110 HR 6179 IH: Promoting Health Information
U.S. House of Representatives
2008-06-04
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; table of
contents
(a)This Act may be cited
as the Promoting Health Information
Technology Act of 2008
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
Title I—Strategic Plan Towards Nationwide
Interoperability
Sec. 101. Office of the National Coordinator for Health
Information Technology.
Sec. 102. Successor to the American Health Information
Community.
Sec. 103. Health Information Technology Resource
Center.
Sec. 104. Strategic plan for coordinating implementation of
health information technology.
Title II—Modernizing the Health Care Delivery System
Sec. 201. Rulemaking to upgrade ASC X12 and NCPDP standards and
ICD codes.
Sec. 202. Procedures to ensure timely updating of standards
that enable electronic exchanges.
Sec. 203. Federal purchasing and data collection.
Sec. 204. Study to improve preservation and protection of
security and confidentiality of health information.
Title III—Incentivizing Adoption of Health IT
Sec. 301. Physician Incentives to Adopt Health IT.
Sec. 302. Elimination of sunset applicable to Stark exception
for electronic health records arrangements.
Sec. 303. Promotion of telehealth services.
Sec. 304. FQHCs included in electronic health records
demonstration.
<enum>I</enum><header>Strategic Plan
Towards Nationwide Interoperability</header>
<section display-inline="no-display-inline" id="H19EE2229A56F4874B7C71321FD7FC59" section-type="subsequent-section"><enum>101.</enum><header>Office of the
National Coordinator for Health Information Technology</header>
<subsection display-inline="no-display-inline" id="HC196FCF420FC4ADBBC6C83A400F6F182"><enum>(a)</enum><header>Establishment</header><text>There
is established within the Department of Health and Human Services an Office of
the National Coordinator for Health Information Technology that shall be headed
by the National Coordinator for Health Information Technology (referred to in
this section as the <quote>National Coordinator</quote>). The National
Coordinator shall be appointed by the President and shall report directly to
the Secretary of Health and Human Services. The National Coordinator shall be
paid at a rate equal to the rate of basic pay for level IV of the Executive
Schedule.</text>
</subsection><subsection id="H0FB4026811E84DAC92D476B55C7F5DD"><enum>(b)</enum><header>Goals of
nationwide interoperable health information technology
infrastructure</header><text>The National Coordinator shall perform the duties
under subsection (c) in a manner consistent with the development of a
nationwide interoperable health information technology infrastructure
that—</text>
<paragraph id="HC860E255EC4F4EB4AC518747E30058D2"><enum>(1)</enum><text>improves health
care quality, reduces medical errors, increases the efficiency of care, and
advances the delivery of appropriate, evidence-based health care
services;</text>
</paragraph><paragraph id="HC74D24859A3D443FBE332EEB52C006B3"><enum>(2)</enum><text>promotes wellness,
disease prevention, and management of chronic illnesses by increasing the
availability and transparency of information related to the health care needs
of an individual for such individual;</text>
</paragraph><paragraph id="HDC0C4F26ACCD4FBEA4A31CDBBADC0FD"><enum>(3)</enum><text>ensures that
appropriate information necessary to make medical decisions is available in a
usable form at the time and in the location that the medical service involved
is provided;</text>
</paragraph><paragraph id="H812117DE826E4608912274B4857B9635"><enum>(4)</enum><text display-inline="yes-display-inline">produces greater value for health care
expenditures by reducing health care costs that result from inefficiency,
medical errors, inappropriate care, and incomplete information;</text>
</paragraph><paragraph id="HDAFF6EDAA885445FB0C78BC50187DDE2"><enum>(5)</enum><text>promotes a more
effective marketplace, greater competition, greater systems analysis, increased
choice, enhanced quality, and improved outcomes in health care services;</text>
</paragraph><paragraph id="HA38C1A0832964402844EC85DFBAA017C"><enum>(6)</enum><text>improves the
coordination of information and the provision of such services through an
effective infrastructure for the secure and authorized exchange and use of
health care information; and</text>
</paragraph><paragraph id="H2A01BD99A9614606BEED009C00965533"><enum>(7)</enum><text>ensures that the
confidentiality of individually identifiable health information of a patient is
secure and protected.</text>
</paragraph></subsection><subsection commented="no" id="H2FF2D56754754555A3EE1CE116EF50D9"><enum>(c)</enum><header>Duties of
National Coordinator</header>
<paragraph commented="no" id="HDDF29B36268C4339A8A2F0C00500C15C"><enum>(1)</enum><header>Strategic
planner for interoperable health information technology</header><text>The
National Coordinator shall maintain, direct, and oversee the continuous
improvement of a strategic plan to guide the nationwide implementation of
interoperable health information technology in both the public and private
health care sectors consistent with subsection (b).</text>
</paragraph><paragraph commented="no" id="HB4A1F21154D34C0ABBE842232498CEF7"><enum>(2)</enum><header>Principal
advisor to HHS</header><text display-inline="yes-display-inline">The National
Coordinator shall serve as the principal advisor of the Secretary of Health and
Human Services on the development, application, and use of health information
technology, and coordinate the health information technology programs of the
Department of Health and Human Services.</text>
</paragraph><paragraph commented="no" id="H0F536B42A48F4ED387A7F8D2DAD2D8E8"><enum>(3)</enum><header>Coordinator of
Federal Government activities</header>
<subparagraph commented="no" id="H6C7F6EB51C4E4229B26401D5EB7685CE"><enum>(A)</enum><header>In
general</header><text>The National Coordinator shall serve as the coordinator
of Federal Government activities relating to health information
technology.</text>
</subparagraph><subparagraph commented="no" id="HB18E3A68272441F092C288A7F8561F2C"><enum>(B)</enum><header>Specific
coordination functions</header><text>In carrying out subparagraph (A), the
National Coordinator shall provide for—</text>
<clause commented="no" id="HD48A2F57D73B42EF82EEF1C789A59210"><enum>(i)</enum><text>the approval of
standards developed and recommended by AHIC 2.0 under section 102 (which may
include standards relating to the interoperability, privacy, and security of
health information technology) to be used in the electronic creation,
maintenance, or exchange of health information; and</text>
</clause><clause commented="no" id="H5FB783518C5A40EA95CB94651C044F14"><enum>(ii)</enum><text>the certification
and inspection of health information technology products, exchanges, and
architectures to ensure that such products, exchanges, and architectures
conform to the applicable standards approved under clause (i).</text>
</clause><continuation-text continuation-text-level="subparagraph">Any
standard approved or health information technology product, exchange, or
architecture certified pursuant to Executive Order 13335 as of the day before
the date of the enactment of this Act shall be deemed to be a standard approved
or product, exchange, or architecture certified, respectively, pursuant to this
subparagraph as of such date of enactment.</continuation-text></subparagraph><subparagraph commented="no" id="H726216EE29534AC989D39FB8E5930338"><enum>(C)</enum><header>Use of private
entities</header><text display-inline="yes-display-inline">The National
Coordinator shall, to the maximum extent possible, contract with or recognize
private entities in carrying out subparagraph (B).</text>
</subparagraph><subparagraph commented="no" id="HD7C381A0E03644A3BCCFE97280FF3876"><enum>(D)</enum><header>Uniform
application of standards</header><text>A standard approved under subparagraph
(B)(i) for use in the electronic creation, maintenance, or exchange of health
information shall preempt a standard adopted under State law, regulation, or
rule for such a use.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H895B36B337204DF69464A973A34531D1"><enum>(4)</enum><header>Intragovernmental
coordinator</header><text display-inline="yes-display-inline">The National
Coordinator shall ensure that health information technology policies and
programs of the Department of Health and Human Services are coordinated with
those of relevant executive branch agencies and departments with a goal to
avoid duplication of effort and to ensure that each agency or department
conducts programs within the areas of its greatest expertise and its mission in
order to create a national interoperable health information system capable of
meeting national public health needs effectively and efficiently.</text>
</paragraph><paragraph commented="no" id="HD65CA9701F6344888422CA5677F1A8CF"><enum>(5)</enum><header>Advisor to
OMB</header><text display-inline="yes-display-inline">The National Coordinator
shall provide to the Director of the Office of Management and Budget comments
and advice with respect to specific Federal health information technology
programs.</text>
</paragraph></subsection><subsection id="H14B1AF8A99124966A5809DC5C4F343C2"><enum>(d)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated such sums
as may be necessary to carry out this section for each of fiscal years 2009
through 2013.</text>
</subsection><subsection id="H9D00D817A286473C9EBBF80550B6E36E"><enum>(e)</enum><header>Treatment of
Executive Order 13335</header><text display-inline="yes-display-inline">Executive Order 13335 shall not have any
force or effect after the date of the enactment of this Act.</text>
</subsection><subsection id="H48BAE734776B4F9DA8732EA2372E5327"><enum>(f)</enum><header>Transition from
ONCHIT under Executive Order</header>
<paragraph display-inline="no-display-inline" id="H92114BB3076D4A96B00084D0423DA500"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">All functions,
personnel, assets, liabilities, administrative actions, and statutory reporting
requirements applicable to the old National Coordinator or the Office of the
old National Coordinator on the date before the date of the enactment of this
Act shall be transferred, and applied in the same manner and under the same
terms and conditions, to the new National Coordinator and the Office of the new
National Coordinator as of the date of the enactment of this Act.</text>
</paragraph><paragraph id="HF8C4040827814069B4A948934168E94"><enum>(2)</enum><header>Acting National
Coordinator</header><text>Before the appointment of the new National
Coordinator, the old National Coordinator shall act as the National Coordinator
for Health Information Technology until the office is filled as provided in
subsection (a). The President may appoint the old National Coordinator as the
new National Coordinator.</text>
</paragraph><paragraph id="H2A4E9AEE7DD8421C9DD29E6B3E5BBD1"><enum>(3)</enum><header>Definitions</header><text>For
purposes of this subsection:</text>
<subparagraph id="H79D029EF685841AAA5DFCA17B9EC5F48"><enum>(A)</enum><header>New National
Coordinator</header><text display-inline="yes-display-inline">The term
<term>new National Coordinator</term> means the National Coordinator for Health
Information Technology appointed under subsection (a).</text>
</subparagraph><subparagraph id="HFDAE0207AC4049C79F60B7485E28CBF5"><enum>(B)</enum><header>Old National
Coordinator</header><text display-inline="yes-display-inline">The term
<term>old National Coordinator</term> means the National Coordinator for Health
Information Technology appointed under Executive Order 13335.</text>
</subparagraph></paragraph></subsection></section><section id="H286B1D131FCF4E08B1D6A419DDBF13CB"><enum>102.</enum><header>Successor to
the American Health Information Community</header>
<subsection id="HE882BCB141AE4982A1DEAE5DC6001B87"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall (through
a grant, contract, or cooperative agreement) ensure the establishment and
provide for the operation of an entity described in subsection (b) (in this Act
to be referred to as <quote>AHIC 2.0</quote>) for purposes of developing and
recommending standards described in section 101(c)(3)(B)(i) for approval under
such section.</text>
</subsection><subsection id="HA713FE4B327044EBA0D835B528F3CB58"><enum>(b)</enum><header>Structure and
procedures of entity</header><text>An entity described in this subsection is an
entity—</text>
<paragraph id="HBB15D08FF7334B78B307AB3D959785E5"><enum>(1)</enum><text>in the operation
of which there is broad participation by a variety of public and private
stakeholders (whether through membership or through other means);</text>
</paragraph><paragraph id="HE7B7F9D31138400EB21FCA810299564C"><enum>(2)</enum><text>that uses a
consensus approach and a fair and open process to support the development of
standards under subsection (a); and</text>
</paragraph><paragraph id="H2507211A4F1E4EAF9068B4D7A8070320"><enum>(3)</enum><text>that has a
business plan and a published set of governance rules that enables the entity
to be self-sustaining and to fulfill the purposes described in subsection
(a).</text>
</paragraph></subsection><subsection id="HB4045AC8768D417FB68BC30378D84156"><enum>(c)</enum><header>Consultation</header><text>In
establishing AHIC 2.0, the entity awarded a grant, contract, or cooperative
agreement pursuant to subsection (a), shall consult with a wide variety of
private and public stakeholders that are knowledgeable with respect to
standards to be developed by AHIC 2.0 or that would be potentially affected by
the recommendations of AHIC 2.0.</text>
</subsection><subsection id="H7EDA7477257E4AC7BDC15E92221BE2B7"><enum>(d)</enum><header>Funding</header>
<paragraph id="H00917C9863BA4F23A53B2583D94FC704"><enum>(1)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section $13,000,000, to remain available until expended.</text>
</paragraph><paragraph id="HB0DE9D7F5598446A819098B00001861D"><enum>(2)</enum><header>Further federal
funding other than dues prohibited</header><text>Except as otherwise provided
by this subsection, and except for such dues as may be paid by a Federal agency
for membership or other participation in AHIC 2.0, no Federal agency may
provide funding to the entity. There are authorized to be appropriated to such
agencies such amounts as are necessary to pay the dues described in the
previous sentence.</text>
</paragraph></subsection><subsection id="H001D0A1671BD4C26AACFD08CABE13D3E"><enum>(e)</enum><header>Nonduplication
of efforts To establish AHIC 2.0</header><text>Nothing in this section shall be
construed as requiring the duplication of Federal efforts (such as awarding a
grant, contract, or cooperative agreement) that were carried out before the
date of the enactment of this Act, with respect to the establishment of an
entity to support the development and recommendation of standards under
subsection (a).</text>
</subsection><subsection id="H37A4A1530F9643098D09ED6712FEAAD5"><enum>(f)</enum><header>Treatment of
standards developed or approved by AHIC</header><text display-inline="yes-display-inline">For purposes of this title, a standard
developed or approved (or in a stage of development or approval) by the
American Health Information Community established pursuant to Executive Order
13335 as of the day before the date of the enactment of this Act shall be
deemed to be a standard developed or approved, respectively, (or in such stage
of development or approval) by AHIC 2.0 as of such date of enactment.</text>
</subsection></section><section id="H425F3B32214D400A974DAAF4FF9FF00"><enum>103.</enum><header>Health
Information Technology Resource Center</header>
<subsection id="H582DE5F636FB4E09B763650634B6E386"><enum>(a)</enum><header>In
general</header><text>There is established within the Office of the National
Coordinator for Health Information Technology the Health Information Technology
Resource Center (referred to in this section as the <quote>Center</quote>) to
carry out the following functions:</text>
<paragraph id="H9CA43A5E574A4B7C8D54756E956D013D"><enum>(1)</enum><text>Provide assistance
and support for adoption and implementation efforts and effective use of
interoperable health information technology.</text>
</paragraph><paragraph id="HE293688916364FFAA4C02779DD78C4DC"><enum>(2)</enum><text>Serve as a forum
for the exchange of knowledge and experience.</text>
</paragraph><paragraph id="H9BC88DD444354C9B8831A9AA703BBDD"><enum>(3)</enum><text display-inline="yes-display-inline">Accelerate the transmission of knowledge
from existing health information initiatives in both the private and public
sectors.</text>
</paragraph><paragraph id="HBE72FDF2CD1C4502BC5B24834DD3F8C6"><enum>(4)</enum><text display-inline="yes-display-inline">Support the establishment of regional and
local health information networks to facilitate the interoperability of health
care data across health care settings.</text>
</paragraph><paragraph id="H31EF4D13C47C4D07BCAC6BEC03F7BBF2"><enum>(5)</enum><text display-inline="yes-display-inline">Develop solutions to barriers to electronic
health information exchange.</text>
</paragraph><paragraph id="H8EE51EC223EA4A74B7CEFD3902F4E01"><enum>(6)</enum><text>Provide technical
assistance and tools to help health information exchanges develop a path toward
financial sustainability.</text>
</paragraph><paragraph id="HCCD4C97651774E42977233D505BA028E"><enum>(7)</enum><text display-inline="yes-display-inline">Establish a longitudinal database to
measure the business sustainability of health information exchange and evaluate
the impact of health information exchange on community health outcomes and
value.</text>
</paragraph></subsection><subsection id="HFD658D937B314D989CAA239F9600952D"><enum>(b)</enum><header>Rule of
construction</header><text>Nothing in this section shall be construed to
require the duplication of Federal efforts with respect to the establishment of
the Center, regardless of whether such efforts were carried out prior to or
after the enactment of this subsection.</text>
</subsection><subsection id="H806108777E12467AAAD3DDCB02D4ED86"><enum>(c)</enum><header>Transition from
National Resource Center for Health Information Technology under
AHRQ</header><text display-inline="yes-display-inline">All functions,
personnel, assets, and liabilities applicable to the National Resource Center
for Health Information Technology under the Agency for Healthcare Research and
Quality as of the day before the date of the enactment of this Act shall be
transferred, and applied in the same manner and under the same terms and
conditions, to the Health Information Technology Resource Center under the
Office of the National Coordinator for Health Information Technology
established under subsection (a) as of the date of the enactment of this
Act.</text>
</subsection></section><section display-inline="no-display-inline" id="HC7CDAD8F55A248028351BB10EB330043" section-type="subsequent-section"><enum>104.</enum><header>Strategic plan for
coordinating implementation of health information technology</header>
<subsection id="H477C4B7249D14291A4A3D5202F5AD69"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Not later than 180
days after the date of the enactment of this Act, the Secretary of Health and
Human Services, in consultation with entities involved in the area of health
information technology, shall develop a strategic plan related to the need for
coordination in such area.</text>
</subsection><subsection id="HF3A9AE6AFC594A23B213EA3F2335BA72"><enum>(b)</enum><header>Coordination of
specific implementation processes</header><text>The strategic plan under
subsection (a) shall address the need for coordination in the implementation of
the following:</text>
<paragraph id="H9CE2F7FBAE2B4C05A307FFC1EDD5CD30"><enum>(1)</enum><header>Health
information technology standards</header><text>Health information technology
standards approved under section 101(c)(3)(B)(i).</text>
</paragraph><paragraph commented="no" id="HF8EB8F77145E4A2488F7D901B8DDB016"><enum>(2)</enum><header>HIPAA
transaction standards</header><text display-inline="yes-display-inline">Transaction standards under section 1173(a)
of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-2">42 U.S.C. 1320d–2(d)</external-xref>).</text>
</paragraph><paragraph id="HA61C79BA6593463CAEC3DEA7C4B5F4FF"><enum>(3)</enum><header>Updated ICD
codes</header><text display-inline="yes-display-inline">The International
Statistical Classification of Diseases and Related Health Problems, 10th
revision, Clinical Modification (ICD–10–CM) and the International Statistical
Classification of Diseases and Related Health Problems, 10th revision,
Procedure Coding System (ICD–10–PCS) described in section 201.</text>
</paragraph></subsection><subsection id="HBC73D059A55D46A38C28D9E58E382FDD"><enum>(c)</enum><header>Coordination
among specific Federal entities</header><text display-inline="yes-display-inline">The strategic plan under subsection (a)
shall address any methods to coordinate, with respect to the electronic
exchange of health information, actions taken by the following entities:</text>
<paragraph id="HC14E6C0AC0684F3B94609EE2CD3D66B3"><enum>(1)</enum><text>The Office of the
National Coordinator for Health Information Technology.</text>
</paragraph><paragraph id="H86C85A66C7B04E84ABEB194D6862927D"><enum>(2)</enum><text>AHIC 2.0
established under section 102.</text>
</paragraph><paragraph id="H60B6F8C689614C26B1B6B50900DF8B00"><enum>(3)</enum><text>The Office of
Electronic Standards and Security of the Centers for Medicare and Medicaid
Services.</text>
</paragraph><paragraph id="H1AC4A9705AB44397B8FCD209F1C8D156"><enum>(4)</enum><text>The National
Committee on Vital Health Statistics.</text>
</paragraph><paragraph id="HED05311B02924B96BFBEFA9694B953E2"><enum>(5)</enum><text>Any other entity
involved in the electronic exchange of health information that the Secretary
determines appropriate.</text>
</paragraph></subsection></section><enum>II</enum><header>Modernizing the
Health Care Delivery System</header>
<section id="H1F246778822446C79B522F664136AE19"><enum>201.</enum><header>Rulemaking to
upgrade ASC X12 and NCPDP standards and ICD codes</header>
<subsection id="H0ED4E4B04F0646D18861E178DA0643B1"><enum>(a)</enum><header>In
general</header>
<paragraph id="H3E4A105B4AE0422DA02F4617F6F2DF07"><enum>(1)</enum><header>ASC X12 and
NCPDP standards</header><text>Not later than April 1, 2009, the Secretary of
Health and Human Services shall promulgate a final rule under section 1174(b)
of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-3">42 U.S.C. 1320d–3(b)</external-xref>) to provide for the following
modification of standards:</text>
<subparagraph id="HF380419F7AAB494D8D259CA0314E8059"><enum>(A)</enum><header>Accredited
Standards Committee X12 (ASC X12) standard</header><text display-inline="yes-display-inline">The replacement of the Accredited Standards
Committee X12 (ASC X12) version 4010 adopted under section 1173(a) of such Act
(<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-2">42 U.S.C. 1320d–2(a)</external-xref>), including for purposes of part A of title XVIII of such
Act, with the ASC X12 version 5010, as reviewed by the National Committee on
Vital Health Statistics.</text>
</subparagraph><subparagraph id="H7F57B989D5784784AD06BBE100579BF"><enum>(B)</enum><header>National Council
for Prescription Drug Programs (NCPDP) telecommunications
standards</header><text display-inline="yes-display-inline">The replacement of
the National Council for Prescription Drug Programs (NCPDP) Telecommunications
Standards version 5.1 adopted under section 1173(a) of such Act (42 U.S.C.
1320d–2(a)), including for purposes of part A of title XVIII of such Act, with
NCPDP Telecommunications Standards version C.3, as approved by such Council and
reviewed by the National Committee on Vital Health Statistics.</text>
</subparagraph></paragraph><paragraph commented="no" id="H0BF2C4C7209D4B30BF36CA003EA18438"><enum>(2)</enum><header>ICD
codes</header><text display-inline="yes-display-inline">Not later than January
1, 2011, the Secretary of Health and Human Services shall promulgate a final
rule under section 1174(b) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-3">42 U.S.C. 1320d–3(b)</external-xref>) to
provide for the replacement of the International Statistical Classification of
Diseases and Related Health Problems, 9th revision, Clinical Modification
(ICD–9–CM) under the regulation promulgated under section 1173(c) of such Act
(<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-2">42 U.S.C. 1320d–2(c)</external-xref>), including for purposes of part A of title XVIII of such
Act, with both of the following:</text>
<subparagraph commented="no" id="H1FA6F4F7919246D699B9B44D69206514"><enum>(A)</enum><text>The International
Statistical Classification of Diseases and Related Health Problems, 10th
revision, Clinical Modification (ICD–10–CM).</text>
</subparagraph><subparagraph commented="no" id="H7A977B8E7FB7446B8E3B3CE511991657"><enum>(B)</enum><text>The International
Statistical Classification of Diseases and Related Health Problems, 10th
revision, Procedure Coding System (ICD–10–PCS).</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H91F7959A7FFA46C0803593349549005C"><enum>(b)</enum><header>Rule of
construction</header><text display-inline="yes-display-inline">Nothing in
subsection (a)(2) shall be construed as affecting the application of
classification methodologies or codes, such as CPT or HCPCS codes, other than
under the International Statistical Classification of Diseases and Related
Health Problems (ICD).</text>
</subsection></section><section display-inline="no-display-inline" id="H23BF47CE29F04076A56260A5005E5F8B" section-type="subsequent-section"><enum>202.</enum><header>Procedures to ensure
timely updating of standards that enable electronic exchanges</header><text display-inline="no-display-inline">Section 1174(b) of the Social Security Act
(<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-3">42 U.S.C. 1320d–3(b)</external-xref>) is amended—</text>
<paragraph id="HD9DFB2B7848940D800EE00FB975B1C20"><enum>(1)</enum><text>in paragraph
(1)—</text>
<subparagraph id="H508D94A7CDBA414D864FA7B92B7DCF0"><enum>(A)</enum><text>in the first
sentence, by inserting <quote>and in accordance with paragraph (3)</quote>
before the period; and</text>
</subparagraph><subparagraph id="H1A08EEF70EDB40C197E5F3BABBEB7025"><enum>(B)</enum><text>by adding at the
end the following new sentence: <quote>For purposes of this subsection and
section 1173(c)(2), the term <term>modification</term> includes a new version
or a version upgrade.</quote>; and</text>
</subparagraph></paragraph><paragraph id="H54199C8239304575A71C8BE3B1F9C1DA"><enum>(2)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="HAF3E16BB0CE94F3B00E9E0E8101F9975" style="OLC">
<paragraph id="HA74528C5E8104E3D951BB51D3C865164"><enum>(3)</enum><header>Expedited
procedures for adoption of additions and modifications to standards</header>
<subparagraph id="HB10D04FAC4CF47FB8B24D10413790C9"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">For purposes of
paragraph (1), the Secretary shall provide for an expedited upgrade program (in
this paragraph referred to as the <quote>upgrade program</quote>), in
accordance with this paragraph, to develop and approve additions and
modifications to the standards adopted under section 1173(a) to improve the
quality of such standards or to extend the functionality of such standards to
meet evolving requirements in health care.</text>
</subparagraph><subparagraph id="H5CB77C55A1CF4DC600E537C91E6E00F"><enum>(B)</enum><header>Publication of
notices</header><text>Under the upgrade program:</text>
<clause id="H0C869F83FF884C46BAA81040D25167CF"><enum>(i)</enum><header>Voluntary notice
of initiation of process</header><text display-inline="yes-display-inline">Not
later than 30 days after the date the Secretary receives a notice from a
standard setting organization that the organization is initiating a process to
develop an addition or modification to a standard adopted under section
1173(a), the Secretary shall publish a notice in the Federal Register
that—</text>
<subclause id="H63970A9453424B5897BD60604F60AAE9"><enum>(I)</enum><text>identifies the
subject matter of the addition or modification;</text>
</subclause><subclause id="H9F3B5102A3CF4AAFB4EB25005D6110D9"><enum>(II)</enum><text display-inline="yes-display-inline">provides a description of how persons may
participate in the development process; and</text>
</subclause><subclause id="HA1FE67D7BE8341FA87153120CE4EF55"><enum>(III)</enum><text>invites public
participation in such process.</text>
</subclause></clause><clause display-inline="no-display-inline" id="H98728AE3E39149008F4C5BA7B11181D"><enum>(ii)</enum><header>Voluntary notice
of preliminary draft of additions or modifications to standards</header><text display-inline="yes-display-inline">Not later than 30 days after the date the
Secretary receives a notice from a standard setting organization that the
organization has prepared a preliminary draft of an addition or modification to
a standard adopted by section 1173(a), the Secretary shall publish a notice in
the Federal Register that—</text>
<subclause id="HEAE46405C54B4828A47BF06DEFA9161C"><enum>(I)</enum><text>identifies the
subject matter of (and summarizes) the addition or modification;</text>
</subclause><subclause id="HCD7809F31E79485DB9DA3BCBBF36C100"><enum>(II)</enum><text>specifies the
procedure for obtaining the draft;</text>
</subclause><subclause display-inline="no-display-inline" id="HA5B96E9A46EF4A69AAB4C3A12F3CA2B3"><enum>(III)</enum><text display-inline="yes-display-inline">provides a description of how persons may
submit comments in writing and at any public hearing or meeting held by the
organization on the addition or modification; and</text>
</subclause><subclause id="H594827618E53488BB0EEF81480B00057"><enum>(IV)</enum><text>invites
submission of such comments and participation in such hearing or meeting
without requiring the public to pay a fee to participate.</text>
</subclause></clause><clause id="H8671937291F54944834F2538ACCE3C60"><enum>(iii)</enum><header>Notice of
proposed addition or modification to standards</header><text display-inline="yes-display-inline">Not later than 30 days after the date the
Secretary receives a notice from a standard setting organization that the
organization has a proposed addition or modification to a standard adopted
under section 1173(a) that the organization intends to submit under
subparagraph (D)(iii), the Secretary shall publish a notice in the Federal
Register that contains, with respect to the proposed addition or modification,
the information required in the notice under clause (ii) with respect to the
addition or modification.</text>
</clause><clause id="H80EB5A355EA84A4DBFBBA8D6008D03E1"><enum>(iv)</enum><header>Construction</header><text>Nothing
in this paragraph shall be construed as requiring a standard setting
organization to request the notices described in clauses (i) and (ii) with
respect to an addition or modification to a standard in order to qualify for an
expedited determination under subparagraph (C) with respect to a proposal
submitted to the Secretary for adoption of such addition or
modification.</text>
</clause></subparagraph><subparagraph id="HAD9A6712F2D64D7893BEF7EF88A0AD10"><enum>(C)</enum><header>Provision of
expedited determination</header><text>Under the upgrade program and with
respect to a proposal by a standard setting organization for an addition or
modification to a standard adopted under section 1173(a), if the Secretary
determines that the standard setting organization developed such addition or
modification in accordance with the requirements of subparagraph (D) and the
National Committee on Vital and Health Statistics recommends approval of such
addition or modification under subparagraph (E), the Secretary shall provide
for expedited treatment of such proposal in accordance with subparagraph
(F).</text>
</subparagraph><subparagraph id="H1DABD0A1F970488A90A2E08C515C001D"><enum>(D)</enum><header>Requirements</header><text>The
requirements under this subparagraph with respect to a proposed addition or
modification to a standard by a standard setting organization are the
following:</text>
<clause id="H13E2B1C7E63942FE9BDAAC69C8BB4B62"><enum>(i)</enum><header>Request for
publication of notice</header><text>The standard setting organization submits
to the Secretary a request for publication in the Federal Register of a notice
described in subparagraph (B)(iii) for the proposed addition or
modification.</text>
</clause><clause id="H140284946D5D4343B88764B06604645"><enum>(ii)</enum><header>Process for
receipt and consideration of public comment</header><text>The standard setting
organization provides for a process through which, after the publication of the
notice referred to under clause (i), the organization—</text>
<subclause id="HBCF14D276370493B9B32D30342F86946"><enum>(I)</enum><text>receives and
responds to public comments submitted on a timely basis on the proposed
addition or modification before submitting such proposed addition or
modification to the National Committee on Vital and Health Statistics under
clause (iii);</text>
</subclause><subclause id="HB8EE65D879C14799A21690E143394B51"><enum>(II)</enum><text display-inline="yes-display-inline">makes publicly available a written
explanation for its response in the proposed addition or modification to
comments submitted on a timely basis; and</text>
</subclause><subclause id="H267A74018E8942CA9BCADF48ACAC95B"><enum>(III)</enum><text>makes public
comments received under clause (I) available, or provides access to such
comments, to the Secretary.</text>
</subclause></clause><clause id="H670E9C48F0224CA4A600A92411124831"><enum>(iii)</enum><header>Submittal of
final proposed addition or modification to NCVHS</header><text display-inline="yes-display-inline">After completion of the process under
clause (ii), the standard setting organization submits the proposed addition or
modification to the National Committee on Vital and Health Statistics for
review and consideration under subparagraph (E). Such submission shall include
information on the organization’s compliance with the notice and comment
requirements (and responses to those comments) under clause (ii).</text>
</clause></subparagraph><subparagraph id="H20317A6893C5454FAF2E2800EA1931FB"><enum>(E)</enum><header>Hearing and
recommendations by National Committee on Vital and Health
Statistics</header><text display-inline="yes-display-inline">Under the upgrade
program, upon receipt of a proposal submitted by a standard setting
organization under subparagraph (D)(iii) for the adoption of an addition or
modification to a standard, the National Committee on Vital and Health
Statistics shall provide notice to the public and a reasonable opportunity for
public testimony at a hearing on such addition or modification. The Secretary
may participate in such hearing in such capacity (including presiding ex
officio) as the Secretary shall determine appropriate. Not later than 90 days
after the date of receipt of the proposal, the Committee shall submit to the
Secretary its recommendation to adopt (or not adopt) the proposed addition or
modification.</text>
</subparagraph><subparagraph id="H31B1AA6A40C749E786103718793FDABE"><enum>(F)</enum><header>Determination by
Secretary to accept or reject National Committee on Vital and Health Statistics
recommendation</header>
<clause id="H163571E2276B4E418B5402F484BF9287"><enum>(i)</enum><header>Timely
determination</header><text display-inline="yes-display-inline">Under the
upgrade program, if the National Committee on Vital and Health Statistics
submits to the Secretary a recommendation under subparagraph (E) to adopt a
proposed addition or modification, not later than 90 days after the date of
receipt of such recommendation the Secretary shall make a determination to
accept or reject the recommendation and shall publish notice of such
determination in the Federal Register not later than 30 days after the date of
the determination.</text>
</clause><clause id="HB6F81C1104B94612A1A63F3E701CFBA2"><enum>(ii)</enum><header>Contents of
notice</header><text display-inline="yes-display-inline">If the determination
is to reject the recommendation, such notice shall include the reasons for the
rejection. If the determination is to accept the recommendation, as part of
such notice the Secretary shall promulgate the modified standard (including the
accepted proposed addition or modification accepted).</text>
</clause><clause id="HE07CE68369504C5A8C8C12E3C2CA1C36"><enum>(iii)</enum><header>Limitation on
consideration</header><text display-inline="yes-display-inline">The Secretary
shall not consider a proposal under this subparagraph unless the Secretary
determines that the requirements of subparagraph (D) (including publication of
notice and opportunity for public comment) have been met with respect to the
proposal.</text>
</clause></subparagraph><subparagraph id="H95E9C9BB355B4A5596C133D99B87C489"><enum>(G)</enum><header>Exemption from
Paperwork Reduction Act</header><text display-inline="yes-display-inline"><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/44/35">Chapter 35</external-xref> of title 44, United States Code,
shall not apply to a final rule promulgated under subparagraph
(F).</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="HEA5DCA9D10FD44FE88284538E948247D"><enum>203.</enum><header>Federal
purchasing and data collection</header>
<subsection id="HF822A24C88A44121BD4E2C52336B58C"><enum>(a)</enum><header>Coordination of
Federal Spending</header>
<paragraph id="HB87D95E1FF0F4F04AA47775CCFFE07AA"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Subject to section
204(c), not later than 1 year after the date of the approval of an applicable
standard under section 101(c)(3)(B)(i), no Federal funds may be used for the
purchase of any health information technology or health information technology
system for clinical care or for the electronic retrieval, storage, or exchange
of health information unless such technology or system has been certified under
section 101(c)(3)(B)(ii) with respect to compliance with such standard.</text>
</paragraph><paragraph id="H480699C2F93E4A7FA03D5CCA17CBB1C1"><enum>(2)</enum><header>Rule of
construction</header><text>Nothing in paragraph (1) shall be construed to
restrict the purchase of minor (as determined by the Secretary) hardware or
software components in order to modify, correct a deficiency in, or extend the
life of existing hardware or software.</text>
</paragraph></subsection><subsection id="H527A2D3E24554493A7D2F01754B585D"><enum>(b)</enum><header>Coordination of
Federal Data Collection</header><text>Subject to section 204(c), not later than
3 years after the date of the approval of an applicable standard under section
101(c)(3)(B)(i), all Federal agencies collecting health data in an electronic
format for the purposes of quality reporting, surveillance, epidemiology,
adverse event reporting, research, or for other purposes determined appropriate
by the Secretary of Health and Human Services, shall comply with such
standard.</text>
</subsection></section><section id="HD64BAA5B629C4F74A55EE04874262448"><enum>204.</enum><header>Study to
improve preservation and protection of security and confidentiality of health
information</header>
<subsection display-inline="no-display-inline" id="H0AB6C05CB0DA45B195CE1D65ECB42C4"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary of
Health and Human Services shall conduct a study of current Federal security and
confidentiality standards to determine the strengths and weaknesses of such
standards for purposes of protecting the security and confidentiality of
individually identifiable health information while taking into account the need
for timely and efficient exchanges of health information to improve quality of
care and ensure the availability of health information necessary to make
medical decisions at the location in which the medical care involved is
provided.</text>
</subsection><subsection id="H8B4A477C010342D29ED6146147B07EB2"><enum>(b)</enum><header>Report</header><text>Not
later than 24 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
under subsection (a) and shall include in such report recommendations for
improving the current Federal security and confidentiality standards, including
recommendations for a mechanism to track breaches to the security or
confidentiality of individually identifiable health information and for
appropriate penalties to apply in the case of such a breach.</text>
</subsection><subsection id="HEEA80E558D6240CE0012608DBE0047E6"><enum>(c)</enum><header>Preservation of
current security and confidentiality standards before submittal of
report</header><text display-inline="yes-display-inline">None of the provisions
of this Act or amendments made by this Act may limit, or require issuance of a
regulation that would limit, the effect of a current Federal security and
confidentiality standard before the date of the submittal of the report under
subsection (b).</text>
</subsection><subsection id="HF2EEDC36E6C047339240C731CCA8B15D"><enum>(d)</enum><header>Current Federal
security and confidentiality standards defined</header><text display-inline="yes-display-inline">For purposes of this section, the term
<term>current Federal security and confidentiality standards</term> means the
Federal privacy standards established pursuant to section 264(c) of the Health
Insurance Portability and Accountability Act of 1996 (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d-2">42 U.S.C. 1320d–2</external-xref> note)
and security standards established under section 1173(d) of the Social Security
Act.</text>
</subsection></section><enum>III</enum><header>Incentivizing
Adoption of Health IT</header>
<section commented="no" display-inline="no-display-inline" id="H38F7A3137CF940F9AC1C68574574915D" section-type="subsequent-section"><enum>301.</enum><header>Physician Incentives
to Adopt Health IT</header>
<subsection commented="no" id="H44C79383AABB467482D6433D5600D6E"><enum>(a)</enum><header>Purchase of
qualified health care information technology</header><text>Section 179 of the
Internal Revenue Code of 1986 (relating to election to expense certain
depreciable assets) is amended by adding at the end the following new
subsection:</text>
<quoted-block display-inline="no-display-inline" id="H955AFF6B8D464D479F61A78339C5CDF2" style="OLC">
<subsection commented="no" id="H89323EF09B5040E991F727873BD88482"><enum>(e)</enum><header>Health care
information technology</header>
<paragraph commented="no" id="H97C305C689C641F600802F8BF071FC23"><enum>(1)</enum><header>In
general</header><text>In the case of qualified health care information
technology purchased by a medical care provider and placed in service during a
taxable year—</text>
<subparagraph commented="no" id="HC1DAD81D53FB428C86C61239CB5939D"><enum>(A)</enum><text>subsection (b)(1)
shall be applied by substituting <quote>$250,000</quote> for
<quote>$100,000</quote>,</text>
</subparagraph><subparagraph commented="no" id="HE549A20961164BD0A673A3BC9D77E1C3"><enum>(B)</enum><text>subsection (b)(2)
shall be applied by substituting <quote>$600,000</quote> for
<quote>$400,000</quote>, and</text>
</subparagraph><subparagraph commented="no" id="HCFE9EA3A2C5545C98EDF55395098D06C"><enum>(C)</enum><text>subsection
(b)(5)(A) shall be applied by substituting <quote>$250,000 and $600,000</quote>
for <quote>$100,000 and $400,000</quote>.</text>
</subparagraph></paragraph><paragraph commented="no" id="H310C711D47954C20B5E1D3E641E69750"><enum>(2)</enum><header>Definitions</header><text>For
purposes of this subsection—</text>
<subparagraph commented="no" id="HC053E3FA1A3B40F9A3C78E79A21FBFE3"><enum>(A)</enum><header>Qualified health
care information technology</header><text display-inline="yes-display-inline">The term <term>qualified health care
information technology</term> means section 179 property which—</text>
<clause commented="no" id="H0EA5633DB3EC4376BEEF144D6B5D4FC5"><enum>(i)</enum><text display-inline="yes-display-inline">has been certified pursuant to section
101(c)(3)(B)(ii) of the Promoting Health Information Technology Act of 2008,
and</text>
</clause><clause commented="no" id="H24221C8D24C34CBFB890B1EDDC5258D"><enum>(ii)</enum><text>is used primarily
for the electronic creation, maintenance, and exchange of medical care
information to improve the quality or efficiency of medical care.</text>
</clause></subparagraph><subparagraph commented="no" id="HEB2EADCC6A3141A2B4A955C7E91C96F"><enum>(B)</enum><header>Medical care
provider</header><text display-inline="yes-display-inline">The term
<term>medical care provider</term> means any person engaged in the trade or
business of providing medical care.</text>
</subparagraph><subparagraph commented="no" id="H314121A057464276831B00264463028C"><enum>(C)</enum><header>Medical
care</header><text>The term <term>medical care</term> has the meaning given
such term by section
213(d).</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="H83B7B2CE4FD848DDB6C5CAA1DC7B8D3B"><enum>(b)</enum><header>Effective
date</header><text>The amendment made by this section shall apply to property
placed in service on or after the date of the enactment of this Act.</text>
</subsection></section><section display-inline="no-display-inline" id="H3B485B5F57CC439380C12D5B3B09CFC8"><enum>302.</enum><header>Elimination of
sunset applicable to Stark exception for electronic health records
arrangements</header><text display-inline="no-display-inline">In applying
section 1877(e) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395(e)</external-xref>), with respect to
a regulation implementing such section by providing an exception to the
prohibition against making certain physician referrals in the case of the
offering or payment of nonmonetary remuneration (consisting of items and
services in the form of software or information technology and training
services) necessary and used predominantly to create, maintain, transmit, or
receive electronic health records, the Secretary of Health and Human Services
shall not limit the period in which such an exception under such a regulation
applies.</text>
</section><section display-inline="no-display-inline" id="H318F3FED074F4FFA8C74D3F9109D8729" section-type="subsequent-section"><enum>303.</enum><header>Promotion of
telehealth services</header>
<subsection id="HF16C0BF01EDD4F9FA8F0994D704EE593"><enum>(a)</enum><header>Facilitating the
Provision of Telehealth Services Across State Lines</header>
<paragraph id="H039386D0471748CA8503D7BBBC9522BC"><enum>(1)</enum><header>In
general</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>
</paragraph><paragraph id="H646AF11CE98844E8ACFC80D9B64202EA"><enum>(2)</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 paragraph (1).</text>
</paragraph><paragraph id="H91EAA63DA524420D9ECF107870D06B1F"><enum>(3)</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>
</paragraph></subsection><subsection id="H7FA06E0FC18F4ED4AA9F140078A71B6F"><enum>(b)</enum><header>Study and report
on expansion of home health-related telehealth services</header>
<paragraph id="H959F857C52314F1BAD884970607983FF"><enum>(1)</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>
<subparagraph id="HD73BCCE9E74D462B9F00DEC18C65EE87"><enum>(A)</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>
</subparagraph><subparagraph id="H86D2AE6CFC20455887A1B749E01996B4"><enum>(B)</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>
</subparagraph></paragraph><paragraph id="HFE5E51AFD3EB4BF0AFA8FA9DE04589E9"><enum>(2)</enum><header>Specifics of
Study</header><text>Such study shall demonstrate whether the changes described
in subparagraphs (A) and (B) of paragraph (1) are likely to result in the
following:</text>
<subparagraph id="H2D208BB2E404482584F73C58AD2D4261"><enum>(A)</enum><text>Enhanced health
outcomes for individuals with one or more chronic conditions.</text>
</subparagraph><subparagraph id="H98FD5C5DDB43466881EFB9F956D4D2DC"><enum>(B)</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>
</subparagraph><subparagraph id="H6B773E55A93F4CB7A98CEAFFF6E68D69"><enum>(C)</enum><text>Facilitation of
communication of more accurate clinical information between health care
providers.</text>
</subparagraph><subparagraph id="HF12926093337458D92F4A97CD38DBB1E"><enum>(D)</enum><text>Closer monitoring
of individuals by health care providers.</text>
</subparagraph><subparagraph id="HBDE173F72B4E4D26AC17C1F241D76F7"><enum>(E)</enum><text>Overall reduction
in expenditures for health care items and services.</text>
</subparagraph><subparagraph id="H3567C1AD46384ADFBABBE49ECBE9E06"><enum>(F)</enum><text>Improved access to
health care.</text>
</subparagraph></paragraph><paragraph id="H99A6CD07945241A1A757F8D073E87FA1"><enum>(3)</enum><header>Home
Health-Related Telehealth Services Defined</header><text>For purposes of this
subsection, 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>
</paragraph><paragraph id="H6B850D71C8814FBCA08D5FF714C2E49"><enum>(4)</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 paragraph (1) and shall include in such report such
recommendations for legislation or administration action as the Secretary
determines appropriate.</text>
</paragraph></subsection><subsection id="HAB94FEFB51F74A049DB109EB074439D5"><enum>(c)</enum><header>Study and report
on store and forward technology for telehealth</header>
<paragraph id="H64F620923DF4464C9550D41E2B753CC1"><enum>(1)</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 health conditions, as specified by
the Secretary.</text>
</paragraph><paragraph id="H0B07428C0F2045F386C9E3CA0098CF07"><enum>(2)</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 paragraph (1) and shall include in such report such
recommendations for legislation or administration action as the Secretary
determines appropriate.</text>
</paragraph></subsection></section><section id="H2DE957D8978C496F9CC72844C5E97727"><enum>304.</enum><header>FQHCs included
in electronic health records demonstration</header><text display-inline="no-display-inline">Effective as of the date of the enactment of
this Act, in developing and implementing a demonstration initiative to foster
the implementation and adoption of electronic health records and health
information technology, the Centers of Medicare & Medicaid Services shall
provide for the eligibility of Federally qualified health centers (as defined
in section 1861(aa)(4) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(aa)(4)</external-xref>) to
participate in such demonstration.</text>
</section>