[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2907 Introduced in Senate (IS)]







108th CONGRESS
  2d Session
                                S. 2907

   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

                            October 6, 2004

 Mr. Dodd (for himself and Mr. Kennedy) 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 ``Information Technology for Health 
Care Quality 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) Director.--The term `Director' means the Director of 
        the Office of Health Information Technology.
            ``(3) 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.
            ``(4) Health information technology.--The term `health 
        information technology' means a computerized system that--
                    ``(A) is consistent with the standards developed 
                pursuant to section 2903;
                    ``(B) permits the secure electronic transmission of 
                information to other health care providers and public 
                health entities; and
                    ``(C) includes--
                            ``(i) an electronic health record (EHR) 
                        that provides access in real-time to the 
                        patient's complete medical record;
                            ``(ii) a personal health record (PHR) 
                        through which an individual (and anyone 
                        authorized by such individual) can maintain and 
                        manage their health information;
                            ``(iii) computerized provider order entry 
                        (CPOE) technology that permits the electronic 
                        ordering of diagnostic and treatment services, 
                        including prescription drugs;
                            ``(iv) decision support to assist 
                        physicians in making clinical decisions by 
                        providing electronic alerts and reminders to 
                        improve compliance with best practices, promote 
                        regular screenings and other preventive 
                        practices, and facilitate diagnoses and 
                        treatments;
                            ``(v) error notification procedures so that 
                        a warning is generated if an order is entered 
                        that is likely to lead to a significant adverse 
                        outcome for the patient; and
                            ``(vi) tools to allow for the collection, 
                        analysis, and reporting of data on adverse 
                        events, near misses, and the quality of care 
                        provided to the patient.
            ``(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 executive 
office of the President an Office of Health Information Technology. The 
Office shall be headed by a Director to be appointed by the President. 
The Director shall report directly to the President.
    ``(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 Federal Government; and
            ``(4) 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) National strategy.--The Office shall develop a 
        national strategy for improving the quality and enhancing the 
        efficiency of health care through the improved use of health 
        information technology and the creation of a National Health 
        Information Infrastructure.
            ``(2) Federal leadership.--The Office shall--
                    ``(A) serve as the principle advisor to the 
                President concerning health information technology;
                    ``(B) direct all health information technology 
                activity within the Federal Government, including 
                approving or disapproving agency policies submitted 
                under paragraph (3);
                    ``(C) work with public and private health 
                information technology stakeholders to implement the 
                national strategy described in paragraph (1); and
                    ``(D) ensure that health information technology is 
                utilized as fully as practicable in carrying out health 
                surveillance efforts.
            ``(3) Agency policies.--
                    ``(A) In general.--The Office shall, in accordance 
                with this paragraph, approve or disapprove the policies 
                of Federal departments or agencies with respect to any 
                policy proposed to be implemented by such agency or 
                department that would significantly affect that agency 
                or department's use of health information technology.
                    ``(B) Submission of proposal.--The head of any 
                Federal Government agency or department that desires to 
                implement any policy with respect to such agency or 
                department that would significantly affect that agency 
                or department's use of health information technology 
                shall submit an implementation proposal to the Office 
                at least 60 days prior to the proposed date of the 
                implementation of such policy.
                    ``(C) Approval or disapproval.--Not later than 60 
                days after the date on which a proposal is received 
                under subparagraph (B), the Office shall determine 
                whether to approve the implementation of such proposal. 
                In making such determination, the Office shall consider 
                whether the proposal is consistent with the national 
                strategy described in paragraph (1). If the Office 
                fails to make a determination within such 60-day 
                period, such proposal shall be deemed to be approved.
                    ``(D) Failure to approve.--Except as otherwise 
                provided for by law, a proposal submitted under 
                subparagraph (B) may not be implemented unless such 
                proposal is approved or deemed to be approved under 
                subparagraph (C).
            ``(4) 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 Federal 
                Government with Federally adopted health information 
                technology data standards;
                    ``(E) 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
                    ``(F) in consultation with private sector, adopt 
                certification and testing criteria to determine if 
                electronic health information systems interoperate.
            ``(5) 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.
            ``(6) 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.
            ``(7) 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.
            ``(8) Federal reimbursement.--
                    ``(A) In general.--Not later than 6 months after 
                the date of enactment of this title, the Office shall 
                make recommendations to the President and the Secretary 
                of Health and Human Service on changes to Federal 
                reimbursement and payment structures that would 
                encourage the adoption of information technology (IT) 
                to improve health care quality and safety.
                    ``(B) Plan.--Not later than 90 days after receiving 
                recommendations under subparagraph (A), the Secretary 
                shall provide to the relevant Committees of Congress a 
                report that provides, with respect to each 
                recommendation, a plan for the implementation, or an 
                explanation as to why implementation is inadvisable, of 
                such recommendations. The Office shall continue to 
                monitor federally funded and supported information 
technology and quality initiatives (including the initiatives 
authorized in this title), and periodically update recommendations to 
the President and the Secretary.
    ``(d) Resources.--The President 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, in 
                collaboration with the Consolidated Health Informatics 
                Initiative (or a successor organization to such 
                Initiative), 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. Except as otherwise provided 
                for in this title, 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).
                    ``(C) Definition.--In this paragraph, the term 
                `provide for' means that the Director shall promulgate, 
                and each Federal agency or department shall adopt, 
                regulations to ensure that each such agency or 
                department complies with the requirements of subsection 
                (b).
            ``(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;
                    ``(C) facilitate clinical decision support through 
                the use of health information technology; and
                    ``(D) ensure the privacy and confidentiality of 
                medical records.
            ``(3) Public private partnership.--Consistent with 
        activities being carried out on the date of enactment of this 
        title, including the Consolidated Health Informatics Initiative 
        (or a successor organization to such 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 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 1 year after the adoption of the 
        technology standards pursuant to subsection (a), the Secretary 
        shall not purchase any health care information technology 
        system unless such system is in compliance with the standards 
        adopted under subsection (a), nor shall the Director approve 
        any proposal pursuant to section 2902(c)(3) unless such 
        proposal utilizes systems that are in compliance with the 
        standards adopted under subsection (a).
            ``(2) Recipients of federal funds.--Effective on the date 
        described in paragraph (1), no appropriated funds may be used 
        to purchase a health care information technology system unless 
        such system is in compliance with applicable 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);
                                    ``(II) hospitals; 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;
            ``(2) to the extent practicable, adopt the national health 
        information technology standards adopted under section 2903;
            ``(3) provide assurances that the entity shall submit to 
        the Director regular reports on the activities carried out 
        under the loan guarantee, including--
                    ``(A) a description of the financial costs and 
                benefits of the project involved and of the entities to 
                which such costs and benefits accrue;
                    ``(B) a description of the impact of the project on 
                health care quality and safety; and
                    ``(C) a description of any reduction in duplicative 
                or unnecessary care as a result of the project 
                involved;
            ``(4) provide assurances that not later than 30 days after 
        the development of the standard quality measures pursuant to 
        section 2906, the entity shall submit to the Director regular 
        reports on such measures, including provider level data and 
        analysis of the impact of information technology on such 
        measures;
            ``(5) 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 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 national or 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 for Certain Entities.--In awarding 
loan guarantees under this section, the Director shall give special 
consideration to eligible entities that--
            ``(1) provide service to low-income and underserved 
        populations; and
            ``(2) agree to electronically submit the information 
        described in paragraphs (3) and (4) of subsection (b) on a 
        daily basis.
    ``(e) Special Considerations for Local Health Information 
Infrastructures.--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.
    ``(f) 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.
    ``(g) 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 the Director 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.
    ``(h) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $250,000,000 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);
                                    ``(II) hospitals; 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) provide assurances that the entity shall submit to 
        the Director regular reports on the activities carried out 
        under the loan guarantee, including--
                    ``(A) a description of the financial costs and 
                benefits of the project involved and of the entities to 
                which such costs and benefits accrue;
                    ``(B) a description of the impact of the project on 
                health care quality and safety; and
                    ``(C) a description of any reduction in duplicative 
                or unnecessary care as a result of the project 
                involved;
            ``(5) provide assurances that not later than 30 days after 
        the development of the standard quality measures pursuant to 
        section 2906, the entity shall submit to the Director regular 
        reports on such measures, including provider level data and 
        analysis of the impact of information technology on such 
measures;
            ``(6) prepare and submit to the Director an application at 
        such time, in such manner, and containing such information as 
        the Director may require; and
            ``(7) agree to provide matching funds in accordance with 
        subsection (g).
    ``(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 national or 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) Special Considerations for Certain Entities.--In awarding 
grants under this section, the Director shall give special 
consideration to eligible entities that--
            ``(1) provide service to low-income and underserved 
        populations; and
            ``(2) agree to electronically submit the information 
        described in paragraphs (4) and (5) of subsection (b).
    ``(e) Special Considerations for Local Health Information 
Infrastructures.--In awarding grants 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;
    ``(f) Areas of Specific Interest.--In awarding grants 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.
    ``(g) 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.
    ``(h) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $250,000,000 for each of fiscal 
        years 2005 through 2010.
            ``(2) Availability.--Amounts appropriated under paragraph 
        (1) shall remain available for obligation until expended.''.

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

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

``SEC. 2906. 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'), in consultation with the Quality Interagency 
        Coordination Taskforce (as established by Executive Order on 
        March 13, 1998), the Institute of Medicine, the Joint 
        Commission on Accreditation of Healthcare Organizations, the 
        National Committee for Quality Assurance, the American Health 
        Quality Association, the National Quality Forum, the Medicare 
        Payment Advisory Committee, and other individuals and 
        organizations determined appropriate by the Secretaries, shall 
        establish uniform health care quality measures to assess the 
        effectiveness, timeliness, patient-centeredness, efficiency, 
        equity, and safety of care delivered across all federally 
        supported health delivery programs.
            ``(2) Development of measures.--Not later than 18 months 
        after the date of enactment of this title, the Secretaries 
        shall develop standardized sets of quality measures for each of 
        the 20 priority areas for improvement in health care quality as 
        identified by the Institute of Medicine in their report 
        entitled `Priority Areas for National Action' in 2003, or other 
        such areas as identified by the Secretaries in order to assist 
        beneficiaries in making informed choices about health plans or 
        care delivery systems. The selection of appropriate quality 
        indicators under this subsection shall include the evaluation 
        criteria formulated by clinical professionals, consumers, and 
        data collection experts.
            ``(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, working 
collaboratively, shall establish public reporting requirements for 
clinicians, institutional providers, and health plans in each of the 
federally supported health delivery program described in subsection 
(a). Such requirements shall provide that the entities described in the 
preceding sentence shall report to the appropriate Secretary on the 
measures developed under subsection (a).
    ``(c) Full Implementation.--The Secretaries, working 
collaboratively, shall implement all sets of quality measures and 
reporting systems developed under subsections (a) and (b) by not later 
than the date that is 1 year after the date on which the measures are 
developed under subsection (a)(2).
    ``(d) Reports.--Not later than 1 year after the date of enactment 
of this title, and annually thereafter, the Secretary shall--
            ``(1) submit to Congress a report that details the 
        collaborative efforts carried out under subsection (a), the 
        progress made on standardizing quality indicators throughout 
        the Federal Government, and the state of quality measurement 
        for priority areas that links data to the report submitted 
        under paragraph (2) for the year involved; and
            ``(2) submit to Congress a report that details areas of 
        clinical care requiring further research necessary to establish 
        effective clinical treatments that will serve as a basis for 
        additional quality indicators.
    ``(e) Comparative Quality Reports.--Beginning not later than 3 
years after the date of enactment of this title, 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) 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 1 year 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 6 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 1 year 
                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.
    ``(h) 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.''.
                                 <all>