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






                                                       Calendar No. 318
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, Mr. Isakson, and Ms. 
  Klobuchar) introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

                             August 1, 2007

               Reported by Mr. Kennedy, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 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,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Wired for Health Care 
Quality Act''.</DELETED>

<DELETED>TITLE I--IMPROVING THE INTEROPERABILITY OF HEALTH INFORMATION 
                          TECHNOLOGY</DELETED>

<DELETED>SEC. 101. IMPROVING HEALTH CARE QUALITY, SAFETY, AND 
              EFFICIENCY..</DELETED>

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

        <DELETED>``TITLE XXX--HEALTH INFORMATION TECHNOLOGY AND 
                           QUALITY</DELETED>

<DELETED>``SEC. 3001. DEFINITIONS; REFERENCE.</DELETED>

<DELETED>    ``(a) In General.--In this title:</DELETED>
        <DELETED>    ``(1) Community.--The term `Community' means the 
        American Health Information Community established under section 
        3004.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(3) Health information.--The term `health 
        information' has the meaning given such term in section 1171(4) 
        of the Social Security Act.</DELETED>
        <DELETED>    ``(4) Health plan.--The term `health plan' has the 
        meaning given such term in section 1171(5) of the Social 
        Security Act.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(6) Laboratory.--The term `laboratory' has the 
        meaning given such term in section 353.</DELETED>
        <DELETED>    ``(7) National coordinator.--The term `National 
        Coordinator' means the National Coordinator of Health 
        Information Technology appointed pursuant to section 
        3002.</DELETED>
        <DELETED>    ``(8) Partnership.--The term `Partnership' means 
        the Partnership for Health Care Improvement established under 
        section 3003.</DELETED>
        <DELETED>    ``(9) Qualified health information technology.--
        The term `qualified health information technology' means a 
        computerized system (including hardware and software) that--
        </DELETED>
                <DELETED>    ``(A) protects the privacy and security of 
                health information;</DELETED>
                <DELETED>    ``(B) maintains and provides permitted 
                access to health information in an electronic 
                format;</DELETED>
                <DELETED>    ``(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;</DELETED>
                <DELETED>    ``(D) incorporates decision support to 
                reduce medical errors and enhance health care 
                quality;</DELETED>
                <DELETED>    ``(E) complies with the standards adopted 
                by the Federal Government under section 3003;</DELETED>
                <DELETED>    ``(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</DELETED>
                <DELETED>    ``(G) allows for the reporting of quality 
                measures adopted under section 3010.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>

<DELETED>``SEC. 3002. OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH 
              INFORMATION TECHNOLOGY.</DELETED>

<DELETED>    ``(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.</DELETED>
<DELETED>    ``(b) Purpose.--The Office of the National Coordinator 
shall be responsible for--</DELETED>
        <DELETED>    ``(1) ensuring that key health information 
        technology initiatives are coordinated across programs of the 
        Department of Health and Human Services;</DELETED>
        <DELETED>    ``(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;</DELETED>
        <DELETED>    ``(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;</DELETED>
        <DELETED>    ``(4) providing comments and advice regarding 
        specific Federal health information technology programs, at the 
        request of Office of Management and Budget; and</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(c) Role With Community and the Partnership.--The Office 
of the National Coordinator shall--</DELETED>
        <DELETED>    ``(1) serve as an ex officio member of the 
        Community, and act as a liaison between the Federal Government 
        and the Community;</DELETED>
        <DELETED>    ``(2) serve as an ex officio member of the 
        Partnership and act as a liaison between the Federal Government 
        and the Partnership; and</DELETED>
        <DELETED>    ``(3) serve as a liaison between the Partnership 
        and the Community.</DELETED>
<DELETED>    ``(d) Reports and Website.--The Office of the National 
Coordinator shall--</DELETED>
        <DELETED>    ``(1) develop and publish a strategic plan for 
        implementing a nationwide interoperable health information 
        technology infrastructure;</DELETED>
        <DELETED>    ``(2) maintain and frequently update an Internet 
        website that--</DELETED>
                <DELETED>    ``(A) publishes the schedule for the 
                assessment of standards for significant use 
                cases;</DELETED>
                <DELETED>    ``(B) publishes the recommendations of the 
                Community;</DELETED>
                <DELETED>    ``(C) publishes the recommendations of the 
                Partnership;</DELETED>
                <DELETED>    ``(D) publishes quality 
                measures;</DELETED>
                <DELETED>    ``(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</DELETED>
                <DELETED>    ``(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;</DELETED>
        <DELETED>    ``(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</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(g) Sunset.--The provisions of this section shall not 
apply after September 30, 2014.</DELETED>

<DELETED>``SEC. 3003. PARTNERSHIP FOR HEALTH CARE IMPROVEMENT-STANDARDS 
              AND TECHNOLOGY.</DELETED>

<DELETED>    ``(a) Establishment.--</DELETED>
        <DELETED>    ``(1) In general.--There is established a public-
        private Partnership for Health Care Improvement to--</DELETED>
                <DELETED>    ``(A) provide advice to the Secretary and 
                the Nation and recommend specific actions to achieve a 
                nationwide interoperable health information technology 
                infrastructure;</DELETED>
                <DELETED>    ``(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;</DELETED>
                <DELETED>    ``(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</DELETED>
                <DELETED>    ``(D) develop and maintain an Internet 
                website that--</DELETED>
                        <DELETED>    ``(i) publishes established 
                        governance rules (including a subsequent 
                        appointment process);</DELETED>
                        <DELETED>    ``(ii) publishes a business 
                        plan;</DELETED>
                        <DELETED>    ``(iii) publishes meeting notices 
                        at least 14 days prior to each 
                        meeting;</DELETED>
                        <DELETED>    ``(iv) publishes meeting agendas 
                        at least 7 days prior to each meeting; 
                        and</DELETED>
                        <DELETED>    ``(v) publishes meeting materials 
                        at least 3 days prior to each 
                        meeting.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(b) Membership.--</DELETED>
        <DELETED>    ``(1) Appointments.--</DELETED>
                <DELETED>    ``(A) In general.--The Partnership shall 
                be composed of members to be appointed as 
                follows:</DELETED>
                        <DELETED>    ``(i) 2 members shall be appointed 
                        by the Secretary.</DELETED>
                        <DELETED>    ``(ii) 1 member shall be appointed 
                        by the majority leader of the Senate.</DELETED>
                        <DELETED>    ``(iii) 1 member shall be 
                        appointed by the minority leader of the 
                        Senate.</DELETED>
                        <DELETED>    ``(iv) 1 member shall be appointed 
                        by the Speaker of the House of 
                        Representatives.</DELETED>
                        <DELETED>    ``(v) 1 member shall be appointed 
                        by the minority leader of the House of 
                        Representatives.</DELETED>
                        <DELETED>    ``(vi) Seven members shall be 
                        appointed by the Comptroller General of whom--
                        </DELETED>
                                <DELETED>    ``(I) one member shall be 
                                a representative of consumer or patient 
                                organizations;</DELETED>
                                <DELETED>    ``(II) one member shall be 
                                a representative of organizations with 
                                expertise in privacy;</DELETED>
                                <DELETED>    ``(III) one member shall 
                                be a representative of organizations 
                                with expertise in security;</DELETED>
                                <DELETED>    ``(IV) one member shall be 
                                a representative of health care 
                                providers;</DELETED>
                                <DELETED>    ``(V) one member shall be 
                                a representative of health plans or 
                                other third party payers;</DELETED>
                                <DELETED>    ``(VI) one member shall be 
                                a representative of information 
                                technology vendors; and</DELETED>
                                <DELETED>    ``(VII) one member shall 
                                be a representative of purchasers or 
                                employers.</DELETED>
                <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(5) Outside involvement.--The Partnership shall 
        ensure an adequate opportunity for the participation of outside 
        advisors, including individuals with expertise in--</DELETED>
                <DELETED>    ``(A) health information 
                privacy;</DELETED>
                <DELETED>    ``(B) health information 
                security;</DELETED>
                <DELETED>    ``(C) health care quality and patient 
                safety, including individuals with expertise in 
                utilizing health information technology to improve 
                health care quality and patient safety;</DELETED>
                <DELETED>    ``(D) medical and clinical research data 
                exchange; and</DELETED>
                <DELETED>    ``(E) developing health information 
                technology standards and new health information 
                technology.</DELETED>
        <DELETED>    ``(6) Quorum.--Two-thirds of the members of the 
        Partnership shall constitute a quorum for the purpose of 
        conducting votes.</DELETED>
<DELETED>    ``(c) Standards and Implementation Specifications.--
</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(d) Certification.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(2) Adoption of criteria.--The Secretary, based 
        upon the recommendations of the Partnership, shall review, and 
        if appropriate, adopt such criteria.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(e) Rule of Construction.--Nothing in this section shall 
be construed as disrupting existing activities described in subsection 
(c) or (d).</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>

<DELETED>``SEC. 3004. AMERICAN HEALTH INFORMATION COMMUNITY--
              POLICIES.</DELETED>

<DELETED>    ``(a) Establishment.--There is established a committee to 
be known as the American Health Information Community. The Community 
shall--</DELETED>
        <DELETED>    ``(1) provide advice to the Secretary and the 
        heads of any relevant Federal agencies concerning the policy 
        considerations related to health information 
        technology;</DELETED>
        <DELETED>    ``(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;</DELETED>
        <DELETED>    ``(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--</DELETED>
                <DELETED>    ``(A) the protection of individually 
                identifiable health information;</DELETED>
                <DELETED>    ``(B) methods to notify individuals if 
                their individually identifiable health information is 
                wrongfully disclosed;</DELETED>
                <DELETED>    ``(C) methods to facilitate secure access 
                to such individual's individually identifiable health 
                information;</DELETED>
                <DELETED>    ``(D) the appropriate uses of a nationwide 
                health information network including--</DELETED>
                        <DELETED>    ``(i) the collection of quality 
                        data and public reporting;</DELETED>
                        <DELETED>    ``(ii) biosurveillance and public 
                        health;</DELETED>
                        <DELETED>    ``(iii) medical and clinical 
                        research; and</DELETED>
                        <DELETED>    ``(iv) drug safety;</DELETED>
                <DELETED>    ``(E) fostering the public understanding 
                of health information technology;</DELETED>
                <DELETED>    ``(F) strategies to enhance the use of 
                health information technology in preventing and 
                managing chronic disease;</DELETED>
                <DELETED>    ``(G) policies to incorporate the input of 
                employees of health care providers in the design and 
                implementation of health information technology 
                systems; and</DELETED>
                <DELETED>    ``(H) other policies determined to be 
                necessary by the Community; and</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(c) Membership.--</DELETED>
        <DELETED>    ``(1) In general.--The Community shall be composed 
        of members to be appointed as follows:</DELETED>
                <DELETED>    ``(A) 3 members shall be appointed by the 
                Secretary, 1 of whom shall be a representative from the 
                Department of Health and Human Services.</DELETED>
                <DELETED>    ``(B) 1 member shall be appointed by the 
                Secretary of Veterans Affairs who shall represent the 
                Department of Veterans Affairs.</DELETED>
                <DELETED>    ``(C) 1 member shall be appointed by the 
                Secretary of Defense who shall represent the Department 
                of Defense.</DELETED>
                <DELETED>    ``(D) 1 member shall be appointed by the 
                majority leader of the Senate.</DELETED>
                <DELETED>    ``(E) 1 member shall be appointed by the 
                minority leader of the Senate.</DELETED>
                <DELETED>    ``(F) 1 member shall be appointed by the 
                Speaker of the House of Representatives.</DELETED>
                <DELETED>    ``(G) 1 member shall be appointed by the 
                minority leader of the House of 
                Representatives.</DELETED>
                <DELETED>    ``(H) Nine members shall be appointed by 
                the Comptroller General of whom--</DELETED>
                        <DELETED>    ``(i) one member shall be 
                        advocates for patients or consumers;</DELETED>
                        <DELETED>    ``(ii) one member shall represent 
                        health care providers;</DELETED>
                        <DELETED>    ``(iii) one member shall be from a 
                        labor organization representing health care 
                        workers;</DELETED>
                        <DELETED>    ``(iv) one member shall have 
                        expertise in privacy and security;</DELETED>
                        <DELETED>    ``(v) one member shall have 
                        expertise in improving the health of vulnerable 
                        populations;</DELETED>
                        <DELETED>    ``(vi) one member shall represent 
                        health plans or other third party 
                        payers;</DELETED>
                        <DELETED>    ``(vii) one member shall represent 
                        information technology vendors;</DELETED>
                        <DELETED>    ``(viii) one member shall 
                        represent purchasers or employers; 
                        and</DELETED>
                        <DELETED>    ``(ix) one member shall have 
                        expertise in health care quality measurement 
                        and reporting.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(5) Terms.--</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(6) Outside involvement.--The Community shall 
        ensure an adequate opportunity for the participation of outside 
        advisors, including individuals with expertise in--</DELETED>
                <DELETED>    ``(A) health information privacy and 
                security;</DELETED>
                <DELETED>    ``(B) improving the health of vulnerable 
                populations;</DELETED>
                <DELETED>    ``(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;</DELETED>
                <DELETED>    ``(D) ethics;</DELETED>
                <DELETED>    ``(E) medical and clinical research data 
                exchange; and</DELETED>
                <DELETED>    ``(F) developing health information 
                technology standards and new health information 
                technology.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(d) Federal Agencies.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(f) Sunset.--The provisions of this section shall not 
apply after September 20, 2014.</DELETED>
<DELETED>    ``(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.</DELETED>

<DELETED>``SEC. 3005. FEDERAL PURCHASING AND DATA COLLECTION.</DELETED>

<DELETED>    ``(a) Coordination of Federal Spending.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(b) Voluntary Adoption.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>

<DELETED>``SEC. 3006. QUALITY AND EFFICIENCY REPORTS.</DELETED>

<DELETED>    ``(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--</DELETED>
        <DELETED>    ``(1) improve the quality and efficiency of health 
        care and advance health care research;</DELETED>
        <DELETED>    ``(2) enhance the education and awareness of 
        consumers for evaluating health care services; and</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(b) Procedures for the Development of Reports.--
</DELETED>
        <DELETED>    ``(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--</DELETED>
                <DELETED>    ``(A) Federal health care data disclosed 
                to the Organization under subsection (c); and</DELETED>
                <DELETED>    ``(B) private data that is publicly 
                available or is provided to the Organization by the 
                entity making the request for the report.</DELETED>
        <DELETED>    ``(2) Definitions.--In this section:</DELETED>
                <DELETED>    ``(A) Federal health care data.--The term 
                `Federal health care data' means --</DELETED>
                        <DELETED>    ``(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</DELETED>
                        <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(B) Quality reporting organization.--The 
                term `Quality Reporting Organization' means an entity 
                with a contract under subsection (d).</DELETED>
<DELETED>    ``(c) Access to Federal Health Care Data.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(2) Update of information.--Not less than every 
        6 months, the Secretary shall update the information disclosed 
        under paragraph (1) to Quality Reporting 
        Organizations.</DELETED>
<DELETED>    ``(d) Quality Reporting Organizations.--</DELETED>
        <DELETED>    ``(1) In general.--</DELETED>
                <DELETED>    ``(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--
                </DELETED>
                        <DELETED>    ``(i) store the Federal health 
                        care data that is to be disclosed under 
                        subsection (c); and</DELETED>
                        <DELETED>    ``(ii) develop and release reports 
                        pursuant to subsection (e).</DELETED>
                <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(2) Qualifications.--The Secretary shall enter 
        into a contract with an entity under paragraph (1) only if the 
        Secretary determines that the entity--</DELETED>
                <DELETED>    ``(A) has the research capability to 
                conduct and complete reports under this 
                section;</DELETED>
                <DELETED>    ``(B) has in place-</DELETED>
                        <DELETED>    ``(i) an information technology 
                        infrastructure to support the database of 
                        Federal health care data that is to be 
                        disclosed to the entity; and</DELETED>
                        <DELETED>    ``(ii) operational standards to 
                        provide security for such database;</DELETED>
                <DELETED>    ``(C) has experience with, and expertise 
                on, the development of reports on health care quality 
                and efficiency; and</DELETED>
                <DELETED>    ``(D) has a significant business presence 
                in the United States.</DELETED>
        <DELETED>    ``(3) Contract requirements.--Each contract with 
        an entity under paragraph (1) shall contain the following 
        requirements:</DELETED>
                <DELETED>    ``(A) Ensuring beneficiary privacy.--
                </DELETED>
                        <DELETED>    ``(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).</DELETED>
                        <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(C) Disclosure.--The entity shall 
                disclose--</DELETED>
                        <DELETED>    ``(i) any financial, reporting, or 
                        contractual relationship between the entity and 
                        any health care provider or supplier or health 
                        care plan; and</DELETED>
                        <DELETED>    ``(ii) if applicable, the fact 
                        that the entity is managed, controlled, or 
                        operated by any health care provider or 
                        supplier or health care plan.</DELETED>
                <DELETED>    ``(D) Component of another organization.--
                If the entity is a component of another organization--
                </DELETED>
                        <DELETED>    ``(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</DELETED>
                        <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(E) Termination or nonrenewal.--If a 
                contract under this section is terminated or not 
                renewed, the following requirements shall 
                apply:</DELETED>
                        <DELETED>    ``(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.</DELETED>
                        <DELETED>    ``(ii) Disposition of data and 
                        reports.--The entity shall--</DELETED>
                                <DELETED>    ``(I) return to the 
                                Secretary all Federal health care data 
                                disclosed to the entity and each report 
                                developed by the entity; or</DELETED>
                                <DELETED>    ``(II) if returning the 
                                Federal health care data and reports is 
                                not practicable, destroy the reports 
                                and Federal health care data.</DELETED>
        <DELETED>    ``(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).</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(e) Development and Release of Reports Based on 
Requests.--</DELETED>
        <DELETED>    ``(1) Request for a report.--</DELETED>
                <DELETED>    ``(A) Request.--</DELETED>
                        <DELETED>    ``(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).</DELETED>
                        <DELETED>    ``(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.</DELETED>
                        <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(2) Development and release of report.--
        </DELETED>
                <DELETED>    ``(A) Development.--</DELETED>
                        <DELETED>    ``(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.</DELETED>
                        <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(C) Release of report.--</DELETED>
                        <DELETED>    ``(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.</DELETED>
                        <DELETED>    ``(ii) Release to public.--The 
                        procedures established under subsection (b)(1) 
                        shall provide for the following:</DELETED>
                                <DELETED>    ``(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.</DELETED>
                                <DELETED>    ``(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.</DELETED>
<DELETED>    ``(f) Annual Review of Reports and Termination of 
Contracts.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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).</DELETED>
<DELETED>    ``(g) Fees.--</DELETED>
        <DELETED>    ``(1) Fees for secretary.--The Secretary shall 
        charge a Quality Reporting Organization a fee for--</DELETED>
                <DELETED>    ``(A) disclosing the data under subsection 
                (c); and</DELETED>
                <DELETED>    ``(B) conducting the review under 
                subsection (e)(2)(B).</DELETED>
        <DELETED>The Secretary shall ensure that such fees are 
        sufficient to cover the costs of the activities described in 
        subparagraph (A) and (B).</DELETED>
        <DELETED>    ``(2) Fees for qro.--</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>

<DELETED>``SEC. 3007. RESEARCH ACCESS TO HEALTH CARE DATA AND REPORTING 
              ON PERFORMANCE.</DELETED>

<DELETED>    ``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--</DELETED>
        <DELETED>    ``(1) have access to all Federal health care data 
        (as defined in section 3006(b)(2)(A)); and</DELETED>
        <DELETED>    ``(2) report on the performance of health care 
        providers and suppliers, including reporting in a provider- or 
        supplier-identifiable format.''.</DELETED>

      <DELETED>TITLE II--FACILITATING THE WIDESPREAD ADOPTION OF 
         INTEROPERABLE HEALTH INFORMATION TECHNOLOGY</DELETED>

<DELETED>SEC. 201. FACILITATING THE WIDESPREAD ADOPTION OF 
              INTEROPERABLE HEALTH INFORMATION TECHNOLOGY.</DELETED>

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

<DELETED>``SEC. 3008. FACILITATING THE WIDESPREAD ADOPTION OF 
              INTEROPERABLE HEALTH INFORMATION TECHNOLOGY.</DELETED>

<DELETED>    ``(a) Competitive Grants for Adoption of Technology.--
</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(2) Eligibility.--To be eligible to receive a 
        grant under paragraph (1) an entity shall--</DELETED>
                <DELETED>    ``(A) submit to the Secretary an 
                application at such time, in such manner, and 
                containing such information as the Secretary may 
                require;</DELETED>
                <DELETED>    ``(B) submit to the Secretary a strategic 
                plan for the implementation of data sharing and 
                interoperability measures;</DELETED>
                <DELETED>    ``(C) adopt the standards adopted by the 
                Federal Government under section 3005;</DELETED>
                <DELETED>    ``(D) implement the measures adopted under 
                section 3010 and report to the Secretary on such 
                measures;</DELETED>
                <DELETED>    ``(E) agree to notify individuals if their 
                individually identifiable health information is 
                wrongfully disclosed;</DELETED>
                <DELETED>    ``(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;</DELETED>
                <DELETED>    ``(G) demonstrate significant financial 
                need;</DELETED>
                <DELETED>    ``(H) provide matching funds in accordance 
                with paragraph (4); and</DELETED>
                <DELETED>    ``(I) be a--</DELETED>
                        <DELETED>    ``(i) public or not for profit 
                        hospital;</DELETED>
                        <DELETED>    ``(ii) federally qualified health 
                        center (as defined in section 1861(aa)(4) of 
                        the Social Security Act);</DELETED>
                        <DELETED>    ``(iii) individual or group 
                        practice (or a consortium thereof); 
                        or</DELETED>
                        <DELETED>    ``(iv) another health care 
                        provider not described in clause (i) or 
                        (ii);</DELETED>
                <DELETED>that serves medically underserved 
                communities.</DELETED>
        <DELETED>    ``(3) Use of funds.--Amounts received under a 
        grant under this subsection shall be used to--</DELETED>
                <DELETED>    ``(A) facilitate the purchase of qualified 
                health information technology systems;</DELETED>
                <DELETED>    ``(B) train personnel in the use of such 
                systems;</DELETED>
                <DELETED>    ``(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</DELETED>
                <DELETED>    ``(D) improve the prevention and 
                management of chronic disease.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(5) Preference in awarding grants.--In awarding 
        grants under this subsection the Secretary shall give 
        preference to--</DELETED>
                <DELETED>    ``(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</DELETED>
                <DELETED>    ``(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.</DELETED>
<DELETED>    ``(b) Competitive Grants for the Development of State Loan 
Programs To Facilitate the Widespread Adoption of Health Information 
Technology.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(3) Eligibility.--To be eligible to receive a 
        grant under paragraph (1) a State shall--</DELETED>
                <DELETED>    ``(A) submit to the Secretary an 
                application at such time, in such manner, and 
                containing such information as the Secretary may 
                require;</DELETED>
                <DELETED>    ``(B) submit to the Secretary a strategic 
                plan in accordance with paragraph (4);</DELETED>
                <DELETED>    ``(C) establish a qualified health 
                information technology loan fund in accordance with 
                paragraph (2);</DELETED>
                <DELETED>    ``(D) require that health care providers 
                receiving loans under the grant--</DELETED>
                        <DELETED>    ``(i) link, to the extent 
                        practicable, the qualified health information 
                        system to a local or regional health 
                        information network;</DELETED>
                        <DELETED>    ``(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;</DELETED>
                        <DELETED>    ``(iii) agree to notify 
                        individuals if their individually identifiable 
                        health information is wrongfully disclosed; 
                        and</DELETED>
                        <DELETED>    ``(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;</DELETED>
                <DELETED>    ``(E) require that health care providers 
                receiving loans under the grant adopt the standards 
                adopted by the Federal Government under section 
                3005;</DELETED>
                <DELETED>    ``(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</DELETED>
                <DELETED>    ``(G) provide matching funds in accordance 
                with paragraph (8).</DELETED>
        <DELETED>    ``(4) Strategic plan.--</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(B) Contents.--A strategic plan under 
                subparagraph (A) shall include--</DELETED>
                        <DELETED>    ``(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;</DELETED>
                        <DELETED>    ``(ii) a description of the 
                        criteria and methods established for the 
                        distribution of funds from the State loan 
                        fund;</DELETED>
                        <DELETED>    ``(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</DELETED>
                        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(5) Use of funds.--</DELETED>
                <DELETED>    ``(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--</DELETED>
                        <DELETED>    ``(i) facilitate the purchase of 
                        qualified health information technology 
                        systems;</DELETED>
                        <DELETED>    ``(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</DELETED>
                        <DELETED>    ``(iii) train personnel in the use 
                        of such systems.</DELETED>
                <DELETED>    ``(B) Limitation.--Amounts received by a 
                State under this subsection may not be used--</DELETED>
                        <DELETED>    ``(i) for the purchase or other 
                        acquisition of any health information 
                        technology system that is not a qualified 
                        health information technology system;</DELETED>
                        <DELETED>    ``(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</DELETED>
                        <DELETED>    ``(iii) for any purpose other than 
                        making loans to eligible entities under this 
                        section.</DELETED>
        <DELETED>    ``(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:</DELETED>
                <DELETED>    ``(A) To award loans that comply with the 
                following:</DELETED>
                        <DELETED>    ``(i) The interest rate for each 
                        loan shall be less than or equal to the market 
                        interest rate.</DELETED>
                        <DELETED>    ``(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.</DELETED>
                        <DELETED>    ``(iii) The State loan fund shall 
                        be credited with all payments of principal and 
                        interest on each loan awarded from the 
                        fund.</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(D) To earn interest on the amounts 
                deposited into the State loan fund.</DELETED>
        <DELETED>    ``(7) Administration of state loan funds.--
        </DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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--</DELETED>
                        <DELETED>    ``(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</DELETED>
                        <DELETED>    ``(ii) guidance to prevent waste, 
                        fraud, and abuse.</DELETED>
                <DELETED>    ``(D) Private sector contributions.--
                </DELETED>
                        <DELETED>    ``(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.</DELETED>
                        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(8) Matching requirements.--</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(c) Competitive Grants for the Implementation of 
Regional or Local Health Information Technology Plans.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(2) Eligibility.--To be eligible to receive a 
        grant under paragraph (1) an entity shall--</DELETED>
                <DELETED>    ``(A) demonstrate financial need to the 
                Secretary;</DELETED>
                <DELETED>    ``(B) demonstrate that one of its 
                principal missions or purposes is to use information 
                technology to improve health care quality and 
                efficiency;</DELETED>
                <DELETED>    ``(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--</DELETED>
                        <DELETED>    ``(i) health care providers 
                        (including health care providers that provide 
                        services to low income and underserved 
                        populations);</DELETED>
                        <DELETED>    ``(ii) pharmacists or 
                        pharmacies;</DELETED>
                        <DELETED>    ``(iii) health plans;</DELETED>
                        <DELETED>    ``(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;</DELETED>
                        <DELETED>    ``(v) patient or consumer 
                        organizations;</DELETED>
                        <DELETED>    ``(vi) organizations dedicated to 
                        improving the health of vulnerable 
                        populations;</DELETED>
                        <DELETED>    ``(vii) employers;</DELETED>
                        <DELETED>    ``(viii) State or local health 
                        departments; and</DELETED>
                        <DELETED>    ``(ix) any other health care 
                        providers or other entities, as determined 
                        appropriate by the Secretary;</DELETED>
                <DELETED>    ``(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);</DELETED>
                <DELETED>    ``(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;</DELETED>
                <DELETED>    ``(F) adopt the standards adopted by the 
                Secretary under section 3005;</DELETED>
                <DELETED>    ``(G) require that health care providers 
                receiving such grants--</DELETED>
                        <DELETED>    ``(i) implement the measures 
                        adopted under section 3010 and report to the 
                        Secretary on such measures; and</DELETED>
                        <DELETED>    ``(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;</DELETED>
                <DELETED>    ``(H) agree to notify individuals if their 
                individually identifiable health information is 
                wrongfully disclosed;</DELETED>
                <DELETED>    ``(I) facilitate the electronic exchange 
                of health information within the local or regional area 
                and among local and regional areas;</DELETED>
                <DELETED>    ``(J) prepare and submit to the Secretary 
                an application in accordance with paragraph 
                (3);</DELETED>
                <DELETED>    ``(K) agree to provide matching funds in 
                accordance with paragraph (5); and</DELETED>
                <DELETED>    ``(L) reduce barriers to the 
                implementation of health information technology by 
                providers.</DELETED>
        <DELETED>    ``(3) Application.--</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(B) Required information.--At a minimum, 
                an application submitted under this paragraph shall 
                include--</DELETED>
                        <DELETED>    ``(i) clearly identified short-
                        term and long-term objectives of the regional 
                        or local health information plan;</DELETED>
                        <DELETED>    ``(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;</DELETED>
                        <DELETED>    ``(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;</DELETED>
                        <DELETED>    ``(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;</DELETED>
                        <DELETED>    ``(v) a plan to ensure the privacy 
                        and security of individually identifiable 
                        health information that is consistent with 
                        Federal and State law;</DELETED>
                        <DELETED>    ``(vi) a governance plan that 
                        defines the manner in which the stakeholders 
                        shall jointly make policy and operational 
                        decisions on an ongoing basis;</DELETED>
                        <DELETED>    ``(vii) a financial or business 
                        plan that describes--</DELETED>
                                <DELETED>    ``(I) the sustainability 
                                of the plan;</DELETED>
                                <DELETED>    ``(II) the financial costs 
                                and benefits of the plan; and</DELETED>
                                <DELETED>    ``(III) the entities to 
                                which such costs and benefits will 
                                accrue;</DELETED>
                        <DELETED>    ``(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</DELETED>
                        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(5) Matching requirement.--</DELETED>
                <DELETED>    ``(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).</DELETED>
                <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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--</DELETED>
        <DELETED>    ``(1) a description of the financial costs and 
        benefits of the project involved and of the entities to which 
        such costs and benefits accrue;</DELETED>
        <DELETED>    ``(2) an analysis of the impact of the project on 
        health care quality and safety;</DELETED>
        <DELETED>    ``(3) a description of any reduction in 
        duplicative or unnecessary care as a result of the project 
        involved; and</DELETED>
        <DELETED>    ``(4) other information as required by the 
        Secretary.</DELETED>
<DELETED>    ``(e) Authorization of Appropriations.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(2) Availability.--Amounts appropriated under 
        paragraph (1) shall remain available through fiscal year 
        2012.</DELETED>

<DELETED>``SEC. 3009. DEMONSTRATION PROGRAM TO INTEGRATE INFORMATION 
              TECHNOLOGY INTO CLINICAL EDUCATION.</DELETED>

<DELETED>    ``(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.</DELETED>
<DELETED>    ``(b) Eligibility.--To be eligible to receive a grant 
under subsection (a), an entity or consortium shall--</DELETED>
        <DELETED>    ``(1) submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require;</DELETED>
        <DELETED>    ``(2) be or include--</DELETED>
                <DELETED>    ``(A) a health professions 
                school;</DELETED>
                <DELETED>    ``(B) a school of nursing; or</DELETED>
                <DELETED>    ``(C) an institution with a graduate 
                medical education program;</DELETED>
        <DELETED>    ``(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</DELETED>
        <DELETED>    ``(4) provide matching funds in accordance with 
        subsection (d).</DELETED>
<DELETED>    ``(c) Use of Funds.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(2) Limitation.--An eligible entity or 
        consortium shall not award a grant under subsection (a) to 
        purchase hardware, software, or services.</DELETED>
<DELETED>    ``(d) Matching Funds.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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--</DELETED>
        <DELETED>    ``(1) describes the specific projects established 
        under this section; and</DELETED>
        <DELETED>    ``(2) contains recommendations for Congress based 
        on the evaluation conducted under subsection (e).</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(h) Sunset.--This provisions of this section shall not 
apply after September 30, 2012.''.</DELETED>

   <DELETED>TITLE III--IMPROVING THE QUALITY OF HEALTH CARE</DELETED>

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

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

<DELETED>``SEC. 3010. FOSTERING DEVELOPMENT AND USE OF HEALTH CARE 
              QUALITY MEASURES.</DELETED>

<DELETED>    ``(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.</DELETED>
<DELETED>    ``(b) Designation of, and Arrangement With, 
Organization.--</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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--</DELETED>
                <DELETED>    ``(A) establishing and managing an 
                integrated national strategy and process for setting 
                priorities and goals in establishing quality 
                measures;</DELETED>
                <DELETED>    ``(B) coordinating and harmonizing the 
                development and testing of such measures;</DELETED>
                <DELETED>    ``(C) establishing standards for the 
                development and testing of such measures;</DELETED>
                <DELETED>    ``(D) endorsing national consensus quality 
                measures;</DELETED>
                <DELETED>    ``(E) recommending, in collaboration with 
                multi-stakeholder groups, quality measures to the 
                Secretary for adoption and use;</DELETED>
                <DELETED>    ``(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</DELETED>
                <DELETED>    ``(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.</DELETED>
<DELETED>    ``(c) Requirements Described.--The requirements described 
in this subsection are the following:</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(2) Board membership.--The members of the board 
        of directors of the entity shall include representatives of--
        </DELETED>
                <DELETED>    ``(A) health care providers or groups 
                representing providers;</DELETED>
                <DELETED>    ``(B) health plans or groups representing 
                health plans;</DELETED>
                <DELETED>    ``(C) patients or consumers enrolled in 
                such plans or groups representing individuals enrolled 
                in such plans;</DELETED>
                <DELETED>    ``(D) health care purchasers and employers 
                or groups representing purchasers or employers; 
                and</DELETED>
                <DELETED>    ``(E) organizations that develop health 
                information technology standards and new health 
                information technology.</DELETED>
        <DELETED>    ``(3) Other membership requirements.--The 
        membership of the board of directors of the entity shall be 
        representative of individuals with experience with--</DELETED>
                <DELETED>    ``(A) urban health care issues;</DELETED>
                <DELETED>    ``(B) safety net health care 
                issues;</DELETED>
                <DELETED>    ``(C) rural or frontier health care 
                issues;</DELETED>
                <DELETED>    ``(D) quality and safety issues;</DELETED>
                <DELETED>    ``(E) State or local health 
                programs;</DELETED>
                <DELETED>    ``(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</DELETED>
                <DELETED>    ``(G) individuals or entities involved in 
                the development and establishment of standards and 
                certification for health information technology systems 
                and clinical data.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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).</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(d) Requirements for Measures.--The quality measures 
developed under this title shall comply with the following:</DELETED>
        <DELETED>    ``(1) Measures.--The designated organization, in 
        promoting the development of quality measures under this title, 
        shall ensure that such measures--</DELETED>
                <DELETED>    ``(A) are evidence-based, reliable, and 
                valid;</DELETED>
                <DELETED>    ``(B) include--</DELETED>
                        <DELETED>    ``(i) measures of clinical 
                        processes and outcomes, patient experience, 
                        efficiency, and equity; and</DELETED>
                        <DELETED>    ``(ii) measures to assess 
                        effectiveness, timeliness, patient self-
                        management, patient centeredness, and safety; 
                        and</DELETED>
                <DELETED>    ``(C) include measures of underuse and 
                overuse.</DELETED>
        <DELETED>    ``(2) Priorities.--In carrying out its 
        responsibilities under this section, the designated 
        organization shall ensure that priority is given to--</DELETED>
                <DELETED>    ``(A) measures with the greatest potential 
                impact for improving the performance and efficiency of 
                care;</DELETED>
                <DELETED>    ``(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;</DELETED>
                <DELETED>    ``(C) measures which may inform health 
                care decisions made by consumers and 
                patients;</DELETED>
                <DELETED>    ``(D) measures that apply to multiple 
                services furnished by different providers during an 
                episode of care;</DELETED>
                <DELETED>    ``(E) measures that can be integrated into 
                certification process described in section 3003; 
                and</DELETED>
                <DELETED>    ``(F) measures that may be integrated into 
                the decision support function of qualified health 
                information technology as defined by this 
                title.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>

<DELETED>``SEC. 3011. ADOPTION AND USE OF QUALITY MEASURES; 
              REPORTING.</DELETED>

<DELETED>    ``(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--</DELETED>
        <DELETED>    ``(1) select quality measures for adoption and 
        use, from quality measures recommended by multi-stakeholder 
        groups and endorsed by the designated organization; 
        and</DELETED>
        <DELETED>    ``(2) ensure that standards adopted under section 
        3005 integrate the quality measures endorsed, adopted, and 
        utilized under this section.</DELETED>
<DELETED>    ``(b) Relationship With Programs Under the Social Security 
Act.--The Secretary shall ensure that the quality measures adopted 
under this section--</DELETED>
        <DELETED>    ``(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</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.''.</DELETED>

           <DELETED>TITLE IV--PRIVACY AND SECURITY</DELETED>

<DELETED>SEC. 401. PRIVACY AND SECURITY.</DELETED>

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

<DELETED>``SEC. 3013. ENSURING PRIVACY AND SECURITY.</DELETED>

<DELETED>    ``(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'.</DELETED>
<DELETED>    ``(b) Health Information Electronic Database Defined.--In 
this section, the term `operator of a health information electronic 
database' means an entity that--</DELETED>
        <DELETED>    ``(1) is constituted, organized, or chartered for 
        the primary purpose of maintaining or transmitting protected 
        health information in a designated record set or 
        sets;</DELETED>
        <DELETED>    ``(2) receives valuable consideration for 
        maintaining or transmitting protected health information in a 
        designated record set or sets; and</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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--
</DELETED>
        <DELETED>    ``(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</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.''.</DELETED>

          <DELETED>TITLE V--MISCELLANEOUS PROVISIONS</DELETED>

<DELETED>SEC. 501. GAO STUDY.</DELETED>

<DELETED>    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.</DELETED>

<DELETED>SEC. 502. HEALTH INFORMATION TECHNOLOGY RESOURCE 
              CENTER.</DELETED>

<DELETED>    Section 914 of the Public Health Service Act (42 U.S.C. 
299b-3) is amended by adding at the end the following:</DELETED>
<DELETED>    ``(d) Health Information Technology Resource Center.--
</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(2) Purposes.--The purposes of the Center are 
        to--</DELETED>
                <DELETED>    ``(A) provide a forum for the exchange of 
                knowledge and experience;</DELETED>
                <DELETED>    ``(B) accelerate the transfer of lessons 
                learned from existing public and private sector 
                initiatives, including those currently receiving 
                Federal financial support;</DELETED>
                <DELETED>    ``(C) assemble, analyze, and widely 
                disseminate evidence and experience related to the 
                adoption, implementation, and effective use of 
                interoperable health information technology;</DELETED>
                <DELETED>    ``(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;</DELETED>
                <DELETED>    ``(E) provide for the development of 
                solutions to barriers to the exchange of electronic 
                health information; and</DELETED>
                <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.''.</DELETED>

<DELETED>SEC. 503. FACILITATING THE PROVISION OF TELEHEALTH SERVICES 
              ACROSS STATE LINES.</DELETED>

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

<DELETED>``SEC. 330L. TELEMEDICINE; INCENTIVE GRANTS REGARDING 
              COORDINATION AMONG STATES.</DELETED>

<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.''.</DELETED>

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 insurance plan.--
                    ``(A) In general.--The term `health insurance plan' 
                means--
                            ``(i) a health insurance issuer (as defined 
                        in section 2791(b)(2));
                            ``(ii) a group health plan (as defined in 
                        section 2791(a)(1)); and
                            ``(iii) a health maintenance organization 
                        (as defined in section 2791(b)(3)); or
                            ``(iv) a safety net health plan.
                    ``(B) Safety net health plan.--The term `safety net 
                health plan' means a managed care organization, as 
                defined in section 1932(a)(1)(B)(i) of the Social 
                Security Act--
                            ``(i) that is exempt from or not subject to 
                        Federal income tax, or that is owned by an 
                        entity or entities exempt from or not subject 
                        to Federal income tax; and
                            ``(ii) for which not less than 75 percent 
                        of the enrolled population receives benefits 
                        under a Federal health care program (as defined 
                        in section 1128B(f)(1) of the Social Security 
                        Act) or a health care plan or program which is 
                        funded, in whole or in part, by a State (other 
                        than a program for government employees).
                    ``(C) References.--All references in this title to 
                `health plan' shall be deemed to be references to 
                `health insurance plan'.
            ``(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, including policies concerning the 
                individual's ability to control the acquisition, uses, 
                and disclosures of individually identifiable health 
                information;
                    ``(B) methods to protect individually identifiable 
                health information from improper use and disclosures 
                and methods to notify patients 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.''.
                                                       Calendar No. 318

110th CONGRESS

  1st Session

                                S. 1693

_______________________________________________________________________

                                 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.

_______________________________________________________________________

                             August 1, 2007

                       Reported with an amendment