110 HR 6478 IH: Access to America’s Orthopedic
U.S. House of Representatives
2008-07-10
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.
(a)This Act may be cited
as the Access to America’s Orthopedic
Services Act of 2008
.
2.Table of
contents; definition
(a)The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents; definition.
Title I—Musculoskeletal Health
Sec. 101. Findings.
Sec. 102. Musculoskeletal research.
Sec. 103. Musculoskeletal trauma research and care.
Sec. 104. Transplants, tissues, and replacement
joints.
Sec. 105. Traffic and workplace safety.
Sec. 106. Public education campaign.
Sec. 107. Orthopedic physician workforce training
study.
Sec. 108. Bone density under the Medicare Program.
Sec. 109. Access to orthopedic services for beneficiaries of
Medicaid and SCHIP.
Sec. 110. Age-related programs.
Sec. 111. Minority health disparities.
Title II—Third longitudinal study on aging
Sec. 201. Third longitudinal study on aging.
(b)For purposes of the
Act, the term Secretary means the Secretary of Health and Human
Services, except as otherwise provided.
<enum>I</enum><header>Musculoskeletal
Health</header>
<section id="H16782C5DCA1648AFBEB29B111380B051"><enum>101.</enum><header>Findings</header><text display-inline="no-display-inline">Congress makes the following
findings:</text>
<paragraph id="H07942CFAD3B84C788C44AA07B2E6613"><enum>(1)</enum><text>Musculoskeletal
diseases and conditions are the leading cause of disability in the United
States.</text>
</paragraph><paragraph id="H06C7D426C0F84A77806D5643267DB555"><enum>(2)</enum><text>Musculoskeletal
diseases account for more than one-half of all chronic conditions in people
over 50 years of age in developed countries.</text>
</paragraph><paragraph id="H5F2E9F2F6E484F1BAB28883F06EEF6"><enum>(3)</enum><text>More than one in
four individuals in the United States has a musculoskeletal condition requiring
medical attention.</text>
</paragraph><paragraph id="H5C774A5E6AC647B9AC19358D8609898C"><enum>(4)</enum><text>Direct and
indirect costs for bone and joint health are $849,000,000,000 per year in the
United States.</text>
</paragraph><paragraph id="HEBDB327B07364E29841EA4E3388BDDA"><enum>(5)</enum><text>Musculoskeletal
conditions are the greatest cause of total lost workdays and medical bed days
in the United States.</text>
</paragraph><paragraph id="H696EE84E85A24DDC9E0033886DBC7835"><enum>(6)</enum><text>The 2004 Surgeon
General Report on Bone Health and Osteoporosis concluded that there is a lack
of awareness of bone disease among the public and health care
professionals.</text>
</paragraph><paragraph id="H472676F5FF694271B3333946646B5067"><enum>(7)</enum><text display-inline="yes-display-inline">Research demonstrates that there is need
among ethnic and racial minorities to improve knowledge of and treatment for
musculoskeletal diseases and conditions.</text>
</paragraph></section><section id="H5758AD3E4102477E004DC1FB99C12844"><enum>102.</enum><header>Musculoskeletal
research</header>
<subsection id="H5803BBADE776407697653100A5570538"><enum>(a)</enum><header>Regulations
concerning reporting criteria for percent of effort</header>
<paragraph id="H9A423AE00DEE411D8FB00083F5FEC60"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, in
consultation with the Director of the National Institutes of Health, shall
establish, by regulation, criteria for accounting and reporting the percent of
effort expended by researchers, with respect to research that is—</text>
<subparagraph id="H8CFB13E1ADA44287AB3799F9249BCC2C"><enum>(A)</enum><text>conducted during
each fiscal year beginning after the last day of the second fiscal year
following the date of enactment of this Act; and</text>
</subparagraph><subparagraph id="HE1AC769EEC15418CA4C0E92BC69700FE"><enum>(B)</enum><text display-inline="yes-display-inline">funded through research grants on
musculoskeletal health awarded by either the Director of the National
Institutes of Health or the Director of the Agency for Healthcare Research and
Quality.</text>
</subparagraph></paragraph><paragraph id="H36F3F82AC28E46DA971FE03B04542C27"><enum>(2)</enum><header>Deadline for
regulations</header><text>Not later than the last day of the 2-year period
beginning on the date of enactment of this Act, the Secretary shall issue and
implement the regulations required by
<internal-xref idref="H9A423AE00DEE411D8FB00083F5FEC60" legis-path="102.(a)(1)">paragraph (1)</internal-xref>.</text>
</paragraph></subsection><subsection id="H6C2AA134C5BD47D38157F7C1AB409746"><enum>(b)</enum><header>New
Investigators in Musculoskeletal Research</header>
<paragraph id="HC2B29D4523114A25B51DECD713882E6"><enum>(1)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 90 days after the last day
of each fiscal year that begins more than one year following the date of
enactment of this Act, the Secretary, in consultation with the Director of the
National Institutes of Health, shall prepare and submit to Congress a report on
the following:</text>
<subparagraph id="HA54E4CEF39CE4E75006D41CCFEF6F560"><enum>(A)</enum><text display-inline="yes-display-inline">The number of new investigators who are
awarded grants for musculoskeletal health research by the National Institutes
of Health during the fiscal year.</text>
</subparagraph><subparagraph id="H2F484B263ECD4508A8E452CF07F639D0"><enum>(B)</enum><text display-inline="yes-display-inline">The total amount of funds awarded to those
investigators under such grants during the fiscal year.</text>
</subparagraph><subparagraph id="H23AB106544F74211002517903D259BA2"><enum>(C)</enum><text display-inline="yes-display-inline">The percentage of the National Institutes
of Health’s budget for musculoskeletal health research that was awarded to such
investigators through such grants during the fiscal year.</text>
</subparagraph><subparagraph id="H642209A6DD704C79BB7EF4E9DB742811"><enum>(D)</enum><text display-inline="yes-display-inline">The race and ethnicity of the new
investigators who are awarded such grants during the fiscal year.</text>
</subparagraph><subparagraph id="H5B3485E3F1B74E8D97EB00ED7073B765"><enum>(E)</enum><text display-inline="yes-display-inline">A description of the efforts made by the
Director of the National Institutes of Health to encourage individuals from
underrepresented minority groups (as defined by the Secretary) to apply for
grants for musculoskeletal health research awarded by the National Institutes
of Health during the fiscal year.</text>
</subparagraph></paragraph><paragraph id="H5576D461CD48460DB0E871220398518D"><enum>(2)</enum><header>Recommendations</header><text display-inline="yes-display-inline">The first report submitted under
<internal-xref idref="HC2B29D4523114A25B51DECD713882E6" legis-path="102.(b)(1)">paragraph (1)</internal-xref> shall include, and
subsequent reports may include, recommendations concerning additional resources
that the National Institutes of Health or other entities could use—</text>
<subparagraph display-inline="no-display-inline" id="HD66662DEA0D04E778B85449F65CF26D8"><enum>(A)</enum><text display-inline="yes-display-inline">to increase the number of new investigators
awarded grants referred to in
<internal-xref idref="HA54E4CEF39CE4E75006D41CCFEF6F560" legis-path="102.(b)(1)(A)">paragraph (1)(A)</internal-xref>; and</text>
</subparagraph><subparagraph id="HBFE588F3B6804BCEAD11F6F062FDFD9E"><enum>(B)</enum><text display-inline="yes-display-inline">to increase the number of new investigators
awarded such grants who are members of underrepresented minority groups.</text>
</subparagraph></paragraph><paragraph id="HD8E91809505B4692A0B5A9A074F6ECB5"><enum>(3)</enum><header>Definitions</header><text>For
purposes of this section, the following definitions apply:</text>
<subparagraph id="H20F3E28D41AD4F7FA5F71FC20027EA11"><enum>(A)</enum><header>New
investigator</header><text display-inline="yes-display-inline">The term
<term>new investigator</term> has the meaning given the term <term>new
investigator</term> by the Secretary for purposes of administering title III of
the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/241">42 U.S.C. 241 et seq.</external-xref>), but only with respect to
musculoskeletal health research.</text>
</subparagraph><subparagraph commented="no" id="H66C2E7C12EEE4C0583E5157D56FC8579"><enum>(B)</enum><header>Race;
ethnicity</header><text display-inline="yes-display-inline">The terms
<term>race</term> and <term>ethnicity</term> have the meaning given such terms
by the Office of Management and Budget for purposes of Federal statistics and
administrative reporting.</text>
</subparagraph></paragraph></subsection></section><section id="H3E67CA3C201246E8ADFEC4A25B000021"><enum>103.</enum><header>Musculoskeletal
trauma research and care</header>
<subsection commented="no" id="H4134BD321FCC4D96914DF226B55BF358"><enum>(a)</enum><header> Musculoskeletal
trauma research</header>
<paragraph id="H412F0F73727A43C8A303948174DCE9A"><enum>(1)</enum><header>Report</header><text>Not
later than 2 years after the date of enactment of this Act, the Secretary shall
prepare and submit to Congress a report on all programs and activities relating
to musculoskeletal trauma care that are being conducted by the Federal
Government or supported by funding made available by Federal Government.</text>
</paragraph><paragraph id="H03E231011CD1495AB95014EDA001B88D"><enum>(2)</enum><header>Contents of
Report</header><text>Such report shall include, at a minimum, the
following:</text>
<subparagraph commented="no" id="H5A96894F42074ABD830633C2ED399401"><enum>(A)</enum><text display-inline="yes-display-inline">Information on the status of each Federal
program and activity referred to in
<internal-xref idref="H412F0F73727A43C8A303948174DCE9A" legis-path="103.(a)(1)">paragraph (1)</internal-xref>, including specific
information on any research program and activity.</text>
</subparagraph><subparagraph commented="no" id="HBBE2C7FBFF9E43FE8099FE1E71D7F00"><enum>(B)</enum><text display-inline="yes-display-inline">Information on the methods being used to
coordinate research being conducted under such Federal programs and activities
and the effectiveness of such methods.</text>
</subparagraph></paragraph><paragraph id="HD4A31B074A3F47F6929B5190D3C82343"><enum>(3)</enum><header>Consultation</header><text display-inline="yes-display-inline">In preparing and submitting the report
under
<internal-xref idref="H412F0F73727A43C8A303948174DCE9A" legis-path="103.(a)(1)">paragraph (1)</internal-xref>, the Secretary shall
consult with—</text>
<subparagraph id="H476EC58D5CD944409269CCA3E2FADB1"><enum>(A)</enum><text>the Secretary of
Defense; and</text>
</subparagraph><subparagraph id="H65FB4C250BB64EDE00CDF4471C5449A5"><enum>(B)</enum><text>the heads of other
Federal departments and agencies that administer programs and activities that
are relevant to musculoskeletal trauma care, as determined by the
Secretary.</text>
</subparagraph></paragraph></subsection><subsection id="H7CD1FA0ADA3A425EB837BCC527A16D00"><enum>(b)</enum><header>orthopedic
treatment through trauma systems</header>
<paragraph id="H37A730DA9A6641B4B3ADEECC8BEF7B00"><enum>(1)</enum><header>Study</header><text display-inline="yes-display-inline">The Secretary shall conduct a study on the
impact of trauma care systems that connect hospitals with other providers of
health care services (including orthopedists) on musculoskeletal health.</text>
</paragraph><paragraph id="HE5997D5928844E2791CA2B9BD1C5769D"><enum>(2)</enum><header>Purposes of
study</header><text>The purposes of the study under
<internal-xref idref="H37A730DA9A6641B4B3ADEECC8BEF7B00" legis-path="103.(b)(1)">paragraph (1)</internal-xref> shall include, at a
minimum, the following:</text>
<subparagraph id="H4F8A17E73C344FEF94F636471FBA6858"><enum>(A)</enum><text>An examination of
the provision of acute and rehabilitative care to trauma patients with
musculoskeletal conditions or injuries.</text>
</subparagraph><subparagraph id="H3A752F5ED5C6404CA5E3F51B36E99940"><enum>(B)</enum><text>An examination of
epidemiological data on trauma patients with musculoskeletal conditions or
injuries, including the number of such patients, the number of such conditions
and injuries, and the types of such conditions and injuries.</text>
</subparagraph><subparagraph id="H57A24652CB4C4C19A260CE8FFEE35738"><enum>(C)</enum><text>An evaluation of
the ability of a patient with an orthopedic condition or injury originating
from musculoskeletal trauma to access specialty care relevant to that condition
or injury.</text>
</subparagraph><subparagraph id="HEE3D032511044D2BA05CEC26BBFD52F0"><enum>(D)</enum><text>An examination of
the impact of trauma rehabilitation care on musculoskeletal health and the
ability of trauma patients with musculoskeletal conditions or injuries to
access postacute rehabilitative services.</text>
</subparagraph></paragraph><paragraph id="H0271723F831441DE9F6DA37F46C00087"><enum>(3)</enum><header>Report</header><text>Not
later than 2 years after the date of enactment of this Act, the Secretary shall
submit to Congress a report on the results of the study under
<internal-xref idref="H37A730DA9A6641B4B3ADEECC8BEF7B00" legis-path="103.(b)(1)">paragraph (1)</internal-xref>, including
recommendations for improving the treatment of trauma patients with
musculoskeletal injuries.</text>
</paragraph></subsection></section><section id="H8DAC5A1065AB45D5A0060495B2891CF9"><enum>104.</enum><header>Transplants,
tissues, and replacement joints</header>
<subsection commented="no" id="HFE0539DA9E9E422482BE7BAAADE550E5"><enum>(a)</enum><header>Transplantation
Transmission Sentinel Network</header><text display-inline="yes-display-inline">Section 372(b)(2) of the Public Health
Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/274">42 U.S.C. 274(b)(2)</external-xref>) is amended—</text>
<paragraph commented="no" id="HD10385C1CCFF4D4A9E11E773ED7B3F80"><enum>(1)</enum><text>in subparagraph
(N) by striking <quote>and</quote> at the end;</text>
</paragraph><paragraph id="H1A0C205FB00E4B42B78B3D75BC9BA901"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (O) by striking the period
at the end and inserting <quote>, and</quote>; and</text>
</paragraph><paragraph commented="no" id="H3FC5DC54B26844FAA7A0E5F63FE1AF2E"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H5D44B0C9181B41E1B66B00423C55CB43" style="OLC">
<subparagraph id="HF5C088C3DE9A4C75B8950927646FE0EA"><enum>(P)</enum><text display-inline="yes-display-inline">establish and operate a national Web-based
system, to be known as the <quote>Transplantation Transmission Sentinel
Network</quote>, for the detection, reporting, and tracking of disease
transmission from organ, tissue, or eye donors to organ, tissue and eye
transplant recipients.</text>
</subparagraph><after-quoted-block>.
</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H70A0632D213B4CE08400A8167194FB06"><enum>(b)</enum><header>Accreditation of
establishments and personnel engaged in the manufacture of human cells,
tissues, or cellular or tissue-based products</header>
<paragraph commented="no" display-inline="no-display-inline" id="HBB2E9573CC2F47A2981128000979A77"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary shall
issue regulations relating to the accreditation of—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H8BE46F78E01F479BBADE329D78CB1D3"><enum>(A)</enum><text display-inline="yes-display-inline">establishments; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H986566FFC82D4FA18FA210B35F809492"><enum>(B)</enum><text display-inline="yes-display-inline">personnel who participate in the recovery,
processing, storage, labeling, packaging, or distribution of human cells,
tissues, or cellular or tissue-based products for such establishments.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H8CECE1C07D2E4EE5AB8DEE30F1DE136"><enum>(2)</enum><header>Authority of
Secretary</header><text display-inline="yes-display-inline">In issuing the
regulations under paragraph (1), the Secretary shall—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H68CAC47875034B4EBCCC4776A290BC06"><enum>(A)</enum><text display-inline="yes-display-inline">establish an accreditation process modeled
after the Joint Commission (previously known as the Joint Commission on
Accreditation of Healthcare Organizations); or</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H688424ECD6FE415DB4591110EEFBDE7B"><enum>(B)</enum><text display-inline="yes-display-inline">adopt an accreditation process established
by a private entity that is in effect on the date of enactment of this
Act.</text>
</subparagraph></paragraph><paragraph id="HE75526CDA7364819B99C0053A1FF043D"><enum>(3)</enum><header>Definitions</header><text>For
purposes of this subsection, the following definitions apply:</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H7641F66FA01645C186000662D0885EA"><enum>(A)</enum><header>Establishment</header><text display-inline="yes-display-inline">The term <term>establishment</term> has the
meaning given such term in <external-xref legal-doc="usc" parsable-cite="usc/21/1271">section 1271.3</external-xref> of title 21, Code of Federal
Regulations (or any successor regulation).</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HE89368437CDF430BAFDB7D11DA815BAE"><enum>(B)</enum><header>Human cells,
tissues, or cellular or tissue-based products</header><text display-inline="yes-display-inline">The term <term>human cells, tissues, or
cellular or tissue-based products</term> has the meaning given such term in
<external-xref legal-doc="regulation" parsable-cite="cfr/21/1271.3">section 1271.3</external-xref> of title 21, Code of Federal Regulations (or any successor
regulation).</text>
</subparagraph></paragraph></subsection><subsection id="H68BA32992F92469388027C833BADA2EB"><enum>(c)</enum><header>National Joint
Replacement Registry Study</header>
<paragraph id="H206C0A69AD374978A441C3E014D2D2E5"><enum>(1)</enum><header>Study</header><text>The
Secretary shall conduct a study evaluating the advantages and disadvantages of
establishing a national registry for the purpose of tracking the safety and
effectiveness of artificial joints used to replace joints in beneficiaries of
the Medicare program under title XVIII of the Social Security Act (42 U.S.C.
1395 et seq.).</text>
</paragraph><paragraph id="H8A7653783A994E0DBC58A4DD75FDDE00"><enum>(2)</enum><header>Contents of
proposed Registry</header><text>In evaluating the proposed registry under
<internal-xref idref="H206C0A69AD374978A441C3E014D2D2E5" legis-path="104.(c)(1)">paragraph (1)</internal-xref>, the Secretary shall
assume that the registry includes, at a minimum, information on—</text>
<subparagraph id="H57586096CDD3431A9779DA3CF651E8F"><enum>(A)</enum><text>the type of joint
replaced;</text>
</subparagraph><subparagraph id="HD65FD8FDF7854B61B5B5C00900AB4FB4"><enum>(B)</enum><text>the side of the
body on which the joint is replaced;</text>
</subparagraph><subparagraph id="HA480BEB88B264E378F3868FD45E17513"><enum>(C)</enum><text>whether more than
one operation was required in connection with an artificial joint replacement;
and</text>
</subparagraph><subparagraph id="HFFBFD619DDE84495B28E0925CCA9C7B6"><enum>(D)</enum><text>uniform
identifiers for the artificial joint (including the device lot number and
catalog number).</text>
</subparagraph></paragraph><paragraph display-inline="no-display-inline" id="HB45F4A1D02CA45628FFC177FAA561809"><enum>(3)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of
enactment of this Act, the Secretary shall submit to Congress a report on the
results of the study under
<internal-xref idref="H206C0A69AD374978A441C3E014D2D2E5" legis-path="104.(c)(1)">paragraph (1)</internal-xref> and recommendation for
changes to the Medicare program, including any necessary changes to the
Medicare claims form, to allow for the collection of information required for
the registry.</text>
</paragraph></subsection></section><section display-inline="no-display-inline" id="H71EFE255505244388963975C56A1DF2F" section-type="subsequent-section"><enum>105.</enum><header>Traffic and
workplace safety</header>
<subsection id="H84BF039A90644F1B934076CE5206263F"><enum>(a)</enum><header>Traffic Safety
Study</header>
<paragraph id="H900B71B875FA4874B0A94135A574E3E"><enum>(1)</enum><header>Study</header><text display-inline="yes-display-inline">The Secretary, in consultation with the
Secretary of Transportation, shall conduct a study, using epidemiological
methods, on the frequency, severity, and likely causes of severe trauma to
extremities resulting from motor vehicle crashes.</text>
</paragraph><paragraph id="HE6AB4E28EC2944A2A55832D50080E2C1"><enum>(2)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of
enactment of this Act, the Secretary shall submit to Congress a report the
results of the study under paragraph (1).</text>
</paragraph><paragraph commented="no" id="H540E9C364FCA4D24000700F2CCE48D47"><enum>(3)</enum><header>Motor vehicle
defined</header><text>For purposes of this subsection, the term <term>motor
vehicle</term> has the meaning given such term in <external-xref legal-doc="usc" parsable-cite="usc/23/405">section 405</external-xref> of title 23,
United States Code.</text>
</paragraph></subsection><subsection id="H54BFBA9F03F343E3A46071D600BD27D"><enum>(b)</enum><header>Workplace Safety
Study</header>
<paragraph id="H5685204F86FE4823A5A167D6CC404609"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, in
consultation with the Secretary of Labor, shall conduct a study, within the
research framework of the National Occupational Research Agenda coordinated by
the National Institute for Occupational Safety and Health, on—</text>
<subparagraph id="H533759DCF2E44C748C4FD57D0700C6EE"><enum>(A)</enum><text>the number of
workplace-related musculoskeletal injuries and conditions; and</text>
</subparagraph><subparagraph id="HBA303A7E887C495B951D50D076D07D03"><enum>(B)</enum><text>medical treatments
provided to individuals to treat such injuries and conditions.</text>
</subparagraph></paragraph><paragraph id="H25F42727F90849509DF7000087593CE9"><enum>(2)</enum><header>Collection
methodology</header><text>In conducting the study under
<internal-xref idref="H5685204F86FE4823A5A167D6CC404609" legis-path="105.(b)(1)">paragraph (1)</internal-xref>, the Secretary shall
collect information in a manner that allows such information to be reported
based on the type of musculoskeletal injury or condition and the race and
ethnicity of the individual with such injury or condition.</text>
</paragraph><paragraph commented="no" id="H8759A190708C4EE1BFB398FD21DA6049"><enum>(3)</enum><header>Request for
information from State Workers Compensation Boards</header><text>The Secretary
may request that the head of each State agency that has jurisdiction over
workers compensation submit information relevant to the study under
<internal-xref idref="H5685204F86FE4823A5A167D6CC404609" legis-path="105.(b)(1)">paragraph (1)</internal-xref> to the Secretary.</text>
</paragraph><paragraph id="HD2AE334F4C0042AEAD9F02E0E94636B0"><enum>(4)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of
enactment of this Act, the Secretary shall submit to Congress a report on the
results of the study under
<internal-xref idref="H5685204F86FE4823A5A167D6CC404609" legis-path="105.(b)(1)">paragraph (1)</internal-xref>, categorized by type of
injury or condition and race and ethnicity.</text>
</paragraph></subsection></section><section display-inline="no-display-inline" id="HF698D5AF414F4FFD85308FC900A948DD" section-type="subsequent-section"><enum>106.</enum><header>Public education
campaign</header>
<subsection id="HD7168C4983A2491D928767D12649A1F0"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, in
consultation with the Secretary of Education, the Secretary of Transportation,
the Consumer Product Safety Commission, and the Chair of the President’s
Council on Physical Fitness and Sports, shall conduct a national public
awareness program on musculoskeletal health.</text>
</subsection><subsection id="H396E503961D24480BD8E36E164E26319"><enum>(b)</enum><header>Contents of
program</header><text>The program shall include, at a minimum, the following
components:</text>
<paragraph id="H97C083086F36432487EF57B32C144472"><enum>(1)</enum><header>General
information for the public</header><text display-inline="yes-display-inline">A
component providing education to the general public on musculoskeletal health,
including education on healthy lifestyle practices relating to musculoskeletal
health.</text>
</paragraph><paragraph id="HBCC7AF8D88E9407793099C7EF6199B0"><enum>(2)</enum><header>Education for
health professionals</header><text>A component providing education to health
professionals on musculoskeletal health, including—</text>
<subparagraph id="HF03D41F5D1FA4102925454B25FA6FD5E"><enum>(A)</enum><text>specific
information on musculoskeletal health in medically underserved populations (as
defined in section 330(b)(3) of the Public Health Service Act (42 U.S.C.
254b(b)(3))); and</text>
</subparagraph><subparagraph id="HAE3A23C4AD29475DB9D6A69939520613"><enum>(B)</enum><text>the impact of
musculoskeletal diseases and conditions on racial and ethnic minority
populations.</text>
</subparagraph></paragraph><paragraph display-inline="no-display-inline" id="HD77D42B9A6D24D5F932F90F9E156819"><enum>(3)</enum><header>Education for
girls</header><text display-inline="yes-display-inline">A component that
utilizes the program popularly known as <quote>powerful bones, powerful
girls</quote> to educate girls between 9 and 12 years of age on optimal bone
health and the methods to achieve such health, with a focus on reducing the
risk that such girls will develop osteoporosis as adults.</text>
</paragraph><paragraph id="H16D3CA4D5D4144A491067DDFFBC340D8"><enum>(4)</enum><header>Education for
special populations</header><text>A component providing education to the
following populations that address the specific needs of those
populations:</text>
<subparagraph id="H0E9EC60B9F2B41FCAFFA59C3F43DA6AC"><enum>(A)</enum><text>Populations of the
United States that have disproportionately high levels of musculoskeletal
disease and injury.</text>
</subparagraph><subparagraph id="H67263762DA6B46C9A2BDD179CA27671"><enum>(B)</enum><text>Populations of the
United States that have disproportionally low levels of access to orthopedic
services.</text>
</subparagraph><subparagraph id="HB653FC3CB2B5456099AD6BF02CF61520"><enum>(C)</enum><text display-inline="yes-display-inline">Racial and ethnic minority populations of
the United States.</text>
</subparagraph></paragraph></subsection></section><section display-inline="no-display-inline" id="H342A823834574A5AB6D5909C84A6CB3D" section-type="subsequent-section"><enum>107.</enum><header>Orthopedic physician
workforce training study</header>
<subsection id="H6B0F6272F66F4C889C25FBBE3CDE2F90"><enum>(a)</enum><header>Study</header><text>The
Secretary, acting through the Administrator of the Health Resource Services
Administration, shall conduct a study on the amount of funding available for
graduate medical education in orthopedics from all sources and the impact of
that amount of funding on the availability of physicians trained in
orthopedics.</text>
</subsection><subsection id="H3F59DF6C38654CF1ADD3573F3269DF4B"><enum>(b)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of
enactment of this Act, the Secretary shall submit to Congress a report on the
results of the study under
<internal-xref idref="H6B0F6272F66F4C889C25FBBE3CDE2F90" legis-path="107.(a)">subsection (a)</internal-xref>.</text>
</subsection></section><section id="H240A7D7028C04F68B0B32644C8C99E53"><enum>108.</enum><header>Bone density
under the Medicare Program</header>
<subsection id="HF989F070EDBA4819A9AE82714428E9F"><enum>(a)</enum><header>Standard
measurement tool for Bone Density study</header>
<paragraph id="H88FA4E2D6B4C4FF0A6C4FDA299210EA"><enum>(1)</enum><header>Study</header><text display-inline="yes-display-inline">The Secretary, in consultation with the
Director of the Agency for Healthcare Research and Quality, the Director of the
National Institute of Biomedical Imaging and Bioengineering, and the
Administrator of the Centers for Medicare & Medicaid Services, shall
conduct a study on—</text>
<subparagraph id="H3A7D7D3140434AB3A761A1E873EEF220"><enum>(A)</enum><text>the
cost-effectiveness of all available methods for measuring bone mass in
beneficiaries of the Medicare program under title XVIII of the Social Security
Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>) for the purpose of identifying the most
cost-effective method;</text>
</subparagraph><subparagraph id="H5F8472A7E2A647E4A3404EC44CDB2B00"><enum>(B)</enum><text>the
cost-effectiveness of different time intervals between each bone mass screening
for each such beneficiary for the purpose of identifying the most
cost-effective interval;</text>
</subparagraph><subparagraph id="H9D0A9405F11E42918000E496B5BA3F9B"><enum>(C)</enum><text display-inline="yes-display-inline">the frequency with which the
cost-effectiveness of such methods and intervals should be reviewed based on
anticipated changes in technology.</text>
</subparagraph></paragraph><paragraph id="H5912F23FB07B45C48F36262991DD3791"><enum>(2)</enum><header>Report</header>
<subparagraph id="HCDF1BDB81ACE46FF002B25921FBC0769"><enum>(A)</enum><header>In
general</header><text>Not later than 2 years after the date of enactment of
this Act, the Secretary shall submit to Congress and the Secretary of Commerce
a report on the results of the study under
<internal-xref idref="H88FA4E2D6B4C4FF0A6C4FDA299210EA" legis-path="108.(a)(1)">paragraph (1)</internal-xref>.</text>
</subparagraph><subparagraph id="H0D4565F7A6B54116B5B0EC8F19E828C8"><enum>(B)</enum><header>Contents of
Report</header><text>The report under
<internal-xref idref="HCDF1BDB81ACE46FF002B25921FBC0769" legis-path="108.(a)(2)(A)">subparagraph (A)</internal-xref> shall include, at a
minimum, the following:</text>
<clause id="H5B8309E586124DB281B71CA3DC008E9B"><enum>(i)</enum><text>The
most cost-effective method for measuring bone mass in beneficiaries of the
Medicare program and a recommendation for the adoption of such method by the
Medicare program.</text>
</clause><clause id="H675F9BA474D84D1091DE81ED04A4D3E2"><enum>(ii)</enum><text>The
most cost-effective interval between bone mass screenings for such
beneficiaries and recommendation for the adoption of such interval by the
Medicare program.</text>
</clause></subparagraph></paragraph><paragraph id="H12EDBACC38EB4AB3ABD04464850482AE"><enum>(3)</enum><header>United States
Preventive Services Task Force</header><text>In making the recommendations
under
<internal-xref idref="H0D4565F7A6B54116B5B0EC8F19E828C8" legis-path="108.(a)(2)(B)">paragraph (2)(B)</internal-xref>, the Secretary
shall take into consideration any relevant guidelines in the most recent Guide
to Clinical Preventive Services by the United States Preventive Services Task
Force.</text>
</paragraph><paragraph id="H283DC3AF15414617BF9EBAD01FF58ED6"><enum>(4)</enum><header>Revisions to
recommendations</header><text display-inline="yes-display-inline">The Secretary
shall monitor developments in technology used to measure bone density and
prepare and submit to Congress and the Secretary of Commerce reports updating
the recommendations made under
<internal-xref idref="H0D4565F7A6B54116B5B0EC8F19E828C8" legis-path="108.(a)(2)(B)">paragraph (2)(B)</internal-xref>, as needed.</text>
</paragraph></subsection><subsection id="HEBF199DFD1954971A7D3C047C38A386"><enum>(b)</enum><header>Standard unit for
measuring bone density</header>
<paragraph id="H93FD99BC95B84D14B5D25617CF876D7B"><enum>(1)</enum><header>Report</header><text>Not
later than three years after the date of enactment of this Act, the Secretary
of Commerce, acting through the Director of the National Institutes of
Standards and Technology, shall prepare and submit to Congress a report on
recommendations concerning a standard unit for the measurement of bone mass for
use by the Medicare program under title XVIII of the Social Security Act (42
U.S.C. 1395 et seq.).</text>
</paragraph><paragraph id="H8F8E5BC77B914565ABB2772D7C7C8CBF"><enum>(2)</enum><header>Considerations
for recommendations</header><text>In proposing the recommendations under
<internal-xref idref="H93FD99BC95B84D14B5D25617CF876D7B" legis-path="108.(b)(1)">paragraph (1)</internal-xref>, the Secretary of
Commerce shall take into consideration the recommendations made under
<internal-xref idref="H0D4565F7A6B54116B5B0EC8F19E828C8" legis-path="108.(a)(2)(B)">subsection (a)(2)(B)</internal-xref>, including any
applicable updates to such recommendations made under
<internal-xref idref="H283DC3AF15414617BF9EBAD01FF58ED6" legis-path="108.(a)(4)">subsection (a)(4)</internal-xref>, and the accuracy and
utility of the recommended standard measurement unit as a diagnostic
tool.</text>
</paragraph></subsection></section><section id="H177259440449497BBDB7DEDC913522B4"><enum>109.</enum><header>Access to
orthopedic services for beneficiaries of Medicaid and SCHIP</header>
<subsection id="H90E377C780B143B9B25F19B346BE421E"><enum>(a)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of
enactment of this Act, the Comptroller General of the United States shall
prepare and submit a report to Congress on access to orthopedic
services—</text>
<paragraph id="H8BD56785C625467593333757C2AD8E69"><enum>(1)</enum><text>by beneficiaries
of the Medicaid program under title XIX of the Social Security Act (42 U.S.C.
1396a et seq.); and</text>
</paragraph><paragraph id="HE86C5795DCB8421DA1F54DC31EAC9EED"><enum>(2)</enum><text>by beneficiaries
of the State Children’s Health Insurance program under title XXI of the Social
Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397aa">42 U.S.C. 1397aa et seq.</external-xref>).</text>
</paragraph></subsection><subsection id="H2EF2E9A1301B4488AB54A2D1B9C7C9FB"><enum>(b)</enum><header>Focus on
barriers To access affecting children</header><text>The report under this
section shall include, at a minimum, information on barriers to access to
orthopedic services that disproportionately affect children who are
beneficiaries of the Medicaid program or the State Children’s Health Insurance
program.</text>
</subsection></section><section id="HE0C06815DF5A498F9977D278F51FF6E"><enum>110.</enum><header>Age-related
programs</header>
<subsection commented="no" id="H2134A7F9D187481A89036D584FB9B25C"><enum>(a)</enum><header>State-based
Examples of Network Innovation, Opportunity, and Replication Grant
Program</header><text display-inline="yes-display-inline">The Secretary shall
award grants to State agencies in a manner similar to the manner in which
grants were awarded under the program of the Department of Health and Human
Services popularly known as the <quote>State-based Examples of Network
Innovation, Opportunity, and Replication Grant Program</quote> for the purpose
of allowing such State agencies to establish or expand health and aging
activities for seniors in the areas of clinical preventive services, physical
activity, chronic disease self-management, and oral health.</text>
</subsection><subsection id="HCC5162EB0F02430E80896654B5286567"><enum>(b)</enum><header>Childhood
musculoskeletal diseases, conditions, and injuries report</header><text>Not
later than 2 years after the date of enactment of this Act, the Surgeon General
of the Public Health Service shall prepare and submit to Congress a report on
the burdens and costs associated with childhood musculoskeletal diseases,
conditions, and injuries in the United States.</text>
</subsection></section><section display-inline="no-display-inline" id="HA4366BDF31A341F88B7C31664BF450ED" section-type="subsequent-section"><enum>111.</enum><header>Minority health
disparities</header><text display-inline="no-display-inline">The Secretary,
acting through the Deputy Assistant Secretary for Minority Health, shall treat
musculoskeletal diseases and conditions as a priority for programs and grants
affiliated with the Office of Minority Health and may incorporate
musculoskeletal diseases and conditions into the initiatives of such
Office.</text>
</section><enum>II</enum><header>Third
longitudinal study on aging</header>
<section id="H403F2D5FEF6949FC9289C4B7E6ABAC63"><enum>201.</enum><header>Third
longitudinal study on aging</header>
<subsection display-inline="no-display-inline" id="HB414CACAB3044468BE8FD1FEEFF2F0AA"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Director of the
National Center for Health Statistics and in consultation with the Director of
the National Institute on Aging, shall conduct a third longitudinal study on
aging in the United States in a manner similar to the manner in which the
second longitudinal study on aging was conducted.</text>
</subsection><subsection id="H38530DE5D6024A24B5EB1D56739BB5CB"><enum>(b)</enum><header>Duration</header><text display-inline="yes-display-inline">The duration of the third longitudinal
study under
<internal-xref idref="HB414CACAB3044468BE8FD1FEEFF2F0AA" legis-path="201.(a)">subsection (a)</internal-xref> shall be at least 6
years.</text>
</subsection><subsection id="HB33D39431C7A4321A7C46218E9F3A912"><enum>(c)</enum><header>Availability of
data</header><text>Data collected through the third longitudinal study under
<internal-xref idref="HB414CACAB3044468BE8FD1FEEFF2F0AA" legis-path="201.(a)">subsection (a)</internal-xref> shall be made available to
the public in a time and manner similar to the time and manner in which data
from the second longitudinal study on aging was made available to the
public.</text>
</subsection></section>