I 

118TH CONGRESS 

2D SESSION H. R. 10135 

To improve the quality, appropriateness, and effectiveness of diagnosis in 

health care, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 15, 2024 

Mr. BEYER (for himself, Mr. VAN DREW, and Ms. SCHRIER) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To improve the quality, appropriateness, and effectiveness 

of diagnosis in health care, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Improving Diagnosis 

5 in Medicine Act of 2024’’. 

6 SEC. 2. RESEARCH PROGRAM TO IMPROVE DIAGNOSTIC 

7 SAFETY AND QUALITY. 

8 Part B of title IX of the Public Health Service Act 

9 (42 U.S.C. 299b et seq.) is amended by adding at the end 

10 the following: 


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1 ‘‘SEC. 918. RESEARCH PROGRAM TO IMPROVE DIAGNOSTIC 

2 SAFETY AND QUALITY. 

3 ‘‘(a) IN GENERAL.—The Director shall establish a 

4 comprehensive program of research and quality improve5 ment to— 

6 ‘‘(1) assess and understand diagnostic errors, 

7 including diagnostic delays, and how to eliminate 

8 common failures in the diagnostic process that lead 

9 to significant patient harm; and 

10 ‘‘(2) identify, develop, implement, and dissemi11 nate evidence-based strategies and best practices for 

12 improving diagnostic quality, safety, and health care 

13 value. 

14 ‘‘(b) ACTIVITIES.—The program established under 

15 subsection (a) shall include the following: 

16 ‘‘(1) CONTINUUM OF RESEARCH.—A portfolio 

17 of conducted and supported activities that is con18 sistent with the research, implementation, and dis19 semination activities of the Center for Quality Im20 provement and Patient Safety, as described in sec21 tion 933, including— 

22 ‘‘(A) investigator-initiated research to as23 sess diagnostic errors and identify improved 

24 methods to prevent errors and the harm errors 

25 cause; 


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1 ‘‘(B) translation and synthesis of research 

2 findings and development of tools for imple3 menting prevention strategies into practice; 

4 ‘‘(C) implementation research to refine evi5 dence-based tools for improving diagnostic proc6 esses and effectively integrate these solutions 

7 into practice; and 

8 ‘‘(D) dissemination to promote implemen9 tation of effective methods, strategies, and tools 

10 for wide-scale improvement, including identi11 fying where digital- and artificial intelligence12 enabled tools could be beneficial. 

13 ‘‘(2) RESEARCH CENTERS OF DIAGNOSTIC EX14 CELLENCE.—Consistent with section 911(b), the 

15 health care improvement research centers described 

16 in such section shall link research directly with clin17 ical practice in geographically diverse locations 

18 throughout the United States, and may include— 

19 ‘‘(A) academic medical and institutional re20 search centers that combine demonstrated mul21 tidisciplinary expertise in diagnostic outcomes 

22 or quality improvement research with linkages 

23 directly or through national, State or local 

24 stakeholder partner organizations to relevant 

25 sites of care; and 


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1 ‘‘(B) provider-based research networks, in2 cluding plan, facility, or delivery system sites of 

3 care (especially primary care), that can evaluate 

4 outcomes and evaluate and promote quality im5 provement approaches. 

6 ‘‘(3) FINANCIAL ASSISTANCE.—The Director 

7 may provide financial assistance to assist in meeting 

8 the costs of planning and establishing new centers, 

9 as well as operating existing and new centers, pursu10 ant to section 902(c). 

11 ‘‘(4) STAKEHOLDER ENGAGEMENT.—The Di12 rector shall identify and enter into a supporting 

13 agreement, pursuant to a grant or contract, with a 

14 nonprofit entity that convenes a coalition of diverse 

15 health care stakeholders for the purpose of— 

16 ‘‘(A) raising attention to diagnostic safety 

17 and quality concerns; 

18 ‘‘(B) facilitating learning, adoption, and 

19 dissemination of effective quality improvement 

20 interventions; and 

21 ‘‘(C) catalyzing novel actions by individual 

22 member organizations to reduce harms from di23 agnostic error and improve patient outcomes. 

24 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.— 


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1 ‘‘(1) IN GENERAL.—To carry out this section, 

2 there are authorized to be appropriated $30,000,000 

3 for fiscal year 2025, $35,000,000 for fiscal year 

4 2026, $40,000,000 for fiscal year 2027, and 

5 $45,000,000 for each of fiscal years 2028 and 2029. 

6 ‘‘(2) RESERVATION.—Of the amount appro7 priated under paragraph (1) for a fiscal year, 

8 $700,000 shall be allocated to carrying out the pur9 pose described in subsection (b)(4). 

10 ‘‘(3) AVAILABILITY.—Amounts appropriated 

11 under this section shall remain available until ex12 pended.’’. 

13 SEC. 3. FELLOWSHIPS AND TRAINING GRANTS. 

14 (a) RUTH KIRSCHSTEIN AWARDS.—Section 487(a) of 

15 the Public Health Service Act (42 U.S.C. 288(a)) is 

16 amended by adding at the end the following: 

17 ‘‘(5) For purposes of the program under this sub18 section, biomedical and behavioral research includes diag19 nostic safety and quality research.’’. 

20 (b) AHRQ PROGRAMS.—Section 902(b)(1) of the 

21 Public Health Service Act (42 U.S.C. 299a(b)(1)) is 

22 amended— 

23 (1) by inserting ‘‘and diagnostic safety and 

24 quality’’ after ‘‘subsection (a)’’; and 


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1 (2) by striking ‘‘under section 487(d)(3)’’ and 

2 inserting ‘‘for purposes of carrying out section 487’’. 

3 SEC. 4. QUALITY MEASURE DEVELOPMENT. 

4 Section 931(c)(2) of the Public Health Service Act 

5 (42 U.S.C. 299b–31(c)(2)) is amended— 

6 (1) by redesignating subparagraphs (B) 

7 through (J) as subparagraphs (C) through (K), re8 spectively; and 

9 (2) by inserting after subparagraph (A) the fol10 lowing: 

11 ‘‘(B) diagnostic safety and quality;’’. 

12 SEC. 5. STANDARDIZED DATA FOR DIAGNOSIS RESEARCH 

13 AND IMPROVEMENT. 

14 Section 937(f) of the Public Health Service Act (42 

15 U.S.C. 299b–37(f)) is amended— 

16 (1) by striking ‘‘The Secretary’’ and inserting 

17 the following: 

18 ‘‘(1) IN GENERAL.—The Secretary’’; and 

19 (2) adding at the end the following: 

20 ‘‘(2) CONSULTATION WITH EXPERT PANEL.—In 

21 carrying out paragraph (1), the Secretary, in coordi22 nation with the Director, the Administrator of the 

23 Centers for Medicare & Medicaid Services, the Na24 tional Coordinator for Health Information Tech25 nology, the Director of the National Library of MedVerDate Sep 11 2014 01:20 Nov 16, 2024 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H10135.IH H10135

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1 icine, the Chief Data Officer of the Department of 

2 Health and Human Services, and the Chief Artificial 

3 Intelligence Officer of the Department of Health and 

4 Human Services, shall convene an expert panel to 

5 consider and make recommendations regarding the 

6 types, sources, and availability of data needed to ac7 celerate diagnostic safety and quality research, train8 ing, and measure development as specified in section 

9 918, including— 

10 ‘‘(A) demographic data; 

11 ‘‘(B) the specificity, interoperability, and 

12 socio-technical aspects of electronic vocabularies 

13 and ontologies related to presenting symptoms, 

14 chief complaints, and the status of diagnosis 

15 (such as tentative, working, or confirmed); and 

16 ‘‘(C) the development and use of symptom17 based clinical registries. Such panel shall con18 sider enhanced data capabilities that are nec19 essary to support both research and improve20 ment of diagnostic safety and quality.’’. 

21 SEC. 6. INTERAGENCY COUNCIL ON IMPROVING DIAGNOSIS 

22 IN HEALTH CARE. 

23 (a) ESTABLISHMENT.—The Secretary of Health and 

24 Human Services (in this section referred to as the ‘‘Sec25 retary’’) shall establish within the Office of the Secretary 


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1 an interagency council to be known as the Interagency 

2 Council on Improving Diagnosis in Health Care (referred 

3 to in this section as the ‘‘Council’’). 

4 (b) OBJECTIVES.—The objectives of the Council shall 

5 be the following: 

6 (1) Enhance the quality, appropriateness, and 

7 effectiveness of diagnosis in health care through— 

8 (A) the establishment and support of a 

9 broad base of scientific research; 

10 (B) the dissemination and implementation 

11 of the results of such research; and 

12 (C) the promotion of improvements in clin13 ical and health system practices. 

14 (2) Identify and eliminate systemic barriers to 

15 supporting research in improving diagnosis in health 

16 care. 

17 (3) Identify knowledge gaps, research and data 

18 needs, and opportunities congruent with agency mis19 sions to strengthen the clinical and translational re20 search pipeline to improve diagnostic safety and 

21 quality, including potential collaborative research ini22 tiatives among 2 or more agencies, offices, institutes, 

23 or centers within the Department of Health and 

24 Human Services or other Federal agencies or offices. 

25 (c) MEMBERSHIP.— 


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1 (1) CHAIRPERSON.—The Director of the Agen2 cy for Healthcare Research and Quality (or the Di3 rector’s designee) shall be the Chairperson of the 

4 Council. 

5 (2) MEMBERS.— 

6 (A) IN GENERAL.—In addition to the 

7 Chairperson, the Council shall be comprised of 

8 the following: 

9 (i) At least 1 designee from each of 

10 the following, appointed by the head of the 

11 applicable department or agency: 

12 (I) The Centers for Disease Con13 trol and Prevention. 

14 (II) The Centers for Medicare & 

15 Medicaid Services. 

16 (III) The Department of Vet17 erans Affairs. 

18 (IV) The Congressionally Di19 rected Medical Research Program of 

20 the Department of Defense. 

21 (V) The Office of the National 

22 Coordinator for Health Information 

23 Technology. 


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1 (VI) The Office of the Chief 

2 Data Officer of the Department of 

3 Health and Human Services. 

4 (VII) The Office of the Chief Ar5 tificial Intelligence Officer of the De6 partment of Health and Human Serv7 ices. 

8 (VIII) The Center for Devices 

9 and Radiological Health of the Food 

10 and Drug Administration. 

11 (ii) Designees from the National Insti12 tutes of Health, including a least 1 des13 ignee from each of the following: 

14 (I) The National Cancer Insti15 tute. 

16 (II) The National Center for Ad17 vancing Translational Sciences. 

18 (III) The National Institute of 

19 Allergy and Infectious Diseases. 

20 (IV) The National Heart, Lung, 

21 and Blood Institute. 

22 (V) The National Institute of 

23 Neurological Disorders and Stroke. 

24 (VI) The National Library of 

25 Medicine. 


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1 (VII) The National Institute on 

2 Minority Health and Health Dispari3 ties. 

4 (VIII) The National Institute of 

5 Nursing Research. 

6 (IX) The Eunice Kennedy Shriv7 er National Institute of Child Health 

8 and Human Development. 

9 (iii) Designees from such other na10 tional research institutes and national cen11 ters as may be appropriate, as determined 

12 by the Director of the National Institutes 

13 of Health. 

14 (B) ADDITIONAL MEMBERS.—In addition 

15 to the designees under subparagraph (A), the 

16 Council may include such other designees from 

17 Federal departments or agencies as the Chair18 person of the Council determines appropriate. 

19 (C) DESIGNATION.—A person appointed to 

20 the Council as a designee shall be a senior offi21 cial or employee of the department or agency 

22 whose responsibilities and subject matter exper23 tise are relevant to the Council’s objectives list24 ed in subsection (b), as determined by the des25 ignating official. 


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1 (d) STRATEGIC PLAN; REPORTS.— 

2 (1) STRATEGIC FEDERAL PLAN TO IMPROVE DI3 AGNOSIS IN HEALTH CARE.—Not later than 18 

4 months after the date of enactment of this Act, the 

5 Council shall develop, submit to the Secretary and 

6 Congress, and make publicly available a strategic 

7 plan, to be known as the Strategic Federal Plan to 

8 Improve Diagnosis, that, consistent with the objec9 tives listed in subsection (b)— 

10 (A) identifies coordinated opportunities to 

11 enhance scientific research and reduce systemic 

12 barriers in order to improve diagnosis in health 

13 care; and 

14 (B) includes legislative and administrative 

15 policy recommendations, including opportunities 

16 to remove barriers to, and enhance, inter-agen17 cy coordination in the planning, conduct, and 

18 funding of, such research. 

19 (2) REPORTS TO CONGRESS.—Not later than 

20 July 31 of every odd-numbered year beginning with 

21 the first such year after the date of submission of 

22 the first Strategic Federal Plan to Improve Diag23 nosis under paragraph (1), the Council shall pre24 pare, submit to the Secretary and Congress, and 


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1 make publicly available an updated Strategic Fed2 eral Plan to Improve Diagnosis that includes— 

3 (A) such updates as the Council deter4 mines to be appropriate; 

5 (B) information on the overall progress of 

6 the Federal Government in reducing barriers to 

7 research on, and supporting projects to im8 prove, diagnosis in health care; and 

9 (C) legislative and administrative policy 

10 recommendations, including addressing any 

11 needs for greater legislative authority to meet 

12 the objectives listed in subsection (b). 

13 (e) AUTHORIZATION OF APPROPRIATIONS.—To carry 

14 out this section, there are authorized to be appropriated 

15 $1,500,000 for each of fiscal years 2025 through 2029. 

16 SEC. 7. NATIONAL ACADEMIES REPORT. 

17 (a) IN GENERAL.—The Director of the Agency for 

18 Healthcare Research and Quality shall seek to enter into 

19 a contract with the National Academies of Sciences, Engi20 neering, and Medicine under which such National Acad21 emies conducts a study and issues a report on disparities 

22 in diagnostic safety and quality that— 

23 (1) identifies what is known about the burden 

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1 nic, socioeconomic, age, gender, geography, language 

2 proficiency, and intersectional interactions; and 

3 (2) includes recommendations on specific ac4 tions that policymakers, researchers, clinicians, and 

5 other stakeholders can take to eliminate such bur6 dens. 

7 (b) AUTHORIZATION OF APPROPRIATIONS.—To carry 

8 out this section, there is authorized to be appropriated 

9 $1,500,000 for fiscal year 2025, to remain available until 

10 expended. 

Æ 


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