[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1039 Introduced in House (IH)]
111th CONGRESS
1st Session
H. R. 1039
To encourage and enhance the adoption of interoperable health
information technology to improve health care quality, reduce medical
errors, and increase the efficiency of care.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 12, 2009
Mr. Sam Johnson of Texas (for himself, Mr. Brady of Texas, Ms. Ginny
Brown-Waite of Florida, Mr. Reichert, Mr. Roskam, and Mr. Boustany)
introduced the following bill; which was referred to the Committee on
Energy and Commerce, and in addition to the Committee on Ways and
Means, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To encourage and enhance the adoption of interoperable health
information technology to improve health care quality, reduce medical
errors, and increase the efficiency of care.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Promoting Health
Information Technology Act of 2009''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--STRATEGIC PLAN TOWARDS NATIONWIDE INTEROPERABILITY
Sec. 101. Office of the National Coordinator for Health Information
Technology.
Sec. 102. Successor to the American Health Information Community.
Sec. 103. Health Information Technology Resource Center.
Sec. 104. Strategic plan for coordinating implementation of health
information technology.
TITLE II--MODERNIZING THE HEALTH CARE DELIVERY SYSTEM
Sec. 201. Procedures to ensure timely updating of standards that enable
electronic exchanges.
Sec. 202. Federal purchasing and data collection.
Sec. 203. Study to improve preservation and protection of security and
confidentiality of health information.
TITLE III--INCENTIVIZING ADOPTION OF HEALTH IT
Sec. 301. Incentives for medical care providers to adopt health care
information technology.
Sec. 302. Elimination of sunset applicable to Stark exception for
electronic health records arrangements.
Sec. 303. Promotion of telehealth services.
Sec. 304. FQHCs included in electronic health records demonstration.
Sec. 305. Interest-free loan program for hospitals to adopt health
information technology.
TITLE I--STRATEGIC PLAN TOWARDS NATIONWIDE INTEROPERABILITY
SEC. 101. OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION
TECHNOLOGY.
(a) Establishment.--There is established within the Department of
Health and Human Services an Office of the National Coordinator for
Health Information Technology that shall be headed by the National
Coordinator for Health Information Technology (referred to in this
section as the ``National Coordinator''). The National Coordinator
shall be appointed by the President and shall report directly to the
Secretary of Health and Human Services. The National Coordinator shall
be paid at a rate equal to the rate of basic pay for level IV of the
Executive Schedule.
(b) Goals of Nationwide Interoperable Health Information Technology
Infrastructure.--The National Coordinator shall perform the duties
under subsection (c) in a manner consistent with the development of a
nationwide interoperable health information technology infrastructure
that--
(1) improves health care quality, reduces medical errors,
increases the efficiency of care, and advances the delivery of
appropriate, evidence-based health care services;
(2) promotes wellness, disease prevention, and management
of chronic illnesses by increasing the availability and
transparency of information related to the health care needs of
an individual for such individual;
(3) ensures that appropriate information necessary to make
medical decisions is available in a usable form at the time and
in the location that the medical service involved is provided;
(4) produces greater value for health care expenditures by
reducing health care costs that result from inefficiency,
medical errors, inappropriate care, and incomplete information;
(5) promotes a more effective marketplace, greater
competition, greater systems analysis, increased choice,
enhanced quality, and improved outcomes in health care
services;
(6) improves the coordination of information and the
provision of such services through an effective infrastructure
for the secure and authorized exchange and use of health care
information; and
(7) ensures that the confidentiality of individually
identifiable health information of a patient is secure and
protected.
(c) Duties of National Coordinator.--
(1) Strategic planner for interoperable health information
technology.--The National Coordinator shall maintain, direct,
and oversee the continuous improvement of a strategic plan to
guide the nationwide implementation of interoperable health
information technology in both the public and private health
care sectors consistent with subsection (b).
(2) Principal advisor to hhs.--The National Coordinator
shall serve as the principal advisor of the Secretary of Health
and Human Services on the development, application, and use of
health information technology, and coordinate the health
information technology programs of the Department of Health and
Human Services.
(3) Coordinator of federal government activities.--
(A) In general.--The National Coordinator shall
serve as the coordinator of Federal Government
activities relating to health information technology.
(B) Specific coordination functions.--In carrying
out subparagraph (A), the National Coordinator shall
provide for--
(i) the approval of standards developed and
recommended by AHIC 2.0 under section 102
(which may include standards relating to the
interoperability, privacy, and security of
health information technology) to be used in
the electronic creation, maintenance, or
exchange of health information; and
(ii) the certification and inspection of
health information technology products,
exchanges, and architectures to ensure that
such products, exchanges, and architectures
conform to the applicable standards approved
under clause (i).
Any standard approved or health information technology
product, exchange, or architecture certified pursuant
to Executive Order 13335 as of the day before the date
of the enactment of this Act shall be deemed to be a
standard approved or product, exchange, or architecture
certified, respectively, pursuant to this subparagraph
as of such date of enactment.
(C) Use of private entities.--The National
Coordinator shall, to the maximum extent possible,
contract with or recognize private entities in carrying
out subparagraph (B).
(D) Uniform application of standards.--A standard
approved under subparagraph (B)(i) for use in the
electronic creation, maintenance, or exchange of health
information shall preempt a standard adopted under
State law, regulation, or rule for such a use.
(4) Intragovernmental coordinator.--The National
Coordinator shall ensure that health information technology
policies and programs of the Department of Health and Human
Services are coordinated with those of relevant executive
branch agencies and departments with a goal to avoid
duplication of effort and to ensure that each agency or
department conducts programs within the areas of its greatest
expertise and its mission in order to create a national
interoperable health information system capable of meeting
national public health needs effectively and efficiently.
(5) Advisor to omb.--The National Coordinator shall provide
to the Director of the Office of Management and Budget comments
and advice with respect to specific Federal health information
technology programs.
(d) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section
for each of fiscal years 2009 through 2013.
(e) Treatment of Executive Order 13335.--Executive Order 13335
shall not have any force or effect after the date of the enactment of
this Act.
(f) Transition From ONCHIT Under Executive Order.--
(1) In general.--All functions, personnel, assets,
liabilities, administrative actions, and statutory reporting
requirements applicable to the old National Coordinator or the
Office of the old National Coordinator on the date before the
date of the enactment of this Act shall be transferred, and
applied in the same manner and under the same terms and
conditions, to the new National Coordinator and the Office of
the new National Coordinator as of the date of the enactment of
this Act.
(2) Acting national coordinator.--Before the appointment of
the new National Coordinator, the old National Coordinator
shall act as the National Coordinator for Health Information
Technology until the office is filled as provided in subsection
(a). The President may appoint the old National Coordinator as
the new National Coordinator.
(3) Definitions.--For purposes of this subsection:
(A) New national coordinator.--The term ``new
National Coordinator'' means the National Coordinator
for Health Information Technology appointed under
subsection (a).
(B) Old national coordinator.--The term ``old
National Coordinator'' means the National Coordinator
for Health Information Technology appointed under
Executive Order 13335.
SEC. 102. SUCCESSOR TO THE AMERICAN HEALTH INFORMATION COMMUNITY.
(a) In General.--The Secretary of Health and Human Services shall
(through a grant, contract, or cooperative agreement) ensure the
establishment and provide for the operation of an entity described in
subsection (b) (in this Act to be referred to as ``AHIC 2.0'') for
purposes of developing and recommending standards described in section
101(c)(3)(B)(i) for approval under such section.
(b) Structure and Procedures of Entity.--An entity described in
this subsection is an entity--
(1) in the operation of which there is broad participation
by a variety of public and private stakeholders, (whether
through membership or through other means);
(2) that uses a consensus approach and a fair and open
process to support the development of standards under
subsection (a); and
(3) that has a business plan and a published set of
governance rules that enables the entity to be self-sustaining
and to fulfill the purposes described in subsection (a).
(c) Consultation.--In establishing AHIC 2.0, the entity awarded a
grant, contract, or cooperative agreement pursuant to subsection (a),
shall consult with a wide variety of private and public stakeholders
that are knowledgeable with respect to standards to be developed by
AHIC 2.0 or that would be potentially affected by the recommendations
of AHIC 2.0.
(d) Funding.--
(1) Authorization of appropriations.--There are authorized
to be appropriated to carry out this section $13,000,000, to
remain available until expended.
(2) Further federal funding other than dues prohibited.--
Except as otherwise provided by this subsection, and except for
such dues as may be paid by a Federal agency for membership or
other participation in AHIC 2.0, no Federal agency may provide
funding to the entity. There are authorized to be appropriated
to such agencies such amounts as are necessary to pay the dues
described in the previous sentence.
(e) Nonduplication of Efforts To Establish AHIC 2.0.--Nothing in
this section shall be construed as requiring the duplication of Federal
efforts (such as awarding a grant, contract, or cooperative agreement)
that were carried out before the date of the enactment of this Act,
with respect to the establishment of an entity to support the
development and recommendation of standards under subsection (a).
(f) Treatment of Standards Developed or Approved by AHIC.--For
purposes of this title, a standard developed or approved (or in a stage
of development or approval) by the American Health Information
Community established pursuant to Executive Order 13335 (or the AHIC
Successor, Inc. doing business as the National eHealth Collaborative)
as of the day before the date of the enactment of this Act shall be
deemed to be a standard developed or approved, respectively, (or in
such stage of development or approval) by AHIC 2.0 as of such date of
enactment.
SEC. 103. HEALTH INFORMATION TECHNOLOGY RESOURCE CENTER.
(a) In General.--There is established within the Office of the
National Coordinator for Health Information Technology the Health
Information Technology Resource Center (referred to in this section as
the ``Center'') to carry out the following functions:
(1) Provide assistance and support for adoption and
implementation efforts and effective use of interoperable
health information technology.
(2) Serve as a forum for the exchange of knowledge and
experience.
(3) Accelerate the transmission of knowledge from existing
health information initiatives in both the private and public
sectors.
(4) Support the establishment of regional and local health
information networks to facilitate the interoperability of
health care data across health care settings.
(5) Develop solutions to barriers to electronic health
information exchange.
(6) Provide technical assistance and tools to help health
information exchanges develop a path toward financial
sustainability.
(7) Establish a longitudinal database to measure the
business sustainability of health information exchange and
evaluate the impact of health information exchange on community
health outcomes and value.
(b) Rule of Construction.--Nothing in this section shall be
construed to require the duplication of Federal efforts with respect to
the establishment of the Center, regardless of whether such efforts
were carried out prior to or after the enactment of this subsection.
(c) Transition From National Resource Center for Health Information
Technology Under AHRQ.--All functions, personnel, assets, and
liabilities applicable to the National Resource Center for Health
Information Technology under the Agency for Healthcare Research and
Quality as of the day before the date of the enactment of this Act
shall be transferred, and applied in the same manner and under the same
terms and conditions, to the Health Information Technology Resource
Center under the Office of the National Coordinator for Health
Information Technology established under subsection (a) as of the date
of the enactment of this Act.
SEC. 104. STRATEGIC PLAN FOR COORDINATING IMPLEMENTATION OF HEALTH
INFORMATION TECHNOLOGY.
(a) In General.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Health and Human Services, in
consultation with entities involved in the area of health information
technology, shall develop a strategic plan related to the need for
coordination in such area.
(b) Coordination of Specific Implementation Processes.--The
strategic plan under subsection (a) shall address the need for
coordination in the implementation of the following:
(1) Health information technology standards.--Health
information technology standards approved under section
101(c)(3)(B)(i).
(2) HIPAA transaction standards.--Transaction standards
under section 1173(a) of the Social Security Act (42 U.S.C.
1320d-2(d)).
(c) Coordination Among Specific Federal Entities.--The strategic
plan under subsection (a) shall address any methods to coordinate, with
respect to the electronic exchange of health information, actions taken
by the following entities:
(1) The Office of the National Coordinator for Health
Information Technology.
(2) AHIC 2.0 established under section 102.
(3) The Office of Electronic Standards and Security of the
Centers for Medicare and Medicaid Services.
(4) The National Committee on Vital Health Statistics.
(5) Any other entity involved in the electronic exchange of
health information that the Secretary determines appropriate.
TITLE II--MODERNIZING THE HEALTH CARE DELIVERY SYSTEM
SEC. 201. PROCEDURES TO ENSURE TIMELY UPDATING OF STANDARDS THAT ENABLE
ELECTRONIC EXCHANGES.
Section 1174(b) of the Social Security Act (42 U.S.C. 1320d-3(b))
is amended--
(1) in paragraph (1)--
(A) in the first sentence, by inserting ``and in
accordance with paragraph (3)'' before the period; and
(B) by adding at the end the following new
sentence: ``For purposes of this subsection and section
1173(c)(2), the term `modification' includes a new
version or a version upgrade.''; and
(2) by adding at the end the following new paragraph:
``(3) Expedited procedures for adoption of additions and
modifications to standards.--
``(A) In general.--For purposes of paragraph (1),
the Secretary shall provide for an expedited upgrade
program (in this paragraph referred to as the `upgrade
program'), in accordance with this paragraph, to
develop and approve additions and modifications to the
standards adopted under section 1173(a) to improve the
quality of such standards or to extend the
functionality of such standards to meet evolving
requirements in health care.
``(B) Publication of notices.--Under the upgrade
program:
``(i) Voluntary notice of initiation of
process.--Not later than 30 days after the date
the Secretary receives a notice from a standard
setting organization that the organization is
initiating a process to develop an addition or
modification to a standard adopted under
section 1173(a), the Secretary shall publish a
notice in the Federal Register that--
``(I) identifies the subject matter
of the addition or modification;
``(II) provides a description of
how persons may participate in the
development process; and
``(III) invites public
participation in such process.
``(ii) Voluntary notice of preliminary
draft of additions or modifications to
standards.--Not later than 30 days after the
date the Secretary receives a notice from a
standard setting organization that the
organization has prepared a preliminary draft
of an addition or modification to a standard
adopted by section 1173(a), the Secretary shall
publish a notice in the Federal Register that--
``(I) identifies the subject matter
of (and summarizes) the addition or
modification;
``(II) specifies the procedure for
obtaining the draft;
``(III) provides a description of
how persons may submit comments in
writing and at any public hearing or
meeting held by the organization on the
addition or modification; and
``(IV) invites submission of such
comments and participation in such
hearing or meeting without requiring
the public to pay a fee to participate.
``(iii) Notice of proposed addition or
modification to standards.--Not later than 30
days after the date the Secretary receives a
notice from a standard setting organization
that the organization has a proposed addition
or modification to a standard adopted under
section 1173(a) that the organization intends
to submit under subparagraph (D)(iii), the
Secretary shall publish a notice in the Federal
Register that contains, with respect to the
proposed addition or modification, the
information required in the notice under clause
(ii) with respect to the addition or
modification.
``(iv) Construction.--Nothing in this
paragraph shall be construed as requiring a
standard setting organization to request the
notices described in clauses (i) and (ii) with
respect to an addition or modification to a
standard in order to qualify for an expedited
determination under subparagraph (C) with
respect to a proposal submitted to the
Secretary for adoption of such addition or
modification.
``(C) Provision of expedited determination.--Under
the upgrade program and with respect to a proposal by a
standard setting organization for an addition or
modification to a standard adopted under section
1173(a), if the Secretary determines that the standard
setting organization developed such addition or
modification in accordance with the requirements of
subparagraph (D) and the National Committee on Vital
and Health Statistics recommends approval of such
addition or modification under subparagraph (E), the
Secretary shall provide for expedited treatment of such
proposal in accordance with subparagraph (F).
``(D) Requirements.--The requirements under this
subparagraph with respect to a proposed addition or
modification to a standard by a standard setting
organization are the following:
``(i) Request for publication of notice.--
The standard setting organization submits to
the Secretary a request for publication in the
Federal Register of a notice described in
subparagraph (B)(iii) for the proposed addition
or modification.
``(ii) Process for receipt and
consideration of public comment.--The standard
setting organization provides for a process
through which, after the publication of the
notice referred to under clause (i), the
organization--
``(I) receives and responds to
public comments submitted on a timely
basis on the proposed addition or
modification before submitting such
proposed addition or modification to
the National Committee on Vital and
Health Statistics under clause (iii);
``(II) makes publicly available a
written explanation for its response in
the proposed addition or modification
to comments submitted on a timely
basis; and
``(III) makes public comments
received under clause (I) available, or
provides access to such comments, to
the Secretary.
``(iii) Submittal of final proposed
addition or modification to ncvhs.--After
completion of the process under clause (ii),
the standard setting organization submits the
proposed addition or modification to the
National Committee on Vital and Health
Statistics for review and consideration under
subparagraph (E). Such submission shall include
information on the organization's compliance
with the notice and comment requirements (and
responses to those comments) under clause (ii).
``(E) Hearing and recommendations by national
committee on vital and health statistics.--Under the
upgrade program, upon receipt of a proposal submitted
by a standard setting organization under subparagraph
(D)(iii) for the adoption of an addition or
modification to a standard, the National Committee on
Vital and Health Statistics shall provide notice to the
public and a reasonable opportunity for public
testimony at a hearing on such addition or
modification. The Secretary may participate in such
hearing in such capacity (including presiding ex
officio) as the Secretary shall determine appropriate.
Not later than 90 days after the date of receipt of the
proposal, the Committee shall submit to the Secretary
its recommendation to adopt (or not adopt) the proposed
addition or modification.
``(F) Determination by secretary to accept or
reject national committee on vital and health
statistics recommendation.--
``(i) Timely determination.--Under the
upgrade program, if the National Committee on
Vital and Health Statistics submits to the
Secretary a recommendation under subparagraph
(E) to adopt a proposed addition or
modification, not later than 90 days after the
date of receipt of such recommendation the
Secretary shall make a determination to accept
or reject the recommendation and shall publish
notice of such determination in the Federal
Register not later than 30 days after the date
of the determination.
``(ii) Contents of notice.--If the
determination is to reject the recommendation,
such notice shall include the reasons for the
rejection. If the determination is to accept
the recommendation, as part of such notice the
Secretary shall promulgate the modified
standard (including the accepted proposed
addition or modification accepted).
``(iii) Limitation on consideration.--The
Secretary shall not consider a proposal under
this subparagraph unless the Secretary
determines that the requirements of
subparagraph (D) (including publication of
notice and opportunity for public comment) have
been met with respect to the proposal.
``(G) Exemption from paperwork reduction act.--
Chapter 35 of title 44, United States Code, shall not
apply to a final rule promulgated under subparagraph
(F).''.
SEC. 202. FEDERAL PURCHASING AND DATA COLLECTION.
(a) Coordination of Federal Spending.--
(1) In general.--Subject to section 203(c), not later than
1 year after the date of the approval of an applicable standard
under section 101(c)(3)(B)(i), no Federal funds may be used for
the purchase of any health information technology or health
information technology system for clinical care or for the
electronic retrieval, storage, or exchange of health
information unless such technology or system has been certified
under section 101(c)(3)(B)(ii) with respect to compliance with
such standard.
(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) Coordination of Federal Data Collection.--Subject to section
203(c), not later than 3 years after the date of the approval of an
applicable standard under section 101(c)(3)(B)(i), all Federal agencies
collecting health data in an electronic format for the purposes of
quality reporting, surveillance, epidemiology, adverse event reporting,
research, or for other purposes determined appropriate by the Secretary
of Health and Human Services, shall comply with such standard.
SEC. 203. STUDY TO IMPROVE PRESERVATION AND PROTECTION OF SECURITY AND
CONFIDENTIALITY OF HEALTH INFORMATION.
(a) In General.--The Secretary of Health and Human Services shall
conduct a study of current Federal security and confidentiality
standards to determine the strengths and weaknesses of such standards
for purposes of protecting the security and confidentiality of
individually identifiable health information while taking into account
the need for timely and efficient exchanges of health information to
improve quality of care and ensure the availability of health
information necessary to make medical decisions at the location in
which the medical care involved is provided.
(b) Report.--Not later than 24 months after the date of the
enactment of this Act, the Secretary of Health and Human Services shall
submit to Congress a report on the study under subsection (a) and shall
include in such report recommendations for improving the current
Federal security and confidentiality standards, including
recommendations for a mechanism to track breaches to the security or
confidentiality of individually identifiable health information and for
appropriate penalties to apply in the case of such a breach.
(c) Preservation of Current Security and Confidentiality Standards
Before Submittal of Report.--None of the provisions of this Act or
amendments made by this Act may limit, or require issuance of a
regulation that would limit, the effect of a current Federal security
and confidentiality standard before the date of the submittal of the
report under subsection (b).
(d) Current Federal Security and Confidentiality Standards
Defined.--For purposes of this section, the term ``current Federal
security and confidentiality standards'' means the Federal privacy
standards established pursuant to section 264(c) of the Health
Insurance Portability and Accountability Act of 1996 (42 U.S.C. 1320d-2
note) and security standards established under section 1173(d) of the
Social Security Act.
TITLE III--INCENTIVIZING ADOPTION OF HEALTH IT
SEC. 301. INCENTIVES FOR MEDICAL CARE PROVIDERS TO ADOPT HEALTH CARE
INFORMATION TECHNOLOGY.
(a) In General.--Subsection (b) of section 179 of the Internal
Revenue Code of 1986 is amended by adding at the end the following new
paragraph:
``(8) Increased limitation for health care information
technology.--
``(A) In general.--In the case of a medical care
provider for any taxable year beginning after December
31, 2008, and before January 1, 2014--
``(i) the dollar amount in effect under
paragraph (1) shall be increased by the lesser
of--
``(I) $250,000, or
``(II) the cost of qualified health
care information technology placed in
service by such provider during the
taxable year, and
``(ii) the dollar amount in effect under
paragraph (2) shall be increased by the lesser
of--
``(I) $800,000, or
``(II) the cost of qualified health
care information technology placed in
service by such provider during the
taxable year.
``(B) Definitions.--For purposes of this
subsection--
``(i) Qualified health care information
technology.--The term `qualified health care
information technology' means section 179
property which--
``(I) has been certified pursuant
to section 101(c)(3)(B)(ii) of the
Promoting Health Information Technology
Act of 2009, and
``(II) is used primarily for the
electronic creation, maintenance, and
exchange of medical care information to
improve the quality or efficiency of
medical care.
``(ii) Medical care provider.--The term
`medical care provider' means any person
engaged in the trade or business of providing
medical care.
``(iii) Medical care.--The term `medical
care' has the meaning given such term by
section 213(d).''.
(b) Effective Date.--The amendment made by this section shall apply
to property placed in service after December 31, 2008.
SEC. 302. ELIMINATION OF SUNSET APPLICABLE TO STARK EXCEPTION FOR
ELECTRONIC HEALTH RECORDS ARRANGEMENTS.
In applying section 1877(e) of the Social Security Act (42 U.S.C.
1395(e)), with respect to a regulation implementing such section by
providing an exception to the prohibition against making certain
physician referrals in the case of the offering or payment of
nonmonetary remuneration (consisting of items and services in the form
of software or information technology and training services) necessary
and used predominantly to create, maintain, transmit, or receive
electronic health records, the Secretary of Health and Human Services
shall not limit the period in which such an exception under such a
regulation applies.
SEC. 303. PROMOTION OF TELEHEALTH SERVICES.
(a) Facilitating the Provision of Telehealth Services Across State
Lines.--
(1) In general.--The Secretary of Health and Human Services
shall, in coordination with physicians, health care
practitioners, patient advocates, and representatives of
States, encourage and facilitate the adoption of State
reciprocity agreements for practitioner licensure in order to
expedite the provision across State lines of telehealth
services.
(2) Report.--Not later than 18 months after the date of the
enactment of this Act, the Secretary of Health and Human
Services shall submit to Congress a report on the actions taken
to carry out paragraph (1).
(3) State defined.--For purposes of this subsection, the
term ``State'' has the meaning given that term for purposes of
title XVIII of the Social Security Act.
(b) Study and Report on Expansion of Home Health-Related Telehealth
Services.--
(1) Study.--The Secretary of Health and Human Services
shall conduct a study to determine the feasibility,
advisability, and the costs of--
(A) including coverage and payment for home health-
related telehealth services as part of home health
services under title XVIII of the Social Security Act;
and
(B) expanding the list of sites described in
paragraph (4)(C)(ii) of section 1834(m) of the Social
Security Act (42 U.S.C. 1395m(m)) to include county
mental health clinics or other publicly funded mental
health facilities for the purpose of payment under such
section for the provision of telehealth services at
such clinics or facilities.
(2) Specifics of study.--Such study shall demonstrate
whether the changes described in subparagraphs (A) and (B) of
paragraph (1) are likely to result in the following:
(A) Enhanced health outcomes for individuals with
one or more chronic conditions.
(B) Health outcomes for individuals furnished
telehealth services or home health-related telehealth
services that are at least comparable to the health
outcomes for individuals furnished similar items and
services by a health care provider at the same location
of the individual or at the home of the individual,
respectively.
(C) Facilitation of communication of more accurate
clinical information between health care providers.
(D) Closer monitoring of individuals by health care
providers.
(E) Overall reduction in expenditures for health
care items and services.
(F) Improved access to health care.
(3) Home health-related telehealth services defined.--For
purposes of this subsection, the term ``home health-related
telehealth services'' means technology-based professional
consultations, patient monitoring, patient training services,
clinical observation, patient assessment, and any other health
services that utilize telecommunications technologies. Such
term does not include a telecommunication that consists solely
of a telephone audio conversation, facsimile, electronic text
mail, or consultation between two health care providers.
(4) Report.--Not later than 18 months after the date of the
enactment of this Act, the Secretary of Health and Human
Services shall submit to Congress a report on the study
conducted under paragraph (1) and shall include in such report
such recommendations for legislation or administration action
as the Secretary determines appropriate.
(c) Study and Report on Store and Forward Technology for
Telehealth.--
(1) Study.--The Secretary of Health and Human Services,
acting through the Director of the Office for the Advancement
of Telehealth, shall conduct a study on the use of store and
forward technologies (that provide for the asynchronous
transmission of health care information in single or multimedia
formats) in the provision of telehealth services. Such study
shall include an assessment of the feasibility, advisability,
and the costs of expanding the use of such technologies for use
in the diagnosis and treatment of certain health conditions, as
specified by the Secretary.
(2) Report.--Not later than 18 months after the date of the
enactment of this Act, the Secretary of Health and Human
Services shall submit to Congress a report on the study
conducted under paragraph (1) and shall include in such report
such recommendations for legislation or administration action
as the Secretary determines appropriate.
SEC. 304. FQHCS INCLUDED IN ELECTRONIC HEALTH RECORDS DEMONSTRATION.
Effective as of the date of the enactment of this Act, in
developing and implementing a demonstration initiative to foster the
implementation and adoption of electronic health records and health
information technology, the Centers of Medicare & Medicaid Services
shall provide for the eligibility of Federally qualified health centers
(as defined in section 1861(aa)(4) of the Social Security Act (42
U.S.C. 1395x(aa)(4)) to participate in such demonstration.
SEC. 305. INTEREST-FREE LOAN PROGRAM FOR HOSPITALS TO ADOPT HEALTH
INFORMATION TECHNOLOGY.
(a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall establish a loan
program that provides loans to hospitals to purchase and implement
health information technology products certified pursuant to section
101(c)(3)(B)(ii).
(b) Application.--No loan may be provided under this section to a
hospital except pursuant to an application that is submitted and
approved in a time, manner, and form specified by the Secretary. A loan
under this section shall be on such terms and conditions and meet such
requirements as the Secretary determines appropriate, in accordance
with the provisions of this section.
(c) Permissible Use of Loan Funds.--A loan provided under this
section shall be used only for the purchase and implementation of
health information technology products certified pursuant to section
1019c)(3)(B)(ii).
(d) Preference.--In making loans under this section, the Secretary
shall give preference to any applicant for such a loan that is a
hospital receiving a high amount of disproportionate share hospital
payments under section 1886(d)(5)(F) of the Social Security Act (42
U.S.C. 1395ww(d)(5)(F)).
(e) Repayment of Loans.--The Secretary shall establish a schedule
for the repayment of loans provided under this section.
(f) No Interest Charged.--The Secretary shall not charge or collect
interest on any loan made under this section.
(g) Penalties.--The Secretary shall establish penalties to which a
hospital receiving a loan under this section would be subject if such
hospital is in violation of any of the terms, conditions, or
requirements specified by the Secretary under subsection (b) or under
this section.
(h) Funding.--
(1) Authorization of appropriations.--For purposes of
carrying out this section, there are authorized to be
appropriated such sums as may be necessary for fiscal year 2009
and each succeeding fiscal year.
(2) Availability.--Amounts appropriated under paragraph (1)
shall remain available until expended.
(3) Repaid loan amounts.--Any amount repaid by, or
recovered from, a hospital under this section shall be credited
to the appropriation account from which the loan amount
involved was originally paid. Any amount so credited shall be
available only for the purpose of carrying out the loan program
under this section.
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