1.This Act may be cited as the
Access to America’s Orthopaedic
Services Act of 2009
.
2.The table of contents
for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Definition.
TITLE I—Musculoskeletal Health
Sec. 101. Findings.
Sec. 102. Musculoskeletal research.
Sec. 103. Musculoskeletal trauma research and care.
Sec. 104. Transplants, tissues, and replacement
joints.
Sec. 105. Traffic and workplace safety.
Sec. 106. Public education campaign.
Sec. 107. Orthopaedic physician workforce training
study.
Sec. 108. Bone density under the Medicare program.
Sec. 109. Access to orthopaedic services for beneficiaries of
Medicaid and SCHIP.
Sec. 110. Age-related programs.
Sec. 111. Minority health disparities.
TITLE II—Third longitudinal study on aging
Sec. 201. Third longitudinal study on aging.
3.In this Act, the term Secretary
means the Secretary of Health and Human Services, except as otherwise
provided.
<enum>I</enum><header>Musculoskeletal
Health</header>
<section id="H15726F9194984CB8B976F5DAD437B21"><enum>101.</enum><header>Findings</header><text display-inline="no-display-inline">Congress makes the following
findings:</text>
<paragraph id="H41BE74B50880419D8E105314990566AF"><enum>(1)</enum><text>Musculoskeletal
diseases and other conditions are the leading cause of disability in the United
States.</text>
</paragraph><paragraph id="H8105D893FD224245891C91F4AC6B06F9"><enum>(2)</enum><text>Musculoskeletal
conditions account for more than one-half of all chronic conditions in people
over 50 years of age in developed countries.</text>
</paragraph><paragraph id="HA0B9ECE31E124F06A7A6BBC311A4D1FA"><enum>(3)</enum><text>More than 1 in 4
individuals in the United States has a musculoskeletal condition requiring
medical attention.</text>
</paragraph><paragraph id="HDA14944F211E4397A2EF6829BB81F5E2"><enum>(4)</enum><text>Direct and
indirect costs for bone and joint health are $849,000,000,000 per year in the
United States.</text>
</paragraph><paragraph id="HCD084D794CA64C728E2B902E1360CFC"><enum>(5)</enum><text>Musculoskeletal
conditions are the greatest cause of total lost workdays and medical bed days
in the United States.</text>
</paragraph><paragraph id="H76FB1F9163B54E6E80CF34D579886691"><enum>(6)</enum><text>The 2004 Surgeon
General Report on Bone Health and Osteoporosis concluded that there is a lack
of awareness of bone disease among the public and health care
professionals.</text>
</paragraph><paragraph id="H4A8ABC65505B4304B1EB9DB871BC8713"><enum>(7)</enum><text display-inline="yes-display-inline">Research demonstrates that there is need
among ethnic and racial minorities to improve knowledge of and treatment for
musculoskeletal diseases and other conditions.</text>
</paragraph></section><section id="HF610044F53C7449E8FAA96BB00B33B40"><enum>102.</enum><header>Musculoskeletal
research</header>
<subsection id="HB39A535DAA2D4DC38FBE4268CDB17BF9"><enum>(a)</enum><header>Regulations
concerning reporting criteria for percent of effort</header>
<paragraph id="H3FC0E824D7CE4EBBAD11EFE9DF37C22"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, in
consultation with the Director of the National Institutes of Health, shall
establish, by regulation, criteria for accounting for and reporting the percent
of effort expended by researchers, with respect to research that is—</text>
<subparagraph id="HBE5BF59A2BB44D8A93D5F7E5129C92EB"><enum>(A)</enum><text>conducted during
each fiscal year beginning after the last day of the second full fiscal year
following the date of enactment of this Act; and</text>
</subparagraph><subparagraph id="HB3468099B6E14FB0BBD8ABE89142998"><enum>(B)</enum><text display-inline="yes-display-inline">funded through research grants, on
musculoskeletal health, awarded by either the Director of the National
Institutes of Health or the Director of the Agency for Healthcare Research and
Quality.</text>
</subparagraph></paragraph><paragraph id="HB42D3E938AD143D284F86C583936804B"><enum>(2)</enum><header>Deadline for
regulations</header><text>Not later than the last day of the 2-year period
beginning on the date of enactment of this Act, the Secretary shall issue the
regulations required by
<internal-xref idref="H3FC0E824D7CE4EBBAD11EFE9DF37C22" legis-path="102.(a)(1)">paragraph (1)</internal-xref>.</text>
</paragraph></subsection><subsection id="H2F6A116E930A4E30B95E81EABE431EE0"><enum>(b)</enum><header>New
Investigators in Musculoskeletal Research</header>
<paragraph id="H4AB9AD188CFF41A4817C85C61355DEAD"><enum>(1)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 90 days after the last day
of each fiscal year that begins more than 1 year following the date of
enactment of this Act, the Secretary, in consultation with the Director of the
National Institutes of Health, shall prepare and submit to Congress a report on
each of the following:</text>
<subparagraph id="H951777DAD4E74FCCBCF2EF05B712954B"><enum>(A)</enum><text display-inline="yes-display-inline">The number of new investigators who are
awarded grants for musculoskeletal health research by the National Institutes
of Health during the fiscal year involved.</text>
</subparagraph><subparagraph id="H7D28AAA8A13F47598E05E2CBADF56DD"><enum>(B)</enum><text display-inline="yes-display-inline">The total amount of funds awarded to those
investigators through such grants during the fiscal year.</text>
</subparagraph><subparagraph id="HE0304B24AF904C89B2E9A55805D6D823"><enum>(C)</enum><text display-inline="yes-display-inline">The percentage of the National Institutes
of Health’s budget for musculoskeletal health research that was awarded to
those investigators through such grants during the fiscal year.</text>
</subparagraph><subparagraph id="H8C8D9E35F8294EA687B6CF6FD1F3E500"><enum>(D)</enum><text display-inline="yes-display-inline">The backgrounds of those investigators who
are awarded such grants during the fiscal year, analyzed by race and
ethnicity.</text>
</subparagraph><subparagraph id="HB8701F76EBC84A769FB819B93441ACF8"><enum>(E)</enum><text display-inline="yes-display-inline">A description of the efforts made by the
Director of the National Institutes of Health to encourage individuals from
underrepresented minority groups (as defined by the Secretary) to apply for
grants for musculoskeletal health research awarded by the National Institutes
of Health during the fiscal year.</text>
</subparagraph></paragraph><paragraph id="H1C2995F151C64268B4B1060989EAD560"><enum>(2)</enum><header>Recommendations</header><text display-inline="yes-display-inline">The first report submitted under
<internal-xref idref="H4AB9AD188CFF41A4817C85C61355DEAD" legis-path="102.(b)(1)">paragraph (1)</internal-xref> shall include, and
subsequent reports may include, recommendations concerning additional resources
that the National Institutes of Health or other entities could use—</text>
<subparagraph display-inline="no-display-inline" id="HFFED40D15BCB4C7800F2AD8295D79D29"><enum>(A)</enum><text display-inline="yes-display-inline">to increase the number of new investigators
awarded grants referred to in
<internal-xref idref="H951777DAD4E74FCCBCF2EF05B712954B" legis-path="102.(b)(1)(A)">paragraph (1)(A)</internal-xref>; and</text>
</subparagraph><subparagraph id="HC88E0F138E3C48B98425FFDC63C3579"><enum>(B)</enum><text display-inline="yes-display-inline">to increase the number of new investigators
awarded such grants who are members of underrepresented minority groups (as
defined by the Secretary).</text>
</subparagraph></paragraph><paragraph id="H7EDE46740E504ED4B94051CAEFD53DC1"><enum>(3)</enum><header>Definitions</header><text>In
this section:</text>
<subparagraph id="H36BF9A02B43E4EBCB50683EEDB46DB2"><enum>(A)</enum><header>New
investigator</header><text display-inline="yes-display-inline">The term
<term>new investigator</term> has the meaning given the term by the Secretary
for purposes of administering title III of the Public Health Service Act (42
U.S.C. 241 et seq.), but only with respect to musculoskeletal health
research.</text>
</subparagraph><subparagraph commented="no" id="HAA83F0A8598E4DCDA5FB9E16894E24C8"><enum>(B)</enum><header>Race;
ethnicity</header><text display-inline="yes-display-inline">The terms
<term>race</term> and <term>ethnicity</term> have the meanings given such terms
by the Office of Management and Budget for purposes of Federal statistics and
administrative reporting.</text>
</subparagraph></paragraph></subsection></section><section id="HA6E8B4E586F94716BB8B74ED958F2900"><enum>103.</enum><header>Musculoskeletal
trauma research and care</header>
<subsection commented="no" id="H57DEB23CFD7F4C7DA318359301E59341"><enum>(a)</enum><header> Musculoskeletal
trauma research</header>
<paragraph id="H38F6CD503FFE44F7B52B76C5D654FB40"><enum>(1)</enum><header>Report</header><text>Not
later than 2 years after the date of enactment of this Act, the Secretary shall
prepare and submit to Congress a report on all programs and activities relating
to musculoskeletal trauma care that are being conducted by the Federal
Government or supported by funding made available by Federal Government.</text>
</paragraph><paragraph id="H81569AFBCE694BE9B8F0903EC31110C7"><enum>(2)</enum><header>Contents of
Report</header><text>Such report shall include, at a minimum, each of the
following:</text>
<subparagraph commented="no" id="H35BD207EA3F44BF8A74269C3A4DE786"><enum>(A)</enum><text display-inline="yes-display-inline">Information on the status of each Federal
program and activity referred to in
<internal-xref idref="H38F6CD503FFE44F7B52B76C5D654FB40" legis-path="103.(a)(1)">paragraph (1)</internal-xref>, including specific
information on any research program and activity.</text>
</subparagraph><subparagraph commented="no" id="H225DA4FA74C84BDA94B678AC5575B5C8"><enum>(B)</enum><text display-inline="yes-display-inline">Information on the methods being used to
coordinate research being conducted under such Federal programs and activities
and the effectiveness of such methods.</text>
</subparagraph></paragraph><paragraph id="H00FFA8EF432C43B697EEB1FBCB4F90"><enum>(3)</enum><header>Consultation</header><text display-inline="yes-display-inline">In preparing the report under
<internal-xref idref="H38F6CD503FFE44F7B52B76C5D654FB40" legis-path="103.(a)(1)">paragraph (1)</internal-xref>, the Secretary shall
consult with—</text>
<subparagraph id="H3372A4444A494713BD55C3478FD3867B"><enum>(A)</enum><text>the Secretary of
Defense; and</text>
</subparagraph><subparagraph id="HEE68ABF24BE44B6BA611A72698AA8E7"><enum>(B)</enum><text>the heads of other
Federal departments and agencies that administer programs and activities
relating to musculoskeletal trauma care, as determined by the Secretary of
Health and Human Services.</text>
</subparagraph></paragraph></subsection><subsection id="HAD2A06001AF74888B09C660711E81454"><enum>(b)</enum><header>Orthopaedic
treatment through trauma care systems</header>
<paragraph id="H6DC2030AE6834C5785FEBEEFDB27512D"><enum>(1)</enum><header>Study</header><text display-inline="yes-display-inline">The Secretary shall conduct a study on the
impact of trauma care systems that connect hospitals with other providers of
musculoskeletal health care services (including orthopedists).</text>
</paragraph><paragraph id="H4D07CD8E09CB4D1E9449B9004A800E7"><enum>(2)</enum><header>Purposes of
study</header><text>The purposes of the study under
<internal-xref idref="H6DC2030AE6834C5785FEBEEFDB27512D" legis-path="103.(b)(1)">paragraph (1)</internal-xref> shall include, at a
minimum, each of the following:</text>
<subparagraph id="HCC51037ECC1E438DBF93CA298CEBE49"><enum>(A)</enum><text>An examination of
the provision of acute and rehabilitative care to trauma patients with
musculoskeletal injuries or other conditions.</text>
</subparagraph><subparagraph id="HC2908469EE8A443E8C2F860224BEB46"><enum>(B)</enum><text>An examination of
epidemiological data on trauma patients with musculoskeletal injuries or other
conditions, including the number of such patients, the number of such injuries
and conditions, and the types of such injuries and conditions.</text>
</subparagraph><subparagraph id="H2E431982C6F64A52ABD428534E005D24"><enum>(C)</enum><text>An evaluation of
the ability of a patient with an orthopaedic injury or other condition
originating from musculoskeletal trauma to access specialty care relevant to
that injury or condition.</text>
</subparagraph><subparagraph id="H892C5A7B1DDF4B839CB067968BCB5594"><enum>(D)</enum><text>An examination of
the impact of trauma rehabilitation care on musculoskeletal health and the
ability of trauma patients with musculoskeletal injuries or other conditions to
access postacute rehabilitative services.</text>
</subparagraph></paragraph><paragraph id="H50059E0778B640F8A7AB9D2278B54000"><enum>(3)</enum><header>Report</header><text>Not
later than 2 years after the date of enactment of this Act, the Secretary shall
submit to Congress a report on the results of the study conducted under
<internal-xref idref="H6DC2030AE6834C5785FEBEEFDB27512D" legis-path="103.(b)(1)">paragraph (1)</internal-xref>, including
recommendations for improving the treatment of trauma patients with
musculoskeletal injuries or other conditions.</text>
</paragraph></subsection></section><section id="H0FFACC1F77C045A2B0E4792558D4FD42"><enum>104.</enum><header>Transplants,
tissues, and replacement joints</header>
<subsection commented="no" id="H5F89563C1A144B798500FC6C7B1ED77B"><enum>(a)</enum><header>Transplantation
Transmission Sentinel Network</header><text display-inline="yes-display-inline">Section 372(b)(2) of the Public Health
Service Act (42 U.S.C. 274(b)(2)) is amended—</text>
<paragraph commented="no" id="HCF5CAA65829C4B939BA8BF54DD1D6138"><enum>(1)</enum><text>in subparagraph
(N), by striking <quote>and</quote> at the end;</text>
</paragraph><paragraph id="H22C513218CAB4F65A3C91987EC48D965"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (O), by striking the period
at the end and inserting <quote>, and</quote>; and</text>
</paragraph><paragraph commented="no" id="H0A8B548C5A74470AA331731FB9A1DBA3"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="HF00A1AEC824A4F66987152BD5B82652B" style="OLC">
<subparagraph id="H6F3C3624073C4FE48803438DE013A1EE" indent="up1"><enum>(P)</enum><text display-inline="yes-display-inline">establish and operate a national web-based
system, to be known as the <quote>Transplantation Transmission Sentinel
Network</quote>, for the detection, reporting, and tracking of disease
transmission from organ, tissue, or eye donors to organ, tissue or eye
transplant recipients.</text>
</subparagraph><after-quoted-block>.
</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H03F6E52076334D05A6E221F4C4002890"><enum>(b)</enum><header>Accreditation of
establishments and personnel engaged in the manufacture of human cells,
tissues, or cellular or tissue-Based products</header>
<paragraph commented="no" display-inline="no-display-inline" id="H82DBAD6033A240B40065FB316083C2DD"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary shall
issue regulations relating to the accreditation of—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H3B0BBFFC32634DD6B4CE6DFFEFF52F63"><enum>(A)</enum><text display-inline="yes-display-inline">establishments; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HAF3D78BAA28D4F9982839108F0B7111B"><enum>(B)</enum><text display-inline="yes-display-inline">personnel who participate in the recovery,
processing, storage, labeling, packaging, or distribution of human cells,
tissues, or cellular or tissue-based products for such establishments.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HA7DF9071FB714B01A2D22B4D2C59B2A9"><enum>(2)</enum><header>Authority of
Secretary</header><text display-inline="yes-display-inline">In issuing the
regulations under paragraph (1), the Secretary shall—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H6A1F4EEEBE1841BEB1B8C07FA91E4FF3"><enum>(A)</enum><text display-inline="yes-display-inline">establish an accreditation process modeled
after the process used by the Joint Commission (previously known as the Joint
Commission on Accreditation of Healthcare Organizations); or</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HCE45BC220ABC415F00C9693D2253C8E"><enum>(B)</enum><text display-inline="yes-display-inline">adopt an accreditation process, established
by a private entity, that is in effect on the date of enactment of this
Act.</text>
</subparagraph></paragraph><paragraph id="H039CC4405BD94F21975000A3E679B42C"><enum>(3)</enum><header>Definitions</header><text>In
this subsection:</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HF071D3D598C9464B9863D2D18D7C248E"><enum>(A)</enum><header>Establishment</header><text display-inline="yes-display-inline">The term <term>establishment</term> has the
meaning given such term in section 1271.3 of title 21, Code of Federal
Regulations (or any corresponding similar regulation or ruling).</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HE08CBF9BA5D04E32A6B790639FB3CF8"><enum>(B)</enum><header>Human cells,
tissues, or cellular or tissue-based products</header><text display-inline="yes-display-inline">The term <term>human cells, tissues, or
cellular or tissue-based products</term> has the meaning given such term in
section 1271.3 of title 21, Code of Federal Regulations (or any corresponding
similar regulation or ruling).</text>
</subparagraph></paragraph></subsection><subsection id="H72D977AC9D164394B67FC7C3E4E9648F"><enum>(c)</enum><header>National Joint
Replacement Registry Study</header>
<paragraph id="H6B6C7EB85E614368A714D99F662390CC"><enum>(1)</enum><header>Study</header><text>The
Secretary shall conduct a study evaluating the advantages and disadvantages of
establishing a national registry for the purpose of tracking the safety and
effectiveness of artificial joints used to replace joints in beneficiaries of
the Medicare program under title XVIII of the Social Security Act (42 U.S.C.
1395 et seq.).</text>
</paragraph><paragraph id="H1D1FA14DD70A4BD398F65EFD9C91738C"><enum>(2)</enum><header>Contents of
proposed Registry</header><text>In evaluating the proposed registry under
<internal-xref idref="H6B6C7EB85E614368A714D99F662390CC" legis-path="104.(c)(1)">paragraph (1)</internal-xref>, the Secretary shall
assume that the registry includes, at a minimum, information on—</text>
<subparagraph id="HCAA2B6A9B1984CC6AB48B206383C6B1F"><enum>(A)</enum><text>the type of joint
replaced;</text>
</subparagraph><subparagraph id="H941B1A9078E4499F8029589008B8A6B4"><enum>(B)</enum><text>the side of the
body on which the joint is replaced;</text>
</subparagraph><subparagraph id="H7F9E7A3031414C1687FB5F438E9358DD"><enum>(C)</enum><text>whether more than
1 operation was required in replacing a joint with an artificial joint;
and</text>
</subparagraph><subparagraph id="H5D3FB5455421451F9B8800E8F009F90"><enum>(D)</enum><text>uniform identifiers
(including the device lot number and catalog number) for the artificial joint
involved.</text>
</subparagraph></paragraph><paragraph display-inline="no-display-inline" id="H9C90D91FDF6A40C8A8706FEAEB69DA75"><enum>(3)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of
enactment of this Act, the Secretary shall submit to Congress a report on the
results of the study under
<internal-xref idref="H6B6C7EB85E614368A714D99F662390CC" legis-path="104.(c)(1)">paragraph (1)</internal-xref> and recommendation for
changes to the Medicare program, including any necessary changes to the
Medicare claims form, to allow for the collection of information required for
the registry.</text>
</paragraph></subsection></section><section display-inline="no-display-inline" id="H545208A3639E468B953ECCAFA9CD02B" section-type="subsequent-section"><enum>105.</enum><header>Traffic and
workplace safety</header>
<subsection id="H1821B6DEF0054876BD57B520D7BE9CE4"><enum>(a)</enum><header>Traffic Safety
Study</header>
<paragraph id="H380922CEAEDF4FAC8C62280067FFD5E5"><enum>(1)</enum><header>Study</header><text display-inline="yes-display-inline">The Secretary, in consultation with the
Secretary of Transportation, shall conduct a study, using epidemiological
methods, on the frequency, severity, and likely causes of severe trauma to
extremities resulting from motor vehicle crashes.</text>
</paragraph><paragraph id="H6A11035043574B128B6BC1121E418E3F"><enum>(2)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of
enactment of this Act, the Secretary of Health and Human Services shall submit
to Congress a report on the results of the study conducted under paragraph
(1).</text>
</paragraph><paragraph commented="no" id="H6F71B6B65ABD4A028D69F23C0671036E"><enum>(3)</enum><header>Motor vehicle
defined</header><text>In this subsection, the term <term>motor vehicle</term>
has the meaning given such term in section 405 of title 23, United States
Code.</text>
</paragraph></subsection><subsection id="H89C01AD84A0641FB841DE38E1934009B"><enum>(b)</enum><header>Workplace Safety
Study</header>
<paragraph id="HF3F5C3AFED084B75B1BD19AC50AE10F8"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, in
consultation with the Secretary of Labor, shall conduct a study, within the
research framework of the National Occupational Research Agenda coordinated by
the National Institute for Occupational Safety and Health, on—</text>
<subparagraph id="H4FDB875082D44A09952D712646B90052"><enum>(A)</enum><text>the number of
workplace-related musculoskeletal injuries and other conditions; and</text>
</subparagraph><subparagraph id="H8655A311DA7146ECB0F77DD689C94F1C"><enum>(B)</enum><text>medical treatments
provided to individuals to treat such injuries and conditions.</text>
</subparagraph></paragraph><paragraph id="HD76577E429BF42C19EACD08B4C5EE326"><enum>(2)</enum><header>Collection
methodology</header><text>In conducting the study under
<internal-xref idref="HF3F5C3AFED084B75B1BD19AC50AE10F8" legis-path="105.(b)(1)">paragraph (1)</internal-xref>, the Secretary of Health
and Human Services shall collect information in a manner that allows such
information to be reported and analyzed on the basis of the type of
musculoskeletal injury or condition involved and the race and ethnicity of the
individual with such injury or condition.</text>
</paragraph><paragraph commented="no" id="H5BB64E6EF0D84E7494D083953699151"><enum>(3)</enum><header>Request for
information from State Workers Compensation Boards</header><text>The Secretary
may request that the head of each State agency that has jurisdiction over
workers compensation submit information relevant to the study under
<internal-xref idref="HF3F5C3AFED084B75B1BD19AC50AE10F8" legis-path="105.(b)(1)">paragraph (1)</internal-xref> to the Secretary.</text>
</paragraph><paragraph id="HF497D5DFCB8A40C0B4CEE831B863C997"><enum>(4)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of
enactment of this Act, the Secretary shall submit to Congress a report on the
results of the study under
<internal-xref idref="HF3F5C3AFED084B75B1BD19AC50AE10F8" legis-path="105.(b)(1)">paragraph (1)</internal-xref>, analyzed by type of
injury or condition, and race and ethnicity.</text>
</paragraph></subsection></section><section display-inline="no-display-inline" id="H0CCD15EFCDD84D969E753DCB6ED2AF39" section-type="subsequent-section"><enum>106.</enum><header>Public education
campaign</header>
<subsection id="H63308ED854984EFA8E824EF1B7562C64"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, in
consultation with the Secretary of Education, the Secretary of Transportation,
the Chairman of the Consumer Product Safety Commission, and the Chair of the
President’s Council on Physical Fitness and Sports, shall conduct a national
public awareness program on musculoskeletal health.</text>
</subsection><subsection id="H13136C9D124C454597B413C0C93127A9"><enum>(b)</enum><header>Contents of
program</header><text>The program shall include, at a minimum, each of the
following components:</text>
<paragraph id="H32D763D39DAA476CA20219767E51FD7F"><enum>(1)</enum><header>General
information for the public</header><text display-inline="yes-display-inline">A
component providing education to the general public on musculoskeletal health,
including education on healthy lifestyle practices relating to musculoskeletal
health.</text>
</paragraph><paragraph id="HB97AE18664674A4CB6F0A3203662D9DC"><enum>(2)</enum><header>Education for
health professionals</header><text>A component providing education to health
professionals on musculoskeletal health, including—</text>
<subparagraph id="H978B519B14774640B37832778F3BF081"><enum>(A)</enum><text>specific
information on musculoskeletal health in medically underserved populations (as
defined in section 330(b)(3) of the Public Health Service Act (42 U.S.C.
254b(b)(3))); and</text>
</subparagraph><subparagraph id="H3D523AC203414970B9C7FC121F7B986F"><enum>(B)</enum><text>information of the
impact of musculoskeletal diseases and other conditions on racial and ethnic
minority populations.</text>
</subparagraph></paragraph><paragraph display-inline="no-display-inline" id="H9964505DA825432E83C300C00093B4A"><enum>(3)</enum><header>Education for
girls</header><text display-inline="yes-display-inline">A component that
utilizes the program popularly known as <quote>powerful bones, powerful
girls</quote> to educate girls ages 9 through 12 on optimal bone health and the
methods to achieve such health, with a focus on reducing the risk that such
girls will develop osteoporosis as adults.</text>
</paragraph><paragraph id="H074EB68B8F504044B279AEA1D78B2600"><enum>(4)</enum><header>Education for
special populations</header><text>A component providing education to each of
the following populations, that addresses the specific needs of those
populations:</text>
<subparagraph id="HA0B2726E620940F180A45012718CB381"><enum>(A)</enum><text>Populations of the
United States that have disproportionately high levels of musculoskeletal
disease and injury and other conditions.</text>
</subparagraph><subparagraph id="H674370DA37A3466DB1A6D792F00F7B2"><enum>(B)</enum><text>Populations of the
United States that have disproportionally low levels of access to orthopaedic
services.</text>
</subparagraph><subparagraph id="H79F5847D90724248B5F023CF3E7EE1F7"><enum>(C)</enum><text display-inline="yes-display-inline">Racial and ethnic minority populations of
the United States.</text>
</subparagraph></paragraph></subsection></section><section display-inline="no-display-inline" id="H8EC5A92867B5446AB644B000ADF34619" section-type="subsequent-section"><enum>107.</enum><header>Orthopaedic
physician workforce training study</header>
<subsection id="HBC2C097F9197438A8C845346CFAE89"><enum>(a)</enum><header>Study</header><text>The
Secretary, acting through the Administrator of the Health Resources and
Services Administration, shall conduct a study on the amount of funding
available, from all sources, for graduate medical education in orthopaedics and
the impact of that amount of funding on the availability of physicians trained
in orthopaedics.</text>
</subsection><subsection id="H80709836CD9C4081AE79AFF2878ECBE0"><enum>(b)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of
enactment of this Act, the Secretary shall submit to Congress a report on the
results of the study conducted under
<internal-xref idref="HBC2C097F9197438A8C845346CFAE89" legis-path="107.(a)">subsection (a)</internal-xref>.</text>
</subsection></section><section id="H79F51FE427C2468ABD9291858871F576"><enum>108.</enum><header>Bone density
under the Medicare Program</header>
<subsection id="H6F9C214074484AA6B11D067D22B131A8"><enum>(a)</enum><header>Standard
measurement tool for Bone Density study</header>
<paragraph id="H0E49B26BB4AC4867B88BC2180200E8A1"><enum>(1)</enum><header>Study</header><text display-inline="yes-display-inline">The Secretary, in consultation with the
Director of the Agency for Healthcare Research and Quality, the Director of the
National Institute of Biomedical Imaging and Bioengineering, and the
Administrator of the Centers for Medicare & Medicaid Services, shall
conduct a study on—</text>
<subparagraph id="HBF8704D301BF432784FC26C35C00E127"><enum>(A)</enum><text>the
cost-effectiveness of all available methods for measuring bone mass in
beneficiaries of the Medicare program under title XVIII of the Social Security
Act (42 U.S.C. 1395 et seq.) for the purpose of identifying the most
cost-effective method;</text>
</subparagraph><subparagraph id="HE8D5636A27F34ED5A876D1C2FE7199F9"><enum>(B)</enum><text>the
cost-effectiveness of different time intervals between bone mass screenings for
such beneficiaries for the purpose of identifying the most cost-effective
interval; and</text>
</subparagraph><subparagraph id="HF49A2C0777EE47E581CAF4F70750054"><enum>(C)</enum><text display-inline="yes-display-inline">the frequency with which the
cost-effectiveness of such methods and intervals should be reviewed based on
anticipated changes in technology.</text>
</subparagraph></paragraph><paragraph id="HADAAC1406CEB4E85A66C75EDCECE6410"><enum>(2)</enum><header>Report</header>
<subparagraph id="H336E3E94D9234196A45980256C360668"><enum>(A)</enum><header>In
general</header><text>Not later than 2 years after the date of enactment of
this Act, the Secretary shall submit to Congress and the Secretary of Commerce
a report on the results of the study under
<internal-xref idref="H0E49B26BB4AC4867B88BC2180200E8A1" legis-path="108.(a)(1)">paragraph (1)</internal-xref>.</text>
</subparagraph><subparagraph id="H66DDC6E4DBEB413A9F968F592EA76397"><enum>(B)</enum><header>Contents of
Report</header><text>The report submitted under
<internal-xref idref="H336E3E94D9234196A45980256C360668" legis-path="108.(a)(2)(A)">subparagraph (A)</internal-xref> shall include, at a
minimum, information on each of the following:</text>
<clause id="H185F09FE292D4EFAA73C25D43C395852"><enum>(i)</enum><text>The
most cost-effective method for measuring bone mass in beneficiaries of the
Medicare program and a recommendation for the adoption of such method by the
Medicare program.</text>
</clause><clause id="H01C7DDC1E55C428EBDF51D11C2F555D8"><enum>(ii)</enum><text>The
most cost-effective interval between bone mass screenings for such
beneficiaries and recommendation for the adoption of such interval by the
Medicare program.</text>
</clause></subparagraph></paragraph><paragraph id="HCE5B857E81A84F2E866942E229F660A9"><enum>(3)</enum><header>United States
Preventive Services Task Force</header><text>In making the recommendations
under
<internal-xref idref="H66DDC6E4DBEB413A9F968F592EA76397" legis-path="108.(a)(2)(B)">paragraph (2)(B)</internal-xref>, the Secretary
shall take into consideration any relevant guidelines in the most recent Guide
to Clinical Preventive Services issued by the United States Preventive Services
Task Force.</text>
</paragraph><paragraph id="HE531E997028E45D6B04E31B4F9C04048"><enum>(4)</enum><header>Revisions to
recommendations</header><text display-inline="yes-display-inline">The Secretary
shall monitor developments in technology used to measure bone density and
prepare and submit to Congress and the Secretary of Commerce reports updating
the recommendations made under
<internal-xref idref="H66DDC6E4DBEB413A9F968F592EA76397" legis-path="108.(a)(2)(B)">paragraph (2)(B)</internal-xref>, as needed.</text>
</paragraph></subsection><subsection id="HA5F37F9ECC7E49BDA1D821F2378BE1B2"><enum>(b)</enum><header>Standard unit
for measuring bone density</header>
<paragraph id="HB8D05E86B3114D17B207CB0006F7ECD4"><enum>(1)</enum><header>Report</header><text>Not
later than 3 years after the date of enactment of this Act, the Secretary of
Commerce, acting through the Director of the National Institute of Standards
and Technology, shall prepare and submit to Congress a report containing
recommendations concerning a standard unit for the measurement of bone mass for
use by the Medicare program under title XVIII of the Social Security Act (42
U.S.C. 1395 et seq.).</text>
</paragraph><paragraph id="HA2C9B829EEAF492DB365C93689A07EFE"><enum>(2)</enum><header>Considerations
for recommendations</header><text>In proposing the recommendations under
<internal-xref idref="HB8D05E86B3114D17B207CB0006F7ECD4" legis-path="108.(b)(1)">paragraph (1)</internal-xref>, the Secretary of
Commerce shall take into consideration the recommendations made under
<internal-xref idref="H66DDC6E4DBEB413A9F968F592EA76397" legis-path="108.(a)(2)(B)">subsection (a)(2)(B)</internal-xref>, including any
applicable updates to such recommendations made under
<internal-xref idref="HE531E997028E45D6B04E31B4F9C04048" legis-path="108.(a)(4)">subsection (a)(4)</internal-xref>, and the accuracy and
utility of the recommended standard measurement unit as a diagnostic
tool.</text>
</paragraph></subsection></section><section id="H69ED5686BC7144049E1BCB00EACDF63"><enum>109.</enum><header>Access to
orthopaedic services for beneficiaries of Medicaid and SCHIP</header>
<subsection id="HFE162B87DE0547FD8DE3D8E650C1F6A1"><enum>(a)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of
enactment of this Act, the Comptroller General of the United States shall
prepare and submit a report to Congress on access to orthopaedic
services—</text>
<paragraph id="HE3BC7D9988EA437A8CF54147C622D767"><enum>(1)</enum><text>by beneficiaries
of the Medicaid program under title XIX of the Social Security Act (42 U.S.C.
1396 et seq.); and</text>
</paragraph><paragraph id="H6AD59A9D72B743A4BDBE21740088C118"><enum>(2)</enum><text>by beneficiaries
of the State children’s health insurance program under title XXI of the Social
Security Act (42 U.S.C. 1397aa et seq.).</text>
</paragraph></subsection><subsection id="H88D5D4591DBB42B68CD015000357143B"><enum>(b)</enum><header>Focus on
barriers To access affecting children</header><text>The report prepared under
this section shall include, at a minimum, information on barriers to access to
orthopaedic services that disproportionately affect children who are
beneficiaries of the Medicaid program or the State children’s health insurance
program.</text>
</subsection></section><section id="H70DD129F6A544429A8BA00369E01C28E"><enum>110.</enum><header>Age-related
programs</header>
<subsection commented="no" id="H6FB75CC8E5F340E08D989FACC76C65FF"><enum>(a)</enum><header>State-Based
Examples of Network Innovation, Opportunity, and Replication Grant
Program</header><text display-inline="yes-display-inline">The Secretary shall
award grants to State agencies in a manner similar to the manner in which
grants were awarded under the program of the Department of Health and Human
Services popularly known as the <quote>State-based Examples of Network
Innovation, Opportunity, and Replication Grant Program</quote> for the purpose
of allowing such State agencies to establish or expand health and aging
activities for seniors in the areas of clinical preventive services, physical
activity, chronic disease self-management, and oral health.</text>
</subsection><subsection id="H7EBEF43ECF464053AA3FD2943B354652"><enum>(b)</enum><header>Childhood
musculoskeletal diseases, conditions, and injuries report</header><text>Not
later than 2 years after the date of enactment of this Act, the Surgeon General
shall prepare and submit to Congress a report on the burdens and costs
associated with childhood musculoskeletal diseases, conditions, and injuries in
the United States.</text>
</subsection></section><section display-inline="no-display-inline" id="H3C91A72016A84165A52FB6E2004B60A6" section-type="subsequent-section"><enum>111.</enum><header>Minority health
disparities</header><text display-inline="no-display-inline">The Secretary,
acting through the Deputy Assistant Secretary for Minority Health, shall treat
musculoskeletal diseases and conditions as a priority for programs and grants
affiliated with the Office of Minority Health and may incorporate initiatives
related to musculoskeletal diseases and conditions into the initiatives of such
Office.</text>
</section><enum>II</enum><header>Third
longitudinal study on aging</header>
<section id="H33A7A5B2C6BC4C3C839E005EADC2FB31"><enum>201.</enum><header>Third
longitudinal study on aging</header>
<subsection display-inline="no-display-inline" id="H49563382C48B4A2E9BDA5766CBD8A315"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Director of the
National Center for Health Statistics and in consultation with the Director of
the National Institute on Aging, shall conduct a third longitudinal study on
aging in the United States in a manner similar to the manner in which the
second longitudinal study on aging was conducted.</text>
</subsection><subsection id="HD5016814FACD44609EEA0FDCB2CDFBD"><enum>(b)</enum><header>Duration</header><text display-inline="yes-display-inline">The duration of the third longitudinal
study under
<internal-xref idref="H49563382C48B4A2E9BDA5766CBD8A315" legis-path="201.(a)">subsection (a)</internal-xref> shall be at least 6
years.</text>
</subsection><subsection id="H10E102DEAE9D4056B0FA8341B8308246"><enum>(c)</enum><header>Availability of
data</header><text>Data collected through the third longitudinal study under
<internal-xref idref="H49563382C48B4A2E9BDA5766CBD8A315" legis-path="201.(a)">subsection (a)</internal-xref> shall be made available to
the public in a time and manner similar to the time and manner in which data
from the second longitudinal study on aging was made available to the
public.</text>
</subsection></section>