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. <> ...


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                    ``(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 
            CARE.

    ``(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 
                the survey.
        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 
        organizations.
            ``(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 
            CARE IMPROVEMENT.

    ``(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 
        information networks;
            ``(4) the delivery and coordination of evidence-based health 
        care services, including the use of real-time health care 
        decision-support programs;
            ``(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 
        improvement.

    ``(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 
        community.
            ``(2) Research.--In carrying out this section, the Center 
        shall conduct and support research concerning--
                    ``(A) the nature and characteristics of primary care 
                practice;
                    ``(B) the management of commonly occurring clinical 
                problems;
                    ``(C) the management of undifferentiated clinical 
                problems; and
                    ``(D) the continuity and coordination of health 
                services.

``SEC. 916. <<NOTE: 42 USC 299b-5.>>  HEALTH CARE PRACTICE AND 
            TECHNOLOGY INNOVATION.

    ``(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 
        technologies;
            ``(3) conducting intramural and supporting extramural 
        assessments of existing and new health care practices and 
        technologies;
            ``(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 
        practices for--
                    ``(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 
                domestic violence.
            ``(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.

    ``(a) Requirement.--
            ``(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 
                research;
                    ``(B) strengthen the research information 
                infrastructure, including databases, pertaining to 
                Federal health services research and health care quality 
                improvement initiatives;
                    ``(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 
                processes through--
                          ``(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; 
                      and
                          ``(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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