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S. 2711 (is) To authorize the Administrator of the Environmental Protection Agency to make grants to the Florida Keys Aqueduct Authority and other appropriate agencies for the purpose of improving water quality throughout the marine ecosystem of the Flori...


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108th CONGRESS
  2d Session
                                S. 2710

   To amend the Public Health Service Act to improve the quality and 
efficiency of health care delivery through improvements in health care 
            information technology, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 21, 2004

  Mr. Gregg (for himself, Mr. Sessions, and Mr. Frist) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to improve the quality and 
efficiency of health care delivery through improvements in health care 
            information technology, and for other purposes.

    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 ``National Health Information 
Technology Adoption Act''.

SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by 
adding at the end thereof the following:

            ``TITLE XXIX--HEALTH CARE INFORMATION TECHNOLOGY

``SEC. 2901. DEFINITIONS.

    ``In this title:
            ``(1) Coverage area.--The term `coverage area' means the 
        boundaries of a local health information infrastructure.
            ``(2) Demographic data.--The term `demographic data' means 
        data that includes race, ethnicity, socio-economic status, and 
        primary language.
            ``(3) Director.--The term `Director' means the Director of 
        the Office of Health Information Technology.
            ``(4) Health care provider.--The term `health care 
        provider' means a hospital, skilled nursing facility, home 
        health entity, health care clinic, community health center, 
        group practice (as defined in section 1877(h)(4) of the Social 
        Security Act, including practices with only 1 physician), and 
        any other facility or clinician determined appropriate by the 
        Director.
            ``(5) Local health information infrastructures.--The term 
        `local health information infrastructure' means an independent 
        organization of health care entities established for the 
        purpose of linking health information systems to electronically 
        share information. A local health information infrastructure 
        may not be a single business entity.
            ``(6) Office.--The term `Office' means the Office of Health 
        Information Technology established under section 2902.

``SEC. 2902. OFFICE OF HEALTH INFORMATION TECHNOLOGY.

    ``(a) Establishment.--There is established within the Office of the 
Secretary an Office of Health Information Technology. The Office shall 
be headed by a Director to be appointed by the Secretary after 
consultation with the President. The Director shall report directly to 
the Secretary.
    ``(b) Purpose.--It shall be the purpose of the Office to--
            ``(1) improve the quality and increase the efficiency of 
        health care delivery through the use of health information 
        technology;
            ``(2) provide national leadership relating to, and 
        encourage the adoption of, health information technology;
            ``(3) direct all health information technology activities 
        within the Department of Health and Human Services;
            ``(4) act as the lead entity responsible for coordinating 
        the health information technology efforts of the Federal 
        Government; and
            ``(5) facilitate the interaction between the Federal 
        Government and the private sector relating to health 
        information technology development and use.
    ``(c) Duties and Responsibilities.--The Office shall be responsible 
for the following:
            ``(1) Federal leadership.--The Office shall--
                    ``(A) serve as the principle advisor to the 
                Secretary concerning health information technology;
                    ``(B) direct all health information technology 
                activity within the Department of Health and Human 
                Services;
                    ``(C) work with public and private health 
                information technology stakeholders to implement a 
                strategic plan for the establishment of a National 
                Health Information Infrastructure; and
                    ``(D) ensure that health information technology is 
                utilized as fully as practicable in carrying out health 
                surveillance efforts.
            ``(2) Coordination.--The Office shall--
                    ``(A) encourage the development and adoption of 
                clinical, messaging, and decision support health 
                information data standards, pursuant to the 
                requirements of section 2903;
                    ``(B) ensure the maintenance and implementation of 
                the data standards described in subparagraph (A);
                    ``(C) oversee and coordinate the health information 
                technology efforts of the Federal Government;
                    ``(D) ensure the compliance of the Department of 
                Health and Human Services with Federally adopted health 
                information technology data standards;
                    ``(E) serve as the representative of the Department 
                of Health and Human Services with respect to the 
                Consolidated Health Informatics Initiative;
                    ``(F) ensure that the Federal Government consults 
                and collaborates on decision making with respect to 
                health information technology with the private sector 
                and other interested parties; and
                    ``(G) in consultation with private sector, adopt 
                certification and testing criteria to determine if 
                electronic health information systems interoperate.
            ``(3) Communication.--The Office shall--
                    ``(A) act as the point of contact for the private 
                sector with respect to the use of health information 
                technology; and
                    ``(B) work with the private sector to collect and 
                disseminate best health information technology 
                practices.
            ``(4) Evaluation and dissemination.--The Office shall 
        coordinate with the Agency for Health Research and Quality and 
        other Federal agencies to--
                    ``(A) evaluate and disseminate information relating 
                to evidence of the costs and benefits of health 
                information technology and to whom those costs and 
                benefits accrue;
                    ``(B) evaluate and disseminate information on the 
                impact of health information technology on the quality 
                and efficiency of patient care; and
                    ``(C) review Federal payment structures and 
                differentials for health care providers that utilize 
                health information technology systems.
            ``(5) Technical assistance.--The Office shall utilize 
        existing private sector quality improvement organizations to--
                    ``(A) promote the adoption of health information 
                technology among healthcare providers; and
                    ``(B) provide technical assistance concerning the 
                implementation of health information technology to 
                healthcare providers.
    ``(d) Resources.--The Secretary shall make available to the Office, 
the resources, both financial and otherwise, necessary to enable the 
Director to carry out the purposes of, and perform the duties and 
responsibilities of the Office under, this section.
    ``(e) Detail of Federal Employees.--Upon the request of the 
Director, the head of any Federal agency is authorized to detail, 
without reimbursement from the Office, any of the personnel of such 
agency to the Office to assist it in carrying out its duties under this 
section. Any such detail shall not interrupt or otherwise affect the 
civil service status or privileges of the Federal employee.

``SEC. 2903. PROMOTING THE INTEROPERABILITY OF HEALTH CARE INFORMATION 
              TECHNOLOGY SYSTEMS.

    ``(a) Development, and Federal Government Adoption, of Standards.--
            ``(1) Adoption.--
                    ``(A) In general.--Not later than 2 years after the 
                date of the enactment of this title, the Director shall 
                provide for the adoption by the Federal Government of 
                national data and communication health information 
                technology standards that promote the efficient 
                exchange of data between varieties of provider health 
                information technology systems. In carrying out the 
                preceding sentence, the Director may adopt existing 
                standards. Standards adopted under this section shall 
                be voluntary for private sector entities.
                    ``(B) Grants or contracts.--The Director may 
                utilize grants or contracts to provide for the private 
                sector development of standards for adoption by the 
                Federal Government under subparagraph (A).
            ``(2) Requirements.--The standards developed and adopted 
        under paragraph (1) shall be designed to--
                    ``(A) enable health information technology to be 
                used for the collection and use of clinically specific 
                data;
                    ``(B) promote the interoperability of health care 
                information across health care settings; and
                    ``(C) facilitate clinical decision support through 
                the use of health information technology.
            ``(3) Public private partnership.--Consistent with 
        activities being carried out on the date of enactment of this 
        title, including the Consolidated Health Informatics 
        initiative, health information technology standards shall be 
        adopted by the Director under paragraph (1) at the conclusion 
        of a collaborative process that includes consultation between 
        the Federal Government and private sector health care and 
        information technology stakeholders.
            ``(4) Privacy and security.--The regulations promulgated by 
        the Secretary under part C of title XI of the Social Security 
        Act (42 U.S.C. 1320d et seq.) and sections 261, 262, 263, and 
        264 of the Health Insurance Portability and Accountability Act 
        of 1996 (42 U.S.C. 1320d-2 note) with respect to the privacy, 
        confidentiality, and security of health information shall apply 
        to the implementation of programs and activities under this 
        title.
            ``(5) Pilot tests.--To the maximum extent practical, the 
        Director shall pilot test the health information technology 
        data standards developed under paragraph (1) prior to their 
        implementation under this section.
            ``(6) Dissemination.--
                    ``(A) In general.--The Director shall ensure that 
                the standards adopted under paragraph (1) are widely 
                disseminated to interested stakeholders.
                    ``(B) Licensing.--To facilitate the dissemination 
                and implementation of the standards developed and 
                adopted under paragraph (1), the Director may license 
                such standards, or utilize other means, to ensure the 
                widespread use of such standards.
    ``(b) Implementation of Standards.--
            ``(1) Purchase of systems by the secretary.--Effective 
        beginning on the date that is 5 years after the date of 
        enactment of this title, the Secretary shall not purchase any 
        health care information technology system unless such system is 
        in compliance with the standards adopted under subsection (a).
            ``(2) Recipients of federal funds.--Effective on the date 
        described in paragraph (1), the Secretary shall require that 
        funds not appropriated under this title that are designated for 
        Federal health information technology purposes shall be used to 
        purchase health care information technology systems that are in 
        compliance with the standards adopted under subsection (a).
    ``(c) Modification of Standards.--The Director shall provide for 
ongoing oversight of the health information technology standards 
developed under subsection (a) to--
            ``(1) identify gaps or other shortcomings in such 
        standards; and
            ``(2) modify such standards when determined appropriate or 
        develop additional standards, in collaboration with standard 
        setting organizations.

``SEC. 2904. LOAN GUARANTEES FOR THE ADOPTION OF HEALTH INFORMATION 
              TECHNOLOGY.

    ``(a) In General.--The Director shall guarantee payment of the 
principal of and the interest on loans made to eligible entities to 
enable such entities--
            ``(1) to implement local health information infrastructures 
        to facilitate the development of interoperability across health 
        care settings to improve quality and efficiency; or
            ``(2) to facilitate the purchase and adoption of health 
        information technology to improve quality and efficiency.
    ``(b) Eligibility.--To be eligible to receive a loan guarantee 
under subsection (a) an entity shall--
            ``(1) with respect to an entity desiring a loan guarantee--
                    ``(A) under subsection (a)(1), be a coalition of 
                entities that represent an independent consortium of 
                health care stakeholders within a community that--
                            ``(i) includes--
                                    ``(I) physicians (as defined in 
                                section 1881(r)(1) of the Social 
                                Security Act), including physicians 
                                that provide services to low income and 
                                underserved populations;
                                    ``(II) hospitals (including 
                                hospitals that provide services to low 
                                income and underserved populations); 
                                and
                                    ``(III) group health plans or other 
                                health insurance issuers (as such terms 
                                are defined in section 2791); and
                            ``(ii) may include any other health care 
                        providers; or
                    ``(B) under subsection (a)(2) be a health care 
                provider that provides health care services to low-
                income and underserved populations;
            ``(2) to the extent practicable, adopt the national health 
        information technology standards adopted under section 2903; 
        and
            ``(3) prepare and submit to the Director an application at 
        such time, in such manner, and containing such information as 
        the Director may require.
    ``(c) Use of Funds.--Amounts received under a loan guarantee under 
subsection (a) shall be used--
            ``(1) with respect to a loan guarantee described in 
        subsection (a)(1)--
                    ``(A) to develop a plan for the implementation of a 
                local health information infrastructure under this 
                section;

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