[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 444 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                 S. 444

To provide for the establishment of a health information technology and 
                            privacy system.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 13, 2009

Mr. Whitehouse introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To provide for the establishment of a health information technology and 
                            privacy system.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``National Health Information 
Technology and Privacy Advancement Act of 2009''.

SEC. 2. POLICY AND PURPOSES.

    (a) Policy.--Congress declares that it is the policy of the United 
States to establish, as expeditiously as practicable, a health 
information technology and privacy system, which should--
            (1) be responsive to public needs and national objectives;
            (2) serve the health care needs of the United States; and
            (3) contribute to improved health care quality and lower 
        costs.
    (b) Purposes.--It is the purpose of this Act to--
            (1) provide for the establishment of a health information 
        technology and privacy system through which new and expanded 
        health care information services will be made available as 
        promptly as possible in a manner that provides national 
        coverage at the earliest practicable date;
            (2) in carrying out the system described in paragraph (1), 
        provide technology services to economically less developed 
        areas as well as those more highly developed, and provide for 
        the efficient and economical use of health care information and 
        protect the confidentiality and security of information within 
        this new technology;
            (3) in order to facilitate the development of the system 
        and provide for the widest possible participation by private 
        enterprise in the system, establish a private nonprofit 
        corporation, subject to appropriate Federal regulation, to 
        administer the system; and
            (4) ensure that--
                    (A) all authorized users of the system have 
                nondiscriminatory access to the system;
                    (B) effective competition be maintained in the 
                provision of equipment and services utilized by the 
                system;
                    (C) the corporation established under this Act is 
                organized and operated so as to maintain and strengthen 
                competition in the provision of health information 
                services to the public; and
                    (D) the activities of the corporation and of the 
                persons or companies participating in the ownership of 
                the corporation is consistent with the Federal 
                antitrust laws.
    (c) Limitation.--Congress declares that it is not the policy of 
this Act to preclude the private development of health information 
technologies.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Authorized health insurers.--The term ``authorized 
        health insurers'' means health insurance issuers (as defined in 
        section 2791 of the Public Health Service Act) and includes 
        payors for services provided under titles XVIII and XIX of the 
        Social Security Act (42 U.S.C. 1395 and 1396 et seq.).
            (2) Authorized providers.--The term ``authorized 
        providers'' means duly licensed or certified health care 
        providers.
            (3) Corporation.--The term ``corporation'' means the 
        corporation authorized by section 5.
            (4) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (5) System.--The term ``system'' means the system of health 
        information and technology established under this Act, with 
        secure retention and sharing among authorized providers, who 
        have access to analytic support to identify and enhance areas 
        where improved quality of care may lower cost, and result in 
        reimbursement rates that can better reflect optimal health care 
        delivery.

SEC. 4. FEDERAL COORDINATION, PLANNING, AND REGULATION.

    (a) Actions by the Secretary.--In order to achieve the policy and 
carry out the purposes of this Act, the Secretary shall--
            (1) provide Federal governmental assistance in the planning 
        and development, and provide for the implementation of, a 
        national program for the establishment and operation, as 
        expeditiously as possible, of a national health information 
        technology and privacy system;
            (2) provide for the continuous review of all phases of the 
        development and operation of the system, including the 
        activities of the corporation;
            (3) provide for the coordination of the activities of 
        Federal agencies with responsibilities relating to health care 
        information technology, so as to ensure that there is a full 
        and effective compliance at all times with the policies and 
        procedures established under this Act;
            (4) exercise such supervision over the relationship of the 
        corporation with State and local entities or other entities as 
        may be appropriate to ensure that such relationships shall be 
        consistent with the national interest and policy of the United 
        States as expressed in this Act;
            (5) ensure that timely arrangements are made under which 
        there can be national participation in the establishment and 
        use of the system; and
            (6) provide for incentives for the adoption and use of 
        health information technology that improves the quality and 
        efficiency of patient care.
    (b) Other Federal Agencies.--The Administrator of the Centers for 
Medicare & Medicaid Services, the National Coordinator for Health 
Information Technology, the Director of the National Institutes of 
Health, the chief executive officer of the Veterans Health 
Administration, and the heads of other relevant Federal agencies, 
shall, upon request of the corporation--
            (1) provide advice to the corporation concerning the 
        technical characteristics of the system;
            (2) provide assistance to the corporation in the conduct of 
        research and development activities relating to the system, 
        including by furnishing to the corporation, upon request, on a 
        reimbursable basis, such services as determined necessary for 
        the most expeditious and economical development of the system; 
        and
            (3) to the extent feasible, furnish other services, on a 
        reimbursable basis, to the corporation in connection with the 
        establishment and operation of the system.
    (c) Actions by the Corporation.--The corporation shall--
            (1) develop plans for the technical specifications of all 
        elements of the system, pursuant to the activities described 
        under section 5(f);
            (2) ensure effective competition, including the use of 
        competitive bidding where appropriate, in the procurement by 
        the corporation of apparatus, equipment, and services required 
        for the establishment and operation of the system;
            (3) ensure that eligible health care providers have 
        equitable and nondiscriminatory access to--
                    (A) the system in a manner that provides for the 
                payment of reasonable assessment for such use 
                consistent with the ability to pay and the savings and 
                benefits to be anticipated;
                    (B) relevant classifications, practices, 
                regulations, and other terms and conditions relating to 
                the use of the system; and
                    (C) available facilities of the system pursuant to 
                regulations relating to the allocation of such 
                facilities among the users thereof;
            (4) ensure that the facilities of the system are 
        technically compatible and operationally interconnected with 
        each other and facilitate interoperability among health 
        information systems;
            (5) prescribe such accounting regulations and systems and, 
        after public hearing and deliberation, engage in such 
        ratemaking procedures as will ensure that any savings made 
        possible by the system are appropriately reflected in rates for 
        access to system services, by license or otherwise for those 
        who utilize or benefit from the system, including the health 
        insurance industry;
            (6) obtain the approval of the Secretary for the 
        implementation of technical and privacy protection 
        characteristics relating to the operation of the system;
            (7) authorize, construct, and operate such system 
        facilities, networks, and programs as will best serve the 
        public interest, convenience, and necessity, as determined 
        after consultation with the Secretary; and
            (8) to the extent feasible, ensure that the system is 
        compatible and interoperable with pre-existing health 
        information technology equipment and systems.
    (d) Office of the National Coordinator for Health Information 
Technology.--
            (1) In general.--There is established within the Office of 
        the Secretary of Health and Human Services an Office of the 
        National Coordinator for Health Information Technology. The 
        Office shall be headed by a National Coordinator appointed by 
        the President, in consultation with the Secretary of Health and 
        Human Services. The National Coordinator shall report directly 
        to the Secretary.
            (2) Rule of construction.--Nothing in this subsection 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 Act.

SEC. 5. NATIONAL CORPORATION FOR HEALTH INFORMATION TECHNOLOGY AND 
              PRIVACY.

    (a) Establishment.--There is authorized to be established a 
nonprofit national health information technology and privacy 
corporation which shall not be an agency or establishment of the United 
States. The corporation shall be subject to the provisions of this Act.
    (b) Incorporation.--Not later than 180 days after the date of 
enactment of this Act, the President, by and with the advice and 
consent of the Senate, shall appoint 9 incorporators of the corporation 
who shall serve as the initial board of directors until their 
successors are elected in accordance with subsection (c). Such 
incorporators shall take whatever actions are necessary to establish 
the corporation, including the filing of articles of incorporation, as 
approved by the President.
    (c) Board of Directors.--
            (1) In general.--The corporation shall have a bipartisan 
        board of directors that shall consist of 9 individuals who 
        shall be citizens of the United States and be appointed by the 
        President, by and with the advice and consent of the Senate.
            (2) Terms.--The terms of service of the members of the 
        board of directors shall be 3 years or until such time as their 
        successors have been appointed, except that of the first 9 
        members of the board appointed under subsection (b), 3 each 
        shall serve for terms of 3, 4, and 5 years, respectively as 
        designated by the President. Any member of the board appointed 
        to fill a vacancy shall be appointed only for the unexpired 
        term of the member which he or she is succeeding. A member may 
        not serve consecutive terms.
            (3) Chairperson.--The members of the board of directors of 
        the corporation shall at its first meeting and annually 
        thereafter elect a member to serve as the chairperson of the 
        board.
    (d) Chief Privacy Officer and Other Officers.--
            (1) Chief privacy officer.--
                    (A) In general.--The president of the Corporation, 
                in consultation with the board of directors, shall 
                appoint a chief privacy officer of the corporation to 
                ensure the confidentiality and security of patient 
                medical records.
                    (B) Duties.--The chief privacy officer of the 
                corporation shall--
                            (i) ensure that the use of technologies by 
                        the corporation sustain, and do not erode, 
                        privacy protections relating to the use, 
                        collection, and disclosure of personal 
                        information;
                            (ii) ensure that personal information 
                        contained in any records maintained as part of 
                        the technology and privacy system is maintained 
                        in full compliance with fair information 
                        practices as contained in the Privacy Act of 
                        1974;
                            (iii) evaluate legislative and regulatory 
                        proposals involving the collection, use, and 
                        disclosure of personal information by the 
                        Federal Government;
                            (iv) Conduct a privacy impact assessment of 
                        proposed rules and procedures of the 
                        corporation on the privacy of personal 
                        information, including the type of personal 
                        information collected and the number of 
                        individuals affected; and
                            (v) submit annually to Congress a report on 
                        activities of the corporation that affect 
                        privacy.
            (2) Other officers.--The corporation shall have a 
        president, and such other officers as may be appointed by the 
        board of directors, who shall be compensated at rates fixed by 
        the board and serve at the pleasure of the board. No officer of 
        the corporation shall receive any salary from any source other 
        than the corporation during the period of employment by the 
        corporation.
    (e) Financing.--The corporation is authorized to issue bonds, 
debentures, and such other financings or certificates of indebtedness 
as the board of directors determines appropriate to carry out its 
duties under this Act.
    (f) Authorized Activities.--
            (1) General activities.--In order to achieve the objectives 
        and to carry out the purposes of this Act, the corporation is 
        authorized to--
                    (A) plan, initiate, construct, own, manage, and 
                operate itself or in conjunction with State and local 
                governments or business entities, a national health 
                information technology and privacy system;
                    (B) furnish, for fees where appropriate and subject 
                to licenses and confidentiality and security 
                requirements, access to individuals, and to authorized 
                providers and payers of health care services;
                    (C) specify rules for allowing access (in 
                accordance with applicable privacy laws) to 
                nonidentifiable health care data for public health and 
                research purposes; and
                    (D) own and operate such facilities as may be 
                required to achieve the purposes of this Act.
            (2) Other activities.--In addition to the activities 
        authorized under paragraph (1), the corporation, to accomplish 
        the purposes of this Act, may--
                    (A) conduct, or enter into contracts for the 
                conduct of, research and development activities related 
                to the mission of the corporation;
                    (B) acquire the physical facilities, equipment, and 
                devices necessary for the operations of the 
                corporation, including health information technologies 
                and associated equipment and facilities, whether by 
                construction, purchase, or gift;
                    (C) purchase or otherwise acquire health 
                information and related services from the United States 
                Government; and
                    (D) enter into contracts with authorized users of 
                health information, including the United States 
                Government, for the use of the services of the system.
    (g) American Health Information Community.--Nothing in this section 
shall be construed to prohibit the American Health Information 
Community (or any successor entity) from serving as the corporation 
under this section.
    (h) Termination.--The corporation shall terminate on the date that 
is 10 years after the date of enactment of this Act.

SEC. 6. BUSINESS PLAN AND ANNUAL REPORT.

    (a) Business Plan.--Not later than 6 months after the date on which 
the corporation is incorporated under section 5, the corporation shall 
file with the President and Congress its initial business plan.
    (b) Annual Report.--Not later than 1 year after the date on which 
the corporation is incorporated under section 5, and each January 1 
thereafter, the corporation shall prepare and submit to Congress a 
report that shall include a comprehensive description of the activities 
and accomplishments during the year for which the report is prepared 
under this Act, together with an evaluation of such activities and 
accomplishments in terms of the attainment of the purposes of this Act. 
Each such report shall include any recommendations of the corporation 
for additional legislative or other action which the corporation may 
consider necessary or desirable for the attainment of such objectives.
    (c) Audits.--The corporation shall be subject to such external 
audits as may be determined appropriate by the Secretary.

SEC. 7. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated such sums as may be 
necessary to carry out this Act for each of fiscal years 2010 through 
2019.
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