[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 1693 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                S. 1693

     To enhance the adoption of a nationwide interoperable health 
information technology system and to improve the quality and reduce the 
               costs of health care in the United States.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 26, 2007

Mr. Kennedy (for himself, Mr. Enzi, Mrs. Clinton, Mr. Hatch, Mr. Obama, 
   Mr. Gregg, Mr. Alexander, Mr. Burr, Mr. Roberts, and Mr. Isakson) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
     To enhance the adoption of a nationwide interoperable health 
information technology system and to improve the quality and reduce the 
               costs of health care in the United States.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Wired for Health Care Quality Act''.

     TITLE I--IMPROVING THE INTEROPERABILITY OF HEALTH INFORMATION 
                               TECHNOLOGY

SEC. 101. IMPROVING HEALTH CARE QUALITY, SAFETY, AND EFFICIENCY..

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

         ``TITLE XXX--HEALTH INFORMATION TECHNOLOGY AND QUALITY

``SEC. 3001. DEFINITIONS; REFERENCE.

    ``(a) In General.--In this title:
            ``(1) Community.--The term `Community' means the American 
        Health Information Community established under section 3004.
            ``(2) Health care provider.--The term `health care 
        provider' means a hospital, skilled nursing facility, home 
        health entity, health care clinic, federally qualified health 
        center, group practice (as defined in section 1877(h)(4) of the 
        Social Security Act), a pharmacist, a pharmacy, a laboratory, a 
        physician (as defined in section 1861(r) of the Social Security 
        Act), a practitioner (as defined in section 1842(b)(18)(CC) of 
        the Social Security Act), a health facility operated by or 
        pursuant to a contract with the Indian Health Service, a rural 
        health clinic, and any other category of facility or clinician 
        determined appropriate by the Secretary.
            ``(3) Health information.--The term `health information' 
        has the meaning given such term in section 1171(4) of the 
        Social Security Act.
            ``(4) Health plan.--The term `health plan' has the meaning 
        given such term in section 1171(5) of the Social Security Act.
            ``(5) Individually identifiable health information.--The 
        term `individually identifiable health information' has the 
        meaning given such term in section 1171 of the Social Security 
        Act.
            ``(6) Laboratory.--The term `laboratory' has the meaning 
        given such term in section 353.
            ``(7) National coordinator.--The term `National 
        Coordinator' means the National Coordinator of Health 
        Information Technology appointed pursuant to section 3002.
            ``(8) Partnership.--The term `Partnership' means the 
        Partnership for Health Care Improvement established under 
        section 3003.
            ``(9) Qualified health information technology.--The term 
        `qualified health information technology' means a computerized 
        system (including hardware and software) that--
                    ``(A) protects the privacy and security of health 
                information;
                    ``(B) maintains and provides permitted access to 
                health information in an electronic format;
                    ``(C) with respect to individually identifiable 
                health information maintained in a designated record 
                set, preserves an audit trail of each individual that 
                has gained access to such record set;
                    ``(D) incorporates decision support to reduce 
                medical errors and enhance health care quality;
                    ``(E) complies with the standards adopted by the 
                Federal Government under section 3003;
                    ``(F) has the ability to transmit and exchange 
                information to other health information technology 
                systems and, to the extent feasible, public health 
                information technology systems; and
                    ``(G) allows for the reporting of quality measures 
                adopted under section 3010.
            ``(10) State.--The term `State' means each of the several 
        States, the District of Columbia, Puerto Rico, the Virgin 
        Islands, Guam, American Samoa, and the Northern Mariana 
        Islands.
    ``(b) References to Social Security Act.--Any reference in this 
section to the Social Security Act shall be deemed to be a reference to 
such Act as in effect on the date of enactment of this title.

``SEC. 3002. OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION 
              TECHNOLOGY.

    ``(a) Establishment.--There is established within the office of the 
Secretary, the Office of the National Coordinator of Health Information 
Technology. The National Coordinator shall be appointed by the 
Secretary in consultation with the President, and shall report directly 
to the Secretary.
    ``(b) Purpose.--The Office of the National Coordinator shall be 
responsible for--
            ``(1) ensuring that key health information technology 
        initiatives are coordinated across programs of the Department 
        of Health and Human Services;
            ``(2) ensuring that health information technology policies 
        and programs of the Department of Health and Human Services are 
        coordinated with such policies and programs of other relevant 
        Federal agencies (including Federal commissions and advisory 
        committees) with a goal of avoiding duplication of efforts and 
        of helping to ensure that each agency undertakes activities 
        primarily within the areas of its greatest expertise and 
        technical capability;
            ``(3) reviewing Federal health information technology 
        investments to ensure that Federal health information 
        technology programs are meeting the objectives of the strategic 
        plan published by the Office of the National Coordinator of 
        Health Information Technology to establish a nationwide 
        interoperable health information technology infrastructure;
            ``(4) providing comments and advice regarding specific 
        Federal health information technology programs, at the request 
        of Office of Management and Budget; and
            ``(5) enhancing the use of health information technology to 
        improve the quality of health care in the prevention and 
        management of chronic disease and to address population health.
    ``(c) Role With Community and the Partnership.--The Office of the 
National Coordinator shall--
            ``(1) serve as an ex officio member of the Community, and 
        act as a liaison between the Federal Government and the 
        Community;
            ``(2) serve as an ex officio member of the Partnership and 
        act as a liaison between the Federal Government and the 
        Partnership; and
            ``(3) serve as a liaison between the Partnership and the 
        Community.
    ``(d) Reports and Website.--The Office of the National Coordinator 
shall--
            ``(1) develop and publish a strategic plan for implementing 
        a nationwide interoperable health information technology 
        infrastructure;
            ``(2) maintain and frequently update an Internet website 
        that--
                    ``(A) publishes the schedule for the assessment of 
                standards for significant use cases;
                    ``(B) publishes the recommendations of the 
                Community;
                    ``(C) publishes the recommendations of the 
                Partnership;
                    ``(D) publishes quality measures;
                    ``(E) identifies sources of funds that will be made 
                available to facilitate the purchase of, or enhance the 
                utilization of, health information technology systems, 
                either through grants or technical assistance; and
                    ``(F) publishes a plan for a transition of any 
                functions of the Office of the National Coordinator 
                that should be continued after September 30, 2014;
            ``(3) prepare a report on the lessons learned from major 
        public and private health care systems that have implemented 
        health information technology systems, including an explanation 
        of whether the systems and practices developed by such systems 
        may be applicable to and usable in whole or in part by other 
        health care providers; and
            ``(4) assess the impact of health information technology in 
        communities with health disparities and identify practices to 
        increase the adoption of such technology by health care 
        providers in such communities.
    ``(e) Rule of Construction.--Nothing in this section shall be 
construed as requiring the duplication of Federal efforts with respect 
to the establishment of the Office of the National Coordinator for 
Health Information Technology, regardless of whether such efforts are 
carried out before or after the date of the enactment of this title.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $5,000,000 for each of fiscal 
years 2008 and 2009.
    ``(g) Sunset.--The provisions of this section shall not apply after 
September 30, 2014.

``SEC. 3003. PARTNERSHIP FOR HEALTH CARE IMPROVEMENT-STANDARDS AND 
              TECHNOLOGY.

    ``(a) Establishment.--
            ``(1) In general.--There is established a public-private 
        Partnership for Health Care Improvement to--
                    ``(A) provide advice to the Secretary and the 
                Nation and recommend specific actions to achieve a 
                nationwide interoperable health information technology 
                infrastructure;
                    ``(B) make recommendations concerning standards, 
                implementation specifications, and certification 
                criteria for the electronic exchange of health 
                information (including for the reporting of quality 
                data under section 3010) for adoption by the Federal 
                Government and voluntary adoption by private entities;
                    ``(C) serve as a forum for the participation of a 
                broad range of stakeholders with specific technical 
                expertise in the development of standards, 
                implementation specifications, and certification 
                criteria to provide input on the effective 
                implementation of health information technology 
                systems; and
                    ``(D) develop and maintain an Internet website 
                that--
                            ``(i) publishes established governance 
                        rules (including a subsequent appointment 
                        process);
                            ``(ii) publishes a business plan;
                            ``(iii) publishes meeting notices at least 
                        14 days prior to each meeting;
                            ``(iv) publishes meeting agendas at least 7 
                        days prior to each meeting; and
                            ``(v) publishes meeting materials at least 
                        3 days prior to each meeting.
            ``(2) Limitation.--The Partnership shall not meet or take 
        any action until an advisory committee charter has been filed 
        with the Secretary and with the appropriate committees of the 
        Senate and House of Representatives for the Community described 
        in section 3004.
    ``(b) Membership.--
            ``(1) Appointments.--
                    ``(A) In general.--The Partnership shall be 
                composed of members to be appointed as follows:
                            ``(i) 2 members shall be appointed by the 
                        Secretary.
                            ``(ii) 1 member shall be appointed by the 
                        majority leader of the Senate.
                            ``(iii) 1 member shall be appointed by the 
                        minority leader of the Senate.
                            ``(iv) 1 member shall be appointed by the 
                        Speaker of the House of Representatives.
                            ``(v) 1 member shall be appointed by the 
                        minority leader of the House of 
                        Representatives.
                            ``(vi) Seven members shall be appointed by 
                        the Comptroller General of whom--
                                    ``(I) one member shall be a 
                                representative of consumer or patient 
                                organizations;
                                    ``(II) one member shall be a 
                                representative of organizations with 
                                expertise in privacy;
                                    ``(III) one member shall be a 
                                representative of organizations with 
                                expertise in security;
                                    ``(IV) one member shall be a 
                                representative of health care 
                                providers;
                                    ``(V) one member shall be a 
                                representative of health plans or other 
                                third party payers;
                                    ``(VI) one member shall be a 
                                representative of information 
                                technology vendors; and
                                    ``(VII) one member shall be a 
                                representative of purchasers or 
                                employers.
                    ``(B) National coordinator.--The National 
                Coordinator shall be a member of the Partnership and 
                act as a liaison among the Partnership, the community, 
                and the Federal Government.
            ``(2) Chairperson and vice chairperson.--The Partnership 
        shall designate one member to serve as the chairperson and one 
        member to serve as the vice chairperson of the Partnership.
            ``(3) Participation.--In appointing members under paragraph 
        (1)(A), and in developing the procedures for conducting the 
        activities of the Partnership, the Partnership shall ensure a 
        balance among various sectors of the health care system so that 
        no single sector unduly influences the recommendations of the 
        Partnership.
            ``(4) Terms.--Members appointed under paragraph (1)(A) 
        shall serve for 3 year terms, except that any member appointed 
        to fill a vacancy for an unexpired term shall be appointed for 
        the remainder of such term. A member may serve for not to 
        exceed 180 days after the expiration of such member's term or 
        until a successor has been appointed.
            ``(5) Outside involvement.--The Partnership shall ensure an 
        adequate opportunity for the participation of outside advisors, 
        including individuals with expertise in--
                    ``(A) health information privacy;
                    ``(B) health information security;
                    ``(C) health care quality and patient safety, 
                including individuals with expertise in utilizing 
                health information technology to improve health care 
                quality and patient safety;
                    ``(D) medical and clinical research data exchange; 
                and
                    ``(E) developing health information technology 
                standards and new health information technology.
            ``(6) Quorum.--Two-thirds of the members of the Partnership 
        shall constitute a quorum for the purpose of conducting votes.
    ``(c) Standards and Implementation Specifications.--
            ``(1) Schedule.--Not later than 90 days after the date of 
        enactment of this title, the Partnership shall develop a 
        schedule for the assessment of standards and implementation 
        specifications under this section. The Partnership shall update 
        such schedule annually. The Secretary shall publish such 
        schedule in the Federal Register and on the Internet website of 
        the Department of Health and Human Services.
            ``(2) First year recommendations.--Consistent with the 
        schedule published under paragraph (1) and not later than 1 
        year after date of enactment of this title, the Partnership 
        shall recommend, and the Secretary shall review, such standards 
        and implementation specifications.
            ``(3) Ongoing recommendations.--The Partnership shall 
        review and modify, as appropriate but at least annually, 
        adopted standards and implementation specifications and 
        continue to recommend additional standards and implementation 
        specifications, consistent with the schedule published pursuant 
        to paragraph (1). The Secretary shall review such modifications 
        and recommendations.
            ``(4) Recognition of private entities.--The Partnership, in 
        consultation with the Secretary, may recognize a private entity 
        or entities for the purpose of developing and updating 
        standards and implementation specifications to achieve uniform 
        and consistent implementation of the standards adopted by the 
        President under this title. Such entity or entities shall make 
        recommendations to the Partnership consistent with this 
        section.
            ``(5) Publication.--All recommendations made by the 
        Partnership pursuant to this section shall be published in the 
        Federal Register and on the Internet website of the Office of 
        the National Coordinator.
            ``(6) Pilot testing.--The Secretary may conduct, or 
        recognize a private entity or entities to conduct, a pilot 
        project to test the standards and implementation specifications 
        developed under this section in order to provide for the 
        efficient implementation of the standards and implementation 
        specifications described in this subsection prior to issuing 
        such recommendations.
            ``(7) Public input.--The Partnership shall conduct open 
        public meetings and develop a process to allow for public 
        comment on the schedule and recommendations described in this 
        section. Such process shall ensure that such comments will be 
        submitted within 30 days of the publication of a recommendation 
        under this section.
            ``(8) Federal action.--Not later than 90 days after the 
        issuance of a recommendation from the Partnership under this 
        subsection, the Secretary, the Secretary of Veterans Affairs, 
        and the Secretary of Defense, in collaboration with 
        representatives of other relevant Federal agencies as 
        determined appropriate by the President, shall jointly review 
        such recommendation. If appropriate, the President shall 
        provide for the adoption by the Federal Government of any 
        standard or implementation specification contained in such 
        recommendation. Such determination shall be published in the 
        Federal Register and on the Internet website of the Office of 
        the National Coordinator within 30 days after such 
        determination is made.
            ``(9) Consistency.--The standards and implementation 
        specifications described in this subsection shall be consistent 
        with the standards for information transactions and data 
        elements developed pursuant to the regulations promulgated 
        under section 264(c) of the Health Insurance Portability and 
        Accountability Act of 1996.
    ``(d) Certification.--
            ``(1) Developing criteria.--The Partnership, in 
        consultation with the Secretary, may recognize a private entity 
        or entities for the purpose of developing and recommending to 
        the Partnership criteria to certify that appropriate categories 
        of health information technology products that claim to be in 
        compliance with applicable standards and implementation 
        specifications adopted under this title have established such 
        compliance.
            ``(2) Adoption of criteria.--The Secretary, based upon the 
        recommendations of the Partnership, shall review, and if 
        appropriate, adopt such criteria.
            ``(3) Conducting certification.--The Secretary may 
        recognize a private entity or entities to conduct the 
        certifications described under paragraph (1) using the criteria 
        adopted by the Secretary under this subsection.
    ``(e) Rule of Construction.--Nothing in this section shall be 
construed as disrupting existing activities described in subsection (c) 
or (d).
    ``(f) Requirement To Consider Recommendations.--In carrying out the 
activities described in subsections (c) and (d), the Partnership shall 
adopt and integrate the recommendations of the Community that are 
adopted by the Secretary.
    ``(g) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $2,000,000 for each of the 
fiscal years 2008 and 2009.

``SEC. 3004. AMERICAN HEALTH INFORMATION COMMUNITY--POLICIES.

    ``(a) Establishment.--There is established a committee to be known 
as the American Health Information Community. The Community shall--
            ``(1) provide advice to the Secretary and the heads of any 
        relevant Federal agencies concerning the policy considerations 
        related to health information technology;
            ``(2) not later than 1 year after the date of enactment of 
        this title, and annually thereafter, make recommendations 
        concerning a policy framework for the development and adoption 
        of a nationwide interoperable health information technology 
        infrastructure;
            ``(3) not later than 1 year after the date of enactment of 
        this title, and annually thereafter, make recommendation 
        concerning national policies for adoption by the Federal 
        Government, and voluntary adoption by private entities, to 
        support the widespread adoption of health information 
        technology, including--
                    ``(A) the protection of individually identifiable 
                health information;
                    ``(B) methods to notify individuals if their 
                individually identifiable health information is 
                wrongfully disclosed;
                    ``(C) methods to facilitate secure access to such 
                individual's individually identifiable health 
                information;
                    ``(D) the appropriate uses of a nationwide health 
                information network including--
                            ``(i) the collection of quality data and 
                        public reporting;
                            ``(ii) biosurveillance and public health;
                            ``(iii) medical and clinical research; and
                            ``(iv) drug safety;
                    ``(E) fostering the public understanding of health 
                information technology;
                    ``(F) strategies to enhance the use of health 
                information technology in preventing and managing 
                chronic disease;
                    ``(G) policies to incorporate the input of 
                employees of health care providers in the design and 
                implementation of health information technology 
                systems; and
                    ``(H) other policies determined to be necessary by 
                the Community; and
            ``(4) serve as a forum for the participation of a broad 
        range of stakeholders to provide input on improving the 
        effective implementation of health information technology 
        systems.
    ``(b) Publication.--All recommendations made by the Community 
pursuant to this section shall be published in the Federal Register and 
on the Internet website of the National Coordinator. The Secretary 
shall review all recommendations and determine which recommendations 
shall be endorsed by the Federal Government and such determination 
shall be published on the Internet website of the Office of the 
National Coordinator within 30 days after the date on which such 
endorsement is made.
    ``(c) Membership.--
            ``(1) In general.--The Community shall be composed of 
        members to be appointed as follows:
                    ``(A) 3 members shall be appointed by the 
                Secretary, 1 of whom shall be a representative from the 
                Department of Health and Human Services.
                    ``(B) 1 member shall be appointed by the Secretary 
                of Veterans Affairs who shall represent the Department 
                of Veterans Affairs.
                    ``(C) 1 member shall be appointed by the Secretary 
                of Defense who shall represent the Department of 
                Defense.
                    ``(D) 1 member shall be appointed by the majority 
                leader of the Senate.
                    ``(E) 1 member shall be appointed by the minority 
                leader of the Senate.
                    ``(F) 1 member shall be appointed by the Speaker of 
                the House of Representatives.
                    ``(G) 1 member shall be appointed by the minority 
                leader of the House of Representatives.
                    ``(H) Nine members shall be appointed by the 
                Comptroller General of whom--
                            ``(i) one member shall be advocates for 
                        patients or consumers;
                            ``(ii) one member shall represent health 
                        care providers;
                            ``(iii) one member shall be from a labor 
                        organization representing health care workers;
                            ``(iv) one member shall have expertise in 
                        privacy and security;
                            ``(v) one member shall have expertise in 
                        improving the health of vulnerable populations;
                            ``(vi) one member shall represent health 
                        plans or other third party payers;
                            ``(vii) one member shall represent 
                        information technology vendors;
                            ``(viii) one member shall represent 
                        purchasers or employers; and
                            ``(ix) one member shall have expertise in 
                        health care quality measurement and reporting.
            ``(2) Chairperson and vice chairperson.--The Community 
        shall designate one member to serve as the chairperson and one 
        member to serve as the vice chairperson of the Community.
            ``(3) National coordinator.--The National Coordinator shall 
        be a member of the Community and act as a liaison among the 
        Community, the partnership, and the Federal Government.
            ``(4) Participation.--The members of the Community 
        appointed under paragraph (1) shall represent a balance among 
        various sectors of the health care system so that no single 
        sector unduly influences the recommendations of the Community.
            ``(5) Terms.--
                    ``(A) In general.--The terms of members of the 
                Community shall be for 3 years except that the 
                Comptroller General shall designate staggered terms for 
                the members first appointed.
                    ``(B) Vacancies.--Any member appointed to fill a 
                vacancy in the membership of the Community that occurs 
                prior to the expiration of the term for which the 
                member's predecessor was appointed shall be appointed 
                only for the remainder of that term. A member may serve 
                after the expiration of that member's term until a 
                successor has been appointed. A vacancy in the 
                Community shall be filled in the manner in which the 
                original appointment was made.
            ``(6) Outside involvement.--The Community shall ensure an 
        adequate opportunity for the participation of outside advisors, 
        including individuals with expertise in--
                    ``(A) health information privacy and security;
                    ``(B) improving the health of vulnerable 
                populations;
                    ``(C) health care quality and patient safety, 
                including individuals with expertise in measurement and 
                the use of health information technology to capture 
                data to improve health care quality and patient safety;
                    ``(D) ethics;
                    ``(E) medical and clinical research data exchange; 
                and
                    ``(F) developing health information technology 
                standards and new health information technology.
            ``(7) Quorum.--Ten members of the Community shall 
        constitute a quorum for purposes of voting, but a lesser number 
        of members may meet and hold hearings.
    ``(d) Federal Agencies.--
            ``(1) Staff of other federal agencies.--Upon the request of 
        the Community, the head of any Federal agency may detail, 
        without reimbursement, any of the personnel of such agency to 
        the Community to assist in carrying out the duties of the 
        Community. Any such detail shall not interrupt or otherwise 
        affect the civil service status or privileges of the Federal 
        employee involved.
            ``(2) Technical assistance.--Upon the request of the 
        Community, the head of a Federal agency shall provide such 
        technical assistance to the Community as the Community 
        determines to be necessary to carry out its duties.
            ``(3) Other resources.--The Community shall have reasonable 
        access to materials, resources, statistical data, and other 
        information from the Library of Congress and agencies and 
        elected representatives of the executive and legislative 
        branches of the Federal Government. The chairperson or vice 
        chairperson of the Community shall make requests for such 
        access in writing when necessary.
    ``(e) Application of FACA.--The Federal Advisory Committee Act (5 
U.S.C. App.) shall apply to the Community, except that the term 
provided for under section 14(a)(2) of such Act shall be not longer 
than 7 years.
    ``(f) Sunset.--The provisions of this section shall not apply after 
September 20, 2014.
    ``(g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $2,000,000 for each of fiscal 
years 2008 and 2009.

``SEC. 3005. FEDERAL PURCHASING AND DATA COLLECTION.

    ``(a) Coordination of Federal Spending.--
            ``(1) In general.--Not later than 1 year after the adoption 
        by the President of a recommendation under section 3003(c)(6), 
        a Federal agency shall not expend Federal funds for the 
        purchase of any new health information technology or health 
        information technology system for clinical care or for the 
        electronic retrieval, storage, or exchange of health 
        information if such technology or system is not consistent with 
        applicable standards adopted by the Federal Government under 
        section 3003.
            ``(2) Rule of construction.--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.
    ``(b) Voluntary Adoption.--
            ``(1) In general.--Any standards and implementation 
        specifications adopted by the Federal Government under section 
        303(c)(6) shall be voluntary with respect to private entities.
            ``(2) Requirement.--Private entities that enter into a 
        contract with the Federal Government shall adopt the standards 
        and implementation specifications adopted by the Federal 
        Government under this section for the purpose of activities 
        under such Federal contract.
            ``(3) Rule of construction.--Nothing in this section shall 
        be construed to require that a private entity that enters into 
        a contract with the Federal Government adopt the standards and 
        implementation specifications adopted by the Federal Government 
        under this section with respect to activities not related to 
        the contract.
    ``(c) Coordination of Federal Data Collection.--Not later than 3 
years after the adoption by the Federal Government of a recommendation 
as provided for in section 303(c)(6), 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, shall comply with the standards and implementation 
specifications adopted under such subsection.

``SEC. 3006. QUALITY AND EFFICIENCY REPORTS.

    ``(a) Purpose.--The purpose of this section is to provide for the 
development of reports based on Federal health care data and private 
data that is publicly available or is provided by the entity making the 
request for the report in order to--
            ``(1) improve the quality and efficiency of health care and 
        advance health care research;
            ``(2) enhance the education and awareness of consumers for 
        evaluating health care services; and
            ``(3) provide the public with reports on national, 
        regional, and provider- and supplier-specific performance, 
        which may be in a provider- or supplier-identifiable format.
    ``(b) Procedures for the Development of Reports.--
            ``(1) In general.--Notwithstanding section 552(b)(6) or 
        552a(b) of title 5, United States Code, not later than 12 
        months after the date of enactment of this section, the 
        Secretary, in accordance with the purpose described in 
        subsection (a), shall establish and implement procedures under 
        which an entity may submit a request to a Quality Reporting 
        Organization for the Organization to develop a report based 
        on--
                    ``(A) Federal health care data disclosed to the 
                Organization under subsection (c); and
                    ``(B) private data that is publicly available or is 
                provided to the Organization by the entity making the 
                request for the report.
            ``(2) Definitions.--In this section:
                    ``(A) Federal health care data.--The term `Federal 
                health care data' means --
                            ``(i) deidentified patient enrollment data, 
                        reimbursement claims, and survey data 
                        maintained by the Secretary or entities under 
                        programs, contracts, grants, or memoranda of 
                        understanding administered by the Secretary; 
                        and
                            ``(ii) where feasible, other deidentified 
                        patient enrollment data, reimbursement claims, 
                        and survey data maintained by the Federal 
                        Government or entities under contract with the 
                        Federal Government.
                    ``(B) Quality reporting organization.--The term 
                `Quality Reporting Organization' means an entity with a 
                contract under subsection (d).
    ``(c) Access to Federal Health Care Data.--
            ``(1) In general.--The procedures established under 
        subsection (b)(1) shall provide for the secure disclosure of 
        Federal health care data to each Quality Reporting 
        Organization.
            ``(2) Update of information.--Not less than every 6 months, 
        the Secretary shall update the information disclosed under 
        paragraph (1) to Quality Reporting Organizations.
    ``(d) Quality Reporting Organizations.--
            ``(1) In general.--
                    ``(A) Three contracts.--Subject to subparagraph 
                (B), the Secretary shall enter into a contract with 3 
                private entities to serve as Quality Reporting 
                Organizations under which an entity shall--
                            ``(i) store the Federal health care data 
                        that is to be disclosed under subsection (c); 
                        and
                            ``(ii) develop and release reports pursuant 
                        to subsection (e).
                    ``(B) Additional contracts.--If the Secretary 
                determines that reports are not being developed and 
                released within 6 months of the receipt of the request 
                for the report, the Secretary shall enter into 
                contracts with additional private entities in order to 
                ensure that such reports are developed and released in 
                a timely manner.
            ``(2) Qualifications.--The Secretary shall enter into a 
        contract with an entity under paragraph (1) only if the 
        Secretary determines that the entity--
                    ``(A) has the research capability to conduct and 
                complete reports under this section;
                    ``(B) has in place-
                            ``(i) an information technology 
                        infrastructure to support the database of 
                        Federal health care data that is to be 
                        disclosed to the entity; and
                            ``(ii) operational standards to provide 
                        security for such database;
                    ``(C) has experience with, and expertise on, the 
                development of reports on health care quality and 
                efficiency; and
                    ``(D) has a significant business presence in the 
                United States.
            ``(3) Contract requirements.--Each contract with an entity 
        under paragraph (1) shall contain the following requirements:
                    ``(A) Ensuring beneficiary privacy.--
                            ``(i) HIPAA.--The entity shall meet the 
                        requirements imposed on a covered entity for 
                        purposes of applying part C of title XI and all 
                        regulatory provisions promulgated thereunder, 
                        including regulations (relating to privacy) 
                        adopted pursuant to the authority of the 
                        Secretary under section 264(c) of the Health 
                        Insurance Portability and Accountability Act of 
                        1996 (42 U.S.C. 1320d-2 note).
                            ``(ii) Privacy.--The entity shall provide 
                        assurances that the entity will not use the 
                        Federal health care data disclosed under 
                        subsection (c) in a manner that violates 
                        sections 552 or 552a of title 5, United States 
                        Code, with regard to the privacy of and 
                        individual's individually identifiable health 
                        information.
                    ``(B) Proprietary information.--The entity shall 
                provide assurances that the entity will not disclose 
                any negotiated price concessions, such as discounts, 
                direct or indirect subsidies, rebates, and direct or 
                indirect remunerations, obtained by health care 
                providers or suppliers or health care plans, or any 
                other proprietary cost information.
                    ``(C) Disclosure.--The entity shall disclose--
                            ``(i) any financial, reporting, or 
                        contractual relationship between the entity and 
                        any health care provider or supplier or health 
                        care plan; and
                            ``(ii) if applicable, the fact that the 
                        entity is managed, controlled, or operated by 
                        any health care provider or supplier or health 
                        care plan.
                    ``(D) Component of another organization.--If the 
                entity is a component of another organization--
                            ``(i) the entity shall maintain Federal 
                        health care data and reports separately from 
                        the rest of the organization and establish 
                        appropriate security measures to maintain the 
                        confidentiality and privacy of the Federal 
                        health care data and reports; and
                            ``(ii) the entity shall not make an 
                        unauthorized disclosure to the rest of the 
                        organization of Federal health care data or 
                        reports in breach of such confidentiality and 
                        privacy requirement.
                    ``(E) Termination or nonrenewal.--If a contract 
                under this section is terminated or not renewed, the 
                following requirements shall apply:
                            ``(i) Confidentiality and privacy 
                        protections.--The entity shall continue to 
                        comply with the confidentiality and privacy 
                        requirements under this section with respect to 
                        all Federal health care data disclosed to the 
                        entity and each report developed by the entity.
                            ``(ii) Disposition of data and reports.--
                        The entity shall--
                                    ``(I) return to the Secretary all 
                                Federal health care data disclosed to 
                                the entity and each report developed by 
                                the entity; or
                                    ``(II) if returning the Federal 
                                health care data and reports is not 
                                practicable, destroy the reports and 
                                Federal health care data.
            ``(4) Competitive procedures.--Competitive procedures (as 
        defined in section 4(5) of the Federal Procurement Policy Act) 
        shall be used to enter into contracts under paragraph (1).
            ``(5) Review of contract in the event of a merger or 
        acquisition.--The Secretary shall review the contract with a 
        Quality Reporting Organization under this section in the event 
        of a merger or acquisition of the Organization in order to 
        ensure that the requirements under this section will continue 
        to be met.
    ``(e) Development and Release of Reports Based on Requests.--
            ``(1) Request for a report.--
                    ``(A) Request.--
                            ``(i) In general.--The procedures 
                        established under subsection (b)(1) shall 
                        include a process for an entity to submit a 
                        request to a Quality Reporting Organization for 
                        a report based on Federal health care data and 
                        private data that is publicly available or is 
                        provided by the entity making the request for 
                        the report. Such request shall comply with the 
                        purpose described in subsection (a).
                            ``(ii) Request for specific methodology.--
                        The process described in clause (i) shall 
                        permit an entity making a request for a report 
                        to request that a specific methodology, 
                        including appropriate risk adjustment, be used 
                        by the Quality Reporting Organization in 
                        developing the report. The Organization shall 
                        work with the entity making the request to 
                        finalize the methodology to be used.
                            ``(iii) Request for a specific qro.--The 
                        process described in clause (i) shall permit an 
                        entity to submit the request for a report to 
                        any Quality Reporting Organization.
                    ``(B) Release to public.--The procedures 
                established under subsection (b)(1) shall provide that 
                at the time a request for a report is finalized under 
                subparagraph (A) by a Quality Reporting Organization, 
                the Organization shall make available to the public, 
                through the Internet website of the Department of 
                Health and Human Services and other appropriate means, 
                a brief description of both the requested report and 
                the methodology to be used to develop such report.
            ``(2) Development and release of report.--
                    ``(A) Development.--
                            ``(i) In general.--If the request for a 
                        report complies with the purpose described in 
                        subsection (a), the Quality Reporting 
                        Organization may develop the report based on 
                        the request.
                            ``(ii) Requirement.--A report developed 
                        under clause (i) shall include a detailed 
                        description of the standards, methodologies, 
                        and measures of quality used in developing the 
                        report.
                    ``(B) Review of report by secretary to ensure 
                compliance with privacy requirement.--Prior to a 
                Quality Reporting Organization releasing a report under 
                subparagraph (C), the Secretary shall review the report 
                to ensure that the report complies with the Federal 
                regulations (concerning the privacy of individually 
                identifiable beneficiary health information) 
                promulgated under section 264(c) of the Health 
                Insurance Portability and Accountability Act of 1996 
                and sections 552 or 552a of title 5, United States 
                Code, with regard to the privacy of individually 
                identifiable beneficiary health information. The 
                Secretary shall act within 30 business days of 
                receiving such report.
                    ``(C) Release of report.--
                            ``(i) Release to entity making request.--If 
                        the Secretary finds that the report complies 
                        with the provisions described in subparagraph 
                        (B), the Quality Reporting Organization shall 
                        release the report to the entity that made the 
                        request for the report.
                            ``(ii) Release to public.--The procedures 
                        established under subsection (b)(1) shall 
                        provide for the following:
                                    ``(I) Updated description.--At the 
                                time of the release of a report by a 
                                Quality Reporting Organization under 
                                clause (i), the entity shall make 
                                available to the public, through the 
                                Internet website of the Department of 
                                Health and Human Services and other 
                                appropriate means, an updated brief 
                                description of both the requested 
                                report and the methodology used to 
                                develop such report.
                                    ``(II) Complete report.--Not later 
                                than 1 year after the date of the 
                                release of a report under clause (i), 
                                the report shall be made available to 
                                the public through the Internet website 
                                of the Department of Health and Human 
                                Services and other appropriate means.
    ``(f) Annual Review of Reports and Termination of Contracts.--
            ``(1) Annual review of reports.--The Comptroller General of 
        the United States shall review reports released under 
        subsection (e)(2)(C) to ensure that such reports comply with 
        the purpose described in subsection (a) and annually submit a 
        report to the Secretary on such review.
            ``(2) Termination of contracts.--The Secretary may 
        terminate a contract with a Quality Reporting Organization if 
        the Secretary determines that there is a pattern of reports 
        being released by the Organization that do not comply with the 
        purpose described in subsection (a).
    ``(g) Fees.--
            ``(1) Fees for secretary.--The Secretary shall charge a 
        Quality Reporting Organization a fee for--
                    ``(A) disclosing the data under subsection (c); and
                    ``(B) conducting the review under subsection 
                (e)(2)(B).
        The Secretary shall ensure that such fees are sufficient to 
        cover the costs of the activities described in subparagraph (A) 
        and (B).
            ``(2) Fees for qro.--
                    ``(A) In general.--Subject to subparagraphs (A) and 
                (B), a Quality Reporting Organization may charge an 
                entity making a request for a report a reasonable fee 
                for the development and release of the report.
                    ``(B) Discount for small entities.--In the case of 
                an entity making a request for a report (including a 
                not-for-profit) that has annual revenue that does not 
                exceed $10,000,000, the Quality Reporting Organization 
                shall reduce the reasonable fee charged to such entity 
                under subparagraph (A) by an amount equal to 10 percent 
                of such fee.
                    ``(C) Increase for large entities that do not agree 
                to release reports within 6 months.--In the case of an 
                entity making a request for a report that is not 
                described in subparagraph (B) and that does not agree 
                to the report being released to the public under clause 
                (ii)(II) of subsection (e)(2)(C) within 6 months of the 
                date of the release of the report to the entity under 
                clause (i) of such subsection, the Quality Reporting 
                Organization shall increase the reasonable fee charged 
                to such entity under subparagraph (A) by an amount 
                equal to 10 percent of such fee.
                    ``(D) Rule of construction.--Nothing in this 
                paragraph shall be construed to effect the requirement 
                that a report be released to the public under clause 
                (ii)(II) of subsection (e)(2)(C)(ii)(II) by not later 
                than 1 year after the date of the release of the report 
                to the requesting entity under clause (i) of such 
                subsection.
    ``(h) Coordination.--Not later than 1 year after the date of 
enactment of this title, the Secretary shall submit a report (including 
recommendations) to the appropriate committees of Congress concerning 
the coordination of existing Federal health care quality initiatives.
    ``(i) Regulations.--Not later than 6 months after the date of 
enactment of this section, the Secretary shall prescribe regulations to 
carry out this section.

``SEC. 3007. RESEARCH ACCESS TO HEALTH CARE DATA AND REPORTING ON 
              PERFORMANCE.

    ``The Secretary shall permit researchers that meet criteria used to 
evaluate the appropriateness of the release data for research purpose 
(as established by the Secretary) to--
            ``(1) have access to all Federal health care data (as 
        defined in section 3006(b)(2)(A)); and
            ``(2) report on the performance of health care providers 
        and suppliers, including reporting in a provider- or supplier-
        identifiable format.''.

TITLE II--FACILITATING THE WIDESPREAD ADOPTION OF INTEROPERABLE HEALTH 
                         INFORMATION TECHNOLOGY

SEC. 201. FACILITATING THE WIDESPREAD ADOPTION OF INTEROPERABLE HEALTH 
              INFORMATION TECHNOLOGY.

    Title XXX of the Public Health Service Act, as added by section 
101, is amended by adding at the end the following:

``SEC. 3008. FACILITATING THE WIDESPREAD ADOPTION OF INTEROPERABLE 
              HEALTH INFORMATION TECHNOLOGY.

    ``(a) Competitive Grants for Adoption of Technology.--
            ``(1) In general.--The Secretary may award competitive 
        grants to eligible entities to facilitate the purchase and 
        enhance the utilization of qualified health information 
        technology systems to improve the quality and efficiency of 
        health care.
            ``(2) Eligibility.--To be eligible to receive a grant under 
        paragraph (1) an entity shall--
                    ``(A) submit to the Secretary an application at 
                such time, in such manner, and containing such 
                information as the Secretary may require;
                    ``(B) submit to the Secretary a strategic plan for 
                the implementation of data sharing and interoperability 
                measures;
                    ``(C) adopt the standards adopted by the Federal 
                Government under section 3005;
                    ``(D) implement the measures adopted under section 
                3010 and report to the Secretary on such measures;
                    ``(E) agree to notify individuals if their 
                individually identifiable health information is 
                wrongfully disclosed;
                    ``(F) take into account the input of employees and 
                staff who are directly involved in patient care of such 
                health care providers in the design, implementation, 
                and use of qualified health information technology 
                systems;
                    ``(G) demonstrate significant financial need;
                    ``(H) provide matching funds in accordance with 
                paragraph (4); and
                    ``(I) be a--
                            ``(i) public or not for profit hospital;
                            ``(ii) federally qualified health center 
                        (as defined in section 1861(aa)(4) of the 
                        Social Security Act);
                            ``(iii) individual or group practice (or a 
                        consortium thereof); or
                            ``(iv) another health care provider not 
                        described in clause (i) or (ii);
                that serves medically underserved communities.
            ``(3) Use of funds.--Amounts received under a grant under 
        this subsection shall be used to--
                    ``(A) facilitate the purchase of qualified health 
                information technology systems;
                    ``(B) train personnel in the use of such systems;
                    ``(C) enhance the utilization of qualified health 
                information technology systems (which may include 
                activities to increase the awareness among consumers of 
                health care privacy protections); or
                    ``(D) improve the prevention and management of 
                chronic disease.
            ``(4) Matching requirement.--To be eligible for a grant 
        under this subsection an entity shall contribute non-Federal 
        contributions to the costs of carrying out the activities for 
        which the grant is awarded in an amount equal to $1 for each $3 
        of Federal funds provided under the grant.
            ``(5) Preference in awarding grants.--In awarding grants 
        under this subsection the Secretary shall give preference to--
                    ``(A) eligible entities that will improve the 
                degree to which such entity will link the qualified 
                health information system to local or regional health 
                information plan or plans; and
                    ``(B) with respect to awards made for the purpose 
                of providing care in an outpatient medical setting, 
                entities that organize their practices as a patient-
                centered medical home.
    ``(b) Competitive Grants for the Development of State Loan Programs 
To Facilitate the Widespread Adoption of Health Information 
Technology.--
            ``(1) In general.--The Secretary may award competitive 
        grants to States for the establishment of State programs for 
        loans to health care providers to facilitate the purchase and 
        enhance the utilization of qualified health information 
        technology.
            ``(2) Establishment of fund.--To be eligible to receive a 
        competitive grant under this subsection, a State shall 
        establish a qualified health information technology loan fund 
        (referred to in this subsection as a `State loan fund') and 
        comply with the other requirements contained in this 
        subsection. Amounts received under a grant under this 
        subsection shall be deposited in the State loan fund 
        established by the State. No funds authorized by other 
        provisions of this title to be used for other purposes 
        specified in this title shall be deposited in any such State 
        loan fund.
            ``(3) Eligibility.--To be eligible to receive a grant under 
        paragraph (1) a State shall--
                    ``(A) submit to the Secretary an application at 
                such time, in such manner, and containing such 
                information as the Secretary may require;
                    ``(B) submit to the Secretary a strategic plan in 
                accordance with paragraph (4);
                    ``(C) establish a qualified health information 
                technology loan fund in accordance with paragraph (2);
                    ``(D) require that health care providers receiving 
                loans under the grant--
                            ``(i) link, to the extent practicable, the 
                        qualified health information system to a local 
                        or regional health information network;
                            ``(ii) consult, as needed, with the Health 
                        Information Technology Resource Center 
                        established in section 914(d) to access the 
                        knowledge and experience of existing 
                        initiatives regarding the successful 
                        implementation and effective use of health 
                        information technology;
                            ``(iii) agree to notify individuals if 
                        their individually identifiable health 
                        information is wrongfully disclosed; and
                            ``(iv) take into account the input of 
                        employees and staff who are directly involved 
                        in patient care of such health care providers 
                        in the design and implementation and use of 
                        qualified health information technology 
                        systems;
                    ``(E) require that health care providers receiving 
                loans under the grant adopt the standards adopted by 
                the Federal Government under section 3005;
                    ``(F) require that health care providers receiving 
                loans under the grant implement the measures adopted 
                under section 3010 and report to the Secretary on such 
                measures; and
                    ``(G) provide matching funds in accordance with 
                paragraph (8).
            ``(4) Strategic plan.--
                    ``(A) In general.--A State that receives a grant 
                under this subsection shall annually prepare a 
                strategic plan that identifies the intended uses of 
                amounts available to the State loan fund of the State.
                    ``(B) Contents.--A strategic plan under 
                subparagraph (A) shall include--
                            ``(i) a list of the projects to be assisted 
                        through the State loan fund in the first fiscal 
                        year that begins after the date on which the 
                        plan is submitted;
                            ``(ii) a description of the criteria and 
                        methods established for the distribution of 
                        funds from the State loan fund;
                            ``(iii) a description of the financial 
                        status of the State loan fund and the short-
                        term and long-term goals of the State loan 
                        fund; and
                            ``(iv) a description of the strategies the 
                        State will use to address challenges in the 
                        adoption of health information technology due 
                        to limited broadband access.
            ``(5) Use of funds.--
                    ``(A) In general.--Amounts deposited in a State 
                loan fund, including loan repayments and interest 
                earned on such amounts, shall be used only for awarding 
                loans or loan guarantees, or as a source of reserve and 
                security for leveraged loans, the proceeds of which are 
                deposited in the State loan fund established under 
                paragraph (1). Loans under this section may be used by 
                a health care provider to--
                            ``(i) facilitate the purchase of qualified 
                        health information technology systems;
                            ``(ii) enhance the utilization of qualified 
                        health information technology systems (which 
                        may include activities to increase the 
                        awareness among consumers of health care of 
                        privacy protections and privacy rights); or
                            ``(iii) train personnel in the use of such 
                        systems.
                    ``(B) Limitation.--Amounts received by a State 
                under this subsection may not be used--
                            ``(i) for the purchase or other acquisition 
                        of any health information technology system 
                        that is not a qualified health information 
                        technology system;
                            ``(ii) to conduct activities for which 
                        Federal funds are expended under this title, or 
                        the amendments made by the Wired for Health 
                        Care Quality Act; or
                            ``(iii) for any purpose other than making 
                        loans to eligible entities under this section.
            ``(6) Types of assistance.--Except as otherwise limited by 
        applicable State law, amounts deposited into a State loan fund 
        under this subsection may only be used for the following:
                    ``(A) To award loans that comply with the 
                following:
                            ``(i) The interest rate for each loan shall 
                        be less than or equal to the market interest 
                        rate.
                            ``(ii) The principal and interest payments 
                        on each loan shall commence not later than 1 
                        year after the date on which the loan was 
                        awarded, and each loan shall be fully amortized 
                        not later than 10 years after such date.
                            ``(iii) The State loan fund shall be 
                        credited with all payments of principal and 
                        interest on each loan awarded from the fund.
                    ``(B) To guarantee, or purchase insurance for, a 
                local obligation (all of the proceeds of which finance 
                a project eligible for assistance under this 
                subsection) if the guarantee or purchase would improve 
                credit market access or reduce the interest rate 
                applicable to the obligation involved.
                    ``(C) As a source of revenue or security for the 
                payment of principal and interest on revenue or general 
                obligation bonds issued by the State if the proceeds of 
                the sale of the bonds will be deposited into the State 
                loan fund.
                    ``(D) To earn interest on the amounts deposited 
                into the State loan fund.
            ``(7) Administration of state loan funds.--
                    ``(A) Combined financial administration.--A State 
                may (as a convenience and to avoid unnecessary 
                administrative costs) combine, in accordance with State 
                law, the financial administration of a State loan fund 
                established under this subsection with the financial 
                administration of any other revolving fund established 
                by the State if not otherwise prohibited by the law 
                under which the State loan fund was established.
                    ``(B) Cost of administering fund.--Each State may 
                annually use not to exceed 4 percent of the funds 
                provided to the State under a grant under this 
                subsection to pay the reasonable costs of the 
                administration of the programs under this section, 
                including the recovery of reasonable costs expended to 
                establish a State loan fund which are incurred after 
                the date of enactment of this title.
                    ``(C) Guidance and regulations.--The Secretary 
                shall publish guidance and promulgate regulations as 
                may be necessary to carry out the provisions of this 
                subsection, including--
                            ``(i) provisions to ensure that each State 
                        commits and expends funds allotted to the State 
                        under this subsection as efficiently as 
                        possible in accordance with this title and 
                        applicable State laws; and
                            ``(ii) guidance to prevent waste, fraud, 
                        and abuse.
                    ``(D) Private sector contributions.--
                            ``(i) In general.--A State loan fund 
                        established under this subsection may accept 
                        contributions from private sector entities, 
                        except that such entities may not specify the 
                        recipient or recipients of any loan issued 
                        under this subsection.
                            ``(ii) Availability of information.--A 
                        State shall make publicly available the 
                        identity of, and amount contributed by, any 
                        private sector entity under clause (i) and may 
                        issue letters of commendation or make other 
                        awards (that have no financial value) to any 
                        such entity.
            ``(8) Matching requirements.--
                    ``(A) In general.--The Secretary may not make a 
                grant under paragraph (1) to a State unless the State 
                agrees to make available (directly or through donations 
                from public or private entities) non-Federal 
                contributions in cash toward the costs of the State 
                program to be implemented under the grant in an amount 
                equal to not less than $1 for each $1 of Federal funds 
                provided under the grant.
                    ``(B) Determination of amount of non-federal 
                contribution.--In determining the amount of non-Federal 
                contributions that a State has provided pursuant to 
                subparagraph (A), the Secretary may not include any 
                amounts provided to the State by the Federal 
                Government.
            ``(9) Preference in awarding grants.--The Secretary may 
        give a preference in awarding grants under this subsection to 
        States that adopt value-based purchasing programs to improve 
        health care quality.
            ``(10) Reports.--The Secretary shall annually submit to the 
        Committee on Health, Education, Labor, and Pensions and the 
        Committee on Finance of the Senate, and the Committee on Energy 
        and Commerce and the Committee on Ways and Means of the House 
        of Representatives, a report summarizing the reports received 
        by the Secretary from each State that receives a grant under 
        this subsection.
    ``(c) Competitive Grants for the Implementation of Regional or 
Local Health Information Technology Plans.--
            ``(1) In general.--The Secretary may award competitive 
        grants to eligible entities to implement regional or local 
        health information plans to improve health care quality and 
        efficiency through the electronic exchange of health 
        information pursuant to the standards, implementation 
        specifications and certification criteria, and other 
        requirements adopted by the Secretary under section 3010.
            ``(2) Eligibility.--To be eligible to receive a grant under 
        paragraph (1) an entity shall--
                    ``(A) demonstrate financial need to the Secretary;
                    ``(B) demonstrate that one of its principal 
                missions or purposes is to use information technology 
                to improve health care quality and efficiency;
                    ``(C) adopt bylaws, memoranda of understanding, or 
                other charter documents that demonstrate that the 
                governance structure and decisionmaking processes of 
                such entity allow for participation on an ongoing basis 
                by multiple stakeholders within a community, 
                including--
                            ``(i) health care providers (including 
                        health care providers that provide services to 
                        low income and underserved populations);
                            ``(ii) pharmacists or pharmacies;
                            ``(iii) health plans;
                            ``(iv) health centers (as defined in 
                        section 330(b)) and federally qualified health 
                        centers (as defined in section 1861(aa)(4) of 
                        the Social Security Act) and rural health 
                        clinics (as defined in section 1861(aa) of the 
                        Social Security Act), if such centers or 
                        clinics are present in the community served by 
                        the entity;
                            ``(v) patient or consumer organizations;
                            ``(vi) organizations dedicated to improving 
                        the health of vulnerable populations;
                            ``(vii) employers;
                            ``(viii) State or local health departments; 
                        and
                            ``(ix) any other health care providers or 
                        other entities, as determined appropriate by 
                        the Secretary;
                    ``(D) demonstrate the participation, to the extent 
                practicable, of stakeholders in the electronic exchange 
                of health information within the local or regional plan 
                pursuant to subparagraph (C);
                    ``(E) adopt nondiscrimination and conflict of 
                interest policies that demonstrate a commitment to 
                open, fair, and nondiscriminatory participation in the 
                health information plan by all stakeholders;
                    ``(F) adopt the standards adopted by the Secretary 
                under section 3005;
                    ``(G) require that health care providers receiving 
                such grants--
                            ``(i) implement the measures adopted under 
                        section 3010 and report to the Secretary on 
                        such measures; and
                            ``(ii) take into account the input of 
                        employees and staff who are directly involved 
                        in patient care of such health care providers 
                        in the design, implementation, and use of 
                        health information technology systems;
                    ``(H) agree to notify individuals if their 
                individually identifiable health information is 
                wrongfully disclosed;
                    ``(I) facilitate the electronic exchange of health 
                information within the local or regional area and among 
                local and regional areas;
                    ``(J) prepare and submit to the Secretary an 
                application in accordance with paragraph (3);
                    ``(K) agree to provide matching funds in accordance 
                with paragraph (5); and
                    ``(L) reduce barriers to the implementation of 
                health information technology by providers.
            ``(3) Application.--
                    ``(A) In general.--To be eligible to receive a 
                grant under paragraph (1), an entity shall submit to 
                the Secretary an application at such time, in such 
                manner, and containing such information as the 
                Secretary may require.
                    ``(B) Required information.--At a minimum, an 
                application submitted under this paragraph shall 
                include--
                            ``(i) clearly identified short-term and 
                        long-term objectives of the regional or local 
                        health information plan;
                            ``(ii) a technology plan that complies with 
                        the standards, implementation specifications, 
                        and certification criteria adopted under 
                        section 3003(c)(6) and that includes a 
                        descriptive and reasoned estimate of costs of 
                        the hardware, software, training, and 
                        consulting services necessary to implement the 
                        regional or local health information plan;
                            ``(iii) a strategy that includes 
                        initiatives to improve health care quality and 
                        efficiency, including the use and reporting of 
                        health care quality measures adopted under 
                        section 3010;
                            ``(iv) a plan that describes provisions to 
                        encourage the implementation of the electronic 
                        exchange of health information by all health 
                        care providers participating in the health 
                        information plan;
                            ``(v) a plan to ensure the privacy and 
                        security of individually identifiable health 
                        information that is consistent with Federal and 
                        State law;
                            ``(vi) a governance plan that defines the 
                        manner in which the stakeholders shall jointly 
                        make policy and operational decisions on an 
                        ongoing basis;
                            ``(vii) a financial or business plan that 
                        describes--
                                    ``(I) the sustainability of the 
                                plan;
                                    ``(II) the financial costs and 
                                benefits of the plan; and
                                    ``(III) the entities to which such 
                                costs and benefits will accrue;
                            ``(viii) a description of whether the State 
                        in which the entity resides has received a 
                        grant under section 319D, alone or as a part of 
                        a consortium, and if the State has received 
                        such a grant, how the entity will coordinate 
                        the activities funded under such section 319D 
                        with the system under this section; and
                            ``(ix) in the case of an applicant entity 
                        that is unable to demonstrate the participation 
                        of all stakeholders pursuant to paragraph 
                        (2)(C), the justification from the entity for 
                        any such nonparticipation.
            ``(4) Use of funds.--Amounts received under a grant under 
        paragraph (1) shall be used to establish and implement a 
        regional or local health information plan in accordance with 
        this subsection.
            ``(5) Matching requirement.--
                    ``(A) In general.--The Secretary may not make a 
                grant under this subsection to an entity unless the 
                entity agrees that, with respect to the costs to be 
                incurred by the entity in carrying out the 
                infrastructure program for which the grant was awarded, 
                the entity will make available (directly or through 
                donations from public or private entities) non-Federal 
                contributions toward such costs in an amount equal to 
                not less than 50 percent of such costs ($1 for each $2 
                of Federal funds provided under the grant).
                    ``(B) Determination of amount contributed.--Non-
                Federal contributions required under subparagraph (A) 
                may be in cash or in kind, fairly evaluated, including 
                equipment, technology, or services. Amounts provided by 
                the Federal Government, or services assisted or 
                subsidized to any significant extent by the Federal 
                Government, may not be included in determining the 
                amount of such non-Federal contributions.
    ``(d) Reports.--Not later than 1 year after the date on which the 
first grant is awarded under this section, and annually thereafter 
during the grant period, an entity that receives a grant under this 
section shall submit to the Secretary a report on the activities 
carried out under the grant involved. Each such report shall include--
            ``(1) a description of the financial costs and benefits of 
        the project involved and of the entities to which such costs 
        and benefits accrue;
            ``(2) an analysis of the impact of the project on health 
        care quality and safety;
            ``(3) a description of any reduction in duplicative or 
        unnecessary care as a result of the project involved; and
            ``(4) other information as required by the Secretary.
    ``(e) Authorization of Appropriations.--
            ``(1) In general.--For the purpose of carrying out this 
        section, there is authorized to be appropriated $139,000,000 
        for fiscal year 2008 and $139,000,000 for fiscal year 2009.
            ``(2) Availability.--Amounts appropriated under paragraph 
        (1) shall remain available through fiscal year 2012.

``SEC. 3009. DEMONSTRATION PROGRAM TO INTEGRATE INFORMATION TECHNOLOGY 
              INTO CLINICAL EDUCATION.

    ``(a) In General.--The Secretary may award grants to eligible 
entities or consortia under this section to carry out demonstration 
projects to develop academic curricula integrating qualified health 
information technology systems in the clinical education of health 
professionals or analyze clinical data sets to discover quality 
measures. Such awards shall be made on a competitive basis and pursuant 
to peer review.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity or consortium shall--
            ``(1) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require;
            ``(2) be or include--
                    ``(A) a health professions school;
                    ``(B) a school of nursing; or
                    ``(C) an institution with a graduate medical 
                education program;
            ``(3) provide for the collection of data regarding the 
        effectiveness of the demonstration project to be funded under 
        the grant in improving the safety of patients and the 
        efficiency of health care delivery; and
            ``(4) provide matching funds in accordance with subsection 
        (d).
    ``(c) Use of Funds.--
            ``(1) In general.--With respect to a grant under subsection 
        (a), an eligible entity or consortium shall use amounts 
        received under the grant in collaboration with 2 or more 
        disciplines.
            ``(2) Limitation.--An eligible entity or consortium shall 
        not award a grant under subsection (a) to purchase hardware, 
        software, or services.
    ``(d) Matching Funds.--
            ``(1) In general.--The Secretary may award a grant to an 
        entity under or consortium this section only if the entity of 
        consortium agrees to make available non-Federal contributions 
        toward the costs of the program to be funded under the grant in 
        an amount that is not less than $1 for each $2 of Federal funds 
        provided under the grant.
            ``(2) Determination of amount contributed.--Non-Federal 
        contributions under paragraph (1) may be in cash or in kind, 
        fairly evaluated, including equipment or services. Amounts 
        provided by the Federal Government, or services assisted or 
        subsidized to any significant extent by the Federal Government, 
        may not be included in determining the amount of such 
        contributions.
    ``(e) Evaluation.--The Secretary shall take such action as may be 
necessary to evaluate the projects funded under this section and 
publish, make available, and disseminate the results of such 
evaluations on as wide a basis as is practicable.
    ``(f) Reports.--Not later than 1 year after the date of enactment 
of this title, and annually thereafter, the Secretary shall submit to 
the Committee on Health, Education, Labor, and Pensions and the 
Committee on Finance of the Senate, and the Committee on Energy and 
Commerce and the Committee on Ways and Means of the House of 
Representatives a report that--
            ``(1) describes the specific projects established under 
        this section; and
            ``(2) contains recommendations for Congress based on the 
        evaluation conducted under subsection (e).
    ``(g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $2,000,000 for each of fiscal 
years 2008 and 2009.
    ``(h) Sunset.--This provisions of this section shall not apply 
after September 30, 2012.''.

            TITLE III--IMPROVING THE QUALITY OF HEALTH CARE

SEC. 301. CONSENSUS PROCESS FOR THE ADOPTION OF QUALITY MEASURES FOR 
              USE IN THE NATIONWIDE INTEROPERABLE HEALTH INFORMATION 
              TECHNOLOGY INFRASTRUCTURE.

    Title XXX of the Public Health Service Act, as amended by section 
201, is further amended by adding at the end the following:

``SEC. 3010. FOSTERING DEVELOPMENT AND USE OF HEALTH CARE QUALITY 
              MEASURES.

    ``(a) In General.--The Secretary shall provide for the development 
and use of health care quality measures (referred to in this title as 
`quality measures') for the purpose of measuring the quality and 
efficiency of health care that patients receive.
    ``(b) Designation of, and Arrangement With, Organization.--
            ``(1) In general.--Not later than 90 days after the date of 
        enactment of this title, the Secretary shall designate, and 
        have in effect an arrangement with, a single organization that 
        meets the requirements of subsection (c) under which such 
        organization shall promote the development of quality measures 
        and provide the Secretary with advice and recommendations on 
        the key elements and priorities of a national system for 
        healthcare performance measurement.
            ``(2) Responsibilities.--The responsibilities to be 
        performed by the organization designated under paragraph (1) 
        (in this title referred to as the `designated organization') 
        shall include--
                    ``(A) establishing and managing an integrated 
                national strategy and process for setting priorities 
                and goals in establishing quality measures;
                    ``(B) coordinating and harmonizing the development 
                and testing of such measures;
                    ``(C) establishing standards for the development 
                and testing of such measures;
                    ``(D) endorsing national consensus quality 
                measures;
                    ``(E) recommending, in collaboration with multi-
                stakeholder groups, quality measures to the Secretary 
                for adoption and use;
                    ``(F) promoting the development and use of 
                electronic health records that contain the 
                functionality for automated collection, aggregation, 
                and transmission of performance measurement 
                information; and
                    ``(G) providing recommendations and advice to the 
                Partnership regarding the integration of quality 
                measures into the certification process outlined under 
                section 3003 and the Community regarding national 
                policies outlined under section 3004.
    ``(c) Requirements Described.--The requirements described in this 
subsection are the following:
            ``(1) Private entity.--The organization shall be a private 
        nonprofit entity that is governed by a board of directors and 
        an individual who is designated as president and chief 
        executive officer.
            ``(2) Board membership.--The members of the board of 
        directors of the entity shall include representatives of--
                    ``(A) health care providers or groups representing 
                providers;
                    ``(B) health plans or groups representing health 
                plans;
                    ``(C) patients or consumers enrolled in such plans 
                or groups representing individuals enrolled in such 
                plans;
                    ``(D) health care purchasers and employers or 
                groups representing purchasers or employers; and
                    ``(E) organizations that develop health information 
                technology standards and new health information 
                technology.
            ``(3) Other membership requirements.--The membership of the 
        board of directors of the entity shall be representative of 
        individuals with experience with--
                    ``(A) urban health care issues;
                    ``(B) safety net health care issues;
                    ``(C) rural or frontier health care issues;
                    ``(D) quality and safety issues;
                    ``(E) State or local health programs;
                    ``(F) individuals or entities skilled in the 
                conduct and interpretation of biomedical, health 
                services, and health economics research and with 
                expertise in outcomes and effectiveness research and 
                technology assessment; and
                    ``(G) individuals or entities involved in the 
                development and establishment of standards and 
                certification for health information technology systems 
                and clinical data.
            ``(4) Open and transparent.--With respect to matters 
        related to the arrangement with the Secretary under subsection 
        (a)(1), the organization shall conduct its business in an open 
        and transparent manner, and provide the opportunity for public 
        comment and ensure a balance among disparate stakeholders, so 
        that no member organization unduly influences the work of the 
        organization.
            ``(5) Voluntary consensus standards setting 
        organizations.--The organization shall operate as a voluntary 
        consensus standards setting organization as defined for 
        purposes of section 12(d) of the National Technology Transfer 
        and Advancement Act of 1995 (Public Law 104-113) and Office of 
        Management and Budget Revised Circular A-119 (published in the 
        Federal Register on February 10, 1998).
            ``(6) Participation.--If the organization requires a fee 
        for membership, the organization shall ensure that such fee is 
        not a substantial barrier to participation in the entity's 
        activities related to the arrangement with the Secretary.
    ``(d) Requirements for Measures.--The quality measures developed 
under this title shall comply with the following:
            ``(1) Measures.--The designated organization, in promoting 
        the development of quality measures under this title, shall 
        ensure that such measures--
                    ``(A) are evidence-based, reliable, and valid;
                    ``(B) include--
                            ``(i) measures of clinical processes and 
                        outcomes, patient experience, efficiency, and 
                        equity; and
                            ``(ii) measures to assess effectiveness, 
                        timeliness, patient self-management, patient 
                        centeredness, and safety; and
                    ``(C) include measures of underuse and overuse.
            ``(2) Priorities.--In carrying out its responsibilities 
        under this section, the designated organization shall ensure 
        that priority is given to--
                    ``(A) measures with the greatest potential impact 
                for improving the performance and efficiency of care;
                    ``(B) measures that may be rapidly implemented by 
                group health plans, health insurance issuers, 
                physicians, hospitals, nursing homes, long-term care 
                providers, and other providers;
                    ``(C) measures which may inform health care 
                decisions made by consumers and patients;
                    ``(D) measures that apply to multiple services 
                furnished by different providers during an episode of 
                care;
                    ``(E) measures that can be integrated into 
                certification process described in section 3003; and
                    ``(F) measures that may be integrated into the 
                decision support function of qualified health 
                information technology as defined by this title.
            ``(3) Risk adjustment.--The designated organization, in 
        consultation with performance measure developers and other 
        stakeholders, shall establish procedures to ensure that quality 
        measures take into account differences in patient health 
        status, patient characteristics, and geographic location, as 
        appropriate.
            ``(4) Maintenance.--The designated organization, in 
        consultation with owners and developers of quality measures, 
        shall require the owners or developers of quality measures to 
        update and enhance such measures, including the development of 
        more accurate and precise specifications, and retire existing 
        outdated measures. Such updating shall occur not more often 
        than once during each 12-month period, except in the case of 
        emergency circumstances requiring a more immediate update to a 
        measure.
    ``(e) Grants for Performance Measure Development.--The Secretary, 
acting through the Agency for Healthcare Research and Quality, may 
award grants, in amounts not to exceed $50,000 each, to organizations 
to support the development and testing of quality measures that meet 
the standards established by the designated organization.

``SEC. 3011. ADOPTION AND USE OF QUALITY MEASURES; REPORTING.

    ``(a) In General.--For purposes of carrying out activities 
authorized or required by this title to ensure the use of quality 
measures and to foster uniformity between health care quality measures 
utilized by private entities, the Secretary shall--
            ``(1) select quality measures for adoption and use, from 
        quality measures recommended by multi-stakeholder groups and 
        endorsed by the designated organization; and
            ``(2) ensure that standards adopted under section 3005 
        integrate the quality measures endorsed, adopted, and utilized 
        under this section.
    ``(b) Relationship With Programs Under the Social Security Act.--
The Secretary shall ensure that the quality measures adopted under this 
section--
            ``(1) complement quality measures developed by the 
        Secretary under programs administered by the Secretary under 
        the Social Security Act, including programs under titles XVIII, 
        XIX, and XXI of such Act; and
            ``(2) do not conflict with the needs and priorities of the 
        programs under titles XVIII, XIX, and XXI of such Act, as set 
        forth by the Administrator of the Centers for Medicare & 
        Medicaid Services.
    ``(c) Reporting.--The Secretary shall implement procedures, 
consistent with generally accepted standards, to enable the Department 
of Health and Human Services to accept the electronic submission of 
data for purposes of performance measurement, including at the provider 
level, using the quality measures developed, endorsed, and adopted 
pursuant to this title.
    ``(d) Dissemination of Information.--In order to make comparative 
performance information available to health care consumers, health 
professionals, public health officials, oversight organizations, 
researchers, and other appropriate individuals and entities, after 
consultation with multi-stakeholder groups, the Secretary shall 
promulgate regulations to provide for the dissemination, aggregation, 
and analysis of quality measures collected pursuant to this title.''.

                     TITLE IV--PRIVACY AND SECURITY

SEC. 401. PRIVACY AND SECURITY.

    Title XXX of the Public Health Service Act, as amended by section 
301, is further amended by adding at the end the following:

``SEC. 3013. ENSURING PRIVACY AND SECURITY.

    ``(a) Privacy Protections Apply to Health Information Electronic 
Databases.--An operator of a health information electronic database 
shall be deemed to be a `covered entity' for purposes of sections 1171 
through 1179 of the Social Security Act and the regulations promulgated 
under section 264(c) of the Health Insurance Portability and 
Accountability Act of 1996 (42 U.S.C. 1320d-2 note) (referred to in 
this section as the `HIPAA privacy regulations'.
    ``(b) Health Information Electronic Database Defined.--In this 
section, the term `operator of a health information electronic 
database' means an entity that--
            ``(1) is constituted, organized, or chartered for the 
        primary purpose of maintaining or transmitting protected health 
        information in a designated record set or sets;
            ``(2) receives valuable consideration for maintaining or 
        transmitting protected health information in a designated 
        record set or sets; and
            ``(3) is not a health plan, healthcare clearinghouse, or 
        healthcare provider who transmits any health information in 
        electronic form in connection with a transaction referred to in 
        section 1173(a)(1) of the Social Security Act.
    ``(c) Right of Individuals To Inspect Their Medical Records 
Maintained in Electronic Format.--To the extent provided for under the 
HIPAA privacy regulations with respect to protected health information, 
an individual shall have a right of access to inspect and obtain a copy 
of protected health information about the individual stored in 
electronic format.
    ``(d) Rights of Individuals Who Are Victims of Medical Fraud.--To 
the extent provided for under the HIPAA privacy regulations and under 
the conditions specified in such regulations, with respect to protected 
health information, an individual who is a victim of medical fraud or 
who believes that there is an error in their protected health 
information stored in an electronic format shall have the right--
            ``(1) to have access to inspect and obtain a copy of 
        protected health information about the individual, including 
        the information fraudulently entered, in a designated record 
        set; and
            ``(2) to have a covered entity amend protected health 
        information or a record about the individual, including 
        information fraudulently entered, in a designated electronic 
        record set for as long as the protected health information is 
        maintained in the designated electronic record set to ensure 
        that fraudulent and inaccurate health information is not shared 
        or re-reported.
    ``(e) Rule of Construction.--Nothing in this section shall be 
construed to supercede or otherwise limit the provisions of any 
contract that provides for the application of privacy protections that 
are greater than the privacy protections provided for under the 
regulations promulgated under section 264 of the Health Insurance 
Portability and Accountability Act of 1996.''.

                   TITLE V--MISCELLANEOUS PROVISIONS

SEC. 501. GAO STUDY.

    Not later than 12 months after the date of enactment of this Act, 
the Comptroller General of the United States shall submit to Congress a 
report on the circumstances in which it is necessary and workable to 
require health plans (as defined in section 1171 of the Social Security 
Act (42 U.S.C. 1320d)), health care clearinghouses (as defined in such 
section 1171), and health care providers (as defined in such section 
1171) who transmit health information in electronic form, to notify 
individuals if their individually identifiable health information (as 
defined in such section 1171) is wrongfully disclosed.

SEC. 502. HEALTH INFORMATION TECHNOLOGY RESOURCE CENTER.

    Section 914 of the Public Health Service Act (42 U.S.C. 299b-3) is 
amended by adding at the end the following:
    ``(d) Health Information Technology Resource Center.--
            ``(1) In general.--The Secretary, acting through the 
        Director, shall develop a Health Information Technology 
        Resource Center (referred to in this subsection as the 
        `Center') to provide technical assistance and develop best 
        practices to support and accelerate efforts to adopt, 
        implement, and effectively use interoperable health information 
        technology in compliance with sections 3003 and 3010.
            ``(2) Purposes.--The purposes of the Center are to--
                    ``(A) provide a forum for the exchange of knowledge 
                and experience;
                    ``(B) accelerate the transfer of lessons learned 
                from existing public and private sector initiatives, 
                including those currently receiving Federal financial 
                support;
                    ``(C) assemble, analyze, and widely disseminate 
                evidence and experience related to the adoption, 
                implementation, and effective use of interoperable 
                health information technology;
                    ``(D) provide for the establishment of regional and 
                local health information networks to facilitate the 
                development of interoperability across health care 
                settings and improve the quality of health care;
                    ``(E) provide for the development of solutions to 
                barriers to the exchange of electronic health 
                information; and
                    ``(F) conduct other activities identified by the 
                States, local, or regional health information networks, 
                or health care stakeholders as a focus for developing 
                and sharing best practices.
            ``(3) Support for activities.--To provide support for the 
        activities of the Center, the Director shall modify the 
        requirements, if necessary, that apply to the National Resource 
        Center for Health Information Technology to provide the 
        necessary infrastructure to support the duties and activities 
        of the Center and facilitate information exchange across the 
        public and private sectors.
            ``(4) Rule of construction.--Nothing in this subsection 
        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.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated, such sums as may be necessary for each of fiscal years 
2008 and 2009 to carry out this section.''.

SEC. 503. FACILITATING THE PROVISION OF TELEHEALTH SERVICES ACROSS 
              STATE LINES.

    Section 330L of the Public Health Service Act (42 U.S.C. 254c-18) 
is amended to read as follows:

``SEC. 330L. TELEMEDICINE; INCENTIVE GRANTS REGARDING COORDINATION 
              AMONG STATES.

    ``(a) Facilitating the Provision of Telehealth Services Across 
State Lines.--The Secretary may make grants to States that have adopted 
regional State reciprocity agreements for practitioner licensure, in 
order to expedite the provision of telehealth services across State 
lines.
    ``(b) Authorization of Appropriations.--For the purpose of carrying 
out subsection (a), there are authorized to be appropriated such sums 
as may be necessary for each of the fiscal years 2008 and 2009.''.
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