II 

111TH CONGRESS 

1ST SESSION S. 2765 

To amend the Small Business Act to authorize loan guarantees for health 

information technology. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 10, 2009 

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

to the Committee on Small Business and Entrepreneurship 

A BILL 

To amend the Small Business Act to authorize loan 

guarantees for health information technology. 

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 ‘‘Small Business Health 

5 Information Technology Financing Act of 2009’’. 

6 SEC. 2. SMALL BUSINESS HEALTH INFORMATION TECH7 NOLOGY FINANCING PROGRAM. 

8 The Small Business Act (15 U.S.C. 631 et seq.) is 

9 amended— 


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1 (1) by redesignating section 44 as section 45; 

2 and 

3 (2) by inserting after section 43 the following: 

4 ‘‘SEC. 44. LOAN GUARANTEES FOR HEALTH INFORMATION 

5 TECHNOLOGY. 

6 ‘‘(a) DEFINITIONS.—In this section— 

7 ‘‘(1) the term ‘cost’ has the meaning given that 

8 term in section 502 of the Federal Credit Reform 

9 Act of 1990 (2 U.S.C. 661a); 

10 ‘‘(2) the term ‘eligible professional’ means— 

11 ‘‘(A) a physician (as defined in section 

12 1861(r) of the Social Security Act (42 U.S.C. 

13 1395x(r))); 

14 ‘‘(B) a practitioner described in section 

15 1842(b)(18)(C) of the Social Security Act (42 

16 U.S.C. 1395u(b)(18)(C)); 

17 ‘‘(C) a physical or occupational therapist; 

18 ‘‘(D) a qualified speech-language patholo19 gist (as defined in section 1861(ll)(4)(A) of the 

20 Social Security Act (42 U.S.C. 

21 1395x(ll)(4)(A)); 

22 ‘‘(E) a qualified audiologist (as defined in 

23 section 1861(ll)(4)(B) of the Social Security 

24 Act (42 U.S.C. 1395x(ll)(4)(B)); 

25 ‘‘(F) a qualified medical transcriptionist; 


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1 ‘‘(G) a State-licensed pharmacist; 

2 ‘‘(H) a State-licensed supplier of durable 

3 medical equipment, prosthetics, orthotics, or 

4 supplies; and 

5 ‘‘(I) a State-licensed, a State-certified, or a 

6 nationally accredited home health care provider; 

7 ‘‘(3) the term ‘health information technology’— 

8 ‘‘(A) means computer hardware, software, 

9 and related technology that— 

10 ‘‘(i) supports the requirements for 

11 being treated as a meaningful EHR user 

12 (as described in section 1848(o)(2)(A) of 

13 the Social Security Act (42 U.S.C. 1395w– 

14 4(o)(2)(A))) and is purchased by an eligi15 ble professional to aid in the provision of 

16 health care in a health care setting, includ17 ing electronic medical records; and 

18 ‘‘(ii) provides for— 

19 ‘‘(I) enhancement of continuity of 

20 care for patients through electronic 

21 storage, transmission, and exchange 

22 of relevant personal health data and 

23 information, such as ensuring that 

24 this information is accessible at the 


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1 times and places where clinical deci2 sions will be or are likely to be made; 

3 ‘‘(II) enhancement of commu4 nication between patients and health 

5 care providers; 

6 ‘‘(III) improvement of quality 

7 measurement by eligible professionals 

8 enabling the eligible professionals to 

9 collect, store, measure, and report on 

10 the processes and outcomes of indi11 vidual and population performance 

12 and quality of care; 

13 ‘‘(IV) improvement of evidence14 based decision support; or 

15 ‘‘(V) enhancement of consumer 

16 and patient empowerment; and 

17 ‘‘(B) does not include information tech18 nology the sole use of which is financial man19 agement, maintenance of inventory of basic 

20 supplies, or appointment scheduling; 

21 ‘‘(4) the term ‘qualified eligible professional’ 

22 means an eligible professional whose office is a small 

23 business concern; and 

24 ‘‘(5) the term ‘qualified medical 

25 transcriptionist’ means a specialist in medical lanVerDate Nov 24 2008 00:59 Nov 11, 2009 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2765.IS S2765

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1 guage and the healthcare documentation process 

2 who— 

3 ‘‘(A) interprets and transcribes dictation 

4 by physicians and other healthcare professionals 

5 to ensure accurate, complete, and consistent 

6 documentation of healthcare encounters; and 

7 ‘‘(B) is certified by or registered with the 

8 Association for Healthcare Documentation In9 tegrity, or a successor association thereto. 

10 ‘‘(b) LOAN GUARANTEES FOR QUALIFIED ELIGIBLE

11 PROFESSIONALS.— 

12 ‘‘(1) IN GENERAL.—Subject to paragraph (2), 

13 the Administrator may guarantee not more than 90 

14 percent of a loan made to a qualified eligible profes15 sional for the acquisition of health information tech16 nology for use in the medical practice of the quali17 fied eligible professional and for the costs associated 

18 with the installation of the health information tech19 nology. Except as otherwise provided in this section, 

20 a loan guaranteed under this section shall be made 

21 on the same terms and conditions as a loan made 

22 under section 7(a). 

23 ‘‘(2) LIMITATIONS ON GUARANTEE AMOUNTS.— 

24 The maximum amount of loan principal guaranteed 

25 under this subsection may not be more than— 


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1 ‘‘(A) $350,000 with respect to any 1 quali2 fied eligible professional; and 

3 ‘‘(B) $2,000,000 with respect to 1 group 

4 of affiliated qualified eligible professionals. 

5 ‘‘(c) FEES.— 

6 ‘‘(1) IN GENERAL.—The Administrator may— 

7 ‘‘(A) impose a guarantee fee on a qualified 

8 eligible professional for the purpose of reducing 

9 the cost of the guarantee to zero in an amount 

10 not to exceed 2 percent of the total guaranteed 

11 portion of any loan guaranteed under this sec12 tion; and 

13 ‘‘(B) impose an annual servicing fee on a 

14 lender making a loan guaranteed under this 

15 section of not more 0.5 percent of the out16 standing balance of the guaranteed portion of 

17 loans by the lender guaranteed under this sec18 tion. 

19 ‘‘(2) NO FEES BY LENDERS.—No service fees, 

20 processing fees, origination fees, application fees, 

21 points, brokerage fees, bonus points, or other fees 

22 may be charged to a loan applicant or recipient by 

23 a lender relating to a loan guaranteed under this 

24 section. 


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1 ‘‘(d) DEFERRAL PERIOD.—A loan guaranteed under 

2 this section shall carry a deferral period of not less than 

3 1 year and not more than 3 years. The Administrator may 

4 subsidize interest during the period for which a loan guar5 anteed under this section is deferred. 

6 ‘‘(e) EFFECTIVE DATE.—The Administrator may not 

7 guarantee a loan under this section until the meaningful 

8 EHR use requirements have been determined by the Sec9 retary of Health and Human Services. 

10 ‘‘(f) SUNSET.—The Administrator may not guar11 antee a loan under this section after the date that is 7 

12 years after meaningful EHR use requirements have been 

13 determined by the Secretary of Health and Human Serv14 ices. 

15 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

16 are authorized to be appropriated such sums as are nec17 essary for the cost of guaranteeing $10,000,000,000 in 

18 loans under this section. The Administrator shall deter19 mine the cost of guaranteeing loans under this section sep20 arately and distinctly from other programs operated by the 

21 Administrator.’’. 

Æ 


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