| Home > 106th Congressional Public Laws > Pub.L. 106-130 To provide for the holding of court at Natchez, Mississippi, in the same manner as court is held at Vicksburg, Mississippi, and for other purposes. <> ...
Pub.L. 106-130 To provide for the holding of court at Natchez, Mississippi, in the same manner as court is held at Vicksburg, Mississippi, and for other purposes. <> ...
``(B) The conduct of research on the comparative
effectiveness, cost-effectiveness, and safety of drugs,
biological products, and devices.
``(C) Such other activities as the Secretary
determines to be appropriate, except that a grant may
not be expended to assist the Secretary in the review of
new drugs, biological products, and devices.
[[Page 113 STAT. 1658]]
``(c) Reducing Errors in Medicine.--The Director shall conduct and
support research and build private-public partnerships to--
``(1) identify the causes of preventable health care errors
and patient injury in health care delivery;
``(2) develop, demonstrate, and evaluate strategies for
reducing errors and improving patient safety; and
``(3) disseminate such effective strategies throughout the
health care industry.
``SEC. 913. <<NOTE: 42 USC 299b-2.>> INFORMATION ON QUALITY AND COST OF
``(a) In General.--The Director shall--
``(1) <<NOTE: Survey. Effective date.>> conduct a survey to
collect data on a nationally representative sample of the
population on the cost, use and, for fiscal year 2001 and
subsequent fiscal years, quality of health care, including the
types of health care services Americans use, their access to
health care services, frequency of use, how much is paid for the
services used, the source of those payments, the types and costs
of private health insurance, access, satisfaction, and quality
of care for the general population including rural residents and
also for populations identified in section 901(c); and
``(2) develop databases and tools that provide information
to States on the quality, access, and use of health care
services provided to their residents.
``(b) Quality and Outcomes Information.--
``(1) In general.-- <<NOTE: Effective date.>> Beginning in
fiscal year 2001, the Director shall ensure that the survey
conducted under subsection (a)(1) will--
``(A) identify determinants of health outcomes and
functional status, including the health care needs of
populations identified in section 901(c), provide data
to study the relationships between health care quality,
outcomes, access, use, and cost, measure changes over
time, and monitor the overall national impact of Federal
and State policy changes on health care;
``(B) provide information on the quality of care and
patient outcomes for frequently occurring clinical
conditions for a nationally representative sample of the
population including rural residents; and
``(C) provide reliable national estimates for
children and persons with special health care needs
through the use of supplements or periodic expansions of
In expanding the Medical Expenditure Panel Survey, as in
existence on the date of the enactment of this title in fiscal
year 2001 to collect information on the quality of care, the
Director shall take into account any outcomes measurements
generally collected by private sector accreditation
``(2) Annual report.-- <<NOTE: Effective date.>> Beginning
in fiscal year 2003, the Secretary, acting through the Director,
shall submit to Congress an annual report on national trends in
the quality of health care provided to the American people.
``SEC. 914. <<NOTE: 42 USC 299b-3.>> INFORMATION SYSTEMS FOR HEALTH
``(a) In General.--In order to foster a range of innovative
approaches to the management and communication of health information,
the Agency shall conduct and support research, evaluations, and
initiatives to advance--
[[Page 113 STAT. 1659]]
``(1) the use of information systems for the study of health
care quality and outcomes, including the generation of both
individual provider and plan-level comparative performance data;
``(2) training for health care practitioners and researchers
in the use of information systems;
``(3) the creation of effective linkages between various
sources of health information, including the development of
``(4) the delivery and coordination of evidence-based health
care services, including the use of real-time health care
``(5) the utility and comparability of health information
data and medical vocabularies by addressing issues related to
the content, structure, definitions and coding of such
information and data in consultation with appropriate Federal,
State and private entities;
``(6) the use of computer-based health records in all
settings for the development of personal health records for
individual health assessment and maintenance, and for monitoring
public health and outcomes of care within populations; and
``(7) the protection of individually identifiable
information in health services research and health care quality
``(b) Demonstration.--The Agency shall support demonstrations into
the use of new information tools aimed at improving shared decision-
making between patients and their care-givers.
``(c) Facilitating Public Access to Information.--The Director shall
work with appropriate public and private sector entities to facilitate
public access to information regarding the quality of and consumer
satisfaction with health care.
``SEC. 915. <<NOTE: 42 USC 299b-4.>> RESEARCH SUPPORTING PRIMARY
CARE AND ACCESS IN UNDERSERVED AREAS.
``(a) Preventive Services Task Force.--
``(1) Establishment and purpose.--The Director may
periodically convene a Preventive Services Task Force to be
composed of individuals with appropriate expertise. Such a task
force shall review the scientific evidence related to the
effectiveness, appropriateness, and cost-effectiveness of
clinical preventive services for the purpose of developing
recommendations for the health care community, and updating
previous clinical preventive recommendations.
``(2) Role of agency.--The Agency shall provide ongoing
administrative, research, and technical support for the
operations of the Preventive Services Task Force, including
coordinating and supporting the dissemination of the
recommendations of the Task Force.
``(3) Operation.--In carrying out its responsibilities under
paragraph (1), the Task Force is not subject to the provisions
of Appendix 2 of title 5, United States Code.
``(b) Primary Care Research.--
``(1) In general.-- <<NOTE: Establishment.>> There is
established within the Agency a Center for Primary Care Research
(referred to in this subsection as the `Center') that shall
serve as the principal source of funding for primary care
practice research in the Department of Health and Human
Services. For purposes of this paragraph,
[[Page 113 STAT. 1660]]
primary care research focuses on the first contact when illness
or health concerns arise, the diagnosis, treatment or referral
to specialty care, preventive care, and the relationship between
the clinician and the patient in the context of the family and
``(2) Research.--In carrying out this section, the Center
shall conduct and support research concerning--
``(A) the nature and characteristics of primary care
``(B) the management of commonly occurring clinical
``(C) the management of undifferentiated clinical
``(D) the continuity and coordination of health
``SEC. 916. <<NOTE: 42 USC 299b-5.>> HEALTH CARE PRACTICE AND
``(a) In General.--The Director shall promote innovation in
evidence-based health care practices and technologies by--
``(1) conducting and supporting research on the development,
diffusion, and use of health care technology;
``(2) developing, evaluating, and disseminating
methodologies for assessments of health care practices and
``(3) conducting intramural and supporting extramural
assessments of existing and new health care practices and
``(4) promoting education and training and providing
technical assistance in the use of health care practice and
technology assessment methodologies and results; and
``(5) working with the National Library of Medicine and the
public and private sector to develop an electronic clearinghouse
of currently available assessments and those in progress.
``(b) Specification of Process.--
``(1) In general.-- <<NOTE: Deadline. Publication.>> Not
later than December 31, 2000, the Director shall develop and
publish a description of the methods used by the Agency and its
contractors for health care practice and technology assessment.
``(2) Consultations.--In carrying out this subsection, the
Director shall cooperate and consult with the Assistant
Secretary for Health, the Administrator of the Health Care
Financing Administration, the Director of the National
Institutes of Health, the Commissioner of Food and Drugs, and
the heads of any other interested Federal department or agency,
and shall seek input, where appropriate, from professional
societies and other private and public entities.
``(3) Methodology.--The Director shall, in developing the
methods used under paragraph (1), consider--
``(A) safety, efficacy, and effectiveness;
``(B) legal, social, and ethical implications;
``(C) costs, benefits, and cost-effectiveness;
``(D) comparisons to alternate health care practices
and technologies; and
``(E) requirements of Food and Drug Administration
approval to avoid duplication.
``(c) Specific Assessments.--
``(1) In general.--The Director shall conduct or support
specific assessments of health care technologies and practices.
[[Page 113 STAT. 1661]]
``(2) Requests for assessments.--The Director is authorized
to conduct or support assessments, on a reimbursable basis, for
the Health Care Financing Administration, the Department of
Defense, the Department of Veterans Affairs, the Office of
Personnel Management, and other public or private entities.
``(3) Grants and contracts.--In addition to conducting
assessments, the Director may make grants to, or enter into
cooperative agreements or contracts with, entities described in
paragraph (4) for the purpose of conducting assessments of
experimental, emerging, existing, or potentially outmoded health
care technologies, and for related activities.
``(4) Eligible entities.--An entity described in this
paragraph is an entity that is determined to be appropriate by
the Director, including academic medical centers, research
institutions and organizations, professional organizations,
third party payers, governmental agencies, minority institutions
of higher education (such as Historically Black Colleges and
Universities, and Hispanic institutions), and consortia of
appropriate research entities established for the purpose of
conducting technology assessments.
``(d) Medical Examination of Certain Victims.--
``(1) In general.-- <<NOTE: Reports.>> The Director shall
develop and disseminate a report on evidence-based clinical
``(A) the examination and treatment by health
professionals of individuals who are victims of sexual
assault (including child molestation) or attempted
sexual assault; and
``(B) the training of health professionals, in
consultation with the Health Resources and Services
Administration, on performing medical evidentiary
examinations of individuals who are victims of child
abuse or neglect, sexual assault, elder abuse, or
``(2) Certain considerations.--In identifying the issues to
be addressed by the report, the Director shall, to the extent
practicable, take into consideration the expertise and
experience of Federal and State law enforcement officials
regarding the victims referred to in paragraph (1), and of other
appropriate public and private entities (including medical
societies, victim services organizations, sexual assault
prevention organizations, and social services organizations).
``SEC. 917. <<NOTE: 42 USC 299b-6.>> COORDINATION OF FEDERAL
GOVERNMENT QUALITY IMPROVEMENT EFFORTS.
``(1) In general.--To avoid duplication and ensure that
Federal resources are used efficiently and effectively, the
Secretary, acting through the Director, shall coordinate all
research, evaluations, and demonstrations related to health
services research, quality measurement and quality improvement
activities undertaken and supported by the Federal Government.
``(2) Specific activities.--The Director, in collaboration
with the appropriate Federal officials representing all
concerned executive agencies and departments, shall develop and
manage a process to--
[[Page 113 STAT. 1662]]
``(A) improve interagency coordination, priority
setting, and the use and sharing of research findings
and data pertaining to Federal quality improvement
programs, technology assessment, and health services
``(B) strengthen the research information
infrastructure, including databases, pertaining to
Federal health services research and health care quality
``(C) set specific goals for participating agencies
and departments to further health services research and
health care quality improvement; and
``(D) strengthen the management of Federal health
care quality improvement programs.
``(b) Study by the Institute of Medicine.--
``(1) In general. <<NOTE: Contracts.>> --To provide
Congress, the Department of Health and Human Services, and other
relevant departments with an independent, external review of
their quality oversight, quality improvement and quality
research programs, the Secretary shall enter into a contract
with the Institute of Medicine--
``(A) to describe and evaluate current quality
improvement, quality research and quality monitoring
``(i) an overview of pertinent health services
research activities and quality improvement
efforts conducted by all Federal programs, with
particular attention paid to those under titles
XVIII, XIX, and XXI of the Social Security Act;
``(ii) a summary of the partnerships that the
Department of Health and Human Services has
pursued with private accreditation, quality
measurement and improvement organizations; and
``(B) to identify options and make recommendations
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106th Congressional Public Laws Records and Documents
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