 2009.
    ``(d) Progress Report.--The Secretary of Health and Human Services 
shall prepare an annual progress report that details the collaborative 
efforts carried out under subsection (a).
    ``(e) Comparative Quality Reports.--Beginning on January 1, 2008, 
in order to make comparative quality information available to health 
care consumers, including members of health disparity populations, 
health professionals, public health officials, researchers, and other 
appropriate individuals and entities, the Secretaries shall provide for 
the pooling, analysis, and dissemination of quality measures collected 
under this section. Nothing in this section shall be construed as 
modifying the privacy standards under the Health Insurance Portability 
and Accountability Act of 1996 (Public Law 104-191).
    ``(f) Ongoing Evaluation of Use.--The Secretary of Health and Human 
Services shall ensure the ongoing evaluation of the use of the health 
care quality measures established under this section.
    ``(g) Existing Activities.--Notwithstanding any other provision of 
law, the measures and reporting activities described in this section 
shall replace, to the extent practicable and appropriate, any 
duplicative or redundant existing measurement and reporting activities 
currently utilized by federally supported health care delivery 
programs.
    ``(h) Evaluation and Regulations.--
            ``(1) Evaluation.--
                    ``(A) In general.--The Secretary shall, directly or 
                indirectly through a contract with another entity, 
                conduct an evaluation of the collaborative efforts of 
                the Secretaries to establish uniform health care 
                quality measures and reporting requirements for 
                federally supported health care delivery programs as 
                required under this section.
                    ``(B) Report.--Not later than 2 years after the 
                date of enactment of this title, the Secretary of 
                Health and Human Services shall submit a report to the 
                appropriate committees of Congress concerning the 
                results of the evaluation under subparagraph (A).
            ``(2) Regulations.--
                    ``(A) Proposed.--Not later than 18 months after the 
                date on which the report is submitted under paragraph 
                (1)(B), the Secretary shall publish proposed 
                regulations regarding the application of the uniform 
                health care quality measures and reporting requirements 
                described in this section to federally supported health 
                delivery programs.
                    ``(B) Final regulations.--Not later than 3 years 
                after the date on which the report is submitted under 
                paragraph (1)(B), the Secretary shall publish final 
                regulations regarding the uniform health care quality 
                measures and reporting requirements described in this 
                section.
    ``(i) Definitions.--In this section, the term `federally supported 
health delivery program' means a program that is funded by the Federal 
Government under which health care items or services are delivered 
directly to patients.

``SEC. 2908. DATA COLLECTION.

    ``The Secretary shall--
            ``(1) ensure that demographic data collected under the 
        medicare program are accurate and available for inclusion in 
        the National Health Disparities Report;
            ``(2) enforce existing State demographic data collection 
        and reporting requirements for enrollees in the medicaid 
        program under title XIX of the Social Security Act (42 U.S.C. 
        1396 et seq.) and the State Children's Health Insurance Program 
        under title XXI of such Act (42 U.S.C. 1397aa et seq.), promote 
        and encourage the collection of such demographic data in those 
        States that do not have existing demographic data collection 
        and reporting requirements under these programs, and ensure 
        that such demographic data are available for inclusion in the 
        National Health Disparities Report;
            ``(3) ensure that any new Federal program initiatives--
                    ``(A) collect and report demographic data and 
                provide technical assistance to promote compliance;
                    ``(B) address technological difficulties;
                    ``(C) ensure privacy and confidentiality of 
                demographic data collected; and
                    ``(D) disseminate an analysis of the demographic 
                data collection to appropriate stakeholders;
            ``(4) work with insurers, providers, agencies and the 
        public to reassure and inform such entities of the importance 
        of demographic data collection regarding health disparity 
        populations to improving health care access and quality; and
            ``(5) support research on existing best practices for data 
        collection.''.
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