| 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. <> ...
[[Page 113 STAT. 1653]]
Public Law 106-129
To amend title IX of the Public Health Service Act to revise and extend
the Agency for Healthcare Policy and Research. <<NOTE: Dec. 6,
1999 - [S. 580]>>
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, <<NOTE: Healthcare
Research and Quality Act of 1999.>>
SECTION <<NOTE: 42 USC 201 note.>> 1. SHORT TITLE.
This Act may be cited as the ``Healthcare Research and Quality Act
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 HEALTHCARE RESEARCH AND QUALITY
``PART A--ESTABLISHMENT AND GENERAL DUTIES
``SEC. <<NOTE: 42 USC 299.>> 901. MISSION AND DUTIES.
``(a) In General.--There is established within the Public Health
Service an agency to be known as the Agency for Healthcare 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 care, including--
``(A) the development and assessment of methods for
enhancing patient participation in their own care and
for facilitating shared patient-physician decision-
``(B) the outcomes, effectiveness, and cost-
effectiveness of health care practices, including
preventive measures and long-term care;
``(C) existing and innovative technologies;
[[Page 113 STAT. 1654]]
``(D) the costs and utilization of, and access to
``(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
``(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
``(3) initiatives to advance private and public efforts to
improve health care quality.
``(c) Requirements With Respect to Rural and Inner-City Areas and
``(1) Research, evaluations and demonstration projects.--In
carrying out this title, the Director shall conduct and support
research and evaluations, and support demonstration projects,
with respect to--
``(A) the delivery of health care in inner-city
areas, and in rural areas (including frontier areas);
``(B) health care for priority populations, which
``(i) low-income groups;
``(ii) minority groups;
``(v) the elderly; and
``(vi) individuals with special health care
needs, including individuals with disabilities and
individuals who need chronic care or end-of-life
``(2) Process to ensure appropriate research.--The Director
shall establish a process to ensure that the requirements of
paragraph (1) are reflected in the overall portfolio of research
conducted and supported by the Agency.
``(3) Office of priority populations.--
<<NOTE: Establishment.>> The Director shall establish an Office
of Priority Populations to assist in carrying out the
requirements of paragraph (1).
``SEC. <<NOTE: 42 USC 299a.>> 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 multidisciplinary
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
``(5) health care technologies, facilities, and equipment;
[[Page 113 STAT. 1655]]
``(6) health care costs, productivity, organization, and
``(7) health promotion and disease prevention, including
clinical preventive services;
``(8) health statistics, surveys, database development, 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) as well as other
``(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 addressing health care issues for the
priority populations identified in section 901(c)(1)(B) and in
addition, shall take into consideration indications of long-term
commitment, amongst applicants for training funds, to addressing
health care needs of 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
``(g) Annual Report.-- <<NOTE: Effective date.>> 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
[[Page 113 STAT. 1656]]
``PART B--HEALTH CARE IMPROVEMENT RESEARCH
``SEC. 911. <<NOTE: 42 USC 299b.>> HEALTH CARE OUTCOME IMPROVEMENT
``(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
``(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
``SEC. 912. <<NOTE: 42 USC 299b-1.>> 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 care 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;
[[Page 113 STAT. 1657]]
``(C) the compilation and dissemination of health
care quality measures developed in the private and
``(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) 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
``(III) risks of new uses and risks
of combinations of drugs and biological
``(ii) To provide objective clinical
information to the following individuals and
``(I) Health care practitioners and
other providers of health care goods or
``(II) Pharmacists, pharmacy benefit
managers and purchasers.
``(III) Health maintenance
organizations and other managed health
``(IV) Health care insurers and
``(V) Patients and consumers.
``(iii) To improve the quality of health care
while reducing the cost of health care through--
``(I) an increase in the appropriate
use of drugs, biological products, or
``(II) the prevention of adverse
effects of drugs, biological products,
and devices and the consequences of such
effects, such as unnecessary
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106th Congressional Public Laws Records and Documents
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