[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1174 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 1174

   To amend title XVIII of the Social Security Act to require public 
 reporting of health care-associated infections data by hospitals and 
 ambulatory surgical centers and to permit the Secretary of Health and 
 Human Services to establish a pilot program to provide incentives to 
  hospitals and ambulatory surgical centers to eliminate the rate of 
                     occurrence of such infections.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 16, 2007

Mr. Tim Murphy of Pennsylvania (for himself, Mrs. Myrick, Mr. Boswell, 
and Ms. Corrine Brown of Florida) introduced the following bill; which 
was referred to the Committee on Ways and Means, and in addition to the 
   Committee on Energy and Commerce, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
   To amend title XVIII of the Social Security Act to require public 
 reporting of health care-associated infections data by hospitals and 
 ambulatory surgical centers and to permit the Secretary of Health and 
 Human Services to establish a pilot program to provide incentives to 
  hospitals and ambulatory surgical centers to eliminate the rate of 
                     occurrence of such infections.

    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 ``Healthy Hospitals Act of 2007''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Health care costs in the United States are rising. From 
        2004 through 2005, the medical costs for a four-person 
        household increased by 9.1 percent to $12,214. A significant 
        portion of these increased costs are attributable to health 
        care-associated infections. When a patient contracts such an 
        infection, that cost is passed on to the insurance companies, 
        State and Federal governments, or individuals.
            (2) Health care-associated infections contribute to over 
        $50,000,000,000 in annual medical costs. An acquired infection 
        adds $150,000 to a medical bill per patient.
            (3) The Centers for Disease Control and Prevention reports 
        that there are an estimated 2,000,000 cases of health care-
        associated infections and an estimated 90,000 deaths related to 
        such infections annually.
            (4) Only six States require hospitals to report their 
        health care-associated infection rates. Only one State makes 
        that information available to the public for each hospital.
            (5) Health care-associated infections include surgical site 
        infections, ventilator associated pneumonia, central line 
        related (IV) blood infections, urinary tract infections, 
        methicillin-resistant Staphylococcus aureus (MRSA) infections, 
        and other types of infections. These infections are transmitted 
        to patients when there is inadequate adherence to clean 
        sanitation and patient safety procedures that would otherwise 
        prevent infectious disease. A study in the American Journal of 
        Medical Quality of almost 12,000 hospitalizations reports that 
        hospital procedures, not the sickness of the patient at the 
        time of admission, tended to be the primary cause of these 
        infections.
            (6) Hospitals and other health care providers have been 
        able to drastically reduce infection rates by strict adherence 
        to clean sanitation techniques, including:
                    (A) Handwashing before and after contact with any 
                patient.
                    (B) Sterilizing all equipment used with patients.
                    (C) Clean up before and after patient procedures.
                    (D) Proper use of antibiotics before and after 
                surgery.
                    (E) Pre-testing patients on admission to evaluate 
                the presence of an infection (such as MRSA).
                    (F) Use of infection control boards at hospitals to 
                monitor and manage procedures.
            (7) The National Surgical Infection Prevention Project 
        found in a study of over 34,000 patients treated nationwide 
        that more than 44 percent of patients did not receive 
        antibiotic doses within the recommended time frame. In 
        addition, the American Journal of Infection Control reports 
        that 70 percent of health care workers do not adhere to 
        handwashing and sterilization procedures.
            (8) Hospitals have successfully reduced infections by 
        improving patient safety. For example, Allegheny General 
        Hospital in Pennsylvania reduced the rate of central line-
        acquired infections to almost zero within 90 days by educating 
        and training health care staff on infection control resulting 
        in savings in three years of over $2,000,000. A major teaching 
        hospital in St. Louis reported a reduction in central line 
        acquired infection rates through introduction of an educational 
        program for all staff resulting in cost savings of over 
        $1,500,000. Mercy Health Center in Oklahoma has performed 400 
        surgeries without any infections by utilizing antibiotics and 
        clean procedures.
            (9) Uniform and accurate public reporting of health care-
        associated infections by hospitals and ambulatory surgical 
        centers will allow health care providers to target their 
        efforts to reduce the occurrence of health care-associated 
        infections, enhance consumer choice of health care providers, 
        reduce health care costs, and save lives.

SEC. 3. REQUIREMENT FOR PUBLIC REPORTING OF HEALTH CARE-ASSOCIATED 
              INFECTIONS DATA BY HOSPITALS AND AMBULATORY SURGICAL 
              CENTERS.

    (a) Required Reporting.--
            (1) Hospitals.--Subsection (a)(1) of section 1866 of the 
        Social Security Act (42 U.S.C. 1395cc) is amended--
                    (A) in subparagraph (U), by striking ``and'' at the 
                end;
                    (B) in subparagraph (V), by striking the period at 
                the end and inserting ``, and''; and
                    (C) by inserting after subparagraph (V) the 
                following new subparagraph:
                    ``(W) in the case of a hospital or critical access 
                hospital, to report to the Secretary data in accordance 
                with subsection (k)(1).''.
            (2) Ambulatory surgical centers.--Section 1832(a)(2)(F)(i) 
        of such Act (42 U.S.C. 1395k(a)(2)(F)(i)) is amended by 
        inserting after ``other standards'' the following: ``, 
        including the reporting to the Secretary of data in accordance 
        with section 1866(k)(1),''.
    (b) Data Reporting and Public Posting of Health Care-Associated 
Infections by Hospitals and Ambulatory Surgical Centers.--Section 1866 
of such Act (42 U.S.C. 1395cc) is further amended by adding at the end 
the following new subsection:
    ``(k) Data Reporting and Public Availability of Health Care-
Associated Infections by Hospitals and Ambulatory Surgical Centers.--
            ``(1) Quarterly reporting requirement.--Not later than 45 
        days after the end of a calendar quarter (beginning more than 
        one year after the date of the enactment of this subsection), a 
        hospital or ambulatory surgical center shall report to the 
        Secretary the rate of each health care-associated infection 
        selected under paragraph (2) occurring in the hospital or 
        center, respectively, during the calendar quarter and 
        information on relevant risk factors (relating to 
        susceptibility of patients to each such infection) that may 
        affect such rate.
            ``(2) Selection of health care-associated infections.--For 
        purposes of this subsection, the Secretary shall select one or 
        more health care-associated infections.
            ``(3) Public posting of data.--The Secretary shall promptly 
        post, on the official public Internet site of the Department of 
        Health and Human Services, the data reported under paragraph 
        (1). Such data shall be set forth in a manner that promotes the 
        comparison of the relative rate of occurrence of each health 
        care-associated infection selected under paragraph (2), taking 
        into account the relevant risk factors reported under such 
        paragraph, among hospitals and ambulatory surgical centers.
            ``(4) Annual report to congress.--For each year for which 
        data is reported under paragraph (1) for any calendar quarter 
        in the year, the Secretary shall submit to Congress a report 
        that summarizes each of the following:
                    ``(A) The rates of occurrence of each health care-
                associated infection selected under paragraph (2) in 
                hospitals and ambulatory surgical centers during such 
                year.
                    ``(B) Factors that contribute to the occurrence of 
                each such infection.
                    ``(C) The measures applied by hospitals and 
                ambulatory surgical centers to reduce each such 
                infection and the effect of such measures during such 
                year.
                    ``(D) The total increases or decreases in health 
                care costs that resulted from increases or decreases in 
                the rates of occurrence of each such infection during 
                such year.
                    ``(E) Recommendations for best practices to 
                eliminate the rates of occurrence of each such 
                infection in hospitals and ambulatory surgical centers.
            ``(5) Civil money penalty.--The Secretary may impose a 
        civil money penalty of not more than $10,000 for each knowing 
        violation of paragraph (1) by a hospital or ambulatory surgical 
        center. A civil money penalty under this paragraph shall be 
        imposed and collected in the same manner as a civil money 
        penalty under subsection (a) of section 1128A is imposed and 
        collected under that section, except that, notwithstanding 
        subsection (f) of such section, if the Secretary designs and 
        implements a pilot program under section 4(a) of the Healthy 
        Hospitals Act of 2007 (relating to the health care-associated 
        infections pilot program), amounts recovered under this 
        paragraph shall be paid to the Secretary and shall be available 
        to carry out such pilot program.
            ``(6) Non-preemption of state laws.--Nothing in this 
        subsection shall be construed as preempting or otherwise 
        affecting any provision of State law relating to the disclosure 
        of additional information on health care-associated infections 
        or patient safety procedures for a hospital or ambulatory 
        surgical center.
            ``(7) Health care-associated infection defined.--For 
        purposes of this subsection, the term `health care-associated 
        infection'--
                    ``(A) means, as defined by the Centers for Disease 
                Control and Prevention, an infection caused from 
                bacteria or a virus that--
                            ``(i) is a localized or systemic condition 
                        that results from an adverse reaction to the 
                        presence of an infectious agent or its toxin 
                        and that was not present or incubating at the 
                        time of admission of a patient to the hospital 
                        involved;
                            ``(ii) is present at any time after 
                        admission and before discharge of such patient; 
                        and
                            ``(iii) could reasonably have been 
                        prevented had patient safety measures, plans, 
                        and guidelines been adopted and followed; and
                    ``(B) includes surgical site infections, ventilator 
                associated pneumonia, central line related (IV) blood 
                infections, urinary tract infections, methicillin-
                resistant Staphylococcus aureus (MRSA) infections, 
                clostridium difficile infections, and any additional 
                infections specified by the Secretary.
            ``(8) Application to critical access hospitals.--For 
        purposes of this subsection, the term `hospital' shall include 
        a critical access hospital.''.
    (c) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2008 through 2010.

SEC. 4. MEDICARE PILOT PROGRAM TO REDUCE HEALTH CARE-ASSOCIATED 
              INFECTION RATES.

    (a) In General.--The Secretary of Health and Human Services is 
authorized to design and implement a pilot program under title XVIII of 
the Social Security Act to provide financial incentives or grants to 
hospitals and ambulatory surgical centers, as selected by the Secretary 
in accordance with subsection (b), that demonstrate to the satisfaction 
of the Secretary a reduction in the rate of occurrence (or elimination) 
of health care-associated infections in the applicable hospital or 
ambulatory surgical center.
    (b) Selection of Hospitals and Ambulatory Surgical Centers.--In 
carrying out subsection (a), the Secretary of Health and Human Services 
shall select hospitals and ambulatory surgical centers--
            (1) that are capable of accurately monitoring and reporting 
        the rate of occurrence of health care-associated infections; 
        and
            (2) the participation of which in such program will likely 
        result in the greatest scientific and health benefit for 
        purposes of reducing the rate of occurrence of such infections.
    (c) Limitation.--Under the pilot program under this section the 
aggregate financial incentives provided under the program for reduction 
in infections in a period shall not exceed 10 percent of the amount 
(estimated by the Secretary) by which Federal expenditures under title 
XVIII of the Social Security Act are reduced in such period as a result 
of such reduction in infections.
    (d) Health Care-Associated Infection Defined.--For purposes of this 
section, the term ``health care-associated infection'' has the meaning 
given such term under section 1866(k)(6) of the Social Security Act, as 
added by section 3(b).
    (e) Application to Critical Access Hospitals.--For purposes of this 
section, the term ``hospital'' shall include a critical access 
hospital.
    (f) Authorization of Appropriations.--To carry out this section 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2008 through 2010.

SEC. 5. SENSE OF CONGRESS.

    It is the sense of Congress that health care providers and 
facilities should take measures to reduce the rate of occurrence of 
health care-associated infections to zero, with respect to patients to 
whom such providers and facilities furnish services.
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