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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public">
	<form>
		<distribution-code display="yes">II</distribution-code>
		<congress>111th CONGRESS</congress>
		<session>1st Session</session>
		<legis-num>S. 2765</legis-num>
		<current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber>
		<action>
			<action-date date="20091110">November 10, 2009</action-date>
			<action-desc><sponsor name-id="S173">Mr. Kerry</sponsor> introduced the
			 following bill; which was read twice and referred to the
			 <committee-name committee-id="SSSB00">Committee on Small Business and
			 Entrepreneurship</committee-name></action-desc>
		</action>
		<legis-type>A BILL</legis-type>
		<official-title>To amend the Small Business Act to authorize loan
		  guarantees for health information technology.</official-title>
	</form>
	<legis-body>
		<section id="S1" section-type="section-one"><enum>1.</enum><header>Short
			 title</header><text display-inline="no-display-inline">This Act may be cited as
			 the <quote><short-title>Small Business Health Information
			 Technology Financing Act of 2009</short-title></quote>.</text>
		</section><section id="HE227909719544A8CB25029902A4F4813" section-type="subsequent-section"><enum>2.</enum><header>Small business health
			 information technology financing program</header><text display-inline="no-display-inline">The Small Business Act (15 U.S.C. 631 et
			 seq.) is amended—</text>
			<paragraph id="id41089BE03C514B3B9561D8856070909E"><enum>(1)</enum><text display-inline="yes-display-inline">by redesignating section 44 as section 45;
			 and</text>
			</paragraph><paragraph id="id81DEF4140AEC4B5E963E4A031275239E"><enum>(2)</enum><text display-inline="yes-display-inline">by inserting after section 43 the
			 following:</text>
				<quoted-block display-inline="no-display-inline" id="HC049940E9AC34C12A9685E2E455EADE5" style="OLC">
					<section id="HD7799876C2EE4F9CBCD1F1ACD67D900F"><enum>44.</enum><header>Loan guarantees
				for health information technology</header>
						<subsection id="H8B49C6BBE46A4FED84DE2349E42255AD"><enum>(a)</enum><header>Definitions</header><text>In
				this section—</text>
							<paragraph id="idA6EB2964AB9948608CEFE376EA816CE2"><enum>(1)</enum><text>the term
				<term>cost</term> has the meaning given that term in section 502 of the Federal
				Credit Reform Act of 1990 (2 U.S.C. 661a);</text>
							</paragraph><paragraph id="HBE4B169DCC3C47E8B62C84D3FE6CFBD6"><enum>(2)</enum><text>the term
				<term>eligible professional</term> means—</text>
								<subparagraph id="H44CE0082E0BE4F2297665CFA977BCAB3"><enum>(A)</enum><text display-inline="yes-display-inline">a physician (as defined in section 1861(r)
				of the Social Security Act (42 U.S.C. 1395x(r)));</text>
								</subparagraph><subparagraph id="HC25E918EE1BD4932A6F1EF9DB7D8A5F3"><enum>(B)</enum><text>a practitioner
				described in section 1842(b)(18)(C) of the Social Security Act (42 U.S.C.
				1395u(b)(18)(C));</text>
								</subparagraph><subparagraph id="H716F29D711AB43268B74EE971BD3E168"><enum>(C)</enum><text>a physical or
				occupational therapist;</text>
								</subparagraph><subparagraph id="idA7BA496E2EDF4962ADBFBE5363B621D4"><enum>(D)</enum><text>a qualified
				speech-language pathologist (as defined in section 1861(ll)(4)(A) of the Social
				Security Act (42 U.S.C. 1395x(ll)(4)(A));</text>
								</subparagraph><subparagraph id="H0E7127049BEF4AF3A4F5DF5477F06366"><enum>(E)</enum><text>a qualified
				audiologist (as defined in section 1861(ll)(4)(B) of the Social Security Act
				(42 U.S.C. 1395x(ll)(4)(B));</text>
								</subparagraph><subparagraph id="H992CD614B8E9477F9049667A475E47A9"><enum>(F)</enum><text>a qualified
				medical transcriptionist;</text>
								</subparagraph><subparagraph id="HC8F03971B47243DCBC93E7676E2041DF"><enum>(G)</enum><text>a State-licensed
				pharmacist;</text>
								</subparagraph><subparagraph id="H77F1A1C2B55845D5ACE8E8719D0E6C84"><enum>(H)</enum><text>a State-licensed
				supplier of durable medical equipment, prosthetics, orthotics, or supplies;
				and</text>
								</subparagraph><subparagraph id="H51E731530B78407191D5EFCEEC25CC00"><enum>(I)</enum><text display-inline="yes-display-inline">a State-licensed, a State-certified, or a
				nationally accredited home health care provider;</text>
								</subparagraph></paragraph><paragraph id="H1B12339F64B84233ACCAA7396E83D682"><enum>(3)</enum><text display-inline="yes-display-inline">the term <term>health information
				technology</term>—</text>
								<subparagraph id="idD2299790927F404AA40383E4BC518032"><enum>(A)</enum><text display-inline="yes-display-inline">means computer hardware, software, and
				related technology that—</text>
									<clause id="id1ECD3540FA2844C9BDABFD3B2CD78855"><enum>(i)</enum><text display-inline="yes-display-inline">supports the requirements for being treated
				as a meaningful EHR user (as described in section 1848(o)(2)(A) of the Social
				Security Act (42 U.S.C. 1395w–4(o)(2)(A))) and is purchased by an eligible
				professional to aid in the provision of health care in a health care setting,
				including electronic medical records; and</text>
									</clause><clause id="idA7F78C85D15B44BE9BB44A67ED58985C"><enum>(ii)</enum><text display-inline="yes-display-inline">provides for—</text>
										<subclause id="H2B8573361680499586378BC2B4864244"><enum>(I)</enum><text>enhancement of
				continuity of care for patients through electronic storage, transmission, and
				exchange of relevant personal health data and information, such as ensuring
				that this information is accessible at the times and places where clinical
				decisions will be or are likely to be made;</text>
										</subclause><subclause id="H7650E925C6C4454C9C39112DD1908D71"><enum>(II)</enum><text>enhancement of
				communication between patients and health care providers;</text>
										</subclause><subclause id="HA6135DDBB93448A3B9EA46BBD3DB7965"><enum>(III)</enum><text>improvement of
				quality measurement by eligible professionals enabling the eligible
				professionals to collect, store, measure, and report on the processes and
				outcomes of individual and population performance and quality of care;</text>
										</subclause><subclause id="H89ECAC4B0655490FBB629459DEDF0179"><enum>(IV)</enum><text>improvement of
				evidence-based decision support; or</text>
										</subclause><subclause id="H334415361BCC4835B3FCC1A7C81C35D7"><enum>(V)</enum><text>enhancement of
				consumer and patient empowerment; and</text>
										</subclause></clause></subparagraph><subparagraph id="id4A34FBDE639B45F5B186600F20E55A3D"><enum>(B)</enum><text>does not include
				information technology the sole use of which is financial management,
				maintenance of inventory of basic supplies, or appointment scheduling;</text>
								</subparagraph></paragraph><paragraph id="HB49E26F20B4440E2924355900794E4D9"><enum>(4)</enum><text>the term
				<term>qualified eligible professional</term> means an eligible professional
				whose office is a small business concern; and</text>
							</paragraph><paragraph id="H3EAC5DBF49EA455C811ED9CCA5A3F30E"><enum>(5)</enum><text>the term
				<term>qualified medical transcriptionist</term> means a specialist in medical
				language and the healthcare documentation process who—</text>
								<subparagraph id="id13C5C69269F648E6986F887D5C59B74A"><enum>(A)</enum><text>interprets and
				transcribes dictation by physicians and other healthcare professionals to
				ensure accurate, complete, and consistent documentation of healthcare
				encounters; and</text>
								</subparagraph><subparagraph id="idC38B05FCDDF042A2915869F47EA229CE"><enum>(B)</enum><text>is certified by
				or registered with the Association for Healthcare Documentation Integrity, or a
				successor association thereto.</text>
								</subparagraph></paragraph></subsection><subsection id="HDDBC20A9BACF44F7A04BD6C3FBCE0F20"><enum>(b)</enum><header>Loan guarantees
				for qualified eligible professionals</header>
							<paragraph id="HEA40121641034CCF99B5D0A7948B2BD7"><enum>(1)</enum><header>In
				general</header><text>Subject to paragraph (2), the Administrator may guarantee
				not more than 90 percent of a loan made to a qualified eligible professional
				for the acquisition of health information technology for use in the medical
				practice of the qualified eligible professional and for the costs associated
				with the installation of the health information technology. Except as otherwise
				provided in this section, a loan guaranteed under this section shall be made on
				the same terms and conditions as a loan made under section 7(a).</text>
							</paragraph><paragraph id="H61539C0E175247B891BB2598B17262AA"><enum>(2)</enum><header>Limitations on
				guarantee amounts</header><text>The maximum amount of loan principal guaranteed
				under this subsection may not be more than—</text>
								<subparagraph id="HDEB4BA3D1B7E4DC9B246CFAD30F22479"><enum>(A)</enum><text display-inline="yes-display-inline">$350,000 with respect to any 1 qualified
				eligible professional; and</text>
								</subparagraph><subparagraph id="HE6305987CD104E55A50DB8D57909E10B"><enum>(B)</enum><text>$2,000,000 with
				respect to 1 group of affiliated qualified eligible professionals.</text>
								</subparagraph></paragraph></subsection><subsection id="H49806EFF9F3C4607BBABD4DF494CE5C5"><enum>(c)</enum><header>Fees</header>
							<paragraph id="HACD62DA79363473E8AA5EEC57FD2730E"><enum>(1)</enum><header>In
				general</header><text>The Administrator may—</text>
								<subparagraph id="id3FFD02F9BDB34528BA75092B8472ECE3"><enum>(A)</enum><text>impose a
				guarantee fee on a qualified eligible professional for the purpose of reducing
				the cost of the guarantee to zero in an amount not to exceed 2 percent of the
				total guaranteed portion of any loan guaranteed under this section; and</text>
								</subparagraph><subparagraph id="id974136F9D0CA4BACB5DCE1F63B821761"><enum>(B)</enum><text>impose an annual
				servicing fee on a lender making a loan guaranteed under this section of not
				more 0.5 percent of the outstanding balance of the guaranteed portion of loans
				by the lender guaranteed under this section.</text>
								</subparagraph></paragraph><paragraph id="HBC2C87190DF84BA39EB6A8F112436424"><enum>(2)</enum><header>No fees by
				lenders</header><text>No service fees, processing fees, origination fees,
				application fees, points, brokerage fees, bonus points, or other fees may be
				charged to a loan applicant or recipient by a lender relating to a loan
				guaranteed under this section.</text>
							</paragraph></subsection><subsection id="H32FE7540C33F4285A367BC2A17EC1116"><enum>(d)</enum><header>Deferral
				period</header><text>A loan guaranteed under this section shall carry a
				deferral period of not less than 1 year and not more than 3 years. The
				Administrator may subsidize interest during the period for which a loan
				guaranteed under this section is deferred.</text>
						</subsection><subsection id="H80215D292FFA4DBBA33349C334ADCA80"><enum>(e)</enum><header>Effective
				date</header><text display-inline="yes-display-inline">The Administrator may
				not guarantee a loan under this section until the meaningful EHR use
				requirements have been determined by the Secretary of Health and Human
				Services.</text>
						</subsection><subsection id="HD2E0028D2A894322B309A2C01A67BCA1"><enum>(f)</enum><header>Sunset</header><text>The
				Administrator may not guarantee a loan under this section after the date that
				is 7 years after meaningful EHR use requirements have been determined by the
				Secretary of Health and Human Services.</text>
						</subsection><subsection commented="no" display-inline="no-display-inline" id="H8C6A04332D5F4127B37CEB324FFEC07F"><enum>(g)</enum><header>Authorization of
				appropriations</header><text>There are authorized to be appropriated such sums
				as are necessary for the cost of guaranteeing $10,000,000,000 in loans under
				this section. The Administrator shall determine the cost of guaranteeing loans
				under this section separately and distinctly from other programs operated by
				the
				Administrator.</text>
						</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
			</paragraph></section></legis-body>
</bill>
