I 

108TH CONGRESS 

2D SESSION H. R. 4805 

To direct the Secretary of Health and Human Services to establish a demonstration program under which the Secretary offsets the costs of electronic prescribing systems of Medicare health care providers. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 9, 2004 

Mr. MURPHY (for himself, Mrs. JOHNSON of Connecticut, Mr. KENNEDY of 

Rhode Island, Mr. GREENWOOD, Mr. WELDON of Florida, Mr. WELDON

of Pennsylvania, Ms. GINNY BROWN-WAITE of Florida, and Mr. 

GINGREY) 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 direct the Secretary of Health and Human Services to 

establish a demonstration program under which the Secretary offsets the costs of electronic prescribing systems 

of Medicare health care providers. 

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 ‘‘Ensuring Medication 

5 Safety for Seniors Act’’. 
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1 SEC. 2. FINDINGS; PURPOSE. 

2 (a) FINDINGS.—Congress finds the following: 

3 (1) Prescription medications are central to the 

4 health care of Americans, accessed by 65 percent of 

5 the U.S. public in a given year. 

6 (2) Medication related errors, or adverse drug 

7 events, are one of the most common types of medical 

8 errors and one of the greatest threats to patient 

9 safety. 

10 (3) Studies and data have documented the prev11 alence of inappropriate prescribing of medications 

12 remains a substantial problem, with an estimated 

13 7,000 deaths in the United States occurring each 

14 year as a result of medication errors. 

15 (4) Medication errors not only are harmful to 

16 patients, but are financially costly to healthcare or17 ganizations and providers. 

18 (5) Resources that could be spent on direct 

19 health care services are diverted to counteract ad20 verse drug events. 

21 (6) New tools and systems are necessary to ad22 dress medical error problems. 

23 (7) Technology can be deployed which can vast24 ly improve the medication management process and 

25 decrease preventable patient injuries. 
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1 (8) Electronic prescribing systems hold the po2 tential to substantially improve health care quality 

3 by reducing preventable adverse drug events. 

4 (9) Investment costs remain an obstacle for 

5 healthcare systems to create electronic prescribing 

6 systems. 

7 (b) PURPOSE.—The purpose of this Act is to encour8 age and create incentives for healthcare systems to develop 

9 an electronic prescribing system to improve safety and 

10 quality of care for all patients. 

11 SEC. 3. DEMONSTRATION PROGRAM FOR MEDICARE 

12 HEALTH CARE PROVIDERS TO IMPLEMENT 

13 ELECTRONIC PRESCRIPTION DRUG PRO14 GRAMS. 

15 (a) ESTABLISHMENT OF DEMONSTRATION PRO16 GRAM.—The Secretary of Health and Human Services 

17 shall establish a demonstration program (in this section 

18 referred to as the ‘‘demonstration program’’) under which 

19 assistance described in subsection (b) is made available, 

20 upon request and on a voluntary basis, to medicare health 

21 care providers for the purpose of assisting those providers 

22 to offset the costs of electronic prescribing systems for 

23 those providers. 
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1 (b) ASSISTANCE.—The assistance referred to in sub2 section (a) consists of the provision, directly or through 

3 grants under subsection (c), of the following: 

4 (1) Computer software and hardware, including 

5 handheld computer technologies and the installation 

6 of such software, hardware, and technologies. 

7 (2) Upgrades and other improvements to exist8 ing computer software and hardware to enable elec9 tronic prescribing systems. 

10 (3) Communications capabilities for clinical 

11 data access. storage, and exchange, including the in12 stallation of such capabilities. 

13 (4) Education and training to eligible staff of 

14 medicare health care providers on computer informa15 tion system technologies made available under this 

16 section. 

17 (c) AWARDING OF GRANTS.— 

18 (1) AUTHORITY.—The Secretary may make 

19 grants to medicare providers of services for the pur20 chase, lease, and installation of the items and tech21 nologies described in subsection (b). 

22 (2) APPLICATION.—No grant may be made 

23 under this section except pursuant to a grant appli24 cation that is submitted and approved in a time, 

25 manner, and form specified by the Secretary con-
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1 taining such information as the Secretary may re2 quire. 

3 (3) LIMITATION ON GRANTS.—Only 1 grant 

4 may be awarded under this section with respect to 

5 any medicare health care provider or group or prac6 tice of providers or suppliers, including providers 

7 furnishing services to medicare beneficiaries in long8 term care facilities, skilled nursing facilities, and 

9 hospitals. 

10 (4) TERMS AND CONDITIONS.— 

11 (A) IN GENERAL.—Grants under this sec12 tion shall be made under such terms and condi13 tions as the Secretary specifies consistent with 

14 this section. 

15 (B) PROVISION OF INFORMATION.—As a 

16 condition for the awarding of a grant under this 

17 section, an applicant shall provide to the Sec18 retary such information as the Secretary may 

19 require in order to— 

20 (i) evaluate the project for which the 

21 grant is made; and 

22 (ii) ensure that funding provided 

23 under the grant is expended only for the 

24 purposes for which it is made. 
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1 (C) AUDIT.—The Secretary shall conduct 

2 appropriate audits of grants under this section. 

3 (d) DEMONSTRATION PROJECT SITES.— 

4 (1) NUMBER OF SITES.—The demonstration 

5 project established under this section shall be con6 ducted in not more than 5 sites selected by the Sec7 retary. 

8 (2) SELECTION CRITERIA.—In selecting such 

9 sites, the Secretary shall give priority to sites in the 

10 following order: 

11 (A) First to sites in counties, or equivalent 

12 areas, in which the largest numbers of medicare 

13 beneficiaries reside. 

14 (B) Second to sites in rural areas. 

15 (e) DURATION.—The authority of the Secretary to 

16 provide assistance under this section shall terminate on 

17 September 30, 2014. 

18 (f) WAIVER AUTHORITY.—The Secretary may waive 

19 such requirements of titles XI and XVIII of the Social 

20 Security Act as may be necessary for the purposes of car21 rying out the demonstration project. 

22 (g) EVALUATION AND REPORT.— 

23 (1) EVALUATION.—The Secretary shall conduct 

24 evaluations of the clinical and cost-effectiveness of 

25 the demonstration project. 
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1 (2) REPORTS.—The Secretary shall submit to 

2 Congress interim reports on the demonstration 

3 project, and not later than 6 months after the com4 pletion of the project, a final report on the dem5 onstration project. Each report shall include the fol6 lowing: 

7 (A) An analysis of the patient outcomes 

8 and costs of furnishing care to the medicare 

9 beneficiaries participating in the project. 

10 (B) Such recommendations regarding the 

11 extension, expansion, or termination of the 

12 project as the Secretary determines appropriate. 

13 (h) DEFINITION.—In this section: 

14 (1) MEDICARE HEALTH CARE PROVIDER.—The 

15 term ‘‘medicare health care providers’’ means any of 

16 the following that furnishes items or services for 

17 which payment is made under title XVIII of the So18 cial Security Act (42 U.S.C. 1395 et seq.): 

19 (A) A provider of services, as that term is 

20 defined in section 1861(u) of the Social Secu21 rity Act (42 U.S.C. 1395x(u)). 

22 (B) A supplier, as that term is defined in 

23 section 1861(d) of the Social Security Act (42 

24 U.S.C. 1395x(d)). 
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1 (2) MEDICARE BENEFICIARY.—The term 

2 ‘‘medicare beneficiary’’ means an individual entitled 

3 to benefits under part A of title XVIII of the Social 

4 Security Act, or enrolled under part B of such title, 

5 or both. 

6 (3) SECRETARY.—The term ‘‘Secretary’’ means 

7 the Secretary of Health and Human Services. 

8 (i) AUTHORIZATION OF APPROPRIATIONS.— 

9 (1) AMOUNT OF AUTHORIZATION.—There are 

10 authorized to be appropriated to the Secretary, from 

11 amounts not otherwise appropriated in the Treasury, 

12 to carry out this section $50,000,000 for fiscal year 

13 2005, and such sums as may be necessary for each 

14 of fiscal years 2006 and 2007. 

15 (2) AVAILABILITY.—Amounts appropriated pur16 suant to the authorization under paragraph (1) shall 

17 remain available without fiscal year limitation 

18 through September 30, 2014. 

19 (j) IMPLEMENTATION.—The Secretary may not im20 plement the demonstration project under this section be21 fore the date on which the Secretary develops, adopts, rec22 ognizes, or modifies initial uniform standards relating to 

23 the requirements for electronic prescription drug pro-
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1 grams under section 1860D–4(e)(4)(A) of the Social Secu2 rity Act (42 U.S.C. 1395w–104(e)(4)(A)). 

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