| Home > 106th Congressional Bills > H.R. 2506 (ih) To amend title IX of the Public Health Service Act to revise and extend the Agency for Health Care Policy and Research. [Introduced in House] ...
H.R. 2506 (ih) To amend title IX of the Public Health Service Act to revise and extend the Agency for Health Care Policy and Research. [Introduced in House] ...
106th CONGRESS 1st Session H. R. 2506 _______________________________________________________________________ AN ACT To amend title IX of the Public Health Service Act to revise and extend the Agency for Health Care Policy and Research. 106th CONGRESS 1st Session H. R. 2506 _______________________________________________________________________ AN ACT To amend title IX of the Public Health Service Act to revise and extend the Agency for Health Care Policy and Research. 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 ``Health Research and Quality Act of 1999''. SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT. (a) In General.--Title IX of the Public Health Service Act (42 U.S.C. 299 et seq.) is amended to read as follows: ``TITLE IX--AGENCY FOR HEALTH RESEARCH AND QUALITY ``PART A--ESTABLISHMENT AND GENERAL DUTIES ``SEC. 901. MISSION AND DUTIES. ``(a) In General.--There is established within the Public Health Service an agency to be known as the Agency for Health Research and Quality, which shall be headed by a director appointed by the Secretary. The Secretary shall carry out this title acting through the Director. ``(b) Mission.--The purpose of the Agency is to enhance the quality, appropriateness, and effectiveness of health services, and access to such services, through the establishment of a broad base of scientific research and through the promotion of improvements in clinical and health system practices, including the prevention of diseases and other health conditions. The Agency shall promote health care quality improvement by conducting and supporting-- ``(1) research that develops and presents scientific evidence regarding all aspects of health, including-- ``(A) the development and assessment of methods for enhancing patient participation in their own care and for facilitating shared patient-physician decision- making; ``(B) the outcomes, effectiveness, and cost- effectiveness of health care practices, including preventive measures and long-term care; ``(C) existing and innovative technologies; ``(D) the costs and utilization of, and access to health care; ``(E) the ways in which health care services are organized, delivered, and financed and the interaction and impact of these factors on the quality of patient care; ``(F) methods for measuring quality and strategies for improving quality; and ``(G) ways in which patients, consumers, purchasers, and practitioners acquire new information about best practices and health benefits, the determinants and impact of their use of this information; ``(2) the synthesis and dissemination of available scientific evidence for use by patients, consumers, practitioners, providers, purchasers, policy makers, and educators; and ``(3) initiatives to advance private and public efforts to improve health care quality. ``(c) Requirements With Respect to Special Populations.--There is established within the Agency an office to be known as the Office on Special Populations, which shall be headed by an official appointed by the Director. The Director, acting through such Office, shall conduct and support research and evaluations, and support demonstration projects, with respect to-- ``(1) the delivery of health services in inner-city areas and in rural areas (including frontier areas); ``(2) health services for low-income groups, and minority groups; ``(3) the health of children; ``(4) the elderly; and ``(5) people with special health care needs, including disabilities, chronic care and end-of-life health care. ``SEC. 902. GENERAL AUTHORITIES. ``(a) In General.--In carrying out section 901(b), the Director shall conduct and support research, evaluations, and training, support demonstration projects, research networks, and multi-disciplinary centers, provide technical assistance, and disseminate information on health care and on systems for the delivery of such care, including activities with respect to-- ``(1) the quality, effectiveness, efficiency, appropriateness and value of health care services; ``(2) quality measurement and improvement; ``(3) the outcomes, cost, cost-effectiveness, and use of health care services and access to such services; ``(4) clinical practice, including primary care and practice-oriented research; ``(5) health care technologies, facilities, and equipment; ``(6) health care costs, productivity, organization, and market forces; ``(7) health promotion and disease prevention, including clinical preventive services; ``(8) health statistics, surveys, database development, and epidemiology; and ``(9) medical liability. ``(b) Health Services Training Grants.-- ``(1) In general.--The Director may provide training grants in the field of health services research related to activities authorized under subsection (a), to include pre- and post- doctoral fellowships and training programs, young investigator awards, and other programs and activities as appropriate. In carrying out this subsection, the Director shall make use of funds made available under section 487(d)(3) for the Agency. ``(2) Requirements.--In developing priorities for the allocation of training funds under this subsection, the Director shall take into consideration shortages in the number of trained researchers who are members of one of the priority populations and the number of trained researchers who are addressing the priority populations. ``(c) Multidisciplinary Centers.--The Director may provide financial assistance to assist in meeting the costs of planning and establishing new centers, and operating existing and new centers, for multidisciplinary health services research, demonstration projects, evaluations, training, and policy analysis with respect to the matters referred to in subsection (a). ``(d) Relation to Certain Authorities Regarding Social Security.-- Activities authorized in this section shall be appropriately coordinated with experiments, demonstration projects, and other related activities authorized by the Social Security Act and the Social Security Amendments of 1967. Activities under subsection (a)(2) of this section that affect the programs under titles XVIII, XIX and XXI of the Social Security Act shall be carried out consistent with section 1142 of such Act. ``(e) Disclaimer.--The Agency shall not mandate national standards of clinical practice or quality health care standards. Recommendations resulting from projects funded and published by the Agency shall include a corresponding disclaimer. ``(f) Rule of Construction.--Nothing in this section shall be construed to imply that the Agency's role is to mandate a national standard or specific approach to quality measurement and reporting. In research and quality improvement activities, the Agency shall consider a wide range of choices, providers, health care delivery systems, and individual preferences. ``(g) Annual Report.--Beginning with fiscal year 2003, the Director shall annually submit to the Congress a report regarding prevailing disparities in health care delivery as it relates to racial factors and socioeconomic factors in priority populations. ``PART B--HEALTH CARE IMPROVEMENT RESEARCH ``SEC. 911. HEALTH CARE OUTCOME IMPROVEMENT RESEARCH. ``(a) Evidence Rating Systems.--In collaboration with experts from the public and private sector, the Agency shall identify and disseminate methods or systems to assess health care research results, particularly methods or systems to rate the strength of the scientific evidence underlying health care practice, recommendations in the research literature, and technology assessments. The Agency shall make methods or systems for evidence rating widely available. Agency publications containing health care recommendations shall indicate the level of substantiating evidence using such methods or systems. ``(b) Health Care Improvement Research Centers and Provider-Based Research Networks.-- ``(1) In general.--In order to address the full continuum of care and outcomes research, to link research to practice improvement, and to speed the dissemination of research findings to community practice settings, the Agency shall employ research strategies and mechanisms that will link research directly with clinical practice in geographically diverse locations throughout the United States, including-- ``(A) health care improvement research centers that combine demonstrated multidisciplinary expertise in outcomes or quality improvement research with linkages to relevant sites of care; ``(B) provider-based research networks, including plan, facility, or delivery system sites of care (especially primary care), that can evaluate outcomes and evaluate and promote quality improvement; and ``(C) other innovative mechanisms or strategies to link research with clinical practice. ``(2) Requirements.--The Director is authorized to establish the requirements for entities applying for grants under this subsection. ``SEC. 912. PRIVATE-PUBLIC PARTNERSHIPS TO IMPROVE ORGANIZATION AND DELIVERY. ``(a) Support for Efforts To Develop Information on Quality.-- ``(1) Scientific and technical support.--In its role as the principal agency for health research and quality, the Agency may provide scientific and technical support for private and public efforts to improve health care quality, including the activities of accrediting organizations. ``(2) Role of the agency.--With respect to paragraph (1), the role of the Agency shall include-- ``(A) the identification and assessment of methods for the evaluation of the health of-- ``(i) enrollees in health plans by type of plan, provider, and provider arrangements; and ``(ii) other populations, including those receiving long-term care services; ``(B) the ongoing development, testing, and dissemination of quality measures, including measures of health and functional outcomes; ``(C) the compilation and dissemination of health care quality measures developed in the private and public sector; ``(D) assistance in the development of improved health care information systems; ``(E) the development of survey tools for the purpose of measuring participant and beneficiary assessments of their health care; and ``(F) identifying and disseminating information on mechanisms for the integration of information on quality into purchaser and consumer decision-making processes. ``(b) Centers for Education and Research on Therapeutics.-- ``(1) In general.--The Secretary, acting through the Director and in consultation with the Commissioner of Food and Drugs, shall establish a program for the purpose of making one or more grants for the establishment and operation of one or more centers to carry out the activities specified in paragraph (2). ``(2) Required activities.--The activities referred to in this paragraph are the following: ``(A) The conduct of state-of-the-art research for the following purposes: ``(i) To increase awareness of-- ``(I) new uses of drugs, biological products, and devices; ``(II) ways to improve the effective use of drugs, biological products, and devices; and ``(III) risks of new uses and risks of combinations of drugs and biological products. ``(ii) To provide objective clinical information to the following individuals and entities: ``(I) Health care practitioners and other providers of health care goods or services. ``(II) Pharmacists, pharmacy benefit managers and purchasers. ``(III) Health maintenance organizations and other managed health care organizations. ``(IV) Health care insurers and governmental agencies. ``(V) Patients and consumers. ``(iii) To improve the quality of health care while reducing the cost of health care through--
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