II 109th CONGRESS 1st Session S. 1355 IN THE SENATE OF THE UNITED STATES June 30, 2005 Mr. Enzi (for himself, Mr. Kennedy, Mr. Grassley, Mr. Baucus, Mr. Dodd, Mr. Alexander, Mr. Harkin, Mr. Isakson, Ms. Mikulski, Mr. DeWine, Mr. Jeffords, Mr. Hatch, Mrs. Murray, Mr. Reed, Mr. Allen, Mr. Burns, Mr. Crapo, Mr. DeMint, Mr. Santorum, Mr. Thomas, and Ms. Cantwell) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To enhance the adoption of health information technology and to improve the quality and reduce the costs of healthcare in the United States.

1.

Short title

This Act may be cited as the Better Healthcare Through Information Technology Act.

2.

Improving healthcare, quality, safety, and efficiency

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

3.

Center for Best Practices

Section 914 of the Public Health Service Act (42 U.S.C. 299b–3) is amended by adding at the end the following: (d)

Center for Best Practices

(1)

In general

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 the efforts of States and healthcare providers to adopt, implement, and effectively use health information technology. (2)

Center for best practices

(A)

In general

In carrying out paragraph (1), the Director shall establish a voluntary Center for Best Practices (referred to in this subsection as the Center) for States and healthcare stakeholders seeking to facilitate mutual learning and accelerate the pace of innovation in, and implementation of, health information technology. The Center shall support activities to meet goals, including— (i)providing for the widespread adoption of interoperable health information technology; (ii)providing for the establishment of regional and local health information networks to facilitate the development of interoperability across healthcare settings; (iii)the development of solutions to barriers to the exchange of electronic health information; or (iv)other activities identified by the States or health care stakeholders as a focus for developing and sharing best practices. (B)

Purposes

The purpose of the Center is to— (i)provide a forum for the exchange of knowledge and experience; (ii)accelerate the transfer of lessons learned from existing public and private sector initiatives, including those currently receiving Federal financial support; (iii)assemble, analyze, and widely disseminate evidence and experience related to the adoption, implementation, and effective use of health information technology; (iv)assure the timely provision of technical and expert assistance from the Agency and its contractors; (v)accelerate the pace of health information technology innovation; and (vi)provide technical assistance to entities developing applications for demonstration grants under subsection (b). (C)

Support for activities

To provide support for the activities of the Center, the Director shall— (i)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 Network and facilitate information exchange across the public and private sectors; (ii)expand the Agency’s focus on the adoption, implementation, and effective use of health information technology through the development of practical implementation guidance based upon existing knowledge and support for rapid-cycle implementation research to address questions for which existing knowledge is insufficient; and (iii)develop the capacity to identify and widely share in a timely manner innovative approaches to advancing health information technology and its ultimate goal, the improvement of the quality, safety, and efficiency of health care. (3)

Technical assistance telephone number or website

The Secretary shall establish a toll-free telephone number or Internet website to provide healthcare providers with a single point of contact to— (A)learn about Federal grants and technical assistance services related to health information technology; (B)learn about qualified health information software that has been certified to be in compliance with the standards adopted by the Federal Government under section 2904 and is available for commercial use; (C)receive referrals to regional and local health information networks for assistance with health information technology; (D)provide information regarding— (i)the electronic submission of health data collected by Federal agencies; and (ii)the uniform and consistent implementation of standards; and (E)disseminate additional information determined by the Secretary to be helpful to such providers. (4)

Authorization of appropriations

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. .

4.

Health information network demonstration program

Section 914 of the Public Health Service Act (42 U.S.C. 299b–3), as amended by subsection (b), is further amended by adding at the end the following: (e)

Health information network demonstration program

(1)

In general

The Director may establish a demonstration program under which grants or contracts shall be awarded to support health information network planning, implementation, and evaluation activities. (2)

Eligibility

To be eligible to receive a grant or contract under the demonstration program under paragraph (1), an entity shall— (A)submit to the Director an application at such time, in such manner, and containing such information as the Director may require; (B)submit to the Director a strategic plan for the implementation of data sharing and interoperability measures across the various health care settings within the proposed network; (C)be a public or nonprofit private entity that is or represents a network or potential network that includes healthcare providers and group health plans in a defined area of geographic proximity or organizational affinity, and that may include for profit entities so long as such an entity is not the grantee; (D)demonstrate, where appropriate, the involvement and commitment of the appropriate State or States; (E)specify a defined area of geographic proximity or organizational affinity that the health information network will encompass; (F)demonstrate active participation in the best practice network described in subsection (d); (G)demonstrate compliance with the data standards and technical policies adopted by the Federal Government under section 2904(e); (H)submit to the Secretary a report on the degree to which such entity has achieved the measures under section 2909; (I)demonstrate financial need; and (J)agree to provide matching funds in accordance with paragraph (4). (3)

Use of funds

(A)

In general

Amounts received under a grant under this subsection shall be used to establish and implement a regional or local health information network. (B)

Limitation

Amounts received under a grant under this subsection may not be used to purchase a health information technology system that is not a qualified health information technology system. (4)

Matching requirement

To be eligible to receive a grant or contract under this subsection an entity shall contribute non-Federal funds to the costs of carrying out the activities for which the grant or contract is awarded in an amount equal to $1 for each of $2 of Federal funds, provided under the grant. (5)

Authorization of appropriations

There are authorized to be appropriated to carry out this subsection, $50,000,000 for fiscal year 2006, $70,000,000 for fiscal year 2007, and such sums as may be necessary for each of fiscal years 2008 through 2010. .

5.

Exception to Federal anti-kickback and stark laws for the provision of permitted support

(a)

Anti-Kickback

Section 1128B(b) of the Social Security Act (42 U.S.C. 1320a–7b(b)(3)) is amended— (1)in paragraph (3)— (A)in subparagraph (G), by striking and at the end; (B)in subparagraph (H), as added by section 237(d) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2213)— (i)by moving such subparagraph 2 ems to the left; and (ii)by striking the period at the end and inserting a semicolon; (C)by redesignating subparagraph (H), as added by section 431(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2287), as subparagraph (I); (D)in subparagraph (I), as so redesignated— (i)by moving such subparagraph 2 ems to the left; and (ii)by striking the period at the end and inserting ; and; and (E)by adding at the end the following new: (J)during the 5-year period beginning on the date the Secretary issues the interim final rule under section 5(c)(1) of the Better Healthcare Through Information Technology Act, the provision, with or without charge, of any permitted support (as defined in paragraph (4)). ; and (2)by adding at the end the following new paragraph: (4)

Permitted support

(A)

Definition of permitted support

Subject to subparagraph (B), in this section, the term permitted support means the provision of any equipment, item, information, right, license, intellectual property, software, training, or service used for developing, implementing, operating, or facilitating the use of systems designed to improve the quality of health care and to promote the electronic exchange of health information. (B)

Exception

The term permitted support shall not include the provision of— (i)any support that is determined in a manner that is related to the volume or value of any referrals or other business generated between the parties for which payment may be made in whole or in part under a Federal health care program; (ii)any support that has more than incidental utility or value to the recipient beyond the exchange of health care information; or (iii)any health information technology system, product, or service that is not in compliance with data standards adopted by the Federal Government under section 2904 of the Public Health Service Act. . (b)

Stark

Section 1877(e) of the Social Security Act (42 U.S.C. 1395nn(e)) is amended by adding at the end the following new paragraph: (9)

Permitted support

During the 5-year period beginning on the date the Secretary issues the interim final rule under section 5(c)(1) of the Better Healthcare Through Information Technology Act, the provision, with or without charge, of any permitted support (as defined in section 1128B(b)(4)). . (c)

Regulations

In order to carry out the amendments made by this section— (1)the Secretary of Health and Human Services shall issue an interim final rule with comment period by not later than the date that is 180 days after the date of enactment of this Act; and (2)the Secretary shall issue a final rule by not later than the date that is 180 days after the date that the interim final rule under paragraph (1) is issued.