1.This Act may be cited as
the National Health Information
Technology and Privacy Advancement Act of 2009
.
2.
(a)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)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)Congress
declares that it is not the policy of this Act to preclude the private
development of health information technologies.
3.In this Act:
(1)Authorized
health insurersThe 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)The term authorized providers means duly
licensed or certified health care providers.
(3)The
term corporation means the corporation authorized by section
5.
(4)The
term Secretary means the Secretary of Health and Human
Services.
(5)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.
4.Federal
coordination, planning, and regulation
(a)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)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
corporationThe 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)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)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.
5.National
Corporation for Health Information Technology and Privacy
(a)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)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)
(1)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)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)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)
(A)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)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)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)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)
(1)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)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 CommunityNothing 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)The
corporation shall terminate on the date that is 10 years after the date of
enactment of this Act.
6.Business plan
and annual report
(a)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)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)The
corporation shall be subject to such external audits as may be determined
appropriate by the Secretary.
7.Authorization of
appropriationsThere are
authorized to be appropriated such sums as may be necessary to carry out this
Act for each of fiscal years 2010 through 2019.