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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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