110 HR 5885 IH: Health
U.S. House of Representatives
2008-04-24
text/xml
EN
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.
1.Short title and table of
contents
(a)This Act may be cited as the Health
Information Technology Promotion Act of 2008
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title and table of contents.
Sec. 2. Preserving privacy and security laws.
Title I—PROMOTING THE USE OF HEALTH INFORMATION TECHNOLOGY TO
BETTER COORDINATE HEALTH CARE
Sec. 101. Safe harbors to antikickback civil penalties and
criminal penalties for provision of Health Information Technology and training
services.
Sec. 102. Exception to limitation on certain physician
referrals (under Stark) for provision of Health Information Technology and
training services to health care professionals.
Sec. 103. Rules of construction regarding use of
consortia.
Title II—ADDITIONAL PROVISIONS
Sec. 201. Promotion of telehealth services.
Sec. 202. Study and report on expansion of home health-related
telehealth services.
Sec. 203. Study and report on store and forward technology for
telehealth.
Sec. 204. Ensuring health care providers participating in PHSA
programs, Medicaid, SCHIP, or the MCH program may maintain health information
in electronic form.
Sec. 205. Ensuring health care providers participating in the
Medicare program may maintain health information in electronic
form.
Sec. 206. Study and report on State, regional, and community
health information exchanges.
Sec. 207. Promoting Health Information Technology as a tool for
chronic disease management.
2.Preserving
privacy and security lawsNothing in this Act (or the amendments made
by this Act) shall be construed to affect the scope, substance, or
applicability of section 264(c) of the Health
Insurance Portability and Accountability Act of 1996 and any
regulation issued pursuant to such section.
<enum>I</enum><header>PROMOTING THE USE
OF HEALTH INFORMATION TECHNOLOGY TO BETTER COORDINATE HEALTH CARE</header>
<section id="HD77AD73110BC4DE5BC76EE91BC7888AA"><enum>101.</enum><header>Safe harbors to
antikickback civil penalties and criminal penalties for provision of Health
Information Technology and training services</header>
<subsection id="H8EC5C9FBFE854E35A97BBBC4C6A0078"><enum>(a)</enum><header>For Civil
Penalties</header><text>Section 1128A of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1320a-7a">42 U.S.C. 1320a–7a</external-xref>) is
amended—</text>
<paragraph id="HBA13FBC6F37B4F2FB52D289C6880F3B6"><enum>(1)</enum><text>in subsection (b),
by adding at the end the following new paragraph:</text>
<quoted-block id="HDB2F714239D740E88687DC39CDEC5F8" style="OLC">
<paragraph id="H8500A7F6094E4630AAA4A4F2444030D8" indent="up1"><enum>(4)</enum><text>For purposes of this subsection,
inducements to reduce or limit services described in paragraph (1) shall not
include the practical or other advantages resulting from health information
technology or related installation, maintenance, support, or training
services.</text>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="HB9143DB3ABF4449F836384A800E229EC"><enum>(2)</enum><text>in subsection (i),
by adding at the end the following new paragraph:</text>
<quoted-block id="H6716FBD237324756841F1956BD34DED5" style="OLC">
<paragraph id="HF03DA167FE4643DCB72845526CCBDBA3"><enum>(8)</enum><text>The term
<term>health information technology</term> means hardware, software, license,
right, intellectual property, equipment, or other information technology
(including new versions, upgrades, and connectivity) designed or provided
primarily for the electronic creation, maintenance, or exchange of health
information to better coordinate care or improve health care quality,
efficiency, or
research.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H91028C3988304073ADDF17A89273D111"><enum>(b)</enum><header>For Criminal
Penalties</header><text>Section 1128B of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320a-7b">42 U.S.C. 1320a–7b</external-xref>) is
amended—</text>
<paragraph id="H0BFF5034D68342C880081B0062B5ECEC"><enum>(1)</enum><text>in subsection
(b)(3)—</text>
<subparagraph id="HC0F3AE5793AD44A4866FDED7ABE3764E"><enum>(A)</enum><text>in subparagraph
(G), by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="H1D1A4181994C4499803871FF34DE16BB"><enum>(B)</enum><text>in the
subparagraph (H) added by section 237(d) of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat.
2213)—</text>
<clause id="H004CAA46E7914A4ABAC9608C5300A726"><enum>(i)</enum><text>by
moving such subparagraph 2 ems to the left; and</text>
</clause><clause id="H13DDFDEB91F740218B48E60010838402"><enum>(ii)</enum><text>by
striking the period at the end and inserting a semicolon;</text>
</clause></subparagraph><subparagraph id="HEAB7FD98C97D4304BC662B18F2FAE6BE"><enum>(C)</enum><text>in the
subparagraph (H) added by section 431(a) of such Act (117 Stat. 2287)—</text>
<clause id="HD611A2C9823744928026477861BE4A0"><enum>(i)</enum><text>by
redesignating such subparagraph as subparagraph (I);</text>
</clause><clause id="HC04F21738C1443C28064C2061DA272E6"><enum>(ii)</enum><text>by
moving such subparagraph 2 ems to the left; and</text>
</clause><clause id="HC421748CE1954CA59B1CD16FEDAB4ED"><enum>(iii)</enum><text>by
striking the period at the end and inserting <quote>; and</quote>; and</text>
</clause></subparagraph><subparagraph id="H0A47A56219CB4FA08DFD9B809DC74E21"><enum>(D)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block id="HA7E7944BDDDE4072BC90CC3180343615" style="OLC">
<subparagraph id="HCE52C36E0359470F89B892D5585087D1" indent="up1"><enum>(J)</enum><text>any nonmonetary remuneration (in the
form of health information technology, as defined in section 1128A(i)(8), or
related installation, maintenance, support, or training services) made to a
person by a specified entity (as defined in subsection (g)) if—</text>
<clause id="HD3F342B470D1416CBF581555134E1229"><enum>(i)</enum><text>the provision of such remuneration
is without an agreement between the parties or legal condition that—</text>
<subclause id="HF419CF33836541AC885BBBE49D95DFA"><enum>(I)</enum><text>limits or restricts the use of the health
information technology to services provided by the physician to individuals
receiving services at the specified entity;</text>
</subclause><subclause id="H353B7879072540D894194EEEA8BB03B3"><enum>(II)</enum><text>limits or restricts the use of the
health information technology in conjunction with other health information
technology; or</text>
</subclause><subclause id="H25D7B753EEDF4560A828CD6662D37C96"><enum>(III)</enum><text>conditions the provision of such
remuneration on the referral of patients or business to the specified
entity;</text>
</subclause></clause><clause id="HF4A6612A46BD4143A3A2841BA166B63E"><enum>(ii)</enum><text>such remuneration is arranged for
in a written agreement that is signed by the parties involved (or their
representatives) and that specifies the remuneration solicited or received (or
offered or paid) and states that the provision of such remuneration is made for
the primary purpose of better coordination of care or improvement of health
quality, efficiency, or research; and</text>
</clause><clause id="H58DDEBB546BA4A29A9F196CED3561081"><enum>(iii)</enum><text>the specified entity providing
the remuneration (or a representative of such entity) has not taken any action
to disable any basic feature of any hardware or software component of such
remuneration that would permit
interoperability.</text>
</clause></subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H33B454DD19B24BBE95C0F8E387E9F18C"><enum>(2)</enum><text>by adding at the
end the following new subsection:</text>
<quoted-block id="H55994982126144858B157400E875DF8C" style="OLC">
<subsection id="H32778203E70D4F22B4EDAC84E17723B8"><enum>(g)</enum><header>Specified Entity
Defined</header><text>For purposes of subsection (b)(3)(J), the term
<term>specified entity</term> means an entity that is a hospital, group
practice, prescription drug plan sponsor, a Medicare Advantage organization, or
any other such entity specified by the Secretary, considering the goals and
objectives of this section, as well as the goals to better coordinate the
delivery of health care and to promote the adoption and use of health
information
technology.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HFBEBB2AFF70F424498AD899EB0EA5ECC"><enum>(c)</enum><header>Effective Date
and Effect on State Laws</header>
<paragraph id="HEB4BA99D998D4583B6053B5C6ED30020"><enum>(1)</enum><header>Effective
date</header><text>The amendments made by subsections (a) and (b) shall take
effect on the date that is 120 days after the date of the enactment of this
Act.</text>
</paragraph><paragraph id="H7DD4AC7387CD42228B49CAF66F3E160"><enum>(2)</enum><header>Preemption of
State laws</header><text>No State (as defined in section 1101(a) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1301(a)) for purposes of title XI of such Act) shall have in effect a State law
that imposes a criminal or civil penalty for a transaction described in section
1128A(b)(4) or section 1128B(b)(3)(J) of such Act, as added by subsections
(a)(1) and (b), respectively, if the conditions described in the respective
provision, with respect to such transaction, are met.</text>
</paragraph></subsection><subsection id="H53A8E91A375E4F749867343882C7EE6C"><enum>(d)</enum><header>Study and report
To assess effect of safe harbors on health system</header>
<paragraph id="H2ACDCF34A5214820B74D467EC85E7B87"><enum>(1)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall conduct
a study to determine the impact of each of the safe harbors described in
paragraph (3). In particular, the study shall examine the following:</text>
<subparagraph id="H5E33DDB767534326BA16914F05DFB0AD"><enum>(A)</enum><text>The effectiveness
of each safe harbor in increasing the adoption of health information
technology.</text>
</subparagraph><subparagraph id="H0988E93E442D4B30B595DFDCFC1D6707"><enum>(B)</enum><text>The types of
health information technology provided under each safe harbor.</text>
</subparagraph><subparagraph id="H1FCC2EC8FA8A476296DA14A21FDA6A0"><enum>(C)</enum><text>The extent to which
the financial or other business relationships between providers under each safe
harbor have changed as a result of the safe harbor in a way that adversely
affects or benefits the health care system or choices available to
consumers.</text>
</subparagraph><subparagraph id="HDEA28422771B4A9694A315A9ECC9F175"><enum>(D)</enum><text>The impact of the
adoption of health information technology on health care quality, cost, and
access under each safe harbor.</text>
</subparagraph></paragraph><paragraph id="H9205F6EE80594FEC92D189C6E41C41C"><enum>(2)</enum><header>Report</header><text>Not
later than three years after the effective date described in subsection (c)(1),
the Secretary of Health and Human Services shall submit to Congress a report on
the study under paragraph (1).</text>
</paragraph><paragraph id="H36655C3374D84C53AF878F33C2EB9784"><enum>(3)</enum><header>Safe harbors
described</header><text>For purposes of paragraphs (1) and (2), the safe
harbors described in this paragraph are—</text>
<subparagraph id="H326FF964184249E8A68B2FCDA8265710"><enum>(A)</enum><text>the safe harbor
under section 1128A(b)(4) of such Act (42 U.S.C. 1320a–7a(b)(4)), as added by
subsection (a)(1); and</text>
</subparagraph><subparagraph id="H8955663350B1469E900015C6949632FF"><enum>(B)</enum><text>the safe harbor
under section 1128B(b)(3)(J) of such Act (42 U.S.C. 1320a–7b(b)(3)(J)), as
added by subsection (b).</text>
</subparagraph></paragraph></subsection></section><section id="HB923E9D004C4487A86926B322D250067"><enum>102.</enum><header>Exception to
limitation on certain physician referrals (under Stark) for provision of Health
Information Technology and training services to health care
professionals</header>
<subsection id="H30BF2F6928934D61A7C9BFE2E3E7C407"><enum>(a)</enum><header>In
General</header><text>Section 1877(b) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395nn">42 U.S.C. 1395nn(b)</external-xref>) is
amended by adding at the end the following new paragraph:</text>
<quoted-block act-name="Social Security Act" id="HDCD1FFA3F1074D6BAE10A40000B3D063" style="OLC">
<paragraph id="H66BD0112C5A843918B4000441975B808"><enum>(6)</enum><header>Information
technology and training services</header>
<subparagraph id="HAD7E6084DD9F4D9A8D1651C82E91E707"><enum>(A)</enum><header>In
general</header><text>Any nonmonetary remuneration (in the form of health
information technology or related installation, maintenance, support or
training services) made by a specified entity to a physician if—</text>
<clause id="H9C4EC0694B8F457EABE380EBFCA935A5"><enum>(i)</enum><text>the provision of
such remuneration is without an agreement between the parties or legal
condition that—</text>
<subclause id="HB6D5FD33C1AD408F96A47DE7BFD3C4B"><enum>(I)</enum><text>limits or restricts
the use of the health information technology to services provided by the
physician to individuals receiving services at the specified entity;</text>
</subclause><subclause id="H6B4774DC5EAC43C9A32CC52FE795A512"><enum>(II)</enum><text>limits or
restricts the use of the health information technology in conjunction with
other health information technology; or</text>
</subclause><subclause id="HF31E62677D3443A6BF335F852E3D5D9E"><enum>(III)</enum><text>conditions the
provision of such remuneration on the referral of patients or business to the
specified entity;</text>
</subclause></clause><clause id="HF14859FE304B4822A73FC100436179F5"><enum>(ii)</enum><text>such remuneration
is arranged for in a written agreement that is signed by the parties involved
(or their representatives) and that specifies the remuneration made and states
that the provision of such remuneration is made for the primary purpose of
better coordination of care or improvement of health quality, efficiency, or
research; and</text>
</clause><clause id="H634EF76EAF1C4A1AAAEBC48F7100E92E"><enum>(iii)</enum><text>the specified
entity (or a representative of such entity) has not taken any action to disable
any basic feature of any hardware or software component of such remuneration
that would permit interoperability.</text>
</clause></subparagraph><subparagraph id="H7423B5EA8AA244798347D3309BB97C3D"><enum>(B)</enum><header>Health
information technology defined</header><text>For purposes of this paragraph,
the term <term>health information technology</term> means hardware, software,
license, right, intellectual property, equipment, or other information
technology (including new versions, upgrades, and connectivity) designed or
provided primarily for the electronic creation, maintenance, or exchange of
health information to better coordinate care or improve health care quality,
efficiency, or research.</text>
</subparagraph><subparagraph id="H2485FDE85E994A04A9D9F21001E9900"><enum>(C)</enum><header>Specified entity
defined</header><text>For purposes of this paragraph, the term <term>specified
entity</term> means an entity that is a hospital, group practice, prescription
drug plan sponsor, a Medicare Advantage organization, or any other such entity
specified by the Secretary, considering the goals and objectives of this
section, as well as the goals to better coordinate the delivery of health care
and to promote the adoption and use of health information
technology.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HFEED147B14A94F1EA656689690DBF98B"><enum>(b)</enum><header>Effective Date;
Effect on State Laws</header>
<paragraph id="H9973B77BDCB54D7FB87700E96674B201"><enum>(1)</enum><header>Effective
date</header><text>The amendment made by subsection (a) shall take effect on
the date that is 120 days after the date of the enactment of this Act.</text>
</paragraph><paragraph id="H2283BED6EB4C456092988487463E0021"><enum>(2)</enum><header>Preemption of
state laws</header><text>No State (as defined in section 1101(a) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1301(a)) for purposes of title XI of such Act) shall have in effect a State law
that imposes a criminal or civil penalty for a transaction described in section
1877(b)(6) of such Act, as added by subsection (a), if the conditions described
in such section, with respect to such transaction, are met.</text>
</paragraph></subsection><subsection id="HB1E520E68F4D45D3A25C10E6D6A0CA98"><enum>(c)</enum><header>Study and Report
To Assess Effect of Exception on Health System</header>
<paragraph id="H52CBB29D5074473A8993C362EFDBD844"><enum>(1)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall conduct
a study to determine the impact of the exception under section 1877(b)(6) of
such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395nn">42 U.S.C. 1395nn(b)(6)</external-xref>), as added by subsection (a). In particular,
the study shall examine the following:</text>
<subparagraph id="HD29D60FDB9E749438CC3361F08EFDEA2"><enum>(A)</enum><text>The effectiveness
of the exception in increasing the adoption of health information
technology.</text>
</subparagraph><subparagraph id="H3CA5B5FDC9D34ABB8C9F007B2DCE05AE"><enum>(B)</enum><text>The types of
health information technology provided under the exception.</text>
</subparagraph><subparagraph id="H88B5AB5E25AF46A9BFED635F656B9106"><enum>(C)</enum><text>The extent to
which the financial or other business relationships between providers under the
exception have changed as a result of the exception in a way that adversely
affects or benefits the health care system or choices available to
consumers.</text>
</subparagraph><subparagraph id="H19874FA8F1A44DDABD5B8B893E7D0036"><enum>(D)</enum><text>The impact of the
adoption of health information technology on health care quality, cost, and
access under the exception.</text>
</subparagraph></paragraph><paragraph id="H217D73E62A5D4F4A81F88931BEDC7C72"><enum>(2)</enum><header>Report</header><text>Not
later than three years after the effective date described in subsection (b)(1),
the Secretary of Health and Human Services shall submit to Congress a report on
the study under paragraph (1).</text>
</paragraph></subsection></section><section id="HF6F74C8F294240DD8921562B7C1B47A8"><enum>103.</enum><header>Rules of
construction regarding use of consortia</header>
<subsection id="HA1ACA7298CA5482F924B2C89F46F6C56"><enum>(a)</enum><header>Application to
Safe Harbor From Criminal Penalties</header><text>Section 1128B(b)(3) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1320a–7b(b)(3)) is amended by adding after and below subparagraph (J), as added
by section 101(b)(1), the following: <quote>For purposes of subparagraph (J),
nothing in such subparagraph shall be construed as preventing a specified
entity, consistent with the specific requirements of such subparagraph, from
forming a consortium composed of health care providers, payers, employers, and
other interested entities to collectively purchase and donate health
information technology, or from offering health care providers a choice of
health information technology products in order to take into account the
varying needs of such providers receiving such products.</quote>.</text>
</subsection><subsection id="H7F1D3D7BA98A41B388EF29ED3CE21D"><enum>(b)</enum><header>Application to
Stark Exception</header><text>Paragraph (6) of section 1877(b) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1395nn(b)), as added by section 102(a), is amended by adding at the end the
following new subparagraph:</text>
<quoted-block act-name="Social Security Act" id="H2C19F41CA08A4997BD9FC5569963D0B2" style="OLC">
<subparagraph id="H49D4601BDDB14792AFABBDB65F12E64"><enum>(D)</enum><header>Rule of
construction</header><text>For purposes of subparagraph (A), nothing in such
subparagraph shall be construed as preventing a specified entity, consistent
with the specific requirements of such subparagraph, from—</text>
<clause id="H6D59152F3702406A816732BB009E04FC"><enum>(i)</enum><text>forming a
consortium composed of health care providers, payers, employers, and other
interested entities to collectively purchase and donate health information
technology; or</text>
</clause><clause id="HF49EBE35F29E45A4B1E61169F9D78B95"><enum>(ii)</enum><text>offering health
care providers a choice of health information technology products in order to
take into account the varying needs of such providers receiving such
products.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><enum>II</enum><header>ADDITIONAL
PROVISIONS</header>
<section id="HB4C249DBC852407086A24EACB23EAE9"><enum>201.</enum><header>Promotion of
telehealth services</header>
<subsection id="H29567C4F92BC436AA91425005FDE88DE"><enum>(a)</enum><header>Facilitating the
Provision of Telehealth Services Across State Lines</header><text>The Secretary
of Health and Human Services shall, in coordination with physicians, health
care practitioners, patient advocates, and representatives of States, encourage
and facilitate the adoption of State reciprocity agreements for practitioner
licensure in order to expedite the provision across State lines of telehealth
services.</text>
</subsection><subsection id="H9C8D451BF20447DAA974D14FBCE0D5A2"><enum>(b)</enum><header>Report</header><text>Not
later than 18 months after the date of the enactment of this Act, the Secretary
of Health and Human Services shall submit to Congress a report on the actions
taken to carry out subsection (a).</text>
</subsection><subsection id="H7A9AF7E8C5E2482CAB68826F93C6D3C"><enum>(c)</enum><header>State
Defined</header><text>For purposes of this subsection, the term
<term>State</term> has the meaning given that term for purposes of title XVIII
of the <act-name parsable-cite="SSA">Social Security Act</act-name>.</text>
</subsection></section><section id="HAD14234AADA64932BD704DB77F737D25"><enum>202.</enum><header>Study and
report on expansion of home health-related telehealth services</header>
<subsection id="H5E56EEC61AAF42CB966CB9362FF2CDA8"><enum>(a)</enum><header>Study</header><text>The
Secretary of Health and Human Services shall conduct a study to determine the
feasibility, advisability, and the costs of—</text>
<paragraph id="H636E31889CFF47A69EF257B52EDA9BC"><enum>(1)</enum><text>including coverage
and payment for home health-related telehealth services as part of home health
services under title XVIII of the <act-name parsable-cite="SSA">Social Security
Act</act-name>; and</text>
</paragraph><paragraph id="HBDD73B5968B04B0BB4D27091F7C9346D"><enum>(2)</enum><text>expanding the list
of sites described in paragraph (4)(C)(ii) of section 1834(m) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1395m(m)) to include county mental health clinics or other publicly funded
mental health facilities for the purpose of payment under such section for the
provision of telehealth services at such clinics or facilities.</text>
</paragraph></subsection><subsection id="H947D9957CAA44678AF3F85444913FE03"><enum>(b)</enum><header>Specifics of
Study</header><text>Such study shall demonstrate whether the changes described
in paragraphs (1) and (2) of subsection (a) will result in the
following:</text>
<paragraph id="H23D27C70A66D44E59D81EBF500B31CAD"><enum>(1)</enum><text>Enhanced health
outcomes for individuals with one or more chronic conditions.</text>
</paragraph><paragraph id="H916994C371774A12928700BF69ECE5C7"><enum>(2)</enum><text>Health outcomes
for individuals furnished telehealth services or home health-related telehealth
services that are at least comparable to the health outcomes for individuals
furnished similar items and services by a health care provider at the same
location of the individual or at the home of the individual,
respectively.</text>
</paragraph><paragraph id="H7FE66E3601F04EA1B59DE4A4A4D3B7F3"><enum>(3)</enum><text>Facilitation of
communication of more accurate clinical information between health care
providers.</text>
</paragraph><paragraph id="H69BE129F7D3746D0AD5400C0ECC6FE1D"><enum>(4)</enum><text>Closer monitoring
of individuals by health care providers.</text>
</paragraph><paragraph id="H67403AEC0745412794C5300457DD373"><enum>(5)</enum><text>Overall reduction
in expenditures for health care items and services.</text>
</paragraph><paragraph id="H569472AAFB534F36A9B1404F17B48570"><enum>(6)</enum><text>Improved access to
health care.</text>
</paragraph></subsection><subsection id="HB0C78781D79C4E46944B5F6571006578"><enum>(c)</enum><header>Home
Health-Related Telehealth Services Defined</header><text>For purposes of this
section, the term <term>home health-related telehealth services</term> means
technology-based professional consultations, patient monitoring, patient
training services, clinical observation, patient assessment, and any other
health services that utilize telecommunications technologies. Such term does
not include a telecommunication that consists solely of a telephone audio
conversation, facsimile, electronic text mail, or consultation between two
health care providers.</text>
</subsection><subsection id="H81A146E6029E4FAA897CFAACEA1E0573"><enum>(d)</enum><header>Report</header><text>Not
later than 18 months after the date of the enactment of this Act, the Secretary
of Health and Human Services shall submit to Congress a report on the study
conducted under subsection (a) and shall include in such report such
recommendations for legislation or administration action as the Secretary
determines appropriate.</text>
</subsection></section><section id="H318BB9C36BE24E12909CD943D003342"><enum>203.</enum><header>Study and report
on store and forward technology for telehealth</header>
<subsection id="HE5F27D5A3C2F4CDFA87BDBA528D3A168"><enum>(a)</enum><header>Study</header><text>The
Secretary of Health and Human Services, acting through the Director of the
Office for the Advancement of Telehealth, shall conduct a study on the use of
store and forward technologies (that provide for the asynchronous transmission
of health care information in single or multimedia formats) in the provision of
telehealth services. Such study shall include an assessment of the feasibility,
advisability, and the costs of expanding the use of such technologies for use
in the diagnosis and treatment of certain conditions.</text>
</subsection><subsection id="HC0AE54ECD29343B0857BD04BD4FD9284"><enum>(b)</enum><header>Report</header><text>Not
later than 18 months after the date of the enactment of this Act, the Secretary
of Health and Human Services shall submit to Congress a report on the study
conducted under subsection (a) and shall include in such report such
recommendations for legislation or administration action as the Secretary
determines appropriate.</text>
</subsection></section><section id="H9A1B1544B67F41AE95D13E13E1A617C"><enum>204.</enum><header>Ensuring health
care providers participating in PHSA programs, Medicaid, SCHIP, or the MCH
program may maintain health information in electronic form</header><text display-inline="no-display-inline">Part B of title II of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> is amended
by adding at the end the following new section:</text>
<quoted-block act-name="Public Health Service Act" id="HEFC5DF83C34A40CA890060B242DD3257" style="OLC">
<section id="H79EFD3822045456998EB89B31915C65F"><enum>249.</enum><header>Ensuring health
care providers may maintain health information in electronic form</header>
<subsection id="H1CEF6A568DEE4B3982AC9BBF21CC0070"><enum>(a)</enum><header>In
General</header><text>Any health care provider that participates in a health
care program that receives Federal funds under this Act, or under title V, XIX,
or XXI of the <act-name parsable-cite="SSA">Social Security Act</act-name>,
shall be deemed as meeting any requirement for the maintenance of data in paper
form under such program (whether or not for purposes of management, billing,
reporting, reimbursement, or otherwise) if the required data is maintained in
an electronic form.</text>
</subsection><subsection id="H1EB05B5AE4734DC6A04F88F0EBCCA1B7"><enum>(b)</enum><header>Relation to
State Laws</header><text>Beginning on the date that is one year after the date
of the enactment of this section, subsection (a) shall supersede any contrary
provision of State law.</text>
</subsection><subsection id="HC0EFF249811B4BC3B28E6934ABDB7F98"><enum>(c)</enum><header>Construction</header><text>Nothing
in this section shall be construed as—</text>
<paragraph id="H5B8F9D34A04B41E0A83BAB1258CE6BAC"><enum>(1)</enum><text>requiring health
care providers to maintain or submit data in electronic form;</text>
</paragraph><paragraph id="H67179E9ACD174700BA56415B7315BC00"><enum>(2)</enum><text>preventing a State
from permitting health care providers to maintain or submit data in paper form;
or</text>
</paragraph><paragraph id="H60A0A47FD7FA4F12AB897251F885B179"><enum>(3)</enum><text>preventing a State
from requiring health care providers to maintain or submit data in electronic
form.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H5EA665D7E94F447C81331EF0EB78E017"><enum>205.</enum><header>Ensuring health
care providers participating in the Medicare program may maintain health
information in electronic form</header><text display-inline="no-display-inline">Section 1871 of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395hh">42 U.S.C. 1395hh</external-xref>)
is amended by adding at the end the following new subsection:</text>
<quoted-block act-name="Social Security Act" id="HF592D15150754B8E8E39F5D510F4F632" style="OLC">
<subsection id="H240101617CB34E5B00ABFEA22B144C8E"><enum>(g)</enum><paragraph commented="no" display-inline="yes-display-inline" id="H793DFFFEA4014501A7576847A19CB019"><enum>(1)</enum><text>Any provider of services
or supplier shall be deemed as meeting any requirement for the maintenance of
data in paper form under this title (whether or not for purposes of management,
billing, reporting, reimbursement, or otherwise) if the required data is
maintained in an electronic form.</text>
</paragraph><paragraph id="H606EAE10957E49C29FB3C1C9ACA32280" indent="up1"><enum>(2)</enum><text>Nothing in this subsection shall be
construed as requiring health care providers to maintain or submit data in
electronic
form.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HE182864756784994910076CB08140100"><enum>206.</enum><header>Study and
report on State, regional, and community health information exchanges</header>
<subsection id="H6D2BA10F56FD49218B6619DE7DEF081"><enum>(a)</enum><header>Study</header><text>The
Secretary of Health and Human Services shall conduct a study on issues related
to the development, operation, and implementation of State, regional, and
community health information exchanges. Such study shall include the following,
with respect to such health information exchanges:</text>
<paragraph id="H9BEA20A3EC7041349C19F772F5001466"><enum>(1)</enum><text>Profiles detailing
the current stages of such health information exchanges with respect to the
progression of the development, operation, implementation, organization, and
governance of such exchanges.</text>
</paragraph><paragraph id="H198D92467B7441CD94FDB2C99D020017"><enum>(2)</enum><text>The impact of such
exchanges on health care quality, safety, and efficiency, including—</text>
<subparagraph id="H1D6E88D6AEBD4A0E92C4A5F4E582968B"><enum>(A)</enum><text>any impact on the
coordination of health information and services across health care providers
and other organizations relevant to health care;</text>
</subparagraph><subparagraph id="HC502752B006143F4B6C7495D9C21B649"><enum>(B)</enum><text>any impact on the
availability of health information at the point-of-care to make timely medical
decisions;</text>
</subparagraph><subparagraph id="H4F6EC7A7836A45DDA0E9966588D193B0"><enum>(C)</enum><text>any benefits with
respect to the promotion of wellness, disease prevention, and chronic disease
management;</text>
</subparagraph><subparagraph id="H7A3FFE78155249499C396D19A2C6C493"><enum>(D)</enum><text>any improvement
with respect to public health preparedness and response;</text>
</subparagraph><subparagraph id="H6FC18844E7444CBAAE335C638C197436"><enum>(E)</enum><text>any impact on the
widespread adoption of interoperable health information technology, including
electronic health records;</text>
</subparagraph><subparagraph id="H65A77C74C82A4939894528D4DF16504C"><enum>(F)</enum><text>any contributions
to achieving an Internet-based national health information network;</text>
</subparagraph><subparagraph id="H0A29CDAC4CE14CD4976FCF8BB43046EE"><enum>(G)</enum><text>any contribution
of health information exchanges to consumer access and to consumers’ use of
their health information; and</text>
</subparagraph><subparagraph id="H52CC152E80C34C74B308B966C6A27175"><enum>(H)</enum><text>any impact on the
operation of—</text>
<clause id="H12E4D92D8C5848FCAD06735C5DA1C56"><enum>(i)</enum><text>the
Medicare and Medicaid programs under title XVIII and XIX, respectively, of the
Social Security Act;</text>
</clause><clause id="H586A9F9F03C044EA9F1F81C2B9A1A51D"><enum>(ii)</enum><text>the
State Children’s Health Insurance Program (SCHIP) under title XXI of such
Act;</text>
</clause><clause id="HC935548562404B3C90A27788C84500CD"><enum>(iii)</enum><text>disproportionate
share hospitals described in section 1923 of such Act;</text>
</clause><clause id="H921CC1AC42144D1A9DE500E1623FE29"><enum>(iv)</enum><text>Federally-qualified
health centers; or</text>
</clause><clause id="H6FF1DFE0A9344468A3D00B0D66CEEA5"><enum>(v)</enum><text display-inline="yes-display-inline">managed care plans, if a significant number
of the plan’s enrollees are beneficiaries in the Medicaid program or State
Children’s Health Insurance Program under title XIX or XXI, respectively, of
such Act.</text>
</clause></subparagraph></paragraph><paragraph id="H3AE58E006E7C4BE1A11047A0365965DB"><enum>(3)</enum><text>Best practice
models for financing, incentivizing, and sustaining such health information
exchanges.</text>
</paragraph><paragraph id="H73C1831302C44689902FECCAF72D506"><enum>(4)</enum><text>Information
identifying the common principles, policies, tools, and standards used (or
proposed) in the public and private sectors to support the development,
operation, and implementation of such health information exchanges.</text>
</paragraph><paragraph id="HF539A12AEC7242D3AF9613899BA47CC3"><enum>(5)</enum><text>A
description of any areas in which Federal Government leadership is needed to
support growth and sustainability of such health information exchanges.</text>
</paragraph></subsection><subsection id="H81EFDB07095946F19C854BD525E17CBB"><enum>(b)</enum><header>Report</header><text>Not
later than one year after the date of enactment of this Act, the Secretary of
Health and Human Services shall submit to Congress a report on the study
described in subsection (a), including such recommendations as the Secretary
determines appropriate to facilitate the development, operation, and
implementation of health information exchanges.</text>
</subsection></section><section id="HD242681848104359A8CA28F7776310DD"><enum>207.</enum><header>Promoting
Health Information Technology as a tool for chronic disease management</header>
<subsection id="H0F21A0AD194B4761BA04D662B574EE00"><enum>(a)</enum><header>In
General</header><text>The Secretary of Health and Human Services shall
establish a two-year project to demonstrate the impact of health information
technology on disease management for individuals entitled to medical assistance
under a State plan under title XIX of the <act-name parsable-cite="SSA">Social
Security Act</act-name>.</text>
</subsection><subsection id="H180A74830FFA4DE7BD8B10F4E5A07039"><enum>(b)</enum><header>Structure of
Project</header><text>The project under subsection (a) shall—</text>
<paragraph id="H258323D3E8BA48C29C5B2FB99E4E25CE"><enum>(1)</enum><text>create a web-based
virtual case management tool that provides access to best practices for
managing chronic disease; and</text>
</paragraph><paragraph id="H70763913FD69444BBB5C2299F6003806"><enum>(2)</enum><text>provide chronic
disease patients and caregivers access to their own medical records and to a
single source of information on chronic disease.</text>
</paragraph></subsection><subsection id="HEBB995FB32B24438A6CE0032F84EC2E3"><enum>(c)</enum><header>Competition</header><text>Not
later than the date that is 90 days after the date of the enactment of this
Act, the Secretary of Health and Human Services shall seek proposals from
States to carry out the project under subsection (a). The Secretary shall
select not less than four of such proposals submitted, and at least one
proposal selected shall include a regional approach that features access to an
integrated hospital information system in at least two adjoining States and
that permits the measurement of health outcomes.</text>
</subsection><subsection id="H37AEF09BD18D4E949FACA2EFC1EACFF2"><enum>(d)</enum><header>Report</header><text>Not
later than the date that is 90 days after the last day of the project under
subsection (a), the Secretary of Health and Human Services shall submit to
Congress a report on such project and shall include in such report the amount
of any cost-savings resulting from the project and such recommendations for
legislation or administrative action as the Secretary determines
appropriate.</text>
</subsection></section>