II 

110TH CONGRESS 

1ST SESSION S. 1455 

To provide for the establishment of a health information technology and 

privacy system 

IN THE SENATE OF THE UNITED STATES 

MAY 23, 2007 

Mr. WHITEHOUSE introduced the following bill; which was read twice and 

referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To provide for the establishment of a health information 

technology and privacy system 

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 ‘‘National Health Infor5 mation Technology and Privacy Advancement Act of 

6 2007’’. 

7 SEC. 2. POLICY AND PURPOSES. 

8 (a) POLICY.—Congress declares that it is the policy 

9 of the United States to establish, as expeditiously as pracmstockstill on PROD1PC66 with BILLS

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1 ticable, a health information technology and privacy sys2 tem, which should— 

3 (1) be responsive to public needs and national 

4 objectives; 

5 (2) serve the health care needs of the United 

6 States; and 

7 (3) contribute to improved health care quality 

8 and lower costs. 

9 (b) PURPOSES.—It is the purpose of this Act to— 

10 (1) provide for the establishment of a health in11 formation technology and privacy system through 

12 which new and expanded health care information 

13 services will be made available as promptly as pos14 sible in a manner that provides national coverage at 

15 the earliest practicable date; 

16 (2) in carrying out the system described in 

17 paragraph (1), provide technology services to eco18 nomically less developed areas as well as those more 

19 highly developed, and provide for the efficient and 

20 economical use of health care information and pro21 tect the confidentiality and security of information 

22 within this new technology; 

23 (3) in order to facilitate the development of the 

24 system and provide for the widest possible participa25 tion by private enterprise in the system, establish a 

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1 private nonprofit corporation, subject to appropriate 

2 Federal regulation, to administer the system; and 

3 (4) ensure that— 

4 (A) all authorized users of the system have 

5 nondiscriminatory access to the system; 

6 (B) effective competition be maintained in 

7 the provision of equipment and services utilized 

8 by the system; 

9 (C) the corporation established under this 

10 Act is organized and operated so as to maintain 

11 and strengthen competition in the provision of 

12 health information services to the public; and 

13 (D) the activities of the corporation and of 

14 the persons or companies participating in the 

15 ownership of the corporation is consistent with 

16 the Federal antitrust laws. 

17 (c) LIMITATION.—Congress declares that it is not the 

18 policy of this Act to preclude the private development of 

19 health information technologies. 

20 SEC. 3. DEFINITIONS. 

21 In this Act: 

22 (1) AUTHORIZED HEALTH INSURERS.—The 

23 term ‘‘authorized health insurers’’ means health in24 surance issuers (as defined in section 2791 of the 

25 Public Health Service Act) and includes payors for 

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1 services provided under titles XVIII and XIX of the 

2 Social Security Act (42 U.S.C. 1395 and 1396 et 

3 seq.). 

4 (2) AUTHORIZED PROVIDERS.—The term ‘‘au5 thorized providers’’ means duly licensed or certified 

6 health care providers. 

7 (3) CORPORATION.—The term ‘‘corporation’’ 

8 means the corporation authorized by section 5. 

9 (4) SECRETARY.—The term ‘‘Secretary’’ means 

10 the Secretary of Health and Human Services. 

11 (5) SYSTEM.—The term ‘‘system’’ means the 

12 system of health information and technology estab13 lished under this Act, with secure retention and 

14 sharing among authorized providers, who have ac15 cess to analytic support to identify and enhance 

16 areas where improved quality of care may lower cost, 

17 and result in reimbursement rates that can better 

18 reflect optimal health care delivery. 

19 SEC. 4. FEDERAL COORDINATION, PLANNING, AND REGU20 LATION. 

21 (a) ACTIONS BY THE SECRETARY.—In order to 

22 achieve the policy and carry out the purposes of this Act, 

23 the Secretary shall— 

24 (1) provide Federal governmental assistance in 

25 the planning and development, and provide for the 

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1 implementation of, a national program for the estab2 lishment and operation, as expeditiously as possible, 

3 of a national health information technology and pri4 vacy system; 

5 (2) provide for the continuous review of all 

6 phases of the development and operation of the sys7 tem, including the activities of the corporation; 

8 (3) provide for the coordination of the activities 

9 of Federal agencies with responsibilities relating to 

10 health care information technology, so as to ensure 

11 that there is a full and effective compliance at all 

12 times with the policies and procedures established 

13 under this Act; 

14 (4) exercise such supervision over the relation15 ship of the corporation with State and local entities 

16 or other entities as may be appropriate to ensure 

17 that such relationships shall be consistent with the 

18 national interest and policy of the United States as 

19 expressed in this Act; 

20 (5) ensure that timely arrangements are made 

21 under which there can be national participation in 

22 the establishment and use of the system; and 

23 (6) provide for incentives for physicians to en24 gage in electronic patient-provider interactions. 

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1 (b) OTHER FEDERAL AGENCIES.—The Adminis2 trator of the Centers for Medicare & Medicaid Services, 

3 the National Coordinator for Health Information Tech4 nology, the Director of the National Institutes of Health, 

5 the chief executive officer of the Veterans Health Adminis6 tration, and the heads of other relevant Federal agencies, 

7 shall, upon request of the corporation— 

8 (1) provide advice to the corporation concerning 

9 the technical characteristics of the system; 

10 (2) provide assistance to the corporation in the 

11 conduct of research and development activities relat12 ing to the system, including by furnishing to the cor13 poration, upon request, on a reimbursable basis, 

14 such services as determined necessary for the most 

15 expeditious and economical development of the sys16 tem; and 

17 (3) to the extent feasible, furnish other services, 

18 on a reimbursable basis, to the corporation in con19 nection with the establishment and operation of the 

20 system. 

21 (c) ACTIONS BY THE CORPORATION.—The corpora22 tion shall— 

23 (1) develop plans for the technical specifications 

24 of all elements of the system, pursuant to the activi25 ties described under section 5(f); 

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1 (2) ensure effective competition, including the 

2 use of competitive bidding where appropriate, in the 

3 procurement by the corporation of apparatus, equip4 ment, and services required for the establishment 

5 and operation of the system; 

6 (3) ensure that eligible health care providers 

7 have equitable and nondiscriminatory access to— 

8 (A) the system in a manner that provides 

9 for the payment of reasonable assessment for 

10 such use consistent with the ability to pay and 

11 the savings and benefits to be anticipated; 

12 (B) relevant classifications, practices, regu13 lations, and other terms and conditions relating 

14 to the use of the system; and 

15 (C) available facilities of the system pursu16 ant to regulations relating to the allocation of 

17 such facilities among the users thereof; 

18 (4) ensure that the facilities of the system are 

19 technically compatible and operationally inter20 connected with each other and facilitate interoper21 ability among health information systems; 

22 (5) prescribe such accounting regulations and 

23 systems and, after public hearing and deliberation, 

24 engage in such ratemaking procedures as will ensure 

25 that any savings made possible by the system are 

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1 appropriately reflected in rates for access to system 

2 services, by license or otherwise for those who utilize 

3 or benefit from the system, including the health in4 surance industry; 

5 (6) obtain the approval of the Secretary for the 

6 implementation of technical and privacy protection 

7 characteristics relating to the operation of the sys8 tem; 

9 (7) authorize, construct, and operate such sys10 tem facilities, networks, and programs as will best 

11 serve the public interest, convenience, and necessity, 

12 as determined after consultation with the Secretary; 

13 and 

14 (8) to the extent feasible, ensure that the sys15 tem is compatible and interoperable with pre-existing 

16 health information technology equipment and sys17 tems. 

18 (d) OFFICE OF THE NATIONAL COORDINATOR FOR

19 HEALTH INFORMATION TECHNOLOGY.— 

20 (1) IN GENERAL.—There is established within 

21 the Office of the Secretary of Health and Human 

22 Services an Office of the National Coordinator for 

23 Health Information Technology. The Office shall be 

24 headed by a National Coordinator appointed by the 

25 President, in consultation with the Secretary of 

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1 Health and Human Services. The National Coordi2 nator shall report directly to the Secretary. 

3 (2) RULE OF CONSTRUCTION.—Nothing in this 

4 subsection shall be construed as requiring the dupli5 cation of Federal efforts with respect to the estab6 lishment of the Office of the National Coordinator 

7 for Health Information Technology, regardless of 

8 whether such efforts are carried out before or after 

9 the date of the enactment of this Act. 

10 SEC. 5. NATIONAL CORPORATION FOR HEALTH INFORMA11 TION TECHNOLOGY AND PRIVACY. 

12 (a) ESTABLISHMENT.—There is authorized to be es13 tablished a nonprofit national health information tech14 nology and privacy corporation which shall not be an agen15 cy or establishment of the United States. The corporation 

16 shall be subject to the provisions of this Act. 

17 (b) INCORPORATION.—Not later than 180 days after 

18 the date of enactment of this Act, the President, by and 

19 with the advice and consent of the Senate, shall appoint 

20 9 incorporators of the corporation who shall serve as the 

21 initial board of directors until their successors are elected 

22 in accordance with subsection (c). Such incorporators shall 

23 take whatever actions are necessary to establish the cor24 poration, including the filing of articles of incorporation, 

25 as approved by the President. 

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1 (c) BOARD OF DIRECTORS.— 

2 (1) IN GENERAL.—The corporation shall have a 

3 bipartisan board of directors that shall consist of 9 

4 individuals who shall be citizens of the United States 

5 and be appointed by the President, by and with the 

6 advice and consent of the Senate. 

7 (2) TERMS.—The terms of service of the mem8 bers of the board of directors shall be 3 years or 

9 until such time as their successors have been ap10 pointed, except that of the first 9 members of the 

11 board appointed under subsection (b), 3 each shall 

12 serve for terms of 3, 4, and 5 years, respectively as 

13 designated by the President. Any member of the 

14 board appointed to fill a vacancy shall be appointed 

15 only for the unexpired term of the member which he 

16 or she is succeeding. A member may not serve con17 secutive terms. 

18 (3) CHAIRPERSON.—The members of the board 

19 of directors of the corporation shall at its first meet20 ing and annually thereafter elect a member to serve 

21 as the chairperson of the board. 

22 (d) CHIEF PRIVACY OFFICER AND OTHER OFFI23 CERS.— 

24 (1) CHIEF PRIVACY OFFICER.— 

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1 (A) IN GENERAL.—The president of the 

2 Corporation, in consultation with the board of 

3 directors, shall appoint a chief privacy officer of 

4 the corporation to ensure the confidentiality 

5 and security of patient medical records. 

6 (B) DUTIES.—The chief privacy officer of 

7 the corporation shall— 

8 (i) ensure that the use of technologies 

9 by the corporation sustain, and do not 

10 erode, privacy protections relating to the 

11 use, collection, and disclosure of personal 

12 information; 

13 (ii) ensure that personal information 

14 contained in any records maintained as 

15 part of the technology and privacy system 

16 is maintained in full compliance with fair 

17 information practices as contained in the 

18 Privacy Act of 1974; 

19 (iii) evaluate legislative and regulatory 

20 proposals involving the collection, use, and 

21 disclosure of personal information by the 

22 Federal Government; 

23 (iv) Conduct a privacy impact assess24 ment of proposed rules and procedures of 

25 the corporation on the privacy of personal 

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1 information, including the type of personal 

2 information collected and the number of 

3 individuals affected; and 

4 (v) submit annually to Congress a re5 port on activities of the corporation that 

6 affect privacy. 

7 (2) OTHER OFFICERS.—The corporation shall 

8 have a president, and such other officers as may be 

9 appointed by the board of directors, who shall be 

10 compensated at rates fixed by the board and serve 

11 at the pleasure of the board. No officer of the cor12 poration shall receive any salary from any source 

13 other than the corporation during the period of em14 ployment by the corporation. 

15 (e) FINANCING.—The corporation is authorized to 

16 issue bonds, debentures, and such other financings or cer17 tificates of indebtedness as the board of directors deter18 mines appropriate to carry out its duties under this Act. 

19 (f) AUTHORIZED ACTIVITIES.— 

20 (1) GENERAL ACTIVITIES.—In order to achieve 

21 the objectives and to carry out the purposes of this 

22 Act, the corporation is authorized to— 

23 (A) plan, initiate, construct, own, manage, 

24 and operate itself or in conjunction with State 

25 and local governments or business entities, a 

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1 national health information technology and pri2 vacy system; 

3 (B) furnish, for fees where appropriate and 

4 subject to licenses and confidentiality and secu5 rity requirements, access to individuals, and to 

6 authorized providers and payers of health care 

7 services; 

8 (C) specify rules for allowing access (in ac9 cordance with applicable privacy laws) to non10 identifiable health care data for public health 

11 and research purposes; and 

12 (D) own and operate such facilities as may 

13 be required to achieve the purposes of this Act. 

14 (2) OTHER ACTIVITIES.—In addition to the ac15 tivities authorized under paragraph (1), the corpora16 tion, to accomplish the purposes of this Act, may— 

17 (A) conduct, or enter into contracts for the 

18 conduct of, research and development activities 

19 related to the mission of the corporation; 

20 (B) acquire the physical facilities, equip21 ment, and devices necessary for the operations 

22 of the corporation, including health information 

23 technologies and associated equipment and fa24 cilities, whether by construction, purchase, or 

25 gift; 

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1 (C) purchase or otherwise acquire health 

2 information and related services from the 

3 United States Government; and 

4 (D) enter into contracts with authorized 

5 users of health information, including the 

6 United States Government, for the use of the 

7 services of the system. 

8 SEC. 6. BUSINESS PLAN AND ANNUAL REPORT. 

9 (a) BUSINESS PLAN.—Not later than 6 months after 

10 the date on which the corporation is incorporated under 

11 section 5, the corporation shall file with the President and 

12 Congress its initial business plan. 

13 (b) ANNUAL REPORT.—Not later than 1 year after 

14 the date on which the corporation is incorporated under 

15 section 5, and each January 1 thereafter, the corporation 

16 shall prepare and submit to Congress a report that shall 

17 include a comprehensive description of the activities and 

18 accomplishments during the year for which the report is 

19 prepared under this Act, together with an evaluation of 

20 such activities and accomplishments in terms of the at21 tainment of the purposes of this Act. Each such report 

22 shall include any recommendations of the corporation for 

23 additional legislative or other action which the corporation 

24 may consider necessary or desirable for the attainment of 

25 such objectives. 

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1 (c) AUDITS.—The corporation shall be subject to 

2 such external audits as may be determined appropriate by 

3 the Secretary. 

4 SEC. 7. AUTHORIZATION OF APPROPRIATIONS. 

5 There are authorized to be appropriated such sums 

6 as may be necessary to carry out this Act for each of fiscal 

7 years 2008 through 2017. 

Æ 

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