I 

109TH CONGRESS 

2D SESSION H. R. 4859 

To amend chapter 89 of title 5, United States Code, to provide for the 

implementation of a system of electronic health records under the Federal 

Employees Health Benefits Program. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 2, 2006 

Mr. PORTER (for himself and Mr. CLAY) introduced the following bill; which 

was referred to the Committee on Government Reform 

A BILL 

To amend chapter 89 of title 5, United States Code, to 

provide for the implementation of a system of electronic 

health records under the Federal Employees Health Benefits Program. 

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 ‘‘Federal Family Health 

5 Information Technology Act of 2006’’. 


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1 SEC. 2. ELECTRONIC HEALTH RECORDS. 

2 (a) IN GENERAL.—Chapter 89 of title 5, United 

3 States Code, is amended by inserting after section 8902a 

4 the following: 

5 ‘‘§ 8902b. Electronic health records 

6 ‘‘(a) This section provides for the establishment, in 

7 connection with the program established under this chap8 ter, of electronic health records for each covered indi9 vidual, including— 

10 ‘‘(1) requiring the establishment of a carrier 

11 electronic health record under subsection (b); 

12 ‘‘(2) requiring the offering by carriers to cov13 ered individuals of a personal electronic health 

14 record under subsection (c); and 

15 ‘‘(3) providing carrier-based incentives for es16 tablishing provider-based electronic health records 

17 under subsection (d). 

18 ‘‘(b)(1) Each contract under this chapter shall re19 quire that the carrier establish, maintain, and make avail20 able, in accordance with standards adopted by the Office 

21 of Personnel Management under this section, a carrier 

22 electronic health record for each covered individual who 

23 is enrolled under this chapter in a health benefits plan 

24 offered by the carrier. 

25 ‘‘(2)(A) A carrier electronic health record for a cov26 ered individual under this subsection shall consist of a carVerDate Aug 31 2005 20:04 Mar 04, 2006 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4859.IH H4859

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1 rier’s health information on the individual’s health care 

2 claims, health care services data, or both, such as informa3 tion describing the individual’s inpatient facility admis4 sions, emergency room visits, and claims for prescription 

5 drugs. Such a record shall include, to the maximum extent 

6 practicable, such information as it relates to claims or 

7 services for another carrier in which the covered individual 

8 was previously enrolled under this title. 

9 ‘‘(B) The information under subparagraph (A) shall 

10 cover the period beginning on the later of January 1, 

11 2008, or the date of the covered individual’s enrollment 

12 with the carrier under this title. Such period is not re13 quired to be longer than the period specified in standards 

14 adopted by the Office of Personnel Management under 

15 this section. 

16 ‘‘(C) In the case of a covered individual who changes 

17 enrollment under this title after the effective date specified 

18 in paragraph (4) from one carrier to another carrier, the 

19 first carrier shall transfer information from the carrier 

20 electronic health record under this subsection to the sec21 ond carrier to the extent specified by the Office of Per22 sonnel Management by not later than 90 days after the 

23 date the first carrier receives notice of the change in en24 rollment. 


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1 ‘‘(3) Information from a carrier electronic health 

2 record for a covered individual shall be made available to 

3 the individual and shall be made available (in accordance 

4 with the regulations promulgated pursuant to section 

5 264(c) of the Health Insurance Portability and Account6 ability Act of 1996) to a health care provider treating the 

7 individual. A carrier shall make such information avail8 able, in accordance with standards adopted under this sec9 tion— 

10 ‘‘(A) promptly; 

11 ‘‘(B) over a secure internet or other electronic12 based connection; 

13 ‘‘(C) in a format useful for diagnosis and treat14 ment; and 

15 ‘‘(D) in a format that permits its importation 

16 into a personal electronic health record under sub17 section (c). 

18 ‘‘(4) The previous provisions of this subsection shall 

19 apply with respect to contracts for contract years begin20 ning with— 

21 ‘‘(A) the 3rd contract year (or 4th contract 

22 year, if the Office of Personnel Management deter23 mines that carriers are not prepared to implement 

24 the previous provisions of this subsection by such 


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1 3rd contract year) beginning after the date of the 

2 enactment of this section; or 

3 ‘‘(B) such earlier contract year as the Office of 

4 Personnel Management may determine. 

5 ‘‘(c)(1) Each contract under this chapter shall re6 quire the carrier in accordance with standards adopted 

7 under this section— 

8 ‘‘(A) to provide, upon the request of a covered 

9 individual, for the establishment and maintenance of 

10 a personal electronic health record for the individual; 

11 ‘‘(B) to establish a method for the individual to 

12 access the individual’s personal electronic health 

13 record through a mechanism that is integrated with 

14 access to the carrier electronic health record for the 

15 individual under subsection (b); and 

16 ‘‘(C) to establish a method for the individual to 

17 transfer the individual’s personal electronic health 

18 record to the individual (or to a carrier or other en19 tity designated by the individual) upon the request 

20 of the individual at any time, including at the time 

21 of disenrollment of the individual. 

22 ‘‘(2) A personal electronic health record for a covered 

23 individual shall consist of such personal health informa24 tion, such as family health history, symptoms, use of over25 the-counter medication, diet, exercise, and other relevant 


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1 health information and activities, as the individual may 

2 provide. Such record may also include information from 

3 a provider-based electronic health record referred to in 

4 subsection (d) as well as from a carrier electronic health 

5 record. 

6 ‘‘(3) Each contract under this chapter shall require 

7 the carrier to enable health information to be imported 

8 in standard electronic format into a personal electronic 

9 health record from a provider-based electronic health 

10 record and from a carrier electronic health record con11 sistent with standards adopted by the Office. 

12 ‘‘(4) Nothing in this subsection shall be construed as 

13 authorizing the carrier or another person, other than a 

14 covered individual, to access a personal electronic health 

15 record of the individual without the authorization of the 

16 individual. 

17 ‘‘(5) The previous provisions of this subsection shall 

18 apply with respect to contracts for contract years begin19 ning with the contract year beginning after the first con20 tract year with respect to which the requirements of sub21 section (b) are in effect under subsection (b)(4). 

22 ‘‘(d)(1) Each contract under this chapter shall re23 quire the carrier to provide, in accordance with standards 

24 adopted by the Office under this section, incentives (sub25 ject to the availability of amounts from the Federal FamVerDate Aug 31 2005 20:04 Mar 04, 2006 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H4859.IH H4859

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1 ily Health Information Technology Trust Fund, as estab2 lished by section 4 of the Federal Family Health Informa3 tion Technology Act of 2006) for providers to implement 

4 a comprehensive system of provider-based electronic 

5 health records for all patients covered by the contract. 

6 ‘‘(2) The previous provisions of this subsection shall 

7 be effective with respect to contract years beginning with 

8 such contract year as the Office of Personnel Management 

9 shall determine. 

10 ‘‘(e) Beginning with the contract year beginning after 

11 the first contract year with respect to which the require12 ments of subsection (b) are in effect, each carrier shall 

13 report to the Office of Personnel Management its progress 

14 and plan for enabling each covered individual, upon re15 quest, to store and access, through a portable, electronic 

16 medium, the individual’s personal electronic health record 

17 established under subsection (c), as well as the carrier 

18 electronic health record for the individual (established 

19 under subsection (b)) and provider-based electronic health 

20 records relating to the individual referred to in subsection 

21 (d). Such plan shall provide a means for such storage and 

22 access through such a portable medium beginning with the 

23 5th contract year after the first contract year with respect 

24 to which the requirements of subsection (b) are in effect. 


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1 ‘‘(f)(1) Standards adopted under this section regard2 ing carrier, personal, and provider-based electronic health 

3 records shall be consistent with any standards for inter4 operability of electronic health records developed by 

5 ONCHIT. 

6 ‘‘(2) In addition to paragraph (1), the Office of Per7 sonnel Management shall consult with ONCHIT in the im8 plementation of this section, including the establishment 

9 of effective dates under subsections (b)(4)(B) and (d)(2). 

10 ‘‘(3) For purposes of this subsection, the term 

11 ‘ONCHIT’ means the Office of the National Coordinator 

12 for Health Information Technology in the Department of 

13 Health and Human Services, and includes any successor 

14 to the functions performed by such Office. 

15 ‘‘(g)(1) The Office of Personnel Management may 

16 waive any or all of the requirements of this section for 

17 a carrier described in paragraph (2) insofar as the carrier 

18 has established an electronic health record system that 

19 substantially meets the purpose of each such requirement 

20 that is waived. 

21 ‘‘(2) A carrier described in this paragraph is a carrier 

22 that— 

23 ‘‘(A) is an integrated health care system that 

24 combines the functions of a health plan, hospitals, 

25 pharmacy, laboratories, and clinicians; and 


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1 ‘‘(B) has developed and is implementing, as of 

2 the date of the enactment of this section, a provider3 based comprehensive electronic medical record for 

4 each member of the health plan. 

5 ‘‘(h) For purposes of this section, the term ‘covered 

6 individual’ has the meaning given such term by section 

7 8902a(a)(1)(B).’’. 

8 (b) CONFORMING AMENDMENTS.—(1) Section 8902 

9 of title 5, United States Code, is amended by adding at 

10 the end the following: 

11 ‘‘(p) A contract may not be made which is not in con12 formance with the requirements of section 8902b, except 

13 that the Office of Personnel Management may phase in 

14 or waive conformance with some or all of such require15 ments during the first two contract years in which a car16 rier has a contract under this title.’’. 

17 (2) The table of sections for chapter 89 of such title 

18 is amended by inserting after the item relating to section 

19 8902a the following: 

‘‘8902b. Electronic health records.’’. 

20 SEC. 3. PROVISION REGARDING RATES. 

21 During the period ending with the contract year fol22 lowing the first contract year with respect to which the 

23 requirements of subsection (b) of section 8902b of title 

24 5, United States Code, as inserted by section 2(a), are 

25 in effect, in determining rates under section 8902(i) of 


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1 such title, the Office of Personnel Management shall not 

2 take into account any carrier administrative costs, mone3 tary savings, or return on investment resulting from im4 plementation of carrier and personal electronic health 

5 records required under subsections (b) and (c) of such sec6 tion 8902b, except that the Office shall have access to the 

7 unused portion of contributions set aside in the Employees 

8 Health Benefits Fund under section 8909(b)(1) of such 

9 title without fiscal year limitation for such use as the Of10 fice considers necessary to assist carriers in complying 

11 with such subsections. 

12 SEC. 4. FEDERAL FAMILY HEALTH INFORMATION TECH13 NOLOGY TRUST FUND. 

14 (a) IN GENERAL.—The Office of Personnel Manage15 ment shall establish the Federal Family Health Informa16 tion Technology Trust Fund (in this section referred to 

17 as the ‘‘Trust Fund’’) for the purpose of receiving dona18 tions to be used to award grants to carriers who meet cer19 tain requirements as set forth by the Office. 

20 (b) ACCEPTANCE OF DONATIONS.—In accordance 

21 with the section, the Office may accept donations made 

22 to the Trust Fund. Donations made to the Trust Fund, 

23 and grants awarded from such Fund to carriers, shall not 

24 be considered to be the solicitation or payment of remu25 neration of any kind, nor shall receipt of such grants be 


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1 considered an inducement to refer, purchase, order, or 

2 lease any good, facility, item, or service. 

3 (c) DEPOSIT OF AMOUNTS RECEIVED.—Funds re4 ceived by the Office under this section shall be transmitted 

5 by the Office to the Trust Fund. 

6 (d) FUNDS TO BE USED FOR CARRIER GRANTS.— 

7 The Office shall award grants from the Trust Fund to 

8 carriers under chapter 89 of title 5, United States Code, 

9 to be distributed under section 8902b(d) of such title as 

10 incentives to their contracting health care providers for 

11 implementing provider-based electronic health records 

12 based on requirements and qualifications set forth by the 

13 Office and standards adopted under section 8902b(f) of 

14 such title. 

15 SEC. 5. IMPLEMENTATION. 

16 The Office of Personnel Management shall provide 

17 for the implementation of this Act through appropriate ad18 ministrative guidance, which may be by regulation, by car19 rier letter, or otherwise. 

20 SEC. 6. HIPAA COMPLIANCE. 

21 Nothing in this Act shall be construed as affecting 

22 the application or compliance with regulations promul23 gated pursuant to section 264(c) of the Health Insurance 


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1 Portability and Accountability Act of 1996 (relating to ac2 cess to and disclosure of health information). 

Æ 


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