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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...
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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