I 

109TH CONGRESS 

2D SESSION H. R. 5559 

To improve the exchange of health information by encouraging the creation, 

use, and maintenance of lifetime electronic health records in independent 

health record banks, by using such records to build a nationwide health 

information technology infrastructure, and by promoting participation 

in health information exchanges by consumers through tax incentives. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 8, 2006 

Mr. RYAN of Wisconsin (for himself, Mr. SESSIONS, Mr. MOORE of Kansas, 

and Mr. HERGER) introduced the following bill; which was referred to the 

Committee on Energy and Commerce, and in addition to the Committee 

on Ways and Means, 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 improve the exchange of health information by encouraging the creation, use, and maintenance of lifetime electronic health records in independent health record banks, 

by using such records to build a nationwide health information technology infrastructure, and by promoting participation in health information exchanges by consumers 

through tax incentives. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Independent Health 

3 Record Bank Act of 2006’’. 

4 SEC. 2. PURPOSE. 

5 It is the purpose of this Act to provide for the estab6 lishment of a nationwide health information technology 

7 network that— 

8 (1) improves health care quality, reduces med9 ical errors, increases the efficiency of care, and ad10 vances the delivery of appropriate, evidence-based 

11 health care services; 

12 (2) promotes wellness, disease prevention, and 

13 the management of chronic illnesses by increasing 

14 the availability and transparency of information re15 lated to the health care needs of an individual; 

16 (3) ensures that appropriate information nec17 essary to make medical decisions is available in a us18 able form at the time and in the location that the 

19 medical service involved is provided; 

20 (4) produces greater value for health care ex21 penditures by reducing health care costs that result 

22 from inefficiency, medical errors, inappropriate care, 

23 and incomplete information; 

24 (5) promotes a more effective marketplace, 

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1 creased choice, enhanced quality, and improved out2 comes in health care services; 

3 (6) improves the coordination of information 

4 and the provision of such services through an effec5 tive infrastructure for the secure and authorized ex6 change and use of health information; and 

7 (7) ensures that the confidentiality of individ8 ually identifiable health information of a patient is 

9 secure and protected. 

10 SEC. 3. DEFINITIONS. 

11 In this Act: 

12 (1) ACCOUNT.—The term ‘‘account’’ means an 

13 electronic health record of an individual contained in 

14 an independent health record bank. 

15 (2) ELECTRONIC HEALTH RECORD.—The term 

16 ‘‘electronic health record’’ means a longitudinal col17 lection of personal health information concerning a 

18 single individual, entered or accepted by health care 

19 providers, and stored electronically. 

20 (3) HEALTH CARE ENTITY.—The term ‘‘health 

21 care entity’’ includes health care consumers, health 

22 care providers, and health care payers, government 

23 agencies, pharmaceutical companies, laboratories, 

24 and health care research institutes. 


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1 (4) HIPAA REGULATIONS.—The term ‘‘HIPAA 

2 regulations’’ means the regulations promulgated 

3 under section 264(c) of the Health Insurance Port4 ability and Accountability Act of 1996 (42 U.S.C. 

5 1320d-2 note). 

6 (5) INDIVIDUALLY IDENTIFIABLE HEALTH IN7 FORMATION.—The term ‘‘individually identifiable 

8 health information’’ has the meaning given such 

9 term in section 1171(6) of the Social Security Act 

10 (42 U.S.C. 1320d(6)). 

11 (6) NONIDENTIFIABLE HEALTH INFORMA12 TION.—The term ‘‘nonidentifiable health informa13 tion’’ means any list, description, or other grouping 

14 of consumer information (including publicly available 

15 information pertaining to them) that is derived with16 out using personally identifiable information that is 

17 not publicly available. 

18 (7) PARTIALLY IDENTIFIABLE HEALTH INFOR19 MATION.—The term ‘‘partially identifiable health in20 formation’’ means any list, description, or other 

21 grouping of consumer information (including pub22 licly available information pertaining to them) that 

23 is derived using any personally identifiable informa24 tion that is not publicly available. 


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1 (8) PROTECTED HEALTH INFORMATION.—The 

2 term ‘‘protected health information’’ shall have the 

3 meaning given such term for purposes of HIPAA 

4 regulations. 

5 (9) BOARD OF GOVERNORS.—The term ‘‘Board 

6 of Governors’’ means the Board of Governors of the 

7 Federal Reserve System. 

8 SEC. 4. INDEPENDENT HEALTH RECORD BANKS. 

9 (a) PURPOSE.—It is the purpose of this section to 

10 provide for the establishment of independent health record 

11 banks to achieve financial savings in the health care sys12 tem and improvements in the provision of health care 

13 through— 

14 (1) the creation and storage of lifetime indi15 vidual electronic health records for individuals that 

16 may contain health plan and debit card functionality 

17 and that serves the interests of all health care enti18 ties; 

19 (2) the utilization of a technological infrastruc20 ture with the goal of connecting health records to 

21 build a national health information network; 

22 (3) the provision of health information data 

23 sets, within distinct authorization boundaries, based 

24 on usage needs, including— 


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1 (A) the sale of approved data for research 

2 and other consumer purposes as provided for 

3 under section 6(b); 

4 (B) the provision of data for emergency 

5 health care as provided for under section 6(c); 

6 and 

7 (C) the provision of data for all other 

8 health care needs determined appropriate by 

9 the Board of Governors (in accordance with the 

10 protections provided for under section 6); 

11 (4) the offering of incentives to employers that 

12 face rising employee health costs, to encourage em13 ployee participation in independent health record 

14 banks; and 

15 (5) the creation of a source of tax-free income 

16 to support the operations of the independent health 

17 record banks, and, through revenue sharing, to pro18 vide incentives to independent health record bank ac19 count holders, health care providers, and fee payers 

20 to contribute health information. 

21 (b) ESTABLISHMENT.— 

22 (1) IN GENERAL.—Not later than one year 

23 after the date of the enactment of this Act, the 

24 Board of Governors shall prescribe standards for the 

25 establishment and certification of independent health 


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1 record banks to carry out the purpose described in 

2 subsection (a). 

3 (2) REQUIREMENT OF NON-PROFIT ENTITY.— 

4 Under the standards under paragraph (1), a non5 profit entity may establish an independent health 

6 record bank as a cooperative entity that operates for 

7 the benefit and in the interests of the membership 

8 of the bank as a whole. Such bank shall be owned 

9 and controlled by its members. 

10 (3) FOR-PROFIT ENTITIES.—Under the stand11 ards under paragraph (1), a for-profit entity may 

12 not participate in the establishment and operation of 

13 an independent health record bank, except to the ex14 tent that such entity is by contract employed to as15 sist in carrying out the operations of the bank. 

16 (4) TREATMENT AS COVERED ENTITY FOR PUR17 POSES OF HIPAA REGULATIONS.—To the extent that 

18 an independent health record bank (or associated 

19 vendor) is engaged in receiving or transmitting pro20 tected health information, the bank shall be consid21 ered to be a HIPAA covered entity for purposes of 

22 HIPAA regulations with respect to such informa23 tion. 

24 (c) MEMBERSHIP.— 


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1 (1) IN GENERAL.—To be eligible to be a mem2 ber of an independent health record bank, an indi3 vidual shall obtain or have obtained a product or 

4 service from a covered entity that is to be used pri5 marily for personal, family, or household purposes, 

6 or that individual’s legal representative. 

7 (2) NO LIMITATION ON MEMBERSHIP.—Nothing 

8 in this subsection shall be construed to permit an 

9 independent health record bank to restrict member10 ship. 

11 (d) RIGHTS RELATING TO INFORMATION IN THE

12 BANK.— 

13 (1) INDIVIDUAL CONSUMERS.— 

14 (A) GENERAL RIGHT.—An individual who 

15 has a health record contained in an independent 

16 health record bank shall maintain ownership 

17 over the entire health record and shall have the 

18 right to review the contents of the entire record 

19 at any time during the normal business oper20 ating hours of the bank. 

21 (B) ADDITIONAL INFORMATION AND LIMI22 TATION.—An individual described in subpara23 graph (A) may add personal health information 

24 to the health record of that individual, except 

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1 tion and shall not alter information that is en2 tered into the health record by a health care en3 tity. Such an individual shall have the right to 

4 propose an amendment to information that is 

5 entered by a health care entity pursuant to 

6 standards prescribed by the Board of Governors 

7 for purposes of correcting such information. 

8 (2) OTHER HEALTH CARE ENTITIES.—A health 

9 care entity (other than the individual who maintains 

10 ownership over the health record involved) shall 

11 serve as the custodian of only information that has 

12 been added by such entity to the health record. Such 

13 entity may be permitted to have access to other 

14 specified information contained in such health record 

15 (including the entire record if appropriate) if such 

16 access is granted by the independent health record 

17 bank and the individual involved (pursuant to stand18 ards prescribed by the Secretary relating to access 

19 to information). 

20 (e) FINANCING OF ACTIVITIES.— 

21 (1) IN GENERAL.—An independent health 

22 record bank may generate revenue to pay for the op23 erations of the bank through— 


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1 (A) charging health care entities, including 

2 individual account holders, account fees for use 

3 of the bank; 

4 (B) the sale of nonidentifiable and par5 tially identifiable health information contained 

6 in the bank for research purposes (as provided 

7 for in section 6(b)); and 

8 (C) the conduct of any other activities de9 termined appropriate by the Board of Gov10 ernors. 

11 (2) SHARING OF REVENUE.—Revenue derived 

12 under paragraph (1)(B) shall be shared with inde13 pendent health record bank account holders, and 

14 may be shared with health care providers and pay15 ers, in accordance with this Act. 

16 (3) TREATMENT OF INCOME.—For purposes of 

17 the Internal Revenue Code of 1986, any revenue de18 scribed in this subsection shall not be included in 

19 gross income of any independent health record bank, 

20 independent health record bank account holder, 

21 health care provider, or payer described in this sub22 section. 

23 SEC. 5. HEALTH CARE CLEARINGHOUSE ACTIVITIES. 

24 (a) APPLICATION OF SECTION.—This section shall 

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1 ated vendors) with respect to activities undertaken by such 

2 bank in operating as a health care clearinghouse (as such 

3 term is defined in section 1171(2) of the Social Security 

4 Act (42 U.S.C. 1329d(2)). 

5 (b) ACCREDITATION.— 

6 (1) IN GENERAL.—To be eligible to carry out 

7 clearinghouse activities under this section, an inde8 pendent health record bank (and associated vendors 

9 performing clearinghouse functions) shall be accred10 ited by a national standards development organiza11 tion, utilizing the criteria described in paragraph 

12 (2), that is properly authenticated and registered 

13 with the Attorney General and the Federal Trade 

14 Commission pursuant to the provisions of the Na15 tional Cooperation Research and Production Act of 

16 1993 (15 U.S.C. 4301 et seq.). 

17 (2) CRITERIA.—The criteria to be used by a na18 tional standards development organization in the ac19 creditation of an independent health record bank 

20 under this section shall be designed to measure the 

21 competency, assets, practices, and procedures of the 

22 bank for purposes of conducting clearinghouse ac23 tivities. Such criteria shall include— 

24 (A) the technical capacity and electronic 

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1 mission, and handling of electronic health infor2 mation transactions; 

3 (B) the ability of the bank to process 

4 transactions to which HIPAA regulations apply; 

5 (C) the backup and disaster recovery plans 

6 and capacity of the bank; 

7 (D) the privacy practices, procedures, and 

8 employee training programs of the bank con9 sistent with HIPAA regulations; and 

10 (E) the security practices, procedures, and 

11 employee training programs of the bank con12 sistent with HIPAA regulations, including com13 pliance with the HIPAA regulations security 

14 rule that protected health information must 

15 only be viewable by the intended recipient. 

16 (3) EXISTING CLEARINGHOUSES.—An inde17 pendent health record bank operated by an entity 

18 that has been certified under part C of title XI of 

19 the Social Security Act (42 U.S.C. 1320d et seq.) as 

20 a health care clearinghouse before the date of the 

21 enactment of this Act shall be considered to be ac22 credited for purposes of paragraph (1). 

23 (c) INFORMATION REQUIREMENT.—An independent 

24 health record bank acting as a health care clearinghouse 

25 under this section shall ensure that reporting services are 


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1 provided to individual consumers in a manner that in2 cludes the provision of lists of individuals or organizations 

3 that have accessed the health record account of the con4 sumer or to whom health information disclosures con5 cerning the consumer have been made in accordance with 

6 the requirements of HIPAA regulations. 

7 SEC. 6. AVAILABILITY AND USE OF HEALTH INFORMATION 

8 IN BANK. 

9 (a) GENERAL RULE.—Except as provided in this sec10 tion, access to an individual’s electronic health record (or 

11 specified parts of such electronic health record) main12 tained by an independent health record bank shall only 

13 be provided with the prior authorization of the individual 

14 involved, as authenticated as provided for under the stand15 ards prescribed by the Board of Governors under section 

16 8. 

17 (b) AVAILABILITY OF DATA FOR RESEARCH AND

18 OTHER ACTIVITIES.—An independent health record bank 

19 may sell nonidentifiable and partially identifiable health 

20 information, with respect to an individual, only if— 

21 (1) the bank and the individual agree to the 

22 sale; 

23 (2) the agreement provided for under para24 graph (1) includes parameters for the disclosure of 

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1 tion of the further disclosure of partially identifiable 

2 health information; 

3 (3) the data involved are to be used for re4 search or other activities only as provided for in the 

5 agreement under paragraph (1); 

6 (4) the data involved do not identify the indi7 vidual who is the subject of the data; 

8 (5) the revenue to be derived from the sale of 

9 the data is collected by the bank and equally divided 

10 between the bank and the individual involved, except 

11 that revenue may also be distributed to health care 

12 providers and payers as incentives to contribute ad13 ditional data to the bank; and 

14 (6) the transaction otherwise meets the require15 ments and standards prescribed by the Board of 

16 Governors. 

17 (c) AVAILABILITY OF DATA FOR EMERGENCY

18 HEALTH CARE.— 

19 (1) FINDINGS.—Congress finds that— 

20 (A) given the size and nature of visits to 

21 emergency departments in the United States, 

22 readily available health information could make 

23 the difference between life and death; and 

24 (B) because of the case mix and volume of 

25 patients treated in emergency departments, 


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1 such departments are well positioned to provide 

2 information for public health surveillance, com3 munity risk assessment, research, education, 

4 training, quality improvement, and other uses. 

5 (2) USE OF DATA.—An independent health 

6 record bank may permit health care providers to ac7 cess, during an emergency department visit, a lim8 ited, authenticated information set concerning an in9 dividual for emergency response purposes without 

10 the prior consent of the individual. Such limited in11 formation may include— 

12 (A) patient identification information, as 

13 determined appropriate by the individual in14 volved; 

15 (B) provider identification that includes 

16 the use of unique provider identifiers as pro17 vided for in section 1173 of the Social Security 

18 Act (42 U.S.C. 1320d–2); 

19 (C) payment information; 

20 (D) arrival and first assessment data; 

21 (E) information related to existing chronic 

22 problems and active clinical conditions of the 

23 individual; 

24 (F) information related to the individual’s 

25 vitals, allergies, and medication history; and 


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1 (G) information concerning physical exami2 nations, procedures, results, and diagnosis in3 formation relating to the visit. 

4 SEC. 7. ENSURING PRIVACY AND SECURITY. 

5 (a) IN GENERAL.—Current Federal security and con6 fidentiality standards and State security amd confiden7 tiality laws shall apply to this Act (and the amendments 

8 made by this Act) until such time as Congress acts to 

9 amend such standards. 

10 (b) APPLICATION OF HIPAA REGULATIONS AND

11 TRANSACTIONAL STANDARDS.—Nothing in this Act (or 

12 the amendments made by this Act) shall be construed to 

13 narrow the scope, substance, or applicability of part C of 

14 title XI of the Social Security Act (42 U.S.C. 1320d et 

15 seq.), or HIPAA regulations, as such provisions or regula16 tions relate to individually identifiable health information 

17 maintained in an independent health record bank. 

18 (c) TREATMENT OF STATE LAWS.—Nothing in this 

19 Act (or the amendments made by this Act) shall be con20 strued as preempting or otherwise affecting any provision 

21 of State law (or any State regulation) relating to the pri22 vacy and confidentiality of individually identifiable health 

23 information or to the security of such information, to the 

24 extent that such provision (or regulation)— 


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1 (1) provides at least as much protection as oth2 erwise provided under this Act and under HIPAA 

3 regulations; and 

4 (2) does not prohibit or restrict the exchange of 

5 health information across State borders. 

6 (d) STATE DEFINED.—For purposes of this section, 

7 the term ‘‘State’’ has the meaning given such term when 

8 used in title XI of the Social Security Act, as provided 

9 under section 1101(a) of such Act (42 U.S.C. 1301(a)). 

10 SEC. 8. REGULATORY OVERSIGHT. 

11 (a) IN GENERAL.—In carrying out this Act, the 

12 Board of Governors, acting through the Under Secretary 

13 for Technology or other appropriate official, shall— 

14 (1) develop a program to certify entities to op15 erate independent health record banks; 

16 (2) provide assistance to encourage the growth 

17 of independent health record banks; 

18 (3) track economic progress as it pertains to 

19 independent health record bank operators and indi20 viduals receiving non-taxable income with respect to 

21 accounts; 

22 (4) conduct public education activities regarding 

23 the creation and use of the independent health 

24 record banks; 


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1 (5) establish an interagency council under sub2 section (b) to develop standards for Federal security 

3 auditing for entities operating independent health 

4 record banks; and 

5 (6) carry out any other activities determined 

6 appropriate by the Board of Governors. 

7 (b) INTERAGENCY COUNCIL FOR SECURITY AUDIT8 ING.— 

9 (1) IN GENERAL.—The Board of Governors, in 

10 consultation with the Secretary of Health and 

11 Human Services and other appropriate Federal offi12 cials, shall establish an interagency council to de13 velop standards for Federal security auditing as it 

14 relates to data security, authentication, and author15 ization recommendations, and reviews of inde16 pendent health record banks. 

17 (2) DUTIES.—The interagency council estab18 lished under paragraph (1) shall take into consider19 ation the following factors when developing rec20 ommendations for security, authentication, and au21 thorization of information in independent health 

22 record banks: 

23 (A) The number and type of factors used 

24 for the exchange of protected health informa25 tion. 


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1 (B) The requirement that individuals, who 

2 have health records that are maintained by the 

3 bank, be notified of a security breech with re4 spect to such records, and any corrective action 

5 taken on behalf of the individual. 

6 (C) The requirement that information sent 

7 to, or received from, an independent health 

8 record bank that has been designated as high9 risk should be authenticated through the use of 

10 methods such as the periodic changing of pass11 words, the use of biometrics, the use of tokens 

12 or other technology as determined appropriate 

13 by the council. 

14 (D) Recommendations for entities oper15 ating independent health record banks, includ16 ing requiring analysis of the potential risk of 

17 health transaction security breaches based on 

18 set criteria. 

19 (E) The conduct of audits of independent 

20 health record banks to ensure that they are in 

21 compliance with the requirements and stand22 ards established under this Act. 

23 (3) COMPLIANCE REPORT.—The interagency 

24 council established under this subsection shall annu25 ally submit to the Board of Governors a report on 


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1 compliance by independent health record banks with 

2 the requirements and standard under this Act. Such 

3 report shall be included in the corresponding annual 

4 report required under subsection (d). 

5 (c) INTERAGENCY MEMORANDUM OF UNDER6 STANDING.—The Board of Governors and the Secretary 

7 of Health and Human Services, and other Federal officials 

8 that may be impacted by this Act, shall ensure, through 

9 the execution of an interagency memorandum of under10 standing among the Board, Secretary, and officials, 

11 that— 

12 (1) regulations, rulings, and interpretations 

13 issued by such Board, Secretary, or officials relating 

14 to the same matter over which two or more of such 

15 entities have responsibility under this Act are ad16 ministered so as to have the same effect at all times; 

17 and 

18 (2) coordination of policies relating to enforcing 

19 the same requirements through the Board, Sec20 retary, or officials in order to have a coordinated en21 forcement strategy that avoids duplication of en22 forcement efforts and assigns priorities in enforce23 ment. 

24 (d) ANNUAL REPORT.—Not later than one year after 

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1 after, the Secretary, acting through the Under Secretary 

2 for Technology, shall submit to the Committee on Energy 

3 and Commerce and the Committee on Ways and Means 

4 of the House of Representatives and the Committee on 

5 Health, Education, Labor, and Pensions and the Com6 mittee on Finance of the Senate, a report that— 

7 (1) describes individual owner or institution op8 erator economic progress as achieved through the 

9 use of independent health record bank and existing 

10 barriers to such use; 

11 (2) describes progress in security auditing as 

12 provided for by the interagency security council 

13 under subsection (b); and 

14 (3) contains information on the other duties of 

15 the Board of Governors, as described in subsection 

16 (a). 

17 SEC. 9. PENALTIES FOR WRONGFUL DISCLOSURE. 

18 The penalties provided for in subsection (a) of section 

19 1177 of the Social Security Act (42 U.S.C. 1320d–6) shall 

20 apply to the wrongful disclosure of information collected, 

21 maintained, or made available by an independent health 

22 record bank under this Act, including disclosures by any 

23 employees or associates of any such bank or other health 

24 care entity using or disclosing such information, in the 


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1 same manner as such penalties apply to a person in viola2 tion of subsection (a) of such section. 

3 SEC. 10. TREATMENT OF EMPLOYER-PROVIDED EMPLOYEE 

4 INDEPENDENT HEALTH RECORD BANK AC5 COUNT FEES. 

6 (a) IN GENERAL.—Section 162 of the Internal Rev7 enue Code of 1986 (relating to trade or business expenses) 

8 is amended by redesignating subsection (q) as subsection 

9 (r) and by inserting after subsection (p) the following new 

10 subsection: 

11 ‘‘(q) TREATMENT OF EMPLOYER-PROVIDED EM12 PLOYEE INDEPENDENT HEALTH RECORD BANK AC13 COUNT FEES.— 

14 ‘‘(1) IN GENERAL.—In the case of a taxpayer, 

15 there shall be allowed as a deduction under this sec16 tion an amount equal to the independent health 

17 record bank account investment provided by such 

18 taxpayer during the taxable year. 

19 ‘‘(2) INDEPENDENT HEALTH RECORD BANK AC20 COUNT INVESTMENT.—For purposes of this sub21 section, the term ‘independent health record bank 

22 account investment’ means, with respect to each em23 ployee of the taxpayer for any taxable year, an 

24 amount equal to the the cost paid by the taxpayer 


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1 during the taxable year for such employee to main2 tain an independent health record bank account. 

3 ‘‘(3) INDEPENDENT HEALTH RECORD BANK AC4 COUNT.—For purposes of this subsection, the term 

5 ‘independent health record bank account’ has the 

6 meaning given to the term ‘account’ under section 

7 3(1) of the Independent Health Record Bank Act of 

8 2006. 

9 ‘‘(4) SPECIAL RULES.—No credit or deduction 

10 (other than under this subsection) shall be allowed 

11 under this chapter with respect to any expense 

12 which is taken into account under paragraph (1) in 

13 determining the deduction under this subsection. 

14 ‘‘(5) REPORTS.— 

15 ‘‘(A) IN GENERAL.—Each taxpayer shall 

16 make such reports to the Chairman of the Fed17 eral Reserve Board of Governors and to employ18 ees of the taxpayer regarding— 

19 ‘‘(i) independent health record bank 

20 account investments made with respect to 

21 such employees during any calendar year, 

22 and 

23 ‘‘(ii) such other information as the 

24 Chairman may require. 


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1 ‘‘(B) TIME FOR MAKING REPORTS.—The 

2 reports required by this subsection— 

3 ‘‘(i) shall be filed at such time and in 

4 such manner as the Chairman of the Fed5 eral Reserve Board of Governors pre6 scribes, and 

7 ‘‘(ii) shall be furnished to employees— 

8 ‘‘(I) not later than January 31 of 

9 the calendar year following the cal10 endar year to which such reports re11 late, and 

12 ‘‘(II) in such manner as the 

13 Chairman prescribes. 

14 ‘‘(6) REGULATIONS.—The Secretary may pre15 scribe such regulations as may be necessary or ap16 propriate to carry out this subsection. 

17 ‘‘(7) APPLICATION OF SUBSECTION.—This sub18 section shall apply with respect to any independent 

19 health record bank account investments made by the 

20 taxpayer for the 5-taxable year period beginning 

21 with the first taxable year during which such invest22 ments are made by the taxpayer.’’. 

23 (b) EFFECTIVE DATE.—The amendment made by 

24 this section shall apply to taxable years beginning after 

25 the date of the enactment of this Act. 


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1 (c) ADDITIONAL INCENTIVE FOR CONSUMERS PAR2 TICIPATING IN IHRB.—Revenue generated by an inde3 pendent health record bank and received by an account 

4 holder, health care entity, or health care payer shall not 

5 be considered taxable income under the Internal Revenue 

6 Code of 1986. 

Æ 


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