[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4859 Introduced in House (IH)]


109th CONGRESS
  2d Session
                                H. R. 4859

To amend chapter 89 of title 5, United States Code, to provide for the 
   implementation of a system of electronic health records under the 
               Federal Employees Health Benefits Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 2, 2006

 Mr. Porter (for himself and Mr. Clay) introduced the following bill; 
        which was referred to the Committee on Government Reform

_______________________________________________________________________

                                 A BILL


 
To amend chapter 89 of title 5, United States Code, to provide for the 
   implementation of a system of electronic health records under the 
               Federal Employees Health Benefits Program.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Federal Family Health Information 
Technology Act of 2006''.

SEC. 2. ELECTRONIC HEALTH RECORDS.

    (a) In General.--Chapter 89 of title 5, United States Code, is 
amended by inserting after section 8902a the following:
``Sec. 8902b. Electronic health records
    ``(a) This section provides for the establishment, in connection 
with the program established under this chapter, of electronic health 
records for each covered individual, including--
            ``(1) requiring the establishment of a carrier electronic 
        health record under subsection (b);
            ``(2) requiring the offering by carriers to covered 
        individuals of a personal electronic health record under 
        subsection (c); and
            ``(3) providing carrier-based incentives for establishing 
        provider-based electronic health records under subsection (d).
    ``(b)(1) Each contract under this chapter shall require that the 
carrier establish, maintain, and make available, in accordance with 
standards adopted by the Office of Personnel Management under this 
section, a carrier electronic health record for each covered individual 
who is enrolled under this chapter in a health benefits plan offered by 
the carrier.
    ``(2)(A) A carrier electronic health record for a covered 
individual under this subsection shall consist of a carrier's health 
information on the individual's health care claims, health care 
services data, or both, such as information describing the individual's 
inpatient facility admissions, emergency room visits, and claims for 
prescription drugs. Such a record shall include, to the maximum extent 
practicable, such information as it relates to claims or services for 
another carrier in which the covered individual was previously enrolled 
under this title.
    ``(B) The information under subparagraph (A) shall cover the period 
beginning on the later of January 1, 2008, or the date of the covered 
individual's enrollment with the carrier under this title. Such period 
is not required to be longer than the period specified in standards 
adopted by the Office of Personnel Management under this section.
    ``(C) In the case of a covered individual who changes enrollment 
under this title after the effective date specified in paragraph (4) 
from one carrier to another carrier, the first carrier shall transfer 
information from the carrier electronic health record under this 
subsection to the second carrier to the extent specified by the Office 
of Personnel Management by not later than 90 days after the date the 
first carrier receives notice of the change in enrollment.
    ``(3) Information from a carrier electronic health record for a 
covered individual shall be made available to the individual and shall 
be made available (in accordance with the regulations promulgated 
pursuant to section 264(c) of the Health Insurance Portability and 
Accountability Act of 1996) to a health care provider treating the 
individual. A carrier shall make such information available, in 
accordance with standards adopted under this section--
            ``(A) promptly;
            ``(B) over a secure internet or other electronic-based 
        connection;
            ``(C) in a format useful for diagnosis and treatment; and
            ``(D) in a format that permits its importation into a 
        personal electronic health record under subsection (c).
    ``(4) The previous provisions of this subsection shall apply with 
respect to contracts for contract years beginning with--
            ``(A) the 3rd contract year (or 4th contract year, if the 
        Office of Personnel Management determines that carriers are not 
        prepared to implement the previous provisions of this 
        subsection by such 3rd contract year) beginning after the date 
        of the enactment of this section; or
            ``(B) such earlier contract year as the Office of Personnel 
        Management may determine.
    ``(c)(1) Each contract under this chapter shall require the carrier 
in accordance with standards adopted under this section--
            ``(A) to provide, upon the request of a covered individual, 
        for the establishment and maintenance of a personal electronic 
        health record for the individual;
            ``(B) to establish a method for the individual to access 
        the individual's personal electronic health record through a 
        mechanism that is integrated with access to the carrier 
        electronic health record for the individual under subsection 
        (b); and
            ``(C) to establish a method for the individual to transfer 
        the individual's personal electronic health record to the 
        individual (or to a carrier or other entity designated by the 
        individual) upon the request of the individual at any time, 
        including at the time of disenrollment of the individual.
    ``(2) A personal electronic health record for a covered individual 
shall consist of such personal health information, such as family 
health history, symptoms, use of over-the-counter medication, diet, 
exercise, and other relevant health information and activities, as the 
individual may provide. Such record may also include information from a 
provider-based electronic health record referred to in subsection (d) 
as well as from a carrier electronic health record.
    ``(3) Each contract under this chapter shall require the carrier to 
enable health information to be imported in standard electronic format 
into a personal electronic health record from a provider-based 
electronic health record and from a carrier electronic health record 
consistent with standards adopted by the Office.
    ``(4) Nothing in this subsection shall be construed as authorizing 
the carrier or another person, other than a covered individual, to 
access a personal electronic health record of the individual without 
the authorization of the individual.
    ``(5) The previous provisions of this subsection shall apply with 
respect to contracts for contract years beginning with the contract 
year beginning after the first contract year with respect to which the 
requirements of subsection (b) are in effect under subsection (b)(4).
    ``(d)(1) Each contract under this chapter shall require the carrier 
to provide, in accordance with standards adopted by the Office under 
this section, incentives (subject to the availability of amounts from 
the Federal Family Health Information Technology Trust Fund, as 
established by section 4 of the Federal Family Health Information 
Technology Act of 2006) for providers to implement a comprehensive 
system of provider-based electronic health records for all patients 
covered by the contract.
    ``(2) The previous provisions of this subsection shall be effective 
with respect to contract years beginning with such contract year as the 
Office of Personnel Management shall determine.
    ``(e) Beginning with the contract year beginning after the first 
contract year with respect to which the requirements of subsection (b) 
are in effect, each carrier shall report to the Office of Personnel 
Management its progress and plan for enabling each covered individual, 
upon request, to store and access, through a portable, electronic 
medium, the individual's personal electronic health record established 
under subsection (c), as well as the carrier electronic health record 
for the individual (established under subsection (b)) and provider-
based electronic health records relating to the individual referred to 
in subsection (d). Such plan shall provide a means for such storage and 
access through such a portable medium beginning with the 5th contract 
year after the first contract year with respect to which the 
requirements of subsection (b) are in effect.
    ``(f)(1) Standards adopted under this section regarding carrier, 
personal, and provider-based electronic health records shall be 
consistent with any standards for interoperability of electronic health 
records developed by ONCHIT.
    ``(2) In addition to paragraph (1), the Office of Personnel 
Management shall consult with ONCHIT in the implementation of this 
section, including the establishment of effective dates under 
subsections (b)(4)(B) and (d)(2).
    ``(3) For purposes of this subsection, the term `ONCHIT' means the 
Office of the National Coordinator for Health Information Technology in 
the Department of Health and Human Services, and includes any successor 
to the functions performed by such Office.
    ``(g)(1) The Office of Personnel Management may waive any or all of 
the requirements of this section for a carrier described in paragraph 
(2) insofar as the carrier has established an electronic health record 
system that substantially meets the purpose of each such requirement 
that is waived.
    ``(2) A carrier described in this paragraph is a carrier that--
            ``(A) is an integrated health care system that combines the 
        functions of a health plan, hospitals, pharmacy, laboratories, 
        and clinicians; and
            ``(B) has developed and is implementing, as of the date of 
        the enactment of this section, a provider-based comprehensive 
        electronic medical record for each member of the health plan.
    ``(h) For purposes of this section, the term `covered individual' 
has the meaning given such term by section 8902a(a)(1)(B).''.
    (b) Conforming Amendments.--(1) Section 8902 of title 5, United 
States Code, is amended by adding at the end the following:
    ``(p) A contract may not be made which is not in conformance with 
the requirements of section 8902b, except that the Office of Personnel 
Management may phase in or waive conformance with some or all of such 
requirements during the first two contract years in which a carrier has 
a contract under this title.''.
    (2) The table of sections for chapter 89 of such title is amended 
by inserting after the item relating to section 8902a the following:

``8902b. Electronic health records.''.

SEC. 3. PROVISION REGARDING RATES.

    During the period ending with the contract year following the first 
contract year with respect to which the requirements of subsection (b) 
of section 8902b of title 5, United States Code, as inserted by section 
2(a), are in effect, in determining rates under section 8902(i) of such 
title, the Office of Personnel Management shall not take into account 
any carrier administrative costs, monetary savings, or return on 
investment resulting from implementation of carrier and personal 
electronic health records required under subsections (b) and (c) of 
such section 8902b, except that the Office shall have access to the 
unused portion of contributions set aside in the Employees Health 
Benefits Fund under section 8909(b)(1) of such title without fiscal 
year limitation for such use as the Office considers necessary to 
assist carriers in complying with such subsections.

SEC. 4. FEDERAL FAMILY HEALTH INFORMATION TECHNOLOGY TRUST FUND.

    (a) In General.--The Office of Personnel Management shall establish 
the Federal Family Health Information Technology Trust Fund (in this 
section referred to as the ``Trust Fund'') for the purpose of receiving 
donations to be used to award grants to carriers who meet certain 
requirements as set forth by the Office.
    (b) Acceptance of Donations.--In accordance with the section, the 
Office may accept donations made to the Trust Fund. Donations made to 
the Trust Fund, and grants awarded from such Fund to carriers, shall 
not be considered to be the solicitation or payment of remuneration of 
any kind, nor shall receipt of such grants be considered an inducement 
to refer, purchase, order, or lease any good, facility, item, or 
service.
    (c) Deposit of Amounts Received.--Funds received by the Office 
under this section shall be transmitted by the Office to the Trust 
Fund.
    (d) Funds To Be Used for Carrier Grants.--The Office shall award 
grants from the Trust Fund to carriers under chapter 89 of title 5, 
United States Code, to be distributed under section 8902b(d) of such 
title as incentives to their contracting health care providers for 
implementing provider-based electronic health records based on 
requirements and qualifications set forth by the Office and standards 
adopted under section 8902b(f) of such title.

SEC. 5. IMPLEMENTATION.

    The Office of Personnel Management shall provide for the 
implementation of this Act through appropriate administrative guidance, 
which may be by regulation, by carrier letter, or otherwise.

SEC. 6. HIPAA COMPLIANCE.

     Nothing in this Act shall be construed as affecting the 
application or compliance with regulations promulgated pursuant to 
section 264(c) of the Health Insurance Portability and Accountability 
Act of 1996 (relating to access to and disclosure of health 
information).
                                 <all>