II 

108TH CONGRESS 

2D SESSION S. 2710

To amend the Public Health Service Act to improve the quality and efficiency 

of health care delivery through improvements in health care information 

technology, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 21, 2004

Mr. GREGG (for himself, Mr. SESSIONS, and Mr. FRIST) introduced the following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL

To amend the Public Health Service Act to improve the 

quality and efficiency of health care delivery through 

improvements in health care information technology, and 

for other purposes.

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘National Health Infor5 mation Technology Adoption Act’’. 
2

•S 2710 IS 

1 SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE 

2 ACT. 

3 The Public Health Service Act (42 U.S.C. 201 et 

4 seq.) is amended by adding at the end thereof the fol5 lowing: 

6 ‘‘TITLE XXIX—HEALTH CARE 

7 INFORMATION TECHNOLOGY 

8 ‘‘SEC. 2901. DEFINITIONS. 

9 ‘‘In this title: 

10 ‘‘(1) COVERAGE AREA.—The term ‘coverage 

11 area’ means the boundaries of a local health infor12 mation infrastructure. 

13 ‘‘(2) DEMOGRAPHIC DATA.—The term ‘demo14 graphic data’ means data that includes race, eth15 nicity, socio-economic status, and primary language. 

16 ‘‘(3) DIRECTOR.—The term ‘Director’ means 

17 the Director of the Office of Health Information 

18 Technology. 

19 ‘‘(4) HEALTH CARE PROVIDER.—The term 

20 ‘health care provider’ means a hospital, skilled nurs21 ing facility, home health entity, health care clinic, 

22 community health center, group practice (as defined 

23 in section 1877(h)(4) of the Social Security Act, in24 cluding practices with only 1 physician), and any 

25 other facility or clinician determined appropriate by 

26 the Director. 
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1 ‘‘(5) LOCAL HEALTH INFORMATION INFRA2 STRUCTURES.—The term ‘local health information 

3 infrastructure’ means an independent organization 

4 of health care entities established for the purpose of 

5 linking health information systems to electronically 

6 share information. A local health information infra7 structure may not be a single business entity. 

8 ‘‘(6) OFFICE.—The term ‘Office’ means the Of9 fice of Health Information Technology established 

10 under section 2902. 

11 ‘‘SEC. 2902. OFFICE OF HEALTH INFORMATION TECH12 NOLOGY. 

13 ‘‘(a) ESTABLISHMENT.—There is established within 

14 the Office of the Secretary an Office of Health Informa15 tion Technology. The Office shall be headed by a Director 

16 to be appointed by the Secretary after consultation with 

17 the President. The Director shall report directly to the 

18 Secretary. 

19 ‘‘(b) PURPOSE.—It shall be the purpose of the Office 

20 to—

21 ‘‘(1) improve the quality and increase the effi22 ciency of health care delivery through the use of 

23 health information technology; 
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•S 2710 IS 

1 ‘‘(2) provide national leadership relating to, and 

2 encourage the adoption of, health information tech3 nology; 

4 ‘‘(3) direct all health information technology ac5 tivities within the Department of Health and 

6 Human Services; 

7 ‘‘(4) act as the lead entity responsible for co8 ordinating the health information technology efforts 

9 of the Federal Government; and 

10 ‘‘(5) facilitate the interaction between the Fed11 eral Government and the private sector relating to 

12 health information technology development and use. 

13 ‘‘(c) DUTIES AND RESPONSIBILITIES.—The Office 

14 shall be responsible for the following: 

15 ‘‘(1) FEDERAL LEADERSHIP.—The Office 

16 shall—

17 ‘‘(A) serve as the principle advisor to the 

18 Secretary concerning health information tech19 nology; 

20 ‘‘(B) direct all health information tech21 nology activity within the Department of Health 

22 and Human Services; 

23 ‘‘(C) work with public and private health 

24 information technology stakeholders to imple25 ment a strategic plan for the establishment of 
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•S 2710 IS 

1 a National Health Information Infrastructure; 

2 and 

3 ‘‘(D) ensure that health information tech4 nology is utilized as fully as practicable in car5 rying out health surveillance efforts. 

6 ‘‘(2) COORDINATION.—The Office shall—

7 ‘‘(A) encourage the development and adop8 tion of clinical, messaging, and decision support 

9 health information data standards, pursuant to 

10 the requirements of section 2903; 

11 ‘‘(B) ensure the maintenance and imple12 mentation of the data standards described in 

13 subparagraph (A); 

14 ‘‘(C) oversee and coordinate the health in15 formation technology efforts of the Federal 

16 Government; 

17 ‘‘(D) ensure the compliance of the Depart18 ment of Health and Human Services with Fed19 erally adopted health information technology 

20 data standards; 

21 ‘‘(E) serve as the representative of the De22 partment of Health and Human Services with 

23 respect to the Consolidated Health Informatics 

24 Initiative;
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•S 2710 IS 

1 ‘‘(F) ensure that the Federal Government 

2 consults and collaborates on decision making 

3 with respect to health information technology 

4 with the private sector and other interested par5 ties; and 

6 ‘‘(G) in consultation with private sector, 

7 adopt certification and testing criteria to deter8 mine if electronic health information systems 

9 interoperate. 

10 ‘‘(3) COMMUNICATION.—The Office shall—

11 ‘‘(A) act as the point of contact for the 

12 private sector with respect to the use of health 

13 information technology; and 

14 ‘‘(B) work with the private sector to collect 

15 and disseminate best health information tech16 nology practices. 

17 ‘‘(4) EVALUATION AND DISSEMINATION.—The 

18 Office shall coordinate with the Agency for Health 

19 Research and Quality and other Federal agencies 

20 to—

21 ‘‘(A) evaluate and disseminate information 

22 relating to evidence of the costs and benefits of 

23 health information technology and to whom 

24 those costs and benefits accrue; 
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•S 2710 IS 

1 ‘‘(B) evaluate and disseminate information 

2 on the impact of health information technology 

3 on the quality and efficiency of patient care; 

4 and 

5 ‘‘(C) review Federal payment structures 

6 and differentials for health care providers that 

7 utilize health information technology systems. 

8 ‘‘(5) TECHNICAL ASSISTANCE.—The Office 

9 shall utilize existing private sector quality improve10 ment organizations to—

11 ‘‘(A) promote the adoption of health infor12 mation technology among healthcare providers; 

13 and 

14 ‘‘(B) provide technical assistance con15 cerning the implementation of health informa16 tion technology to healthcare providers. 

17 ‘‘(d) RESOURCES.—The Secretary shall make avail18 able to the Office, the resources, both financial and other19 wise, necessary to enable the Director to carry out the pur20 poses of, and perform the duties and responsibilities of 

21 the Office under, this section. 

22 ‘‘(e) DETAIL OF FEDERAL EMPLOYEES.—Upon the 

23 request of the Director, the head of any Federal agency 

24 is authorized to detail, without reimbursement from the 

25 Office, any of the personnel of such agency to the Office 
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•S 2710 IS 

1 to assist it in carrying out its duties under this section. 

2 Any such detail shall not interrupt or otherwise affect the 

3 civil service status or privileges of the Federal employee. 

4 ‘‘SEC. 2903. PROMOTING THE INTEROPERABILITY OF 

5 HEALTH CARE INFORMATION TECHNOLOGY 

6 SYSTEMS. 

7 ‘‘(a) DEVELOPMENT, AND FEDERAL GOVERNMENT

8 ADOPTION, OF STANDARDS.—

9 ‘‘(1) ADOPTION.—

10 ‘‘(A) IN GENERAL.—Not later than 2 years 

11 after the date of the enactment of this title, the 

12 Director shall provide for the adoption by the 

13 Federal Government of national data and com14 munication health information technology 

15 standards that promote the efficient exchange 

16 of data between varieties of provider health in17 formation technology systems. In carrying out 

18 the preceding sentence, the Director may adopt 

19 existing standards. Standards adopted under 

20 this section shall be voluntary for private sector 

21 entities. 

22 ‘‘(B) GRANTS OR CONTRACTS.—The Direc23 tor may utilize grants or contracts to provide 

24 for the private sector development of standards 
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•S 2710 IS 

1 for adoption by the Federal Government under 

2 subparagraph (A). 

3 ‘‘(2) REQUIREMENTS.—The standards devel4 oped and adopted under paragraph (1) shall be de5 signed to—

6 ‘‘(A) enable health information technology 

7 to be used for the collection and use of clinically 

8 specific data; 

9 ‘‘(B) promote the interoperability of health 

10 care information across health care settings; 

11 and 

12 ‘‘(C) facilitate clinical decision support 

13 through the use of health information tech14 nology. 

15 ‘‘(3) PUBLIC PRIVATE PARTNERSHIP.—Con16 sistent with activities being carried out on the date 

17 of enactment of this title, including the Consolidated 

18 Health Informatics initiative, health information 

19 technology standards shall be adopted by the Direc20 tor under paragraph (1) at the conclusion of a col21 laborative process that includes consultation between 

22 the Federal Government and private sector health 

23 care and information technology stakeholders. 

24 ‘‘(4) PRIVACY AND SECURITY.—The regulations 

25 promulgated by the Secretary under part C of title 
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•S 2710 IS 

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

2 seq.) and sections 261, 262, 263, and 264 of the 

3 Health Insurance Portability and Accountability Act 

4 of 1996 (42 U.S.C. 1320d–2 note) with respect to 

5 the privacy, confidentiality, and security of health 

6 information shall apply to the implementation of 

7 programs and activities under this title. 

8 ‘‘(5) PILOT TESTS.—To the maximum extent 

9 practical, the Director shall pilot test the health in10 formation technology data standards developed 

11 under paragraph (1) prior to their implementation 

12 under this section. 

13 ‘‘(6) DISSEMINATION.—

14 ‘‘(A) IN GENERAL.—The Director shall en15 sure that the standards adopted under para16 graph (1) are widely disseminated to interested 

17 stakeholders. 

18 ‘‘(B) LICENSING.—To facilitate the dis19 semination and implementation of the stand20 ards developed and adopted under paragraph 

21 (1), the Director may license such standards, or 

22 utilize other means, to ensure the widespread 

23 use of such standards. 

24 ‘‘(b) IMPLEMENTATION OF STANDARDS.—
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•S 2710 IS 

1 ‘‘(1) PURCHASE OF SYSTEMS BY THE SEC2 RETARY.—Effective beginning on the date that is 5 

3 years after the date of enactment of this title, the 

4 Secretary shall not purchase any health care infor5 mation technology system unless such system is in 

6 compliance with the standards adopted under sub7 section (a). 

8 ‘‘(2) RECIPIENTS OF FEDERAL FUNDS.—Effec9 tive on the date described in paragraph (1), the Sec10 retary shall require that funds not appropriated 

11 under this title that are designated for Federal 

12 health information technology purposes shall be used 

13 to purchase health care information technology sys14 tems that are in compliance with the standards 

15 adopted under subsection (a). 

16 ‘‘(c) MODIFICATION OF STANDARDS.—The Director 

17 shall provide for ongoing oversight of the health informa18 tion technology standards developed under subsection (a) 

19 to—

20 ‘‘(1) identify gaps or other shortcomings in 

21 such standards; and 

22 ‘‘(2) modify such standards when determined 

23 appropriate or develop additional standards, in col24 laboration with standard setting organizations. 
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•S 2710 IS 

1 ‘‘SEC. 2904. LOAN GUARANTEES FOR THE ADOPTION OF 

2 HEALTH INFORMATION TECHNOLOGY. 

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

4 payment of the principal of and the interest on loans made 

5 to eligible entities to enable such entities—

6 ‘‘(1) to implement local health information in7 frastructures to facilitate the development of inter8 operability across health care settings to improve 

9 quality and efficiency; or 

10 ‘‘(2) to facilitate the purchase and adoption of 

11 health information technology to improve quality and 

12 efficiency. 

13 ‘‘(b) ELIGIBILITY.—To be eligible to receive a loan 

14 guarantee under subsection (a) an entity shall—

15 ‘‘(1) with respect to an entity desiring a loan 

16 guarantee—

17 ‘‘(A) under subsection (a)(1), be a coalition 

18 of entities that represent an independent con19 sortium of health care stakeholders within a 

20 community that—

21 ‘‘(i) includes—

22 ‘‘(I) physicians (as defined in 

23 section 1881(r)(1) of the Social Secu24 rity Act), including physicians that 

25 provide services to low income and un26 derserved populations; 
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•S 2710 IS 

1 ‘‘(II) hospitals (including hos2 pitals that provide services to low in3 come and underserved populations); 

4 and 

5 ‘‘(III) group health plans or 

6 other health insurance issuers (as 

7 such terms are defined in section 

8 2791); and 

9 ‘‘(ii) may include any other health 

10 care providers; or 

11 ‘‘(B) under subsection (a)(2) be a health 

12 care provider that provides health care services 

13 to low-income and underserved populations; 

14 ‘‘(2) to the extent practicable, adopt the na15 tional health information technology standards 

16 adopted under section 2903; and 

17 ‘‘(3) prepare and submit to the Director an ap18 plication at such time, in such manner, and con19 taining such information as the Director may re20 quire. 

21 ‘‘(c) USE OF FUNDS.—Amounts received under a 

22 loan guarantee under subsection (a) shall be used—

23 ‘‘(1) with respect to a loan guarantee described 

24 in subsection (a)(1)—
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•S 2710 IS 

1 ‘‘(A) to develop a plan for the implementa2 tion of a local health information infrastructure 

3 under this section; 

4 ‘‘(B) to establish systems for the sharing 

5 of data in accordance with the national health 

6 information technology standards developed 

7 under section 2903; 

8 ‘‘(C) to purchase directly related inte9 grated hardware and software to establish an 

10 interoperable health information technology sys11 tem that is capable of linking to a local health 

12 care information infrastructure; and 

13 ‘‘(D) to train staff, maintain health infor14 mation technology systems, and maintain ade15 quate security and privacy protocols; 

16 ‘‘(2) with respect to a loan or loan guarantee 

17 described in subsection (a)(2)—

18 ‘‘(A) to develop a plan for the purchase 

19 and installation of health information tech20 nology; 

21 ‘‘(B) to purchase directly related inte22 grated hardware and software to establish an 

23 interoperable health information technology sys24 tem that is capable of linking to a local health 

25 care information infrastructure; and 
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•S 2710 IS 

1 ‘‘(C) to train staff, maintain health infor2 mation technology systems, and maintain ade3 quate security and privacy protocols; and 

4 ‘‘(3) to carry out any other activities deter5 mined appropriate by the Director. 

6 ‘‘(d) SPECIAL CONSIDERATIONS.—In awarding loan 

7 guarantees under this section to local health information 

8 infrastructures, the Director shall give special consider9 ation to eligible entities that—

10 ‘‘(1) include at least 50 percent of the patients 

11 living in the designated coverage area; 

12 ‘‘(2) incorporate public health surveillance and 

13 reporting into the overall architecture of the pro14 posed infrastructure; and 

15 ‘‘(3) link local health information infrastruc16 tures. 

17 ‘‘(e) AREAS OF SPECIFIC INTEREST.—In awarding 

18 loan guarantees under this section, the Director shall in19 clude—

20 ‘‘(1) entities with a coverage area that includes 

21 an entire State; and 

22 ‘‘(2) entities with a multi-state coverage area. 

23 ‘‘(f) ADMINISTRATIVE PROVISIONS.—

24 ‘‘(1) AGGREGATE AMOUNT.—
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•S 2710 IS 

1 ‘‘(A) IN GENERAL.—Except as provided in 

2 subparagraph (B), the aggregate amount of 

3 principal of loans guaranteed under subsection 

4 (a) with respect to an eligible entity may not 

5 exceed $5,000,000. In any 12-month period the 

6 amount disbursed to an eligible entity under 

7 this section (by a lender under a guaranteed 

8 loan) may not exceed $5,000,000. 

9 ‘‘(B) EXCEPTION.—The cumulative total 

10 of the principal of the loans outstanding at any 

11 time to which guarantees have been issued 

12 under subsection (a) may not exceed such limi13 tations as may be specified in appropriation 

14 Acts. 

15 ‘‘(2) PROTECTION OF FEDERAL GOVERN16 MENT.—

17 ‘‘(A) IN GENERAL.—The Director may not 

18 approve an application for a loan guarantee 

19 under this section unless the Director deter20 mines that—

21 ‘‘(i) the terms, conditions, security (if 

22 any), and schedule and amount of repay23 ments with respect to the loan are suffi24 cient to protect the financial interests of 

25 the United States and are otherwise rea-
17

•S 2710 IS 

1 sonable, including a determination that the 

2 rate of interest does not exceed such per3 cent per annum on the principal obligation 

4 outstanding as the Director determines to 

5 be reasonable, taking into account the 

6 range of interest rates prevailing in the 

7 private market for loans with similar ma8 turities, terms, conditions, and security 

9 and the risks assumed by the United 

10 States; and 

11 ‘‘(ii) the loan would not be available 

12 on reasonable terms and conditions with13 out the enactment of this section. 

14 ‘‘(B) RECOVERY.—

15 ‘‘(i) IN GENERAL.—The United States 

16 shall be entitled to recover from the appli17 cant for a loan guarantee under this sec18 tion the amount of any payment made pur19 suant to such loan guarantee, unless the 

20 Director for good cause waives such right 

21 of recovery, and, upon making any such 

22 payment, the United States shall be sub23 rogated to all of the rights of the recipient 

24 of the payments with respect to which the 

25 loan was made. 
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•S 2710 IS 

1 ‘‘(ii) MODIFICATION OF TERMS.—Any 

2 terms and conditions applicable to a loan 

3 guarantee under this section may be modi4 fied by the Director to the extent he deter5 mines it to be consistent with the financial 

6 interest of the United States. 

7 ‘‘(3) DEFAULTS.—The Director may take such 

8 action as the Director deems appropriate to protect 

9 the interest of the United States in the event of a 

10 default on a loan guaranteed under this section, in11 cluding taking possession of, holding, and using real 

12 property pledged as security for such a loan guar13 antee. 

14 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—

15 ‘‘(1) IN GENERAL.—There is authorized to be 

16 appropriated to carry out this section, $50,000,000 

17 for each of fiscal years 2005 through 2010. 

18 ‘‘(2) AVAILABILITY.—Amounts appropriated 

19 under subparagraph (A) shall remain available for 

20 obligation until expended. 

21 ‘‘SEC. 2905. GRANTS FOR THE PURCHASE OF HEALTH IN22 FORMATION TECHNOLOGY. 

23 ‘‘(a) IN GENERAL.—The Director may award com24 petitive grants to eligible entities—
19

•S 2710 IS 

1 ‘‘(1) to implement local health information in2 frastructures to facilitate the development of inter3 operability across health care settings; or 

4 ‘‘(2) to facilitate the purchase and adoption of 

5 health information technology. 

6 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

7 under section (a) an entity shall—

8 ‘‘(1) demonstrate financial need to the Director; 

9 ‘‘(2) with respect to an entity desiring a 

10 grant—

11 ‘‘(A) under subsection (a)(1), represent an 

12 independent consortium of health care stake13 holders within a community that—

14 ‘‘(i) includes—

15 ‘‘(I) physicians (as defined in 

16 section 1881(r)(1) of the Social Secu17 rity Act), including physicians that 

18 provide services to low income and un19 derserved populations; 

20 ‘‘(II) hospitals (including hos21 pitals that provide services to low in22 come and underserved populations); 

23 and 

24 ‘‘(III) group health plans or 

25 other health insurance issuers (as 
20

•S 2710 IS 

1 such terms are defined in section 

2 2791); and 

3 ‘‘(ii) may include any other health 

4 care providers; or 

5 ‘‘(B) under subsection (a)(2) be a health 

6 care provider that provides health care services 

7 to low-income and underserved populations; 

8 ‘‘(3) adopt the national health information tech9 nology standards developed under section 2903; 

10 ‘‘(4) prepare and submit to the Director an ap11 plication at such time, in such manner, and con12 taining such information as the Director may re13 quire; and 

14 ‘‘(5) agree to provide matching funds in accord15 ance with subsection (d). 

16 ‘‘(c) USE OF FUNDS.—Amounts received under a 

17 grant under subsection (a) shall be used to—

18 ‘‘(1) with respect to a grant described in sub19 section (a)(1)—

20 ‘‘(A) to develop a plan for the implementa21 tion of a local health information infrastructure 

22 under this section; 

23 ‘‘(B) to establish systems for the sharing 

24 of data in accordance with the national health 
21

•S 2710 IS 

1 information technology standards developed 

2 under section 2903; 

3 ‘‘(C) to implement, enhance, or upgrade a 

4 comprehensive, electronic health information 

5 technology system; and 

6 ‘‘(D) to maintain adequate security and 

7 privacy protocols; 

8 ‘‘(2) with respect to a grant described in sub9 section (a)(2)—

10 ‘‘(A) to develop a plan for the purchase 

11 and installation of health information tech12 nology; 

13 ‘‘(B) to purchase directly related inte14 grated hardware and software to establish an 

15 interoperable health information technology sys16 tem that is capable of linking to a local health 

17 care information infrastructure; and 

18 ‘‘(C) to train staff, maintain health infor19 mation technology systems, and maintain ade20 quate security and privacy protocols; 

21 ‘‘(3) maintain adequate security and privacy 

22 protocols; and 

23 ‘‘(4) to carry out any other activities deter24 mined appropriate by the Director. 

25 ‘‘(d) MATCHING REQUIREMENT.—
22

•S 2710 IS 

1 ‘‘(1) IN GENERAL.—The Director may not 

2 make a grant under this section to an entity unless 

3 the entity agrees that, with respect to the costs to 

4 be incurred by the entity in carrying out the infra5 structure program for which the grant was awarded, 

6 the entity will make available (directly or through 

7 donations from public or private entities) non-Fed8 eral contributions toward such costs in an amount 

9 equal to not less than 20 percent of such costs ($1 

10 for each $5 of Federal funds provided under the 

11 grant). 

12 ‘‘(2) DETERMINATION OF AMOUNT CONTRIB13 UTED.—Non-Federal contributions required under 

14 paragraph (1) may be in cash or in kind, fairly eval15 uated, including equipment, technology, or services. 

16 Amounts provided by the Federal Government, or 

17 services assisted or subsidized to any significant ex18 tent by the Federal Government, may not be in19 cluded in determining the amount of such non-Fed20 eral contributions. 

21 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—

22 ‘‘(1) IN GENERAL.—There is authorized to be 

23 appropriated to carry out this section, $50,000,000 

24 for each of fiscal years 2005 through 2010. 
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•S 2710 IS 

1 ‘‘(2) AVAILABILITY.—Amounts appropriated 

2 under paragraph (1) shall remain available for obli3 gation until expended. 

4 ‘‘SEC. 2906. REPORTS. 

5 ‘‘(a) IN GENERAL.—Not later than 1 year after the 

6 date of enactment of this title, and annually thereafter, 

7 an entity that receives a grant or loan guarantee under 

8 this title shall submit to the Director a report on the ac9 tivities carried out under the grant or loan guarantee in10 volved. Each such report shall include—

11 ‘‘(1) a description of the financial costs and 

12 benefits of the project involved and of the entities to 

13 which such costs and benefits accrue; 

14 ‘‘(2) a description of the impact of the project 

15 on health care quality and safety; and 

16 ‘‘(3) a description of any reduction in duplica17 tive or unnecessary care as a result of the project in18 volved. 

19 ‘‘(b) PREFERENCE.—In awarding grants and loan 

20 guarantees under this title, the Director may give a pref21 erence to eligible entities that agree to electronically sub22 mit reports on a daily basis.’’. 
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•S 2710 IS 

1 SEC. 3. STANDARDIZED MEASURES OF QUALITY HEALTH 

2 CARE AND DATA COLLECTION. 

3 Title XIX of the Public Health Service Act, as added 

4 by section 2, is amended by adding at the end the fol5 lowing: 

6 ‘‘SEC. 2907. STANDARDIZED MEASURES OF QUALITY 

7 HEALTH CARE. 

8 ‘‘(a) IN GENERAL.—

9 ‘‘(1) COLLABORATION.—The Secretary of 

10 Health and Human Services, the Secretary of De11 fense, and the Secretary of Veterans Affairs (re12 ferred to in this section as the ‘Secretaries’) shall es13 tablish uniform health care quality measures to as14 sess the effectiveness, timeliness, patient self-man15 agement, efficiency, and safety of care delivered 

16 across all federally supported health delivery pro17 grams, including those in which health care services 

18 are delivered to health disparity populations. 

19 ‘‘(2) DEVELOPMENT OF MEASURES.—Relying 

20 on earlier work by the Secretary of Health and 

21 Human Services or other Federal departments or 

22 agencies and with an emphasis on health conditions 

23 disproportionately affecting health disparity popu24 lations and taking into account health literacy and 

25 primary language and cultural factors, the Secre-
25

•S 2710 IS 

1 taries shall develop standardized sets of quality 

2 measures for—

3 ‘‘(A) 5 common health conditions by not 

4 later than January 1, 2006; and 

5 ‘‘(B) an additional 10 common health con6 ditions by not later than January 1, 2007. 

7 ‘‘(3) PILOT TESTING.—Each federally sup8 ported health delivery program may conduct a pilot 

9 test of the quality measures developed under para10 graph (2) that shall include a collection of patient11 level data and a public release of comparative per12 formance reports. 

13 ‘‘(b) PUBLIC REPORTING REQUIREMENTS.—The 

14 Secretaries shall work collaboratively to establish public 

15 reporting requirements for clinicians, institutional pro16 viders, and health plans in each of the federally supported 

17 health delivery program described in subsection (a). 

18 ‘‘(c) FULL IMPLEMENTATION.—The Secretaries shall 

19 work collaboratively to implement all sets of quality meas20 ures and reporting systems developed under subsections 

21 (a) and (b) by not later than January 1, 2009. 

22 ‘‘(d) PROGRESS REPORT.—The Secretary of Health 

23 and Human Services shall prepare an annual progress re24 port that details the collaborative efforts carried out under 

25 subsection (a). 
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•S 2710 IS 

1 ‘‘(e) COMPARATIVE QUALITY REPORTS.—Beginning 

2 on January 1, 2008, in order to make comparative quality 

3 information available to health care consumers, including 

4 members of health disparity populations, health profes5 sionals, public health officials, researchers, and other ap6 propriate individuals and entities, the Secretaries shall 

7 provide for the pooling, analysis, and dissemination of 

8 quality measures collected under this section. Nothing in 

9 this section shall be construed as modifying the privacy 

10 standards under the Health Insurance Portability and Ac11 countability Act of 1996 (Public Law 104–191). 

12 ‘‘(f) ONGOING EVALUATION OF USE.—The Secretary 

13 of Health and Human Services shall ensure the ongoing 

14 evaluation of the use of the health care quality measures 

15 established under this section. 

16 ‘‘(g) EXISTING ACTIVITIES.—Notwithstanding any 

17 other provision of law, the measures and reporting activi18 ties described in this section shall replace, to the extent 

19 practicable and appropriate, any duplicative or redundant 

20 existing measurement and reporting activities currently 

21 utilized by federally supported health care delivery pro22 grams. 

23 ‘‘(h) EVALUATION AND REGULATIONS.—

24 ‘‘(1) EVALUATION.—
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•S 2710 IS 

1 ‘‘(A) IN GENERAL.—The Secretary shall, 

2 directly or indirectly through a contract with 

3 another entity, conduct an evaluation of the col4 laborative efforts of the Secretaries to establish 

5 uniform health care quality measures and re6 porting requirements for federally supported 

7 health care delivery programs as required under 

8 this section. 

9 ‘‘(B) REPORT.—Not later than 2 years 

10 after the date of enactment of this title, the 

11 Secretary of Health and Human Services shall 

12 submit a report to the appropriate committees 

13 of Congress concerning the results of the eval14 uation under subparagraph (A). 

15 ‘‘(2) REGULATIONS.—

16 ‘‘(A) PROPOSED.—Not later than 18 

17 months after the date on which the report is 

18 submitted under paragraph (1)(B), the Sec19 retary shall publish proposed regulations re20 garding the application of the uniform health 

21 care quality measures and reporting require22 ments described in this section to federally sup23 ported health delivery programs. 

24 ‘‘(B) FINAL REGULATIONS.—Not later 

25 than 3 years after the date on which the report 
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•S 2710 IS 

1 is submitted under paragraph (1)(B), the Sec2 retary shall publish final regulations regarding 

3 the uniform health care quality measures and 

4 reporting requirements described in this section. 

5 ‘‘(i) DEFINITIONS.—In this section, the term ‘feder6 ally supported health delivery program’ means a program 

7 that is funded by the Federal Government under which 

8 health care items or services are delivered directly to pa9 tients. 

10 ‘‘SEC. 2908. DATA COLLECTION. 

11 ‘‘The Secretary shall—

12 ‘‘(1) ensure that demographic data collected 

13 under the medicare program are accurate and avail14 able for inclusion in the National Health Disparities 

15 Report; 

16 ‘‘(2) enforce existing State demographic data 

17 collection and reporting requirements for enrollees in 

18 the medicaid program under title XIX of the Social 

19 Security Act (42 U.S.C. 1396 et seq.) and the State 

20 Children’s Health Insurance Program under title 

21 XXI of such Act (42 U.S.C. 1397aa et seq.), pro22 mote and encourage the collection of such demo23 graphic data in those States that do not have exist24 ing demographic data collection and reporting re25 quirements under these programs, and ensure that 
29

•S 2710 IS 

1 such demographic data are available for inclusion in 

2 the National Health Disparities Report; 

3 ‘‘(3) ensure that any new Federal program ini4 tiatives—

5 ‘‘(A) collect and report demographic data 

6 and provide technical assistance to promote 

7 compliance; 

8 ‘‘(B) address technological difficulties; 

9 ‘‘(C) ensure privacy and confidentiality of 

10 demographic data collected; and 

11 ‘‘(D) disseminate an analysis of the demo12 graphic data collection to appropriate stake13 holders; 

14 ‘‘(4) work with insurers, providers, agencies and 

15 the public to reassure and inform such entities of 

16 the importance of demographic data collection re17 garding health disparity populations to improving 

18 health care access and quality; and 

19 ‘‘(5) support research on existing best practices 

20 for data collection.’’.

Æ