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<bill bill-stage="Introduced-in-House" dms-id="H7E4407B76FEB407ABF1C15B52BD421E4" public-private="public" bill-type="olc"> 
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<dublinCore>
<dc:title>109 HR 4642 IH: Wired for Health Care Quality Act</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2005-12-18</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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</metadata>
<form> 
<distribution-code display="yes">I</distribution-code> 
<congress>109th CONGRESS</congress> <session>1st Session</session> 
<legis-num>H. R. 4642</legis-num> 
<current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber> 
<action> 
<action-date date="20051218">December 18, 2005</action-date> 
<action-desc><sponsor name-id="I000056">Mr. Issa</sponsor> introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name></action-desc> 
</action> 
<legis-type>A BILL</legis-type> 
<official-title>To enhance the adoption of a nationwide interoperable health information technology system and to improve the quality and reduce the costs of health care in the United States.</official-title> 
</form> 
<legis-body id="H61906F0811834AC295543EF9142EBF9C" style="OLC"> 
<section commented="no" display-inline="no-display-inline" id="H05C00B3727594E9FB2FF1E2999B441B2" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Wired for Health Care Quality Act</short-title></quote>.</text></section> 
<section commented="no" display-inline="no-display-inline" id="H035421AE9E874BB69F727B05E4C58EE3" section-type="subsequent-section"><enum>2.</enum><header>Improving health care, quality, safety, and efficiency</header> 
<subsection commented="no" display-inline="no-display-inline" id="H361501AEAA2C4BDEAFD9A494BBA4C879"><enum></enum><text display-inline="yes-display-inline">The Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/201">42 U.S.C. 201 et seq.</external-xref>) is amended by adding at the end the following:</text> 
<quoted-block display-inline="no-display-inline" id="HC6294DC892814D07A5B11FD2F6A1F229" style="OLC"> 
<title commented="no" id="H127F8E9C43A6477A8EC3B7CFFB5DD4C" style="OLC"><enum>XXIX</enum><header>Health information technology</header> 
<section commented="no" display-inline="no-display-inline" id="H16F735109CF5486A90A35BB75EE925F3" section-type="subsequent-section"><enum>2901.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text> 
<paragraph commented="no" display-inline="no-display-inline" id="H7302AA3E86A747448035C8833082D73F"><enum>(1)</enum><header>health care provider</header><text display-inline="yes-display-inline">The term <term>health care provider</term> means a hospital, skilled nursing facility, home health entity, health care clinic, federally qualified health center, group practice (as defined in section 1877(h)(4) of the Social Security Act), a pharmacist, a pharmacy, a laboratory, a physician (as defined in section 1861(r) of the Social Security Act), a health facility operated by or pursuant to a contract with the Indian Health Service, a rural health clinic, and any other category of facility or clinician determined appropriate by the Secretary.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H543FF7AD5E0D461382652D271360EA74"><enum>(2)</enum><header>Health information</header><text display-inline="yes-display-inline">The term <term>health information</term> has the meaning given such term in section 1171(4) of the Social Security Act.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HEDAAE58BA5194E739463C31844350BA"><enum>(3)</enum><header>Health insurance plan</header><text display-inline="yes-display-inline">The term <term>health insurance plan</term> means—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="HA959417416E442AB89CF588444E70238"><enum>(A)</enum><text display-inline="yes-display-inline">a health insurance issuer (as defined in section 2791(b)(2));</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H4561A386846A424D9B44A7599CB780BD"><enum>(B)</enum><text display-inline="yes-display-inline">a group health plan (as defined in section 2791(a)(1)); and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H138243F7619E44DB8181866800956544"><enum>(C)</enum><text display-inline="yes-display-inline">a health maintenance organization (as defined in section 2791(b)(3)).</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HC4C8DA38FEB04F8685B0559FE99083B1"><enum>(4)</enum><header>Laboratory</header><text display-inline="yes-display-inline">The term <term>laboratory</term> has the meaning given that term in section 353.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H43A2252EA94744AD9C8C523061825FD7"><enum>(5)</enum><header>Pharmacist</header><text display-inline="yes-display-inline">The term <term>pharmacist</term> has the meaning given that term in section 804 of the Federal Food, Drug, and Cosmetic Act.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HE16AA31E60E34954B16C01924E9CE05D"><enum>(6)</enum><header>Qualified health information technology</header><text display-inline="yes-display-inline">The term <term>qualified health information technology</term> means a computerized system (including hardware, software, and training) that—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="HD0FDD59D29EF48F5BB00D62414AEB23F"><enum>(A)</enum><text display-inline="yes-display-inline">protects the privacy and security of health information;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H339F916C0EF74B27AAB3BE5CDF10DA65"><enum>(B)</enum><text display-inline="yes-display-inline">maintains and provides permitted access to health information in an electronic format;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HB45AA0EBB61D4C99BC9492C81ED0BD43"><enum>(C)</enum><text display-inline="yes-display-inline">incorporates decision support to reduce medical errors and enhance health care quality;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HEF8998D2EBA1415798B287E271E3C33F"><enum>(D)</enum><text display-inline="yes-display-inline">complies with the standards adopted by the Federal Government under section 2903; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HB7541E5868CB47769CC63F31E8F1DFEE"><enum>(E)</enum><text display-inline="yes-display-inline">allows for the reporting of quality measures under section 2908.</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H7B56CD60B3E849DAB61431D9A7ECC8DE"><enum>(7)</enum><header>State</header><text display-inline="yes-display-inline">The term <term>State</term> means each of the several States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.</text></paragraph></section> 
<section commented="no" display-inline="no-display-inline" id="H26B2CE2B0C574769835659D7ECC791E3" section-type="subsequent-section"><enum>2902.</enum><header>Office of the National Coordinator of Health Information Technology</header> 
<subsection commented="no" display-inline="no-display-inline" id="H72C4CB6F26074B72AD69B19DE952923D"><enum>(a)</enum><header>Office of National Health Information Technology</header><text display-inline="yes-display-inline">There is established within the Office of the Secretary an Office of the National Coordinator of Health Information Technology (referred to in this section as the <quote>Office</quote>). The Office shall be headed by a National Coordinator who shall be appointed by the President, in consultation with the Secretary, and shall report directly to the Secretary.</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H9121ED5FBCEC4E57BD114DE2933CB02E"><enum>(b)</enum><header>Purpose</header><text display-inline="yes-display-inline">It shall be the purpose of the Office to carry out programs and activities to develop a nationwide interoperable health information technology infrastructure that—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="HFEDAC11F17B14D34BB92649E216F784B"><enum>(1)</enum><text display-inline="yes-display-inline">ensures that patients' health information is secure and protected;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HC17B8FBF9BCB4E96A9EDF37C18E65298"><enum>(2)</enum><text display-inline="yes-display-inline">improves health care quality, reduces medical errors, and advances the delivery of patient-centered medical care;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H1C687995E359405A9427AB305E93D501"><enum>(3)</enum><text display-inline="yes-display-inline">reduces health care costs resulting from inefficiency, medical errors, inappropriate care, and incomplete information;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H710FBE2D43494FE38F597FFA4601B31"><enum>(4)</enum><text display-inline="yes-display-inline">ensures that appropriate information to help guide medical decisions is available at the time and place of care;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H82B207F859E34EC099F8EEA5E8310083"><enum>(5)</enum><text display-inline="yes-display-inline">promotes a more effective marketplace, greater competition, and increased choice through the wider availability of accurate information on health care costs, quality, and outcomes;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HFB8CD8DA15084B4A9D836E5FE8E97E8C"><enum>(6)</enum><text display-inline="yes-display-inline">improves the coordination of care and information among hospitals, laboratories, physician offices, and other entities through an effective infrastructure for the secure and authorized exchange of health care information;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H4BD6A3632AD2471DBD43FDED3DA218FA"><enum>(7)</enum><text display-inline="yes-display-inline">improves public health reporting and facilitates the early identification and rapid response to public health threats and emergencies, including bioterror events and infectious disease outbreaks;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H6C844117F137497B95D23BBF3B15BF5B"><enum>(8)</enum><text display-inline="yes-display-inline">facilitates health research; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H83BAF3B92BD14275A5836997D7D336E5"><enum>(9)</enum><text display-inline="yes-display-inline">promotes prevention of chronic diseases.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HED19C75D9E5E490592A716A9C09D60ED"><enum>(c)</enum><header>Duties of the National Coordinator</header><text display-inline="yes-display-inline">The National Coordinator shall—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="HB0A212ECEB7840C5A5B9B9FDE7F19AA"><enum>(1)</enum><text display-inline="yes-display-inline">serve as a member of the public-private American Health Information Collaborative established under section 2903;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H02E962018CAB48F0B4C74DFB6121E713"><enum>(2)</enum><text display-inline="yes-display-inline">serve as the principal advisor to the Secretary concerning the development, application, and use of health information technology, and coordinate and oversee the health information technology programs of the Department;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HD9047817CA0840149CAFDAF43C396E15"><enum>(3)</enum><text display-inline="yes-display-inline">facilitate the adoption of a nationwide, interoperable system for the electronic exchange of health information;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H25A1C2CF073F49DF001DEDDBC7168EF"><enum>(4)</enum><text display-inline="yes-display-inline">ensure the adoption and implementation of standards for the electronic exchange of health information to reduce cost and improve health care quality;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H69C57BB6DA964601A67D064053770874"><enum>(5)</enum><text display-inline="yes-display-inline">ensure that health information technology policy and programs of the Department are coordinated with those of relevant executive branch agencies (including Federal commissions) with a goal of avoiding duplication of efforts and of helping to ensure that each agency undertakes health information technology activities primarily within the areas of its greatest expertise and technical capability;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HA0F1827FA0C143ACB3A11285414897B9"><enum>(6)</enum><text display-inline="yes-display-inline">to the extent permitted by law, coordinate outreach and consultation by the relevant executive branch agencies (including Federal commissions) with public and private parties of interest, including consumers, payers, employers, hospitals and other health care providers, physicians, community health centers, laboratories, vendors and other stakeholders;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H075C69D885244F1B9DDFF9BF1FD55E2C"><enum>(7)</enum><text display-inline="yes-display-inline">advise the President regarding specific Federal health information technology programs; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HB3DA71D13FDE406D8957C1AD9BD155EA"><enum>(8)</enum><text display-inline="yes-display-inline">submit the reports described under section 2903(i) (excluding paragraph (4) of such section).</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HE2D4D8C19B6A41B8B19B808C288C10AD"><enum>(d)</enum><header>Detail of Federal employees</header> 
<paragraph commented="no" display-inline="no-display-inline" id="H3B93ABC2782B42DDBF1B70B500F29EFA"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Upon the request of the National Coordinator, the head of any Federal agency is authorized to detail, with or 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.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H640CCBC1EBA54A58BAEF9361F12E9EEB"><enum>(2)</enum><header>Effect of detail</header><text display-inline="yes-display-inline">Any detail of personnel under paragraph (1) shall—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H798874DAD8EB4744A727F6B3EDEA25FC"><enum>(A)</enum><text display-inline="yes-display-inline">not interrupt or otherwise affect the civil service status or privileges of the Federal employee; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HA1A7833E2AA44737B6D660C7AE691BD1"><enum>(B)</enum><text display-inline="yes-display-inline">be in addition to any other staff of the Department employed by the National Coordinator.</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H65DBB2753BE248B8A64CB60006A089B9"><enum>(3)</enum><header>Acceptance of detailees</header><text display-inline="yes-display-inline">Notwithstanding any other provision of law, the Office may accept detailed personnel from other Federal agencies without regard to whether the agency described under paragraph (1) is reimbursed.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H5EB1BCDB31C54769B694894000119108"><enum>(e)</enum><header>Rule of construction</header><text display-inline="yes-display-inline">Nothing in this section shall be construed to require the duplication of Federal efforts with respect to the establishment of the Office, regardless of whether such efforts were carried out prior to or after the enactment of this title.</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HD2AA1F5778D84EE4A2EC3CDBD46334DB"><enum>(f)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There are authorized to be appropriated such sums as may be necessary to carry out the activities of the Office under this section for each of fiscal years 2006 through 2010.</text></subsection></section> 
<section commented="no" display-inline="no-display-inline" id="H0F86BCFD24704DA4B0D0D0495E586E87" section-type="subsequent-section"><enum>2903.</enum><header>American Health Information Collaborative</header> 
<subsection commented="no" display-inline="no-display-inline" id="H449E708489E34FB2A6D8CC22A7E5F66C"><enum>(a)</enum><header>Purpose</header><text display-inline="yes-display-inline">The Secretary shall establish the public-private American Health Information Collaborative (referred to in this section as the <quote>Collaborative</quote>) to—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="H65E6555B9BA44099868E7336C5CBEC4C"><enum>(1)</enum><text display-inline="yes-display-inline">advise the Secretary and recommend specific actions to achieve a nationwide interoperable health information technology infrastructure;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HDE048124E9404806A75927C1897F53F7"><enum>(2)</enum><text display-inline="yes-display-inline">serve as a forum for the participation of a broad range of stakeholders to provide input on achieving the interoperability of health information technology; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HC8C4FF04ACDB4786B82F4C8CEF897F9D"><enum>(3)</enum><text display-inline="yes-display-inline">recommend standards (including content, communication, and security standards) for the electronic exchange of health information for adoption by the Federal Government and voluntary adoption by private entities.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HA716EFDEF35B48D082935EEAF78971EE"><enum>(b)</enum><header>Composition</header> 
<paragraph commented="no" display-inline="no-display-inline" id="HFBC0A9CFC9F646588CFB5ECCCFF688BB"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Collaborative shall be composed of—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H8B2F6C9D55394A09BE47329558E2EBB2"><enum>(A)</enum><text display-inline="yes-display-inline">the Secretary, who shall serve as the chairperson of the Collaborative;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H624696B5C6124CBC001B1BB338AAA56F"><enum>(B)</enum><text display-inline="yes-display-inline">the Secretary of Defense, or his or her designee;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H24E29193C71B4FE2A720DFFBE650DF17"><enum>(C)</enum><text display-inline="yes-display-inline">the Secretary of Veterans Affairs, or his or her designee;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HB5B66A9B7840404786204DDF0013E9DA"><enum>(D)</enum><text display-inline="yes-display-inline">the Secretary of Commerce, or his or her designee;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H6E542C6C2E80444F85009307E5309B54"><enum>(E)</enum><text display-inline="yes-display-inline">the National Coordinator for Health Information Technology;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H73F6928E6B1E41729DB23BB37817C300"><enum>(F)</enum><text display-inline="yes-display-inline">representatives of other relevant Federal agencies, as determined appropriate by the Secretary; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H1D876283477247B2ABFCC600B37EB94D"><enum>(G)</enum><text display-inline="yes-display-inline">representatives from each of the following categories to be appointed by the Secretary from nominations submitted by the public—</text> 
<clause commented="no" display-inline="no-display-inline" id="H6373257A09FD4069A848A498B1752559"><enum>(i)</enum><text display-inline="yes-display-inline">consumer and patient organizations;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HB044CE6181DD4E45A8D433A4B516FCC3"><enum>(ii)</enum><text display-inline="yes-display-inline">experts in health information privacy and security;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H2C9EB048D936447B90715CE3306900EB"><enum>(iii)</enum><text display-inline="yes-display-inline">health care providers;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HD3A1CDD4C22049B9B09D421FEE2860A"><enum>(iv)</enum><text display-inline="yes-display-inline">health insurance plans or other third party payors;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H9875A7E1C805498B8900B128411C8268"><enum>(v)</enum><text display-inline="yes-display-inline">standards development organizations;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HAD2506BE0DDC4ACDB00706DB0074C872"><enum>(vi)</enum><text display-inline="yes-display-inline">information technology vendors;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HD540B4AD642D45DDB5E970D55233BDB5"><enum>(vii)</enum><text display-inline="yes-display-inline">purchasers or employers; and</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HF8FD1334D8304972A015C4B9F6C6BA84"><enum>(viii)</enum><text display-inline="yes-display-inline">State or local government agencies or Indian tribe or tribal organizations.</text></clause></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HCF2E4D3B12984B09A3F1158CFAA0B7AC"><enum>(2)</enum><header>Considerations</header><text display-inline="yes-display-inline">In appointing members under paragraph (1)(G), the Secretary shall select individuals with expertise in—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H65299EF08F424F24B307F05E1E705900"><enum>(A)</enum><text display-inline="yes-display-inline">health information privacy;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H7727BCCCC4974B9880235344A15B30A5"><enum>(B)</enum><text display-inline="yes-display-inline">health information security;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HD5446E2AB2E048FE9B95F6C37E2999D6"><enum>(C)</enum><text display-inline="yes-display-inline">health care quality and patient safety, including those individuals with experience in utilizing health information technology to improve health care quality and patient safety;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HA0AB959DAA4146AEA0777147DAABD9F2"><enum>(D)</enum><text display-inline="yes-display-inline">data exchange; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H3A680C677FC24C7CA3D505C01EBD6FC3"><enum>(E)</enum><text display-inline="yes-display-inline">developing health information technology standards and new health information technology.</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H0C889B83BD0A4D7A9E30CFC7A0C8E124"><enum>(3)</enum><header>Terms</header><text display-inline="yes-display-inline">Members appointed under paragraph (1)(G) shall serve for 2 year terms, except that any member appointed to fill a vacancy for an unexpired term shall be appointed for the remainder of such term. A member may serve for not to exceed 180 days after the expiration of such member's term or until a successor has been appointed.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HD35B0C87F276455C97A08EBF6CCC5D39"><enum>(c)</enum><header>Recommendations and policies</header><text display-inline="yes-display-inline">The Collaborative shall make recommendations to identify uniform national policies for adoption by the Federal Government and voluntary adoption by private entities to support the widespread adoption of health information technology, including—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="H1D9DBB2A107B448D976B7FA4DA68208"><enum>(1)</enum><text display-inline="yes-display-inline">protection of health information through privacy and security practices;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HC498C5907B8C4749932EF47003931E9"><enum>(2)</enum><text display-inline="yes-display-inline">measures to prevent unauthorized access to health information;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HA5DAD867837F43F0AB662182E2A10327"><enum>(3)</enum><text display-inline="yes-display-inline">methods to facilitate secure patient access to health information;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H12932142BA9445CCBDF46E9C3871E6AB"><enum>(4)</enum><text display-inline="yes-display-inline">the ongoing harmonization of industry-wide health information technology standards;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HE255D8EFA1B848BC9620EB203CDD5E3D"><enum>(5)</enum><text display-inline="yes-display-inline">recommendations for a nationwide interoperable health information technology infrastructure;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HAAD4279C58B74C97B65F861948365EC4"><enum>(6)</enum><text display-inline="yes-display-inline">the identification and prioritization of specific use cases for which heath information technology is valuable, beneficial, and feasible;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HE5D491587B8A4A940069BC00DCD34C7D"><enum>(7)</enum><text display-inline="yes-display-inline">recommendations for the establishment of an entity to ensure the continuation of the functions of the Collaborative; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HC300AF38DD43416A83B17C74EE2CEE83"><enum>(8)</enum><text display-inline="yes-display-inline">other policies determined to be necessary by the Collaborative.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H846788B94D9646F1812ED61252754EF8"><enum>(d)</enum><header>Standards</header> 
<paragraph commented="no" display-inline="no-display-inline" id="H63F59A61EE634E3794C7C707E8EE4940"><enum>(1)</enum><header>Existing standards</header><text display-inline="yes-display-inline">The standards adopted by the Consolidated Health Informatics Initiative shall be deemed to have been recommended by the Collaborative under this section.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H15D55C649E684BF4AC934C41532203C6"><enum>(2)</enum><header>First year review</header><text display-inline="yes-display-inline">Not later than 1 year after the date of enactment of this title, the Collaborative shall—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H0DC15E2032B84DA28FDA594F982BE8BA"><enum>(A)</enum><text display-inline="yes-display-inline">review existing standards (including content, communication, and security standards) for the electronic exchange of health information, including such standards adopted by the Secretary under paragraph (2)(A);</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HCF5F565808B0472EAB7C6F3FFBE805B9"><enum>(B)</enum><text display-inline="yes-display-inline">identify deficiencies and omissions in such existing standards; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H2D2421739DCE4A3D813F32553D41F73D"><enum>(C)</enum><text display-inline="yes-display-inline">identify duplication and overlap in such existing standards;</text></subparagraph><continuation-text commented="no" continuation-text-level="paragraph">and recommend modifications to such standards as necessary.</continuation-text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H2D0D7CF73BD848549139AEB2A86E19B0"><enum>(3)</enum><header>Ongoing review</header><text display-inline="yes-display-inline">Beginning 1 year after the date of enactment of this title, and annually thereafter, the Collaborative shall—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H8297907BF7454C3300554B98F9295B2"><enum>(A)</enum><text display-inline="yes-display-inline">review existing standards (including content, communication, and security standards) for the electronic exchange of health information, including such standards adopted by the Secretary under paragraph (2)(A);</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HEA7363DF6CA445FC90E026D56B2ECDEF"><enum>(B)</enum><text display-inline="yes-display-inline">identify deficiencies and omissions in such existing standards; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HC544163427A048F895F9BCF8E134EBF5"><enum>(C)</enum><text display-inline="yes-display-inline">identify duplication and overlap in such existing standards;</text></subparagraph><continuation-text commented="no" continuation-text-level="paragraph">and recommend modifications to such standards as necessary.</continuation-text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H843FB9DF7BFA41D2B7C9893C5ED0AB60"><enum>(4)</enum><header>Limitation</header><text display-inline="yes-display-inline">The standards described in this section shall be consistent with any standards developed pursuant to the Health Insurance Portability and Accountability Act of 1996.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H2077F7A1FED146D1BBA8F232EC241815"><enum>(e)</enum><header>Federal action</header><text display-inline="yes-display-inline">Not later than 60 days after the issuance of a recommendation from the Collaborative under subsection (d)(2), the Secretary of Health and Human Services, the Secretary of Veterans Affairs, and the Secretary of Defense, in collaboration with representatives of other relevant Federal agencies, as determined appropriate by the Secretary, shall jointly review such recommendations. The Secretary shall provide for the adoption by the Federal Government of any standard or standards contained in such recommendation.</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H775038CC07014D4C8B6CC66C01392875"><enum>(f)</enum><header>Coordination of federal spending</header><text display-inline="yes-display-inline">Not later than 1 year after the adoption by the Federal Government of a recommendation as provided for in subsection (e), and in compliance with <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/40/113">chapter 113</external-xref> of title 40, United States Code, no Federal agency shall expend Federal funds for the purchase of any form of health information technology or health information technology system for clinical care or for the electronic retrieval, storage, or exchange of health information that is not consistent with applicable standards adopted by the Federal Government under subsection (e).</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HE84B7F75AD794701A1649FF3CEF109AD"><enum>(g)</enum><header>Coordination of federal data collection</header><text display-inline="yes-display-inline">Not later than 3 years after the adoption by the Federal Government of a recommendation as provided for in subsection (e), all Federal agencies collecting health data for the purposes of surveillance, epidemiology, adverse event reporting, research, or for other purposes determined appropriate by the Secretary shall comply with standards adopted under subsection (e).</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H1DEB4291C2B64DBDB456258EC86FA1C4"><enum>(h)</enum><header>Voluntary adoption</header><text display-inline="yes-display-inline">Any standards adopted by the Federal Government under subsection (e) shall be voluntary with respect to private entities.</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H41F84AC5305A41478C7100A04818821E"><enum>(i)</enum><header>Reports</header><text display-inline="yes-display-inline">The Secretary shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives, on an annual basis, a report that—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="H17188CB3D1734546B6BB00F9A86FB6E7"><enum>(1)</enum><text display-inline="yes-display-inline">describes the specific actions that have been taken by the Federal Government and private entities to facilitate the adoption of an interoperable nationwide system for the electronic exchange of health information;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H49EB54A905CD48908940FBF76F957204"><enum>(2)</enum><text display-inline="yes-display-inline">describes barriers to the adoption of such a nationwide system;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H1CDA129ED0E845C0B917DB59ADD6D73B"><enum>(3)</enum><text display-inline="yes-display-inline">contains recommendations to achieve full implementation of such a nationwide system; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H731807D86D874DAAB8C5D1C8CCC9CA54"><enum>(4)</enum><text display-inline="yes-display-inline">contains a plan and progress toward the establishment of an entity to ensure the continuation of the functions of the Collaborative.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HCE7D068F81A94E2EB00060F8DC34A826"><enum>(j)</enum><header>Application of FACA</header><text display-inline="yes-display-inline">The Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the Collaborative, except that the term provided for under section 14(a)(2) shall be 5 years.</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H1FE18BC93F57431C0047007304616019"><enum>(k)</enum><header>Rule of construction</header><text display-inline="yes-display-inline">Nothing in this section shall be construed to require the duplication of Federal efforts with respect to the establishment of the Collaborative, regardless of whether such efforts were carried out prior to or after the enactment of this title.</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H21A122D3B00C4C3FA267EBB1E0CC7729"><enum>(l)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There are authorized to be appropriated such sums as may be necessary to carry out this section for each of fiscal years 2006 through 2010.</text></subsection></section> 
<section commented="no" display-inline="no-display-inline" id="H3C8EA200E8FB43B2929702C2EE9DD0DC" section-type="subsequent-section"><enum>2904.</enum><header>Implementation and certification of health information standards</header> 
<subsection commented="no" display-inline="no-display-inline" id="H6F4A674F961E4AD7A64FD7E018CF3249"><enum>(a)</enum><header>Implementation</header> 
<paragraph commented="no" display-inline="no-display-inline" id="H78AF973E0BB64FD300C063AADD9C528"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary, based upon the recommendations of the Collaborative, shall develop criteria to ensure uniform and consistent implementation of any standards for the electronic exchange of health information voluntarily adopted by private entities in technical conformance with such standards adopted under this title.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HD4C7D1EF3A544D98AFA64C2F25BB226C"><enum>(2)</enum><header>Implementation assistance</header><text display-inline="yes-display-inline">The Secretary may recognize a private entity or entities to assist private entities in the implementation of the standards adopted under this title using the criteria developed by the Secretary under this section.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H6B0CA89EDFE24F8EA4AF5E64807D6F58"><enum>(b)</enum><header>Certification</header> 
<paragraph commented="no" display-inline="no-display-inline" id="H6267C396172A4B49B275BB167597C662"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary, based upon the recommendations of the Collaborative, shall develop criteria to ensure and certify that hardware, software, and support services that claim to be in compliance with any standard for the electronic exchange of health information adopted under this title have established and maintained such compliance in technical conformance with such standards.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H589DD5BB83DE4EE9A71816D3D383568"><enum>(2)</enum><header>Certification assistance</header><text display-inline="yes-display-inline">The Secretary may recognize a private entity or entities to assist in the certification described under paragraph (1) using the criteria developed by the Secretary under this section.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H6DDA0BD1BABB45C391C03747A0082CE"><enum>(c)</enum><header>Delegation authority</header><text display-inline="yes-display-inline">The Secretary, through consultation with the Collaborative, may delegate the development of the criteria under subsections (a) and (b) to a private entity.</text></subsection></section> 
<section commented="no" display-inline="no-display-inline" id="H17A0A82594A14BF0815CCC37A6EAF128" section-type="subsequent-section"><enum>2905.</enum><header>Grants to facilitate the widespread adoption of interoperable health information technology</header> 
<subsection commented="no" display-inline="no-display-inline" id="H8968AF742C8C4CE989B7C277C7F71BD6"><enum>(a)</enum><header>Competitive grants to facilitate the widespread adoption of health information technology</header> 
<paragraph commented="no" display-inline="no-display-inline" id="HB0A0E3249F2348E3A4C6BACCAF1E79E"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary may award competitive grants to eligible entities to facilitate the purchase and enhance the utilization of qualified health information technology systems to improve the quality and efficiency of health care.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HD4DAD83E94C44780B39C0098B35B891B"><enum>(2)</enum><header>Eligibility</header><text display-inline="yes-display-inline">To be eligible to receive a grant under paragraph (1) an entity shall—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H1312AAE0C7534EE2A752E504E94092A6"><enum>(A)</enum><text display-inline="yes-display-inline">submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HEB35006AF4784CCCA42BBFF21B02AD6"><enum>(B)</enum><text display-inline="yes-display-inline">submit to the Secretary a strategic plan for the implementation of data sharing and interoperability measures;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H3D7C28C86ADA40018F9D23BBE70000BE"><enum>(C)</enum><text display-inline="yes-display-inline">be a—</text> 
<clause commented="no" display-inline="no-display-inline" id="H7DD1D90764A24779A205E2987EE21C5"><enum>(i)</enum><text display-inline="yes-display-inline">not for profit hospital;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H2A248AB19BB94FF6A42544AA6114EC45"><enum>(ii)</enum><text display-inline="yes-display-inline">group practice (including a single physician); or</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H8124AC8EC3294BAAB527C5B5188DA968"><enum>(iii)</enum><text display-inline="yes-display-inline">another health care provider not described in clause (i) or (ii);</text></clause></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H8685575CFA27455C84C0CC00142B3BBB"><enum>(D)</enum><text display-inline="yes-display-inline">adopt the standards adopted by the Federal Government under section 2903;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H12AAE0EAE85F4894AF348D3DAA400883"><enum>(E)</enum><text display-inline="yes-display-inline">require that health care providers receiving such grants implement the measurement system adopted under section 2908 and report to the Secretary on such measures;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HE30097BDF80746E3AEBEDFD415B961B6"><enum>(F)</enum><text display-inline="yes-display-inline">demonstrate significant financial need; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H3AF8E19652DE4ED7847FA8E72BDD5CFC"><enum>(G)</enum><text display-inline="yes-display-inline">provide matching funds in accordance with paragraph (4).</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HC5906A1339FD467594F906F56D64E08"><enum>(3)</enum><header>Use of funds</header><text display-inline="yes-display-inline">Amounts received under a grant under this subsection shall be used to facilitate the purchase and enhance the utilization of qualified health information technology systems.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H71C77C23CFF34285A726BBF3585812FB"><enum>(4)</enum><header>Matching requirement</header><text display-inline="yes-display-inline">To be eligible for a grant under this subsection an entity shall contribute non-Federal contributions to the costs of carrying out the activities for which the grant is awarded in an amount equal to $1 for each $3 of Federal funds provided under the grant.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H891AF3DCAA5B4FCEA8FDCB99383B60DB"><enum>(5)</enum><header>Preference in awarding grants</header><text display-inline="yes-display-inline">In awarding grants under this subsection the Secretary shall give preference to—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="HD883A9E3F1BD45F1B5E5474F769E7F85"><enum>(A)</enum><text display-inline="yes-display-inline">eligible entities that are located in rural, frontier, and other underserved areas as determined by the Secretary; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H346E8932A65F4879A53C9BC4059E5D72"><enum>(B)</enum><text display-inline="yes-display-inline">eligible entities that will link, to the extent practicable, the qualified health information system to local or regional health information networks.</text></subparagraph></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HCF56550399F44CC8A380F66FBC94D420"><enum>(b)</enum><header>Competitive grants to states for the development of state loan programs to facilitate the widespread adoption of health information technology</header> 
<paragraph commented="no" display-inline="no-display-inline" id="H27A4C0738D9642049C6FBE73EE256D57"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary may award competitive grants to States for the establishment of State programs for loans to health care providers to facilitate the purchase and enhance the utilization of qualified health information technology.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HF2D0BC565374403595736FEFC921072"><enum>(2)</enum><header>Establishment of fund</header><text display-inline="yes-display-inline">To be eligible to receive a competitive grant under this subsection, a State shall establish a qualified health information technology loan fund (referred to in this subsection as a <quote>State loan fund</quote>) and comply with the other requirements contained in this section. A grant to a State under this subsection shall be deposited in the State loan fund established by the State. No funds authorized by other provisions of this title to be used for other purposes specified in this title shall be deposited in any State loan fund.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HF2D03763490242839902E029B6049B87"><enum>(3)</enum><header>Eligibility</header><text display-inline="yes-display-inline">To be eligible to receive a grant under paragraph (1) a State shall—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H95C17B9F377E448BB6D4FE392C7421A2"><enum>(A)</enum><text display-inline="yes-display-inline">submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H7044DDED609D4EDF813E4BA1DD0000CD"><enum>(B)</enum><text display-inline="yes-display-inline">submit to the Secretary a strategic plan in accordance with paragraph (4);</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HDEE91FAF8B294089829439EF9846E068"><enum>(C)</enum><text display-inline="yes-display-inline">establish a qualified health information technology loan fund in accordance with paragraph (2);</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HDCCD44063C014F959100DD53FC00A7E"><enum>(D)</enum><text display-inline="yes-display-inline">require that health care providers receiving such loans—</text> 
<clause commented="no" display-inline="no-display-inline" id="H3A54D5B92A884475ADFBA56219AB447E"><enum>(i)</enum><text display-inline="yes-display-inline">link, to the extent practicable, the qualified health information system to a local or regional health information network; and</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H731BE45EAF644E4388152434B0BF3E16"><enum>(ii)</enum><text display-inline="yes-display-inline">consult with the Center for Best Practices established in section 914(d) to access the knowledge and experience of existing initiatives regarding the successful implementation and effective use of health information technology;</text></clause></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H4FBB3ACEE8624AC59F27B9358FB6F297"><enum>(E)</enum><text display-inline="yes-display-inline">require that health care providers receiving such loans adopt the standards adopted by the Federal Government under section 2903(d);</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H000B97864E9D4144BA6135D8D0352605"><enum>(F)</enum><text display-inline="yes-display-inline">require that health care providers receiving such loans implement the measurement system adopted under section 2908 and report to the Secretary on such measures; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H8C17471BF1C34B2B9C00629FF453BE00"><enum>(G)</enum><text display-inline="yes-display-inline">provide matching funds in accordance with paragraph (8).</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HF900B95D752045B287716C3484EBEF7B"><enum>(4)</enum><header>Strategic plan</header> 
<subparagraph commented="no" display-inline="no-display-inline" id="H03F30542F9F7412CB49F23A600B4011"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">A State that receives a grant under this subsection shall annually prepare a strategic plan that identifies the intended uses of amounts available to the State loan fund of the State.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H8A6C7200A84F42FFAC568BE3A42BC2E3"><enum>(B)</enum><header>Contents</header><text display-inline="yes-display-inline">A strategic plan under subparagraph (A) shall include—</text> 
<clause commented="no" display-inline="no-display-inline" id="HCB2FA3458B364E5B925B8F6E7D18C8DA"><enum>(i)</enum><text display-inline="yes-display-inline">a list of the projects to be assisted through the State loan fund in the first fiscal year that begins after the date on which the plan is submitted;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H676E2474A0AA48ACAA0059D4B27B15D1"><enum>(ii)</enum><text display-inline="yes-display-inline">a description of the criteria and methods established for the distribution of funds from the State loan fund; and</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H37D4819E81DA4644AA52C8EF956011D5"><enum>(iii)</enum><text display-inline="yes-display-inline">a description of the financial status of the State loan fund and the short-term and long-term goals of the State loan fund.</text></clause></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H85491BEB7181473F9BE500FF65BE3185"><enum>(5)</enum><header>Use of funds</header> 
<subparagraph commented="no" display-inline="no-display-inline" id="H0E349B99A7BB462DAEDF91273FF62DBD"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">Amounts deposited in a State loan fund, including loan repayments and interest earned on such amounts, shall be used only for awarding loans or loan guarantees, or as a source of reserve and security for leveraged loans, the proceeds of which are deposited in the State loan fund established under paragraph (1). Loans under this section may be used by a health care provider to facilitate the purchase and enhance the utilization of qualified health information technology.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H50E8E3D1D72942E2A46C9DB5002C99B"><enum>(B)</enum><header>Limitation</header><text display-inline="yes-display-inline">Amounts received by a State under this subsection may not be used—</text> 
<clause commented="no" display-inline="no-display-inline" id="H55B2F70139514190A9CCD7EC63798660"><enum>(i)</enum><text display-inline="yes-display-inline">for the purchase or other acquisition of any health information technology system that is not a qualified health information technology system;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HD9B12CB322D849179000B904B558B63"><enum>(ii)</enum><text display-inline="yes-display-inline">to conduct activities for which Federal funds are expended under this title, or the amendments made by the <short-title>Wired for Health Care Quality Act</short-title>; or</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H9BB5A1EC17D84895846163E8D48C51C7"><enum>(iii)</enum><text display-inline="yes-display-inline">for any purpose other than making loans to eligible entities under this section.</text></clause></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HB6656C66879847A0002103232D6D62C9"><enum>(6)</enum><header>Types of assistance</header><text display-inline="yes-display-inline">Except as otherwise limited by applicable State law, amounts deposited into a State loan fund under this subsection may only be used for the following:</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="HFB62FCFFC1BE4D1BABEF04D2E4957B9B"><enum>(A)</enum><text display-inline="yes-display-inline">To award loans that comply with the following:</text> 
<clause commented="no" display-inline="no-display-inline" id="HF261F0C3CE914E57941591BBD56B8C2"><enum>(i)</enum><text display-inline="yes-display-inline">The interest rate for each loan shall be less than or equal to the market interest rate.</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HF6DF3148DE87454F814FCD801F082466"><enum>(ii)</enum><text display-inline="yes-display-inline">The principal and interest payments on each loan shall commence not later than 1 year after the loan was awarded, and each loan shall be fully amortized not later than 10 years after the date of the loan.</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H96E3070FEBED4441BCDA2A3A82E0090"><enum>(iii)</enum><text display-inline="yes-display-inline">The State loan fund shall be credited with all payments of principal and interest on each loan awarded from the fund.</text></clause></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H8EA67B1B682C4598930600C8FC9BACB5"><enum>(B)</enum><text display-inline="yes-display-inline">To guarantee, or purchase insurance for, a local obligation (all of the proceeds of which finance a project eligible for assistance under this subsection) if the guarantee or purchase would improve credit market access or reduce the interest rate applicable to the obligation involved.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H2829B6A95FCF40C597A9EDA74CA4C170"><enum>(C)</enum><text display-inline="yes-display-inline">As a source of revenue or security for the payment of principal and interest on revenue or general obligation bonds issued by the State if the proceeds of the sale of the bonds will be deposited into the State loan fund.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H551EBC4F849B453681829F16A8CEA71E"><enum>(D)</enum><text display-inline="yes-display-inline">To earn interest on the amounts deposited into the State loan fund.</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H6BD0E582A95F4F60BC227D45E71D44E3"><enum>(7)</enum><header>Administration of state loan funds</header> 
<subparagraph commented="no" display-inline="no-display-inline" id="H8DF7DEE4FFBB4633A52D55E6E9B38254"><enum>(A)</enum><header>Combined financial administration</header><text display-inline="yes-display-inline">A State may (as a convenience and to avoid unnecessary administrative costs) combine, in accordance with State law, the financial administration of a State loan fund established under this subsection with the financial administration of any other revolving fund established by the State if otherwise not prohibited by the law under which the State loan fund was established.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H87EDD422A492429DAE726989262C8205"><enum>(B)</enum><header>Cost of administering fund</header><text display-inline="yes-display-inline">Each State may annually use not to exceed 4 percent of the funds provided to the State under a grant under this subsection to pay the reasonable costs of the administration of the programs under this section, including the recovery of reasonable costs expended to establish a State loan fund which are incurred after the date of enactment of this title.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HC3F17215C50B4959B2BEE39F95E362A9"><enum>(C)</enum><header>Guidance and regulations</header><text display-inline="yes-display-inline">The Secretary shall publish guidance and promulgate regulations as may be necessary to carry out the provisions of this subsection, including—</text> 
<clause commented="no" display-inline="no-display-inline" id="HF8CA22C402204AE396C34DC2719CEE22"><enum>(i)</enum><text display-inline="yes-display-inline">provisions to ensure that each State commits and expends funds allotted to the State under this subsection as efficiently as possible in accordance with this title and applicable State laws; and</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H13123331E7D04D698F79E4F2B4013DDB"><enum>(ii)</enum><text display-inline="yes-display-inline">guidance to prevent waste, fraud, and abuse.</text></clause></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H57137DE098B247D4B3B0A433DA4E680"><enum>(D)</enum><header>Private sector contributions</header> 
<clause commented="no" display-inline="no-display-inline" id="H00555B19FB044B7D8509DE08CFB9C9F"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">A State loan fund established under this subsection may accept contributions from private sector entities, except that such entities may not specify the recipient or recipients of any loan issued under this subsection.</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H0CC1988A8D6244569D706D14681F35D2"><enum>(ii)</enum><header>Availability of information</header><text display-inline="yes-display-inline">A State shall make publically available the identity of, and amount contributed by, any private sector entity under clause (i) and may issue letters of commendation or make other awards (that have no financial value) to any such entity.</text></clause></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H92C951F36A72492DBE80EFA4F5BB6B7"><enum>(8)</enum><header>Matching requirements</header> 
<subparagraph commented="no" display-inline="no-display-inline" id="HCA687232DBA24425B0B336D5AF4600AF"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary may not make a grant under paragraph (1) to a State unless the State agrees to make available (directly or through donations from public or private entities) non-Federal contributions in cash toward the costs of the State program to be implemented under the grant in an amount equal to not less than $1 for each $1 of Federal funds provided under the grant.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HA3F6B31003004F1D9200B6A4ED99DCD0"><enum>(B)</enum><header>Determination of amount of non-federal contribution</header><text display-inline="yes-display-inline">In determining the amount of non-Federal contributions that a State has provided pursuant to subparagraph (A), the Secretary may not include any amounts provided to the State by the Federal Government.</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H18395AD775C64446A98C3B649BAF92E1"><enum>(9)</enum><header>Preference in awarding grants</header><text display-inline="yes-display-inline">The Secretary may give a preference in awarding grants under this subsection to States that adopt value-based purchasing programs to improve health care quality.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H695AF804C551407AAC98E0D5495B6205"><enum>(10)</enum><header>Reports</header><text display-inline="yes-display-inline">The Secretary shall annually submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate, and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives, a report summarizing the reports received by the Secretary from each State that receives a grant under this subsection.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HC9DE7181806749B2A6BCC9EC2C3BB93B"><enum>(c)</enum><header>Grants for the implementation of regional or local health information technology plans</header> 
<paragraph commented="no" display-inline="no-display-inline" id="H37F6C371E6124D0CAF673E82986E3D68"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary may award competitive grants to eligible entities to implement regional or local health information plans to improve health care quality and efficiency through the electronic exchange of health information pursuant to the standards, protocols, and other requirements adopted by the Secretary under sections 2903 and 2908.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H6A5670BE833B400D8BEACE10222CAD9"><enum>(2)</enum><header>Eligibility</header><text display-inline="yes-display-inline">To be eligible to receive a grant under paragraph (1) an entity shall—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H73446C67881A4ADAA29CB98051913CBF"><enum>(A)</enum><text display-inline="yes-display-inline">demonstrate financial need to the Secretary;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H0F83D034643F4FC4A01B00CA009C87C9"><enum>(B)</enum><text display-inline="yes-display-inline">demonstrate that one of its principal missions or purposes is to use information technology to improve health care quality and efficiency;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H66901E87BB8D4E39830084F4097228F0"><enum>(C)</enum><text display-inline="yes-display-inline">adopt bylaws, memoranda of understanding, or other charter documents that demonstrate that the governance structure and decisionmaking processes of such entity allow for participation on an ongoing basis by multiple stakeholders within a community, including—</text> 
<clause commented="no" display-inline="no-display-inline" id="HC02A29C236B74601B8803E00AFE916C3"><enum>(i)</enum><text display-inline="yes-display-inline">physicians (as defined in section 1861(r) of the <act-name parsable-cite="SSA">Social Security Act</act-name>), including physicians that provide services to low income and underserved populations;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H2DD97D7ED0534C469F49A8DF42008FC8"><enum>(ii)</enum><text display-inline="yes-display-inline">hospitals (including hospitals that provide services to low income and underserved populations);</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H46893080CBAC4EF200AAFEB994B7234"><enum>(iii)</enum><text display-inline="yes-display-inline">pharmacists or pharmacies;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HD6B8DBBD6DDB435FB5DA33035734131"><enum>(iv)</enum><text display-inline="yes-display-inline">health insurance plans;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H79D0934A8C1844078368ADE324DED83B"><enum>(v)</enum><text display-inline="yes-display-inline">health centers (as defined in section 330(b)) and Federally qualified health centers (as defined in section 1861(aa)(4) of the <act-name parsable-cite="SSA">Social Security Act</act-name>);</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HE7C0BD1B13B740128CE542D56984D700"><enum>(vi)</enum><text display-inline="yes-display-inline">rural health clinics (as defined in section 1861(aa) of the <act-name parsable-cite="SSA">Social Security Act</act-name>);</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H60F73262A1CD4C1CBF00E7E2A2450000"><enum>(vii)</enum><text display-inline="yes-display-inline">patient or consumer organizations;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HC313283D2C534023BF00AA4103232B51"><enum>(viii)</enum><text display-inline="yes-display-inline">employers; and</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H9B3B4DFEF5FD4BCF98EDDE75EFA00B3"><enum>(ix)</enum><text display-inline="yes-display-inline">any other health care providers or other entities, as determined appropriate by the Secretary;</text></clause></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H80E78DE7512F4AAA99612456592371F7"><enum>(D)</enum><text display-inline="yes-display-inline">adopt nondiscrimination and conflict of interest policies that demonstrate a commitment to open, fair, and nondiscriminatory participation in the health information plan by all stakeholders;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H83E0A2290B2A4470BDF72C2CC3A38038"><enum>(E)</enum><text display-inline="yes-display-inline">adopt the standards adopted by the Secretary under section 2903;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H09A20E7EBF3846518CD1E1A9514B892C"><enum>(F)</enum><text display-inline="yes-display-inline">require that health care providers receiving such loans implement the measurement system adopted under section 2908 and report to the Secretary on such measures;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H6ADF463AE06341E9B207E2D13337DA83"><enum>(G)</enum><text display-inline="yes-display-inline">facilitate the electronic exchange of health information within the local or regional area and among local and regional areas;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H9CF08563AE08455A8806760276A761AB"><enum>(H)</enum><text display-inline="yes-display-inline">prepare and submit to the Secretary an application in accordance with paragraph (3); and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HDBDB97239B044656AC19AC1B9D00AD01"><enum>(I)</enum><text display-inline="yes-display-inline">agree to provide matching funds in accordance with paragraph (5).</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HAC82B500234F4CEDA7E24FCBCD3EA9CA"><enum>(3)</enum><header>Application</header> 
<subparagraph commented="no" display-inline="no-display-inline" id="HAC43A29A0CC3462DB61B81A455C7CDAC"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">To be eligible to receive a grant under paragraph (1), an entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HF03FDFF6D0BF4757BAE6C77EEE6F00EC"><enum>(B)</enum><header>Required information</header><text display-inline="yes-display-inline">At a minimum, an application submitted under this paragraph shall include—</text> 
<clause commented="no" display-inline="no-display-inline" id="H1DB667BFF8C143188CC4C55BD9D0970"><enum>(i)</enum><text display-inline="yes-display-inline">clearly identified short-term and long-term objectives of the regional or local health information plan;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HE00D1CC8BA6C4FB3A6B3B23B2EE2F209"><enum>(ii)</enum><text display-inline="yes-display-inline">a technology plan that complies with the standards adopted under section 2903 and that includes a descriptive and reasoned estimate of costs of the hardware, software, training, and consulting services necessary to implement the regional or local health information plan;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H7B0658D8F1674804A73F2B4E9B22B041"><enum>(iii)</enum><text display-inline="yes-display-inline">a strategy that includes initiatives to improve health care quality and efficiency, including the use and reporting of health care quality measures adopted under section 2908;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H80D455436B7242F398E537D7BA6452B7"><enum>(iv)</enum><text display-inline="yes-display-inline">a plan that describes provisions to encourage the implementation of the electronic exchange of health information by all physicians, including single physician practices and small physician groups participating in the health information plan;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HC7764A4213ED483884A712585417757C"><enum>(v)</enum><text display-inline="yes-display-inline">a plan to ensure the privacy and security of personal health information that is consistent with Federal and State law;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HEFA43952EBFF40449F02B8AEA4210065"><enum>(vi)</enum><text display-inline="yes-display-inline">a governance plan that defines the manner in which the stakeholders shall jointly make policy and operational decisions on an ongoing basis; and</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H6238CC22354E497BB940EE5EA8BEDB47"><enum>(vii)</enum><text display-inline="yes-display-inline">a financial or business plan that describes—</text> 
<subclause commented="no" display-inline="no-display-inline" id="HEBA4C3D7ED004C5BA2264BE09F82CFE"><enum>(I)</enum><text display-inline="yes-display-inline">the sustainability of the plan;</text></subclause> 
<subclause commented="no" display-inline="no-display-inline" id="H0E92F03BB6794DF9AB6C1D38E75EF57"><enum>(II)</enum><text display-inline="yes-display-inline">the financial costs and benefits of the plan; and</text></subclause> 
<subclause commented="no" display-inline="no-display-inline" id="H6717D3D873404230BADF15B7BEA4579"><enum>(III)</enum><text display-inline="yes-display-inline">the entities to which such costs and benefits will accrue.</text></subclause></clause></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HB3EF92F0326B411E8EC6A226A338F9C"><enum>(4)</enum><header>Use of funds</header><text display-inline="yes-display-inline">Amounts received under a grant under paragraph (1) shall be used to establish and implement a regional or local health information plan in accordance with this subsection.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H21FC152E5A1245B29B458F00F7FB78C6"><enum>(5)</enum><header>Matching requirement</header> 
<subparagraph commented="no" display-inline="no-display-inline" id="H59C1FB25B70C49C6B9F0E89B94B19815"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary may not make a grant under this subsection 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 50 percent of such costs ($1 for each $2 of Federal funds provided under the grant).</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H34FE376B8813418AA06DACB37D16E269"><enum>(B)</enum><header>Determination of amount contributed</header><text display-inline="yes-display-inline">Non-Federal contributions required under subparagraph (A) 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.</text></subparagraph></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H12FB7F259F454A2A94A7535000A2DD8B"><enum>(d)</enum><header>Reports</header><text display-inline="yes-display-inline">Not later than 1 year after the date on which the first grant is awarded under this section, and annually thereafter during the grant period, an entity that receives a grant under this section shall submit to the Secretary a report on the activities carried out under the grant involved. Each such report shall include—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="H914A89759423465D83A6BD98DBD22524"><enum>(1)</enum><text display-inline="yes-display-inline">a description of the financial costs and benefits of the project involved and of the entities to which such costs and benefits accrue;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H4C366C2915A5413A9E67B96220A93100"><enum>(2)</enum><text display-inline="yes-display-inline">an analysis of the impact of the project on health care quality and safety;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HD6C7434F3F3E4BD4AD759274522B6F49"><enum>(3)</enum><text display-inline="yes-display-inline">a description of any reduction in duplicative or unnecessary care as a result of the project involved;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HF51C18E62E8145F3A7C04E4CEA814ED1"><enum>(4)</enum><text display-inline="yes-display-inline">a description of the efforts of recipients under this section to facilitate secure patient access to health information; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H0920B1FFFCC54EF5A0F1041181C2CC26"><enum>(5)</enum><text display-inline="yes-display-inline">other information as required by the Secretary.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HBB10B11F17F04B42B37586DA1F9494CD"><enum>(e)</enum><header>Authorization of appropriations</header> 
<paragraph commented="no" display-inline="no-display-inline" id="H30A60308A65C4AC099CC588FD91F337F"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">For the purpose of carrying out this section, there is authorized to be appropriated $125,000,000 for fiscal year 2006, $150,000,000 for fiscal year 2007, and such sums as may be necessary for each of fiscal years 2008 through 2010.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H15780706444C4B78B51E0917A7871F69"><enum>(2)</enum><header>Availability</header><text display-inline="yes-display-inline">Amounts appropriated under paragraph (1) shall remain available through fiscal year 2010.</text></paragraph></subsection></section> 
<section commented="no" display-inline="no-display-inline" id="H043FA3BB80FA4367980170C0BA8F6496" section-type="subsequent-section"><enum>2906.</enum><header>Demonstration program to integrate information technology into clinical education</header> 
<subsection commented="no" display-inline="no-display-inline" id="H2471E48E3E2D4C14858230011C643E8F"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary may award grants under this section to carry out demonstration projects to develop academic curricula integrating qualified health information technology systems in the clinical education of health professionals. Such awards shall be made on a competitive basis and pursuant to peer review.</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HD3D27578DB9E4451969651D8B8D47DCF"><enum>(b)</enum><header>Eligibility</header><text display-inline="yes-display-inline">To be eligible to receive a grant under subsection (a), an entity shall—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="HFA4E67A036EE45EE8288B7107647262E"><enum>(1)</enum><text display-inline="yes-display-inline">submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HAF37E1049A7C4D65A7FB157100B371B7"><enum>(2)</enum><text display-inline="yes-display-inline">submit to the Secretary a strategic plan for integrating qualified health information technology in the clinical education of health professionals and for ensuring the consistent utilization of decision support software to reduce medical errors and enhance health care quality;</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H7BF2334C58154B959D35607DCC6E35D2"><enum>(3)</enum><text display-inline="yes-display-inline">be—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="HCF6653510E8A464B005051448F36D7E5"><enum>(A)</enum><text display-inline="yes-display-inline">a health professions school;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H342F6A4BAB084F3A841841A0F014A589"><enum>(B)</enum><text display-inline="yes-display-inline">a school of nursing; or</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H78AF8C4E710C49D8AD708E50B4603740"><enum>(C)</enum><text display-inline="yes-display-inline">a graduate medical education program;</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H71F5D81C522E463A88B699F40033DD58"><enum>(4)</enum><text display-inline="yes-display-inline">provide for the collection of data regarding the effectiveness of the demonstration project to be funded under the grant in improving the safety of patients, the efficiency of health care delivery, and in increasing the likelihood that graduates of the grantee will adopt and incorporate health information technology in the delivery of health care services; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H819253BA811944A1A47D1FC1049FE922"><enum>(5)</enum><text display-inline="yes-display-inline">provide matching funds in accordance with subsection (c).</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H9C6134B1EB404DC08FEDF001C85B5E8F"><enum>(c)</enum><header>Use of funds</header> 
<paragraph commented="no" display-inline="no-display-inline" id="H39D338F7F0D7420F89BDC2A2BB7FE91"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">With respect to a grant under subsection (a), an eligible entity shall—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H6E6E71006E74466B89E5D60842D98BA8"><enum>(A)</enum><text display-inline="yes-display-inline">use grant funds in collaboration with 2 or more disciplines; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H78C39CE805984FCF00F59CA57D004BFC"><enum>(B)</enum><text display-inline="yes-display-inline">use grant funds to integrate qualified health information technology into community-based clinical education.</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H3FF279CF97FA42A998840096BDA8F37D"><enum>(2)</enum><header>Limitation</header><text display-inline="yes-display-inline">An eligible entity shall not use amounts received under a grant under subsection (a) to purchase hardware, software, or services.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H109B0653BCF94850B1B2CBD33B35E494"><enum>(d)</enum><header>Matching funds</header> 
<paragraph commented="no" display-inline="no-display-inline" id="HA6BC391D0A00482E8CA7DD22FA9E668"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary may award a grant to an entity under this section only if the entity agrees to make available non-Federal contributions toward the costs of the program to be funded under the grant in an amount that is not less than $1 for each $2 of Federal funds provided under the grant.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HABF5E258E2124146B1BD38744BCF9394"><enum>(2)</enum><header>Determination of amount contributed</header><text display-inline="yes-display-inline">Non-Federal contributions under paragraph (1) may be in cash or in kind, fairly evaluated, including equipment 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 contributions.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HF01E68601CC84827BAA250F2B0000BD"><enum>(e)</enum><header>Evaluation</header><text display-inline="yes-display-inline">The Secretary shall take such action as may be necessary to evaluate the projects funded under this section and publish, make available, and disseminate the results of such evaluations on as wide a basis as is practicable.</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HEC7D462B51E8462BA7B79898BBA4D600"><enum>(f)</enum><header>Reports</header><text display-inline="yes-display-inline">Not later than 1 year after the date of enactment of this title, and annually thereafter, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate, and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives a report that—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="HD11CF08A6CC941B58550E82E50B3978"><enum>(1)</enum><text display-inline="yes-display-inline">describes the specific projects established under this section; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H1664A6503CB04DD98F66B02742F946D7"><enum>(2)</enum><text display-inline="yes-display-inline">contains recommendations for Congress based on the evaluation conducted under subsection (e).</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HE72166300C8B431BB2247B00B00DA32"><enum>(g)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated to carry out this section, $5,000,000 for fiscal year 2007, and such sums as may be necessary for each of fiscal years 2008 through 2010.</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H6E5F1EDE7D5E42D795ACA8007E29F089"><enum>(h)</enum><header>Sunset</header><text display-inline="yes-display-inline">This section shall not apply after September 30, 2010.</text></subsection></section> 
<section commented="no" display-inline="no-display-inline" id="H163E03F47FAC4C898500007228CB1BF7" section-type="subsequent-section"><enum>2907.</enum><header>Licensure and the electronic exchange of health information</header> 
<subsection commented="no" display-inline="no-display-inline" id="H38892EDF078E4AA9B8A527661FD527BB"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall carry out, or contract with a private entity to carry out, a study that examines—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="H81F8C6FD00AA40DAAF287416A600FBF1"><enum>(1)</enum><text display-inline="yes-display-inline">the variation among State laws that relate to the licensure, registration, and certification of medical professionals; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HB22742E4FEA24C349DA043381DDB3EB"><enum>(2)</enum><text display-inline="yes-display-inline">how such variation among State laws impacts the secure electronic exchange of health information—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H2BB4963846564FBA85BDAC00D594C300"><enum>(A)</enum><text display-inline="yes-display-inline">among the States; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H49E219AA83E04491B89951D00D0EC1F"><enum>(B)</enum><text display-inline="yes-display-inline">between the States and the Federal Government.</text></subparagraph></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H4C9CF4DA388A4A0BA9B5824B5D1B5C3F"><enum>(b)</enum><header>Report and recommendations</header><text display-inline="yes-display-inline">Not later than 1 year after the date of enactment of this title, the Secretary shall publish a report that—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="HC3BC81E4E91A4586A07C457497A069B2"><enum>(1)</enum><text display-inline="yes-display-inline">describes the results of the study carried out under subsection (a); and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H39B52B88C6E3422085541DE93CCC6D51"><enum>(2)</enum><text display-inline="yes-display-inline">makes recommendations to States regarding the harmonization of State laws based on the results of such study.</text></paragraph></subsection></section> 
<section commented="no" display-inline="no-display-inline" id="HF707DF50D4C246C5B343C1C1B8C0F3B1" section-type="subsequent-section"><enum>2908.</enum><header>Quality measurement systems</header> 
<subsection commented="no" display-inline="no-display-inline" id="H766DEA8AD47F46F1A8AC925B58F9E81B"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services, the Secretary of Veterans Affairs, the Secretary of Defense, and representatives of other relevant Federal agencies, as determined appropriate by the Secretary, (referred to in the section as the <quote>Secretaries</quote>) shall jointly develop a quality measurement system for the purpose of measuring the quality of care patients receive.</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H13777FCA25294DF3A91EE5B372F562C0"><enum>(b)</enum><header>Requirements</header><text display-inline="yes-display-inline">The Secretaries shall ensure that the quality measurement system developed under subsection (a) comply with the following:</text> 
<paragraph commented="no" display-inline="no-display-inline" id="H50C2913826874622AE352168036448F5"><enum>(1)</enum><header>Measures</header> 
<subparagraph commented="no" display-inline="no-display-inline" id="H60A78672430F4A439769AD18FD093C12"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">Subject to subparagraph (B), the Secretaries shall select measures of quality to be used by the Secretaries under the systems.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H358E287D37D94A00B400DCA35ED31FCB"><enum>(B)</enum><header>Requirements</header><text display-inline="yes-display-inline">In selecting the measures to be used under each system pursuant to subparagraph (A), the Secretaries shall, to the extent feasible, ensure that—</text> 
<clause commented="no" display-inline="no-display-inline" id="H4F66D4D1FC1742B4AEDE00592405C0F7"><enum>(i)</enum><text display-inline="yes-display-inline">such measures are evidence based, reliable and valid;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H8CC8EF9E3B0F4B4B90FFE846C1D368D6"><enum>(ii)</enum><text display-inline="yes-display-inline">such measures include measures of process, structure, patient experience, efficiency, and equity; and</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HD3E9C122B85743A5894CAEEB9ECF674E"><enum>(iii)</enum><text display-inline="yes-display-inline">such measures include measures of overuse, underuse, and misuse of health care items and services.</text></clause></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HC90AEF04A8D04C8B922940798099F7E"><enum>(2)</enum><header>Priorities</header><text display-inline="yes-display-inline">In developing the system under subsection (a), the Secretaries shall ensure that priority is given to—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="HA1F7EC6843B64277A52177DD9AED0D3"><enum>(A)</enum><text display-inline="yes-display-inline">measures with the greatest potential impact for improving the quality and efficiency of care provided under Federal programs;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H83A322C9951B45DBAC00EBC6B6C8E971"><enum>(B)</enum><text display-inline="yes-display-inline">measures that may be rapidly implemented by group health plans, health insurance issuers, physicians, hospitals, nursing homes, long-term care providers, and other providers; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HDAFDBA36BBC940A0BE1942D19BE344C2"><enum>(C)</enum><text display-inline="yes-display-inline">measures which may inform health care decisions made by consumers and patients.</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H6F7D9F94ACF842E09F0000D5F619622C"><enum>(3)</enum><header>Weights of measures</header><text display-inline="yes-display-inline">The Secretaries shall assign weights to the measures used by the Secretaries under each system established under subsection (a).</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H6EA27C82E846488DB4D57251E2580678"><enum>(4)</enum><header>Risk adjustment</header><text display-inline="yes-display-inline">The Secretaries shall establish procedures to account for differences in patient health status, patient characteristics, and geographic location. To the extent practicable, such procedures shall recognize existing procedures.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H7A62BEB701794898902D8D65FDC815C1"><enum>(5)</enum><header>Maintenance</header><text display-inline="yes-display-inline">The Secretaries shall, as determined appropriate, but in no case more often than once during each 12-month period, update the quality measurement systems developed under subsection (a), including through—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H5D9ACC06538A4693B51377A601C7EC95"><enum>(A)</enum><text display-inline="yes-display-inline">the addition of more accurate and precise measures under the systems and the retirement of existing outdated measures under the systems; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H78332D1AB78E4E2B9BB536023B5D329C"><enum>(B)</enum><text display-inline="yes-display-inline">the refinement of the weights assigned to measures under the systems.</text></subparagraph></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HA1F9ED27E27549280042DB021479DB1"><enum>(c)</enum><header>Required considerations in developing and updating the systems</header><text display-inline="yes-display-inline">In developing and updating the quality measurement systems under this section, the Secretaries shall—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="H97066FC5E3C145E4AD72868D00F47748"><enum>(1)</enum><text display-inline="yes-display-inline">consult with, and take into account the recommendations of, the entity that the Secretaries has an arrangement with under subsection (e);</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H58A35049B535412C9E7F25E8579B9022"><enum>(2)</enum><text display-inline="yes-display-inline">consult with representatives of health care providers, consumers, employers, and other individuals and groups that are interested in the quality of health care; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H1CF177F0398448A690FAB765009774EE"><enum>(3)</enum><text display-inline="yes-display-inline">take into account—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="HC71B89941A0C443DBC4925B370D1C0A5"><enum>(A)</enum><text display-inline="yes-display-inline">any demonstration or pilot program conducted by the Secretaries relating to measuring and rewarding quality and efficiency of care;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HDCBCCB256C2C430EAA47D086DEDD1163"><enum>(B)</enum><text display-inline="yes-display-inline">any existing activities conducted by the Secretaries relating to measuring and rewarding quality and efficiency;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H3217AF2815EE497485CD388017462C9"><enum>(C)</enum><text display-inline="yes-display-inline">any existing activities conducted by private entities including health insurance plans and payors; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HD6821F70D26A4EF1B7FC6C5C95A9FCFD"><enum>(D)</enum><text display-inline="yes-display-inline">the report by the Institute of Medicine of the National Academy of Sciences under section 238(b) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.</text></subparagraph></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H9D0547942EE347AAB9522D05BD4EC399"><enum>(d)</enum><header>Required considerations in implementing the systems</header><text display-inline="yes-display-inline">In implementing the quality measurement systems under this section, the Secretaries shall take into account the recommendations of public-private entities—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="H0B8AE01DDBBB4FACA8F708C3AC66BDE0"><enum>(1)</enum><text display-inline="yes-display-inline">that are established to examine issues of data collection and reporting, including the feasibility of collecting and reporting data on measures; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H6243338CD7FB44A9BA5FFD6C64DCBEEF"><enum>(2)</enum><text display-inline="yes-display-inline">that involve representatives of health care providers, consumers, employers, and other individuals and groups that are interested in quality of care.</text></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="HC370A6A4531C4982AFD6E9EC703470D0"><enum>(e)</enum><header>Arrangement with an entity to provide advice and recommendations</header> 
<paragraph commented="no" display-inline="no-display-inline" id="HDFA087F08D804944A124E0CB3D9F068B"><enum>(1)</enum><header>Arrangement</header><text display-inline="yes-display-inline">On and after July 1, 2006, the Secretaries shall have in place an arrangement with an entity that meets the requirements described in paragraph (2) under which such entity provides the Secretaries with advice on, and recommendations with respect to, the development and updating of the quality measurement systems under this section, including the assigning of weights to the measures under subsection (b)(2).</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H22EF30D00F314F7BB3109BCF5C21B658"><enum>(2)</enum><header>Requirements described</header><text display-inline="yes-display-inline">The requirements described in this paragraph are the following:</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H68E4BFC0DC294B1D903036BC48AD162D"><enum>(A)</enum><text display-inline="yes-display-inline">The entity is a private nonprofit entity governed by an executive director and a board.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HFED542EF7380447DBD005868FF00DBA5"><enum>(B)</enum><text display-inline="yes-display-inline">The members of the entity include representatives of—</text> 
<clause commented="no" display-inline="no-display-inline" id="HE053387F12424102899BE48BBEB098F6"><enum>(i)</enum><text display-inline="yes-display-inline">health insurance plans and providers with experience in the care of individuals with multiple complex chronic conditions or groups representing such health insurance plans and providers;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H16A033B6A3324745B000D38C36D399D"><enum>(ii)</enum><text display-inline="yes-display-inline">groups representing patients and consumers;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HD3E381A5EFE540DF85519B6DE4A133D9"><enum>(iii)</enum><text display-inline="yes-display-inline">purchasers and employers or groups representing purchasers or employers;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H029BC220F2114580B48EE3D064806E4"><enum>(iv)</enum><text display-inline="yes-display-inline">organizations that focus on quality improvement as well as the measurement and reporting of quality measures;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H977A166B7E494579B47640A4AC9EFFD0"><enum>(v)</enum><text display-inline="yes-display-inline">State government health programs;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HF2948CBCC4E5424786F61DAB3956B5C4"><enum>(vi)</enum><text display-inline="yes-display-inline">individuals or entities skilled in the conduct and interpretation of biomedical, health services, and health economics research and with expertise in outcomes and effectiveness research and technology assessment; and</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H47B2E183AF1C4BDB9920CA6882A439D1"><enum>(vii)</enum><text display-inline="yes-display-inline">individuals or entities involved in the development and establishment of standards and certification for health information technology systems and clinical data.</text></clause></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HA0443B37667E40AA9014A0001C1F3EC0"><enum>(C)</enum><text display-inline="yes-display-inline">The membership of the entity is representative of individuals with experience with urban health care issues and individuals with experience with rural and frontier health care issues.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H189B0D30A61C42289CB40054E7620021"><enum>(D)</enum><text display-inline="yes-display-inline">If the entity requires a fee for membership, the entity shall provide assurances to the Secretaries that such fees are not a substantial barrier to participation in the entity's activities related to the arrangement with the Secretaries.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H00E34FD9DEB947FAA678C3C00763527"><enum>(E)</enum><text display-inline="yes-display-inline">The entity—</text> 
<clause commented="no" display-inline="no-display-inline" id="HFB578A13EADA4B0B87015CC811F5F7A3"><enum>(i)</enum><text display-inline="yes-display-inline">permits any member described in subparagraph (B) to vote on matters of the entity related to the arrangement with the Secretary under paragraph (1); and</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HB8DF5E0D78094E79BBAC6F07C6D1A5C9"><enum>(ii)</enum><text display-inline="yes-display-inline">ensures that member voting provides a balance among disparate stakeholders, so that no member organization described in subparagraph (B) unduly influences the outcome.</text></clause></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H848857D25C5947A4BDF713C3DC263368"><enum>(F)</enum><text display-inline="yes-display-inline">With respect to matters related to the arrangement with the Secretary under paragraph (1), the entity conducts its business in an open and transparent manner and provides the opportunity for public comment.</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H74839128CFAB458C9B455572F258D6DD"><enum>(G)</enum><text display-inline="yes-display-inline">The entity operates as a voluntary consensus standards setting organization as defined for purposes of section 12(d) of the National Technology Transfer and Advancement Act of 1995 (<external-xref legal-doc="public-law" parsable-cite="pl/104/113">Public Law 104–113</external-xref>) and Office of Management and Budget Revised Circular A–119 (published in the Federal Register on February 10, 1998).</text></subparagraph></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H51BD0169F71E41BD89FFA48E96F9A6AA"><enum>(f)</enum><header>Use of quality measurement system</header> 
<paragraph commented="no" display-inline="no-display-inline" id="HE1EA14C2456146CE9D5535235E3B164F"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">For purposes of activities conducted or supported by the Secretary under this Act, the Secretary shall, to the extent practicable, adopt and utilize the measurement system developed under this section.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HCFCBF91A6F7D45E78561374F10E34098"><enum>(2)</enum><header>Collaborative agreements</header><text display-inline="yes-display-inline">With respect to activities conducted or supported by the Secretary under this Act, the Secretary may establish collaborative agreements with private entities, including group health plans and health insurance issuers, providers, purchasers, consumer organizations, and entities receiving a grant under section 2908, to—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H566EA7372DA14836AE2F8F9F00539FC"><enum>(A)</enum><text display-inline="yes-display-inline">encourage the use of the health care quality measures adopted by the Secretary under this section; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H03E46FAB69724A49002B7374BBB5947F"><enum>(B)</enum><text display-inline="yes-display-inline">foster uniformity between the health care quality measures utilized by private entities.</text></subparagraph></paragraph></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H9195227C9E694E64B700808D157B1072"><enum>(g)</enum><header>Dissemination of information</header><text display-inline="yes-display-inline">Beginning on January 1, 2008, in order to make comparative quality information available to health care consumers, health professionals, public health officials, researchers, and other appropriate individuals and entities, the Secretary shall provide for the aggregation and analysis of quality measures collected under section 2905 and the dissemination of recommendations and best practices derived in part from such analysis.</text></subsection> 
<subsection commented="no" display-inline="no-display-inline" id="H4D6124EE193E4971B051A663F6B38B83"><enum>(h)</enum><header>Technical assistance</header><text display-inline="yes-display-inline">The Secretary shall provide technical assistance to public and private entities to enable such entities to—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="H8730AAC917A744D1870006B0CDA39E48"><enum>(1)</enum><text display-inline="yes-display-inline">implement and use evidence-based guidelines with the greatest potential to improve health care quality, efficiency, and patient safety; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HEECB4860B87F4166B82C2EAAE83A304"><enum>(2)</enum><text display-inline="yes-display-inline">establish mechanisms for the rapid dissemination of information regarding evidence-based guidelines with the greatest potential to improve health care quality, efficiency, and patient safety.</text></paragraph></subsection></section> 
<section commented="no" display-inline="no-display-inline" id="HB8BB04D5E633425F8F911535EC1800D4" section-type="subsequent-section"><enum>2909.</enum><header>Applicability of privacy and security regulations</header><text display-inline="no-display-inline">The regulations promulgated by the Secretary under part C of title XI of the Social Security Act and sections 261, 262, 263, and 264 of the Health Insurance Portability and Accountability Act of 1996 with respect to the privacy, confidentiality, and security of health information shall—</text> 
<paragraph commented="no" display-inline="no-display-inline" id="H989640FBC97645DF99B92DAAAE573E57"><enum>(1)</enum><text display-inline="yes-display-inline">apply to any health information stored or transmitted in an electronic format on or after the date of enactment of this title; and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H5708F865BDE845E29EA2013766704FA2"><enum>(2)</enum><text display-inline="yes-display-inline">apply to the implementation of standards, programs, and activities under this title.</text></paragraph> </section> 
<section commented="no" display-inline="no-display-inline" id="H5BECEFDC860E4D52B8EE163900D6008D" section-type="subsequent-section"><enum>2910.</enum><header>Study of reimbursement incentives</header><text display-inline="no-display-inline">The Secretary shall carry out, or contract with a private entity to carry out, a study that examines methods to create efficient reimbursement incentives for improving health care quality in Federally qualified health centers, rural health clinics, and free clinics.</text> </section></title><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section> 
<section commented="no" display-inline="no-display-inline" id="H6DAFAF4919C84BA69900555961565FB0" section-type="subsequent-section"><enum>3.</enum><header>Health information technology resource center</header><text display-inline="no-display-inline">Section 914 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/299b-3">42 U.S.C. 299b–3</external-xref>) is amended by adding at the end the following:</text> 
<quoted-block display-inline="no-display-inline" id="HB053DC3EC65940E79CEB6504438B8853" style="OLC"> 
<subsection commented="no" display-inline="no-display-inline" id="H91EDB17945D041A8B7614F6EA114EB7D"><enum>(d)</enum><header>Center for Best Practices</header> 
<paragraph commented="no" display-inline="no-display-inline" id="H50AC8953C1CE4ACEBABE2F37123B1D6D"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary, acting through the Director, shall develop a Center for Best Practices to provide technical assistance and develop best practices to support and accelerate efforts to adopt, implement, and effectively use interoperable health information technology in compliance with section 2903 and 2908.</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HB95256594D9C4D2A95CF5ACA8F48768"><enum>(2)</enum><header>Center for best practices</header> 
<subparagraph commented="no" display-inline="no-display-inline" id="H2E077C3AE56E49759E5B5317BE00C666"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The Center shall support activities to meet goals, including—</text> 
<clause commented="no" display-inline="no-display-inline" id="H478D021D45394646B4F8E8BF6400269B"><enum>(i)</enum><text display-inline="yes-display-inline">providing for the widespread adoption of interoperable health information technology;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H0C0DDB467D7540B4A0838C4072EB0758"><enum>(ii)</enum><text display-inline="yes-display-inline">providing for the establishment of regional and local health information networks to facilitate the development of interoperability across health care settings and improve the quality of health care;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HC964A686C9014B479C744FF3368EE0A1"><enum>(iii)</enum><text display-inline="yes-display-inline">the development of solutions to barriers to the exchange of electronic health information; or</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H0811D9510E284978ABB851FB7BE07700"><enum>(iv)</enum><text display-inline="yes-display-inline">other activities identified by the States, local or regional health information networks, or health care stakeholders as a focus for developing and sharing best practices.</text></clause></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HFFAFAE6157464F0CA66DC84C13B42B65"><enum>(B)</enum><header>Purposes</header><text display-inline="yes-display-inline">The purpose of the Center is to—</text> 
<clause commented="no" display-inline="no-display-inline" id="H4CB41AEF4D844EC4969ECD69AF829F9B"><enum>(i)</enum><text display-inline="yes-display-inline">provide a forum for the exchange of knowledge and experience;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H788E946C4EE645AFB36D5233429CF4E9"><enum>(ii)</enum><text display-inline="yes-display-inline">accelerate the transfer of lessons learned from existing public and private sector initiatives, including those currently receiving Federal financial support;</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HED3B314BC5B64D2789A91FBE45C74E04"><enum>(iii)</enum><text display-inline="yes-display-inline">assemble, analyze, and widely disseminate evidence and experience related to the adoption, implementation, and effective use of interoperable health information technology; and</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="H2B06B6293A91469986E5E3859051FA62"><enum>(iv)</enum><text display-inline="yes-display-inline">assure the timely provision of technical and expert assistance from the Agency and its contractors.</text></clause></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H3F8155BB37E140F7957CEFB200E9E0CA"><enum>(C)</enum><header>Support for activities</header><text display-inline="yes-display-inline">To provide support for the activities of the Center, the Director shall modify the requirements, if necessary, that apply to the National Resource Center for Health Information Technology to provide the necessary infrastructure to support the duties and activities of the Center and facilitate information exchange across the public and private sectors.</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H5AD35EC10FED4F2EACF333861C15E388"><enum>(3)</enum><header>Technical assistance telephone number or website</header><text display-inline="yes-display-inline">The Secretary shall establish a toll-free telephone number or Internet website to provide health care providers and patients with a single point of contact to—</text> 
<subparagraph commented="no" display-inline="no-display-inline" id="H8AC96C7B22374A2FAEA827314B8F3485"><enum>(A)</enum><text display-inline="yes-display-inline">learn about Federal grants and technical assistance services related to interoperable health information technology;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="HCF35EFD772AE49538E2DABA94F56D061"><enum>(B)</enum><text display-inline="yes-display-inline">learn about qualified health information technology and the quality measurement system adopted by the Federal Government under sections 2903 and 2908;</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H17F37BDFF40142EBBEC6A8F3A2C5AD29"><enum>(C)</enum><text display-inline="yes-display-inline">learn about regional and local health information networks for assistance with health information technology; and</text></subparagraph> 
<subparagraph commented="no" display-inline="no-display-inline" id="H8DF5491105274D249BAE6478FE4ED2DD"><enum>(D)</enum><text display-inline="yes-display-inline">disseminate additional information determined by the Secretary.</text></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="HE13EF569983843AFB0833361642000B3"><enum>(4)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There are authorized to be appropriated to carry out this subsection, such sums as may be necessary for each of fiscal years 2006 through 2010.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section> 
<section commented="no" display-inline="no-display-inline" id="H4FC408CF705741F7B87FB8B642AE5426" section-type="subsequent-section"><enum>4.</enum><header>Reauthorization of incentive grants regarding telemedicine</header><text display-inline="no-display-inline">Section 330L(b) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254c-18">42 U.S.C. 254c–18(b)</external-xref>) is amended by striking <quote>2002 through 2006</quote> and inserting <quote>2006 through 2010</quote>.</text></section> 
</legis-body> 
</bill> 


