[Weekly Compilation of Presidential Documents Volume 42, Number 34 (Monday, August 28, 2006)]
[Pages 1501-1503]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Executive Order 13410--Promoting Quality and Efficient Health Care in 
Federal Government Administered or Sponsored Health Care Programs

August 22, 2006

    By the authority vested in me as President by the Constitution and 
the laws of the United States, and in order to promote federally led 
efforts to implement more transparent and high-quality health care, it 
is hereby ordered as follows:
    Section 1. Purpose. It is the purpose of this order to ensure that 
health care programs administered or sponsored by the Federal Government 
promote quality and efficient delivery of health care through the use of 
health information technology, transparency regarding health care 
quality and price, and better incentives for program beneficiaries, 
enrollees, and providers. It is the further purpose of this order to 
make relevant information available to these beneficiaries, enrollees, 
and providers in a readily useable manner and in collaboration with

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similar initiatives in the private sector and non-Federal public sector. 
Consistent with the purpose of improving the quality and efficiency of 
health care, the actions and steps taken by Federal Government agencies 
should not incur additional costs for the Federal Government.
    Sec. 2. Definitions. For purposes of this order:
    (a) ``Agency'' means an agency of the Federal Government that 
administers or sponsors a Federal health care program.
    (b) ``Federal health care program'' means the Federal Employees 
Health Benefit Program, the Medicare program, programs operated directly 
by the Indian Health Service, the TRICARE program for the Department of 
Defense and other uniformed services, and the health care program 
operated by the Department of Veterans Affairs. For purposes of this 
order, ``Federal health care program'' does not include State operated 
or funded federally subsidized programs such as Medicaid, the State 
Children's Health Insurance Program, or services provided to Department 
of Veterans' Affairs beneficiaries under 38 U.S.C. 1703.
    (c) ``Interoperability'' means the ability to communicate and 
exchange data accurately, effectively, securely, and consistently with 
different information technology systems, software applications, and 
networks in various settings, and exchange data such that clinical or 
operational purpose and meaning of the data are preserved and unaltered.
    (d) ``Recognized interoperability standards'' means interoperability 
standards recognized by the Secretary of Health and Human Services (the 
``Secretary''), in accordance with guidance developed by the Secretary, 
as existing on the date of the implementation, acquisition, or upgrade 
of health information technology systems under subsections (1) or (2) of 
section 3(a) of this order.
    Sec. 3. Directives for Agencies. Agencies shall perform the 
following functions:
    (a) Health Information Technology.
 (1)         For Federal Agencies. As each agency implements, acquires, 
            or upgrades health information technology systems used for 
            the direct exchange of health information between agencies 
            and with non-Federal entities, it shall utilize, where 
            available, health information technology systems and 
            products that meet recognized interoperability standards.
 (2)         For Contracting Purposes. Each agency shall require in 
            contracts or agreements with health care providers, health 
            plans, or health insurance issuers that as each provider, 
            plan, or issuer implements, acquires, or upgrades health 
            information technology systems, it shall utilize, where 
            available, health information technology systems and 
            products that meet recognized interoperability standards.
    (b) Transparency of Quality Measurements.
 (1)         In General. Each agency shall implement programs measuring 
            the quality of services supplied by health care providers to 
            the beneficiaries or enrollees of a Federal health care 
            program. Such programs shall be based upon standards 
            established by multi-stakeholder entities identified by the 
            Secretary or by another agency subject to this order. Each 
            agency shall develop its quality measurements in 
            collaboration with similar initiatives in the private and 
            non-Federal public sectors.
 (2)         Facilitation. An agency satisfies the requirements of this 
            subsection if it participates in the aggregation of claims 
            and other appropriate data for the purposes of quality 
            measurement. Such aggregation shall be based upon standards 
            established by multi-stakeholder entities identified by the 
            Secretary or by another agency subject to this order.
    (c) Transparency of Pricing Information. Each agency shall make 
available (or provide for the availability) to the beneficiaries or 
enrollees of a Federal health care program (and, at the option of the 
agency, to the public) the prices that it, its health insurance issuers, 
or its health insurance plans pay for procedures to providers in the 
health care program with which the agency, issuer, or plan contracts. 
Each agency shall also, in collaboration with multi-stakeholder groups

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such as those described in subsection (b)(1), participate in the 
development of information regarding the overall costs of services for 
common episodes of care and the treatment of common chronic diseases.
    (d) Promoting Quality and Efficiency of Care. Each agency shall 
develop and identify, for beneficiaries, enrollees, and providers, 
approaches that encourage and facilitate the provision and receipt of 
high-quality and efficient health care. Such approaches may include pay-
for-performance models of reimbursement consistent with current law. An 
agency will satisfy the requirements of this subsection if it makes 
available to beneficiaries or enrollees consumer-directed health care 
insurance products.
    Sec. 4. Implementation Date. Agencies shall comply with the 
requirements of this order by January 1, 2007.
    Sec. 5. Administration and Judicial Review.
    (a) This order does not assume or rely upon additional Federal 
resources or spending to promote quality and efficient health care. 
Further, the actions directed by this order shall be carried out subject 
to the availability of appropriations and to the maximum extent 
permitted by law.
    (b) This order shall be implemented in new contracts or new contract 
cycles as they may be renewed from time to time. Renegotiation outside 
of the normal contract cycle processes should be avoided.
    (c) This order is not intended to, and does not, create any right or 
benefit, substantive or procedural, enforceable at law or in equity 
against the United States, its departments, agencies, or entities, its 
officers, employees, or agents, or any other person.
                                                George W. Bush
 The White House,
 August 22, 2006.

 [Filed with the Office of the Federal Register, 8:45 a.m., August 25, 
2006]

Note: This Executive order was published in the Federal Register on 
August 28.