```

[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2363 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 2363

    To foster further innovation and entrepreneurship in the health 
                     information technology sector.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             June 13, 2013

  Mr. Honda introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees on 
  Ways and Means and Small Business, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL

 
    To foster further innovation and entrepreneurship in the health 
                     information technology sector.

    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 ``Health Care Innovation and 
Marketplace Technologies Act of 2013''.

SEC. 2. HEALTH INFORMATION TECHNOLOGY PLACED IN SERVICE BY MEDICAL CARE 
              PROVIDER.

    (a) In General.--Part VI of subchapter B of chapter 1 of the 
Internal Revenue Code of 1986 is amended by adding at the end the 
following:

``SEC. 200. HEALTH IT PLACED IN SERVICE BY MEDICAL CARE PROVIDER.

    ``(a) In General.--In the case of a medical care provider, there 
shall be allowed as a deduction an amount equal to the amount paid or 
incurred by the medical care provider for qualified health information 
technology placed in service by the provider during the taxable year.
    ``(b) Limitation.--The amount allowed as a deduction to a medical 
care provider by subsection (a) for a taxable year shall not exceed 
$250,000.
    ``(c) Definitions.--For purposes of this section--
            ``(1) Medical care provider.--The term `medical care 
        provider' means--
                    ``(A) a provider of services (as defined in section 
                1861(u) of the Social Security Act (42 U.S.C. 
                1395x(u)),
                    ``(B) a provider of medical or health services (as 
                defined in section 1861(s) of the Social Security Act 
                (42 U.S.C. 1395x(s)), and
                    ``(C) any other person who furnishes, bills, or is 
                paid for health care in the normal course of business.
            ``(2) Qualified health information technology.--The term 
        `qualified health information technology' means the application 
        of information processing involving both computer hardware and 
        software that deals with the storage, retrieval, sharing, and 
        use of health care information, data, and knowledge for 
        communication and decisionmaking. Such term does not include 
        certified EHR technology.
    ``(d) Special Rules.--
            ``(1) Pass-thru entities.--In the case of a partnership or 
        S corporation, this section shall be applied at the entity 
        level and at the partner or similar level.
            ``(2) Coordination with other deductions.--Any amount taken 
        into account under subsection (a) shall not be allowed as a 
        deduction under any other section of this chapter.
    ``(e) Termination.--This section shall not apply to amounts paid or 
incurred after December 31, 2018.''.
    (b) Clerical Amendment.--The table of sections for part VI of 
subchapter B of chapter 1 of such Code is amended by adding at the end 
the following new item:

``Sec. 200. Health IT placed in service by medical care provider.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2013.

SEC. 3. SMALL BUSINESS HEALTH INFORMATION TECHNOLOGY FINANCING PROGRAM.

    The Small Business Act (15 U.S.C. 631 et seq.) is amended by 
redesignating sections 45, 46, and 47 as sections 46, 47, and 48, 
respectively, and by inserting the following new section after section 
44:

``SEC. 45. LOAN GUARANTEES FOR HEALTH INFORMATION TECHNOLOGY.

    ``(a) Definitions.--As used in this section:
            ``(1) The term `health information technology' means 
        computer hardware, software, services, and related technology 
        that is purchased by an eligible professional to aid in the 
        provision of health care in a health care setting and that 
        provides for--
                    ``(A) enhancement of continuity of care for 
                patients through electronic storage, transmission, and 
                exchange of relevant personal health data and 
                information, such that this information is accessible 
                at the times and places where clinical decisions will 
                be or are likely to be made;
                    ``(B) enhancement of communication between patients 
                and health care providers;
                    ``(C) improvement of quality measurement by 
                eligible professionals enabling them to collect, store, 
                measure, and report on the processes and outcomes of 
                individual and population performance and quality of 
                care;
                    ``(D) improvement of evidence-based decision 
                support;
                    ``(E) enhancement of consumer and patient 
                empowerment; or
                    ``(F) services that assist with workflow redesign, 
                training, system configuration, human change management 
                and other similar services focused on getting the best 
                value from existing technology that has already been 
                purchased.
        Such term shall not include information technology whose sole 
        use is financial management, maintenance of inventory of basic 
        supplies, or appointment scheduling.
            ``(2) The term `eligible professional' means any of the 
        following:
                    ``(A) A physician (as defined in section 1861(r) of 
                the Social Security Act (42 U.S.C. 1395x(r))).
                    ``(B) A practitioner described in section 
                1842(b)(18)(C) of that Act.
                    ``(C) A physical or occupational therapist or a 
                qualified speech-language pathologist.
                    ``(D) A qualified audiologist (as defined in 
                section 1861(ll)(3)(B)) of that Act.
                    ``(E) A State-licensed pharmacist.
                    ``(F) A State-licensed, a State-certified, or a 
                nationally accredited home health care provider.
            ``(3) The term `qualified eligible professional' means an 
        eligible professional whose office can be classified as a small 
        business concern by the Administrator for purposes of this Act 
        under size standards established under section 3 of this Act.
    ``(b) Loan Guarantees for Qualified Eligible Professionals.--
            ``(1) In general.--Subject to paragraph (2), the 
        Administrator may guarantee up to 90 percent of the amount of a 
        loan made to a qualified eligible professional to be used for 
        the acquisition of health information technology for use in 
        such eligible professional's medical practice and for the costs 
        associated with the installation of such technology. Except as 
        otherwise provided in this section, the terms and conditions 
        that apply to loans made under section 7(a) of this Act shall 
        apply to loan guarantees made under this section.
            ``(2) Limitations on guarantee amounts.--The maximum amount 
        of loan principal guaranteed under this subsection may not 
        exceed--
                    ``(A) $250,000 with respect to any single qualified 
                eligible professional; and
                    ``(B) $500,000 with respect to a single group of 
                affiliated qualified eligible professionals.
    ``(c) Fees.--(1) The Administrator may impose a guarantee fee on 
the borrower for the purpose of reducing the cost (as defined in 
section 502(5) of the Federal Credit Reform Act of 1990) of the 
guarantee to zero in an amount not to exceed 2 percent of the total 
guaranteed portion of any loan guaranteed under this section. The 
Administrator may also impose annual servicing fees on lenders not to 
exceed 0.5 percent of the outstanding balance of the guarantees on 
lenders' books.
            ``(2) No service fees, processing fees, origination fees, 
        application fees, points, brokerage fees, bonus points, or 
        other fees may be charged to a loan applicant or recipient by a 
        lender in the case of a loan guaranteed under this section.
    ``(d) Deferral Period.--Loans guaranteed under this section shall 
carry a deferral period of not less than 1 year and not more than 3 
years. The Administrator shall have the authority to subsidize interest 
during the deferral period.
    ``(e) Effective Date.--No loan may be guaranteed under this section 
after the date that is 6 months after the date of enactment of this 
section.
    ``(f) Sunset.--No loan may be guaranteed under this section after 
the date that is 10 years after the date that is 6 months after the 
date of enactment of this section.
    ``(g) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as are necessary for the cost (as defined in 
section 502(5) of the Federal Credit Reform Act of 1990) of 
guaranteeing $25,000,000 in loans under this section. The Administrator 
shall determine such program cost separately and distinctly from other 
programs operated by the Administrator.''.

SEC. 4. CHALLENGE GRANT PROGRAM; DISRUPTIVE TECHNOLOGIES PRIZE PROGRAM.

    (a) In General.--Subtitle B of title XXX of the Public Health 
Service Act (42 U.S.C. 300jj-31 et. seq.) is amended--
            (1) by redesignating sections 3017 and 3018 as sections 
        3019 and 3020, respectively; and
            (2) by inserting after section 3016 the following new 
        sections:

``SEC. 3017. CHALLENGE GRANT PROGRAM.

    ``(a) In General.--Subject to the availability of appropriations, 
the Secretary, acting through the National Coordinator, shall award 
competitive grants to eligible entities to carry out the activities 
described in subsection (d).
    ``(b) Eligible Entity Defined.--In this section, the term `eligible 
entity' means any individual or entity, except for an entity that--
            ``(1) has 500 or more employees; and
            ``(2) has an annual revenue of $7,000,000 or more.
    ``(c) Application.--An eligible entity seeking a grant under this 
section shall submit an application to the National Coordinator at such 
time, in such manner, and containing such information as the National 
Coordinator may require, including a description of the product, 
process, or structure described in subsection (d) for which the entity 
intends to use the grant.
    ``(d) Uses of Funds.--An eligible entity that receives a grant 
under this section shall use such funds to develop an effective 
product, process, or structure that enhances the use, particularly by 
patients, of health information technology, by--
            ``(1) integrating more than one aspect of health 
        information;
            ``(2) performing a medical consultation using technology;
            ``(3) providing health information to physicians or 
        patients;
            ``(4) allowing better coordination during the delivery and 
        follow-up after the delivery of health care; or
            ``(5) addressing any of the three areas that the Commission 
        established under section 3018(e)(1) has identified pursuant to 
        its duties under section 3018(e)(2)(A).
    ``(e) Prohibited Use of Funds.--An eligible entity that receives a 
grant under this section may not use such grant to develop a product, 
process, or structure that meets only the requirements that are 
necessary to be a certified EHR technology.
    ``(f) Grant Amount.--A grant awarded under this section may not be 
greater than $75,000.
    ``(g) Report.--Not later than one year after the date of receipt of 
a grant under this section, an eligible entity shall submit to the 
National Coordinator and the Administrator of the Centers for Medicare 
& Medicaid Services a report that describes--
            ``(1) the progress that the entity has made on the product, 
        process, or structure funded by the grant; and
            ``(2) how patients, health care providers, and other 
        individuals and entities involved in the delivery of 
        healthcare, including the Centers for Medicare & Medicaid 
        Services, could use the product, process, or structure funded 
        by the grant to enhance the delivery of and reduce the cost of 
        health care.
    ``(h) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for each of fiscal 
years 2015 through 2017.

``SEC. 3018. DISRUPTIVE TECHNOLOGIES PRIZE PROGRAM.

    ``(a) Prize Program Authorized.--For purposes of rewarding 
innovation in health information technology, the Secretary, acting 
through the National Coordinator, shall carry out a program to award 
one prize competitively in each of the three areas identified by the 
Commission under subsection (e)(2)(A) using the benchmarks developed 
under subsection (e)(2)(B) to select the prize recipient in each 
category.
    ``(b) Administration of Program.--In carrying out the program under 
subsection (a), the following shall apply:
            ``(1) Advertising.--The National Coordinator shall widely 
        advertise the prize competition to encourage broad 
        participation.
            ``(2) Requirements and registration.--The National 
        Coordinator shall publish a notice in the Federal Register 
        announcing--
                    ``(A) the rules for being eligible to participate 
                in the competition;
                    ``(B) the process for participants to register for 
                the competition;
                    ``(C) the areas of health information technology 
                that the Commission develops under subsection (e)(2)(A) 
                for each prize; and
                    ``(D) the benchmarks that the Commission develops 
                under subsection (e)(2)(B) based on which a winner will 
                be selected in each such area.
    ``(c) Eligibility.--To be eligible to win a prize under this 
section, an individual or entity--
            ``(1) shall register to participate in the competition in 
        accordance with any rules promulgated by the National 
        Coordinator under subsection (b)(2);
            ``(2) in the case of an entity, shall be incorporated in 
        and maintain a primary place of business in the United States, 
        and in the case of an individual, whether participating singly 
        or in a group, shall be a citizen or permanent resident of the 
        United States; and
            ``(3) may not be a Federal entity or Federal employee 
        acting within the scope of their employment; and
            ``(4) shall submit an application that includes an 
        explanation of the anticipated market viability of the 
        technology that such individual or entity would develop with 
        funds received under the prize program.
    ``(d) Prize Amount.--
            ``(1) In general.--Subject to paragraph (2), a prize 
        awarded under this section shall be in the amount of 
        $10,000,000.
            ``(2) Alternative rule.--In the case that the amount made 
        available for prize awards under this section is less than 
        $33,000,000, the National Coordinator may reserve not more than 
        10 percent for the administrative costs of carrying out this 
        section, and shall divide the remaining amount equally for the 
        three prizes awarded under this section.
    ``(e) Commission.--
            ``(1) In general.--There is established a commission to 
        carry out the activities described in paragraph (2) (referred 
        to in this section as the `Commission').
            ``(2) Duties.--
                    ``(A) Areas of health information technology.--For 
                the purposes of the prize program under subsection (a), 
                the Commission shall identify three areas within the 
                field of health information technology that are not 
                adequately addressed by certified EHR technologies and 
                the use of such technologies. Each area identified 
                shall be an area that will promote the development of 
                technologies that would be widely useful, would help 
                decrease the cost of health care, and would improve the 
                quality of health care, particularly for patients.
                    ``(B) Benchmarks.--The Commission shall develop the 
                benchmarks that the National Coordinator shall use to 
                determine the prize recipient in each area identified 
                under subparagraph (A). The Commission shall identify 
                such benchmarks with the goals of--
                            ``(i) attracting participants from outside 
                        the health information technology field that 
                        will take new approaches to addressing the 
                        areas identified by the Commission under 
                        subparagraph (A);
                            ``(ii) solving such challenges; and
                            ``(iii) promoting the development of 
                        technologies that will be widely adopted, 
                        particularly by patients.
                    ``(C) Restriction of prize award.--The Commission 
                shall determine how to restrict the prize recipients' 
                use of the funds awarded as a prize under this section, 
                with respect to the development of health information 
                technology, in order to ensure that the prize 
                recipients use such funds to further develop the 
                technologies for which such prize was awarded.
            ``(3) Members.--
                    ``(A) Number and appointment.--The Commission shall 
                be composed of 10 members appointed by the National 
                Coordinator not later than 90 days after the date of 
                the enactment of this Act.
                    ``(B) Composition.--Each member of the Commission 
                shall be appointed to represent one of the following 
                four categories:
                            ``(i) The varied disciplines within the 
                        health information technology field.
                            ``(ii) The varied disciplines within the 
                        medical field that are not described in clause 
                        (i).
                            ``(iii) Individuals who--
                                    ``(I) represent a patient-led, 
                                patient-centered organization with a 
                                patient constituency;
                                    ``(II) have experience with health 
                                information technology and privacy; and
                                    ``(III) are trained, knowledgeable, 
                                and prepared to participate in the 
                                decisionmaking process regarding health 
                                information technology.
                            ``(iv) Officers or employees of the Federal 
                        Government.
                    ``(C) Representation of membership categories.--At 
                least two members of the Commission shall represent 
                each of the categories described in subparagraph (B).
                    ``(D) Travel expenses.--Each member shall receive 
                travel expenses, including per diem in lieu of 
                subsistence, in accordance with applicable provisions 
                under subchapter I of chapter 57 of title 5, United 
                States Code.
                    ``(E) First meeting.--The Commission shall hold its 
                first meeting not later than 180 days after the date of 
                the enactment of this Act.
            ``(4) Report to the national coordinator.--Not later than 
        one year after the date of enactment of this Act, the 
        Commission shall submit to the National Coordinator a report 
        containing the areas, benchmarks, and restrictions on the uses 
        of prize awards that the Commission identifies for the prize 
        program under paragraph (2).
            ``(5) Termination.--The Commission shall terminate upon 
        submitting its report to the National Coordinator under 
        paragraph (4).
    ``(f) Authorization of Appropriations.--In addition to sums 
authorized to be appropriated to carry out this subtitle under section 
3020, there is authorized to be appropriated to carry out this section 
$33,000,000 for fiscal year 2015.''.
    (b) Conforming Amendments.--
            (1) Section 3011 of such Act (42 U.S.C. 300jj-31) is 
        amended--
                    (A) in subsection (a), by striking ``section 3018'' 
                and inserting ``section 3020''; and
                    (B) in subsection (c), by striking ``section 3018'' 
                and inserting ``section 3020''.
            (2) Section 3020 of such Act (as so redesignated) is 
        amended by inserting ``except for section 3018,'' after ``For 
        purposes of carrying out this subtitle,''.

SEC. 5. ESTABLISHMENT OF THE OFFICE OF WIRELESS HEALTH TECHNOLOGY.

    Chapter X of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
391 et seq.) is amended by adding at the end the following new section:

``SEC. 1013. OFFICE OF WIRELESS HEALTH TECHNOLOGY.

    ``(a) Establishment.--There is established within the Office of the 
Commissioner an office to be known as the Office of Wireless Health 
Technology (referred to in this section as the `Office'), which shall 
be headed by a director.
    ``(b) Appointment of First Director.--The first Director of the 
Office shall be appointed by the Commissioner not later than 90 days 
after the date of enactment of this section.
    ``(c) Duties.--The Director of the Office shall--
            ``(1) through public meetings and other forms of 
        communication with individuals and entities that design, 
        produce, disseminate, or have a prevailing interest in wireless 
        health technology, receive and analyze recommendations with 
        respect to ways that existing regulations regarding wireless 
        health technology might be made more reasonable and 
        predictable, including ways that such regulations could be 
        clarified and simplified;
            ``(2) coordinate with Federal agencies, offices, 
        institutes, and centers involved in the regulation of wireless 
        health technology, including the Federal Communications 
        Commission, the Office of the National Coordinator for Health 
        Information Technology, the Centers for Medicare & Medicaid 
        Services, the Agency for Healthcare Research and Quality, the 
        National Institute of Standards and Technology, the Health 
        Resources and Services Administration, and the National 
        Institutes of Health, regarding activities of such agencies, 
        offices, institutes, and centers that can be improved so as to 
        make such regulation more robust, predictable, and easily 
        understood and navigated by individuals and entities that 
        design, produce, disseminate, or have a prevailing interest in 
        wireless health technology;
            ``(3) provide information to individuals and entities that 
        design, produce, disseminate, or have a prevailing interest in 
        wireless health technology on how to design, produce, or 
        disseminate wireless health technology in accordance with 
        existing law; and
            ``(4) publish and make available on the public Internet Web 
        site of the Food and Drug Administration in a searchable format 
        an annual report that--
                    ``(A) explains how the Food and Drug Administration 
                implemented regulations regarding wireless health 
                technology during the prior year;
                    ``(B) analyzes the effectiveness of--
                            ``(i) such regulations; and
                            ``(ii) other wireless health-related 
                        efforts by the Food and Drug Administration; 
                        and
                    ``(C) provides specific recommendations on how the 
                Food and Drug Administration should improve its 
                practices with regard to wireless health technology (in 
                a manner that ensures consistency within the Food and 
                Drug Administration regarding the application of its 
                regulatory approach without compromising patient safety 
                or privacy) in order to--
                            ``(i) remove barriers to innovations in 
                        such technology; and
                            ``(ii) align such practices with the 
                        practices of other Federal agencies.
    ``(d) Consultation With Working Groups and Commissions.--In 
carrying out the duties specified in subsection (c), the Director of 
the Office may consult with any working groups or commissions, 
including any working group or commission convened for a purpose 
related to the regulation of wireless health technology.
    ``(e) Definition of Wireless Health Technology.--For purposes of 
this section, the term `wireless health technology' has such meaning as 
specified by the Commissioner pursuant to regulation, but in no case 
shall include technology this is not regulated under the provisions of 
this Act (other than this section).
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $1,000,000 for each of fiscal 
years 2015 through 2019.''.

SEC. 6. MOBILE HEALTH SOFTWARE APPLICATION TECHNOLOGY RESPONSIBILITIES 
              OF THE HEALTH INFORMATION TECHNOLOGY RESEARCH CENTER.

    Section 3012 of the Public Health Service Act (42 U.S.C. 300jj-32) 
is amended--
            (1) in subsection (b), by adding at the end the following 
        new paragraph:
            ``(4) Encouragement of design, production, and 
        dissemination of mobile health software application 
        technology.--
                    ``(A) In general.--In addition to the purposes 
                under paragraph (3), the Center shall--
                            ``(i) establish an educational Web site 
                        repository and a response mechanism (such as a 
                        national telephone number) to provide timely 
                        responses to questions in order to make 
                        information available and provide direct 
                        support to individuals and entities that 
                        design, produce, disseminate, or have a 
                        prevailing interest in mobile health software 
                        application technology regarding the actions 
                        such individuals and entities must take in 
                        order to ensure that such technology is 
                        designed, produced, and disseminated in 
                        accordance with Federal law; and
                            ``(ii) publish and make available on the 
                        public Internet Web site of the Department in a 
                        searchable format an annual report that--
                                    ``(I) highlights and explains the 
                                laws and regulations that commonly 
                                impede efforts by individuals and 
                                entities to design, produce, or 
                                disseminate mobile health software 
                                application technology; and
                                    ``(II) discusses the work the 
                                Center has completed in the past year 
                                with regard to mobile health software 
                                application technology, including 
                                accomplishments by the Center and 
                                challenges that may require more work 
                                or outside support in order for the 
                                Center to accomplish the objectives 
                                outlined in this subparagraph.
                    ``(B) Definition of mobile health software 
                application technology.--For purposes of subparagraph 
                (A), the term `mobile health software application 
                technology' means a software program that--
                            ``(i) offers health-related services and 
                        runs on a mobile device; or
                            ``(ii) enables health-related services 
                        through other portals associated with the use 
                        of a mobile device.
                    ``(C) Authorization of appropriations.--There is 
                authorized to be appropriated to carry out this 
                paragraph $500,000 for each of fiscal years 2015 
                through 2019.''; and
            (2) in subsection (c)(8), by deleting ``paragraph (3)'' and 
        inserting ``paragraphs (3) and (4)''.

SEC. 7. WORKFORCE RETRAINING GRANTS.

    (a) In General.--The National Coordinator for Health Information 
Technology may award to eligible entities grants to be used for 
training health care workers in health information technology (in this 
section referred to as ``HIT'').
    (b) Period of Grant.--The period of a grant under this section 
shall be 24 months.
    (c) Eligible Entities.--In this section, ``eligible entities'' 
means entities that provide clinical health care services to 
individuals within the United States.
    (d) Job Transition.--As a condition on receipt of a grant under 
this section, a grantee shall ensure that each employee whose HIT 
training is funded by that grant assumes expanded duties with the 
grantee, either in the form of a new employment position or revised 
duties within such employee's existing employment position, that 
requires the use of HIT, not more than 1 year after the employee 
completes the training.
    (e) Reporting.--Each grantee shall submit a report not later than 
24 months after receipt of a grant to the National Coordinator for 
Health Information Technology including the following:
            (1) The number of employees who received training pursuant 
        to the grant.
            (2) The HIT skills covered during such training or 
        trainings.
            (3) Documentation that each trained employee commenced or 
        will commence work in a new position that satisfies the 
        condition set forth in subsection (d).
    (f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2015 through 2019.
                                 <all>
```