IIB 

108TH CONGRESS 

1ST SESSION H. R. 663

IN THE SENATE OF THE UNITED STATES 

MARCH 13, 2003

Received; read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

AN ACT

To amend title IX of the Public Health Service Act to 

provide for the improvement of patient safety and to 

reduce the incidence of events that adversely affect patient safety, 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,
2

HR 663 RFS 

1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

2 (a) SHORT TITLE.—This Act may be cited as the 

3 ‘‘Patient Safety and Quality Improvement Act’’. 

4 (b) TABLE OF CONTENTS.—The table of contents for 

5 this Act is as follows:

Sec. 1. Short title; table of contents. 

Sec. 2. Findings and purposes. 

TITLE I—PATIENT SAFETY AND QUALITY IMPROVEMENT 

Sec. 101. Amendments to Public Health Service Act. 

Sec. 102. Promoting the diffusion and interoperability of information technology systems involved with health care delivery. 

Sec. 103. Required use of product identification technology. 

Sec. 104. Grants for electronic prescription programs. 

Sec. 105. Grants to hospitals and other health care providers for information 

technologies. 

Sec. 106. Authorization of appropriations for grants under sections 104 and 

105. 

TITLE II—MEDICAL INFORMATION TECHNOLOGY ADVISORY 

BOARD. 

Sec. 201. Medical Information Technology Advisory Board.

6 SEC. 2. FINDINGS AND PURPOSES. 

7 (a) FINDINGS.—The Congress finds as follows: 

8 (1) In 1999, the Institute of Medicine released 

9 a report entitled ‘‘To Err Is Human’’ that described 

10 medical errors as the 8th leading cause of death in 

11 the United States, with as many as 98,000 people 

12 dying as a result of medical errors each year. 

13 (2) To address these deaths and injuries due to 

14 medical errors, the health care system must identify 

15 and learn from such errors so that systems of care 

16 can be improved. 
3

HR 663 RFS 

1 (3) Myriad public and private patient safety ini2 tiatives have begun. The Quality Interagency Coordi3 nation Task Force has recommended steps to im4 prove patient safety that may be taken by each Fed5 eral agency involved in health care and activities re6 lating to these steps are ongoing. 

7 (4) The Department of Health and Human 

8 Services has initiated several patient safety projects. 

9 The Joint Commission on Accreditation of 

10 Healthcare Organizations issued a patient safety 

11 standard that went into effect on July 1, 2001, and 

12 the peer review organizations are conducting ongoing 

13 studies of clinical performance measurement of care 

14 delivered to beneficiaries under the medicare pro15 gram under title XVIII of the Social Security Act. 

16 (5) Several steps can be taken now to improve 

17 patient safety. For example, according to the Cen18 ters for Disease Control and Prevention, hand wash19 ing is the single most important means of preventing 

20 the spread of infection. Repeated studies indicate 

21 that lack of or improper hand washing still contrib22 utes significantly to disease transmission in health 

23 care settings. Working with experts from the private 

24 sector, the Centers for Disease Control and Preven25 tion has drafted ‘‘Guidelines for Hand Hygiene in 
4

HR 663 RFS 

1 Healthcare Settings’’ setting forth recommendations 

2 to promote improved hand hygiene practices and re3 duce transmission of pathogenic microorganisms to 

4 patients and personnel in health care settings. 

5 (6) According to the Centers for Disease Con6 trol and Prevention, nosocomial infections affect ap7 proximately 2 million patients annually in acute care 

8 facilities in the United States at an estimated direct 

9 patient care cost of approximately $3.5 billion each 

10 year. 

11 (7) The Congress encourages the continuation 

12 and acceleration of private sector efforts to take im13 mediate steps to improve patient safety and recog14 nizes the need for action in the public sector to com15 plement these efforts. 

16 (8) The research on patient safety unequivo17 cally calls for a learning environment, where pro18 viders will feel safe to report health care errors, in 

19 order to improve patient safety. 

20 (9) Voluntary data gathering systems are more 

21 supportive than mandatory systems in creating the 

22 learning environment referred to in paragraph (8) as 

23 stated in the Institute of Medicine’s report. 

24 (10) Promising patient safety reporting systems 

25 have been established throughout the United States, 
5

HR 663 RFS 

1 and the best ways to structure and use these sys2 tems are currently being determined, largely through 

3 projects funded by the Agency for Healthcare Re4 search and Quality. 

5 (11) Many organizations currently collecting 

6 patient safety information have expressed a need for 

7 protections that will allow them to review protected 

8 information so that they may collaborate in the de9 velopment and implementation of patient safety im10 provement strategies. Currently, the State peer re11 view protections provide inadequate conditions to 

12 allow the sharing of information to promote patient 

13 safety. 

14 (12) In 2001, the Institute of Medicine released 

15 a report entitled ‘‘Crossing the Quality Chasm’’ that 

16 found that the United States health care system 

17 does not consistently deliver high-quality care to pa18 tients. 

19 (b) PURPOSES.—The purposes of this Act are—

20 (1) to encourage a culture of safety and quality 

21 in the United States health care system by providing 

22 for a health care errors reporting system that both 

23 protects information and improves patient safety 

24 and quality of health care; and 
6

HR 663 RFS 

1 (2) to ensure accountability by raising stand2 ards and expectations for continuous quality im3 provements in patient safety through the actions of 

4 the Secretary of Health and Human Services. 

5 TITLE I—PATIENT SAFETY AND 

6 QUALITY IMPROVEMENT 

7 SEC. 101. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT. 

8 (a) IN GENERAL.—Title IX of the Public Health 

9 Service Act (42 U.S.C. 299 et seq.) is amended—

10 (1) in section 912(c), by inserting ‘‘, in accord11 ance with part C,’’ after ‘‘The Director shall’’; 

12 (2) by redesignating part C as part D;

13 (3) by redesignating sections 921 through 928, 

14 as sections 931 through 938, respectively; 

15 (4) in section 938(1) (as so redesignated), by 

16 striking ‘‘921’’ and inserting ‘‘931’’; and 

17 (5) by inserting after part B the following: 

18 ‘‘PART C—PATIENT SAFETY IMPROVEMENT 

19 ‘‘SEC. 921. DEFINITIONS. 

20 ‘‘In this part: 

21 ‘‘(1) IDENTIFIABLE INFORMATION.—The term 

22 ‘identifiable information’ means information that is 

23 presented in a form and manner that allows the 

24 identification of any provider, patient, or reporter of 

25 patient safety work product. With respect to pa-
7

HR 663 RFS 

1 tients, such information includes any individually 

2 identifiable health information as that term is de3 fined in the regulations promulgated pursuant to 

4 section 264(c) of the Health Insurance Portability 

5 and Accountability Act of 1996 (Public Law 104–

6 191; 110 Stat. 2033). 

7 ‘‘(2) NONIDENTIFIABLE INFORMATION.—The 

8 term ‘nonidentifiable information’ means informa9 tion that is presented in a form and manner that 

10 prevents the identification of any provider, patient, 

11 or reporter of patient safety work product. With re12 spect to patients, such information must be de-iden13 tified consistent with the regulations promulgated 

14 pursuant to section 264(c) of the Health Insurance 

15 Portability and Accountability Act of 1996 (Public 

16 Law 104–191; 110 Stat. 2033). 

17 ‘‘(3) PATIENT SAFETY EVALUATION SYSTEM.—

18 The term ‘patient safety evaluation system’ means a 

19 process that involves the collection, management, or 

20 analysis of information for submission to or by a pa21 tient safety organization. 

22 ‘‘(4) PATIENT SAFETY ORGANIZATION.—The 

23 term ‘patient safety organization’ means a private or 

24 public organization or component thereof that is cer25 tified, through a process to be determined by the 
8

HR 663 RFS 

1 Secretary under section 925, to perform each of the 

2 following activities: 

3 ‘‘(A) The conduct, as the organization or 

4 component’s primary activity, of efforts to im5 prove patient safety and the quality of health 

6 care delivery. 

7 ‘‘(B) The collection and analysis of patient 

8 safety work product that is submitted by pro9 viders. 

10 ‘‘(C) The development and dissemination 

11 of evidence-based information to providers with 

12 respect to improving patient safety, such as rec13 ommendations, protocols, or information re14 garding best practices. 

15 ‘‘(D) The utilization of patient safety work 

16 product to carry out activities limited to those 

17 described under this paragraph and for the pur18 poses of encouraging a culture of safety and of 

19 providing direct feedback and assistance to pro20 viders to effectively minimize patient risk. 

21 ‘‘(E) The maintenance of confidentiality 

22 with respect to identifiable information. 

23 ‘‘(F) The provision of appropriate security 

24 measures with respect to patient safety work 

25 product. 
9

HR 663 RFS 

1 ‘‘(G) The submission of nonidentifiable in2 formation to the Agency consistent with stand3 ards established by the Secretary under section 

4 923(b) for any National Patient Safety Data5 base. 

6 ‘‘(5) PATIENT SAFETY WORK PRODUCT.—

7 ‘‘(A) The term ‘patient safety work prod8 uct’ means any document or communication 

9 (including any information, report, record, 

10 memorandum, analysis, deliberative work, state11 ment, or root cause analysis) that—

12 ‘‘(i) except as provided in subpara13 graph (B), is developed by a provider for 

14 the purpose of reporting to a patient safety 

15 organization, and is reported to a patient 

16 safety organization; 

17 ‘‘(ii) is created by a patient safety or18 ganization; or 

19 ‘‘(iii) would reveal the deliberations or 

20 analytic process of a patient safety evalua21 tion system (as defined in paragraph (3)). 

22 ‘‘(B)(i) Patient safety work product de23 scribed in subparagraph (A)(i)—

24 ‘‘(I) does not include any separate in25 formation described in clause (ii); and 
10

HR 663 RFS 

1 ‘‘(II) shall not be construed to include 

2 such separate information merely by rea3 son of inclusion of a copy of the document 

4 or communication involved in a submission 

5 to, or the fact of submission of such a copy 

6 to, a patient safety organization. 

7 ‘‘(ii) Separate information described in this 

8 clause is a document or communication (includ9 ing a patient’s medical record or any other pa10 tient or hospital record) that is developed or 

11 maintained, or exists, separately from any pa12 tient safety evaluation system. 

13 ‘‘(C) Information available from sources 

14 other than a patient safety work product under 

15 this section may be discovered or admitted in a 

16 civil or administrative proceeding, if discover17 able or admissible under applicable law. 

18 ‘‘(6) PROVIDER.—The term ‘provider’ means—

19 ‘‘(A) an individual or entity licensed or 

20 otherwise authorized under State law to provide 

21 health care services, including—

22 ‘‘(i) a hospital, nursing facility, com23 prehensive outpatient rehabilitation facil24 ity, home health agency, and hospice pro25 gram; 
11

HR 663 RFS 

1 ‘‘(ii) a physician, physician assistant, 

2 nurse practitioner, clinical nurse specialist, 

3 certified nurse midwife, nurse anesthetist, 

4 psychologist, certified social worker, reg5 istered dietitian or nutrition professional, 

6 physical or occupational therapist, or other 

7 individual health care practitioner; 

8 ‘‘(iii) a pharmacist; and 

9 ‘‘(iv) a renal dialysis facility, ambula10 tory surgical center, pharmacy, physician 

11 or health care practitioner’s office, long12 term care facility, behavioral health resi13 dential treatment facility, clinical labora14 tory, or community health center; or 

15 ‘‘(B) any other person or entity specified 

16 in regulations by the Secretary after public no17 tice and comment. 

18 ‘‘SEC. 922. PRIVILEGE FOR PATIENT SAFETY WORK PROD19 UCT. 

20 ‘‘(a) PRIVILEGE.—Notwithstanding any other provi21 sion of law and subject to subsection (c), patient safety 

22 work product shall not be—

23 ‘‘(1) subject to a civil or administrative sub24 poena or order; 
12

HR 663 RFS 

1 ‘‘(2) subject to discovery in connection with a 

2 civil or administrative proceeding; 

3 ‘‘(3) subject to disclosure pursuant to section 

4 552 of title 5, United States Code (commonly known 

5 as the Freedom of Information Act), or any other 

6 similar Federal or State law; 

7 ‘‘(4) required to be admitted as evidence or oth8 erwise disclosed in any State or Federal civil or ad9 ministrative proceeding; or 

10 ‘‘(5) if the patient safety work product is identi11 fiable information and is received by a national ac12 creditation organization in its capacity as a patient 

13 safety organization—

14 ‘‘(A) used by a national accreditation orga15 nization in an accreditation action against the 

16 provider that reported the information; 

17 ‘‘(B) shared by such organization with its 

18 survey team; or 

19 ‘‘(C) required as a condition of accredita20 tion by a national accreditation association. 

21 ‘‘(b) REPORTER PROTECTION.—

22 ‘‘(1) IN GENERAL.—A provider may not use 

23 against an individual in an adverse employment ac24 tion described in paragraph (2) the fact that the in25 dividual in good faith reported information—
13

HR 663 RFS 

1 ‘‘(A) to the provider with the intention of 

2 having the information reported to a patient 

3 safety organization; or 

4 ‘‘(B) directly to a patient safety organiza5 tion. 

6 ‘‘(2) ADVERSE EMPLOYMENT ACTION.—For 

7 purposes of this subsection, an ‘adverse employment 

8 action’ includes—

9 ‘‘(A) the failure to promote an individual 

10 or provide any other employment-related benefit 

11 for which the individual would otherwise be eli12 gible; 

13 ‘‘(B) an adverse evaluation or decision 

14 made in relation to accreditation, certification, 

15 credentialing, or licensing of the individual; and 

16 ‘‘(C) a personnel action that is adverse to 

17 the individual concerned. 

18 ‘‘(3) REMEDIES.—Any provider that violates 

19 this subsection shall be subject to a civil monetary 

20 penalty of not more than $20,000 for each such vio21 lation involved. Such penalty shall be imposed and 

22 collected in the same manner as civil money pen23 alties under subsection (a) of section 1128A of the 

24 Social Security Act are imposed and collected. 
14

HR 663 RFS 

1 ‘‘(c) DISCLOSURES.—Nothing in this section pro2 hibits any of the following disclosures: 

3 ‘‘(1) Voluntary disclosure of nonidentifiable in4 formation. 

5 ‘‘(2) Voluntary disclosure of identifiable infor6 mation by a provider or patient safety organization, 

7 if such disclosure—

8 ‘‘(A) is authorized by the provider for the 

9 purposes of improving quality and safety; 

10 ‘‘(B) is to an entity or person subject to 

11 the requirements of section 264(c) of the 

12 Health Insurance Portability and Accountability 

13 Act of 1996 (Public Law 104–191; 110 Stat. 

14 2033), or any regulation promulgated under 

15 such section; and 

16 ‘‘(C) is not in conflict with such section or 

17 any regulation promulgated under such section. 

18 ‘‘(3) Disclosure as required by law by a pro19 vider to the Food and Drug Administration, or on 

20 a voluntary basis by a provider to a federally estab21 lished patient safety program, with respect to an Ad22 ministration-regulated product or activity for which 

23 that entity has responsibility, for the purposes of ac24 tivities related to the quality, safety, or effectiveness 

25 of such Administration-regulated product or activity. 
15

HR 663 RFS 

1 ‘‘(4) Disclosures of patient safety work product 

2 in accordance with this part by a provider to a pa3 tient safety organization. 

4 ‘‘(d) EFFECT OF TRANSFER, DISCLOSURE.—The fol5 lowing shall not be treated as a waiver of any privilege 

6 or protection established under this part: 

7 ‘‘(1) The transfer of any patient safety work 

8 product between a provider and a patient safety or9 ganization. 

10 ‘‘(2) Disclosure of patient safety work product 

11 as described in subsection (c). 

12 ‘‘(3) The unauthorized disclosure of patient 

13 safety work product.

14 ‘‘(e) PENALTY.—

15 ‘‘(1) PROHIBITION.—Except as provided in this 

16 part, and subject to paragraphs (2) and (4), it shall 

17 be unlawful for any person to disclose patient safety 

18 work product in violation of this section, if such dis19 closure constitutes a negligent or knowing breach of 

20 confidentiality. 

21 ‘‘(2) RELATION TO HIPAA.—The penalty under 

22 paragraph (3) for a disclosure in violation of para23 graph (1) does not apply if the person would be sub24 ject to a penalty under section 264(c) of the Health 

25 Insurance Portability and Accountability Act of 
16

HR 663 RFS 

1 1996 (Public Law 104–191; 110 Stat. 2033), or any 

2 regulation promulgated under such section, for the 

3 same disclosure. 

4 ‘‘(3) AMOUNT.—Any person who violates para5 graph (1) shall be subject to a civil monetary penalty 

6 of not more than $10,000 for each such violation in7 volved. Such penalty shall be imposed and collected 

8 in the same manner as civil money penalties under 

9 subsection (a) of section 1128A of the Social Secu10 rity Act are imposed and collected. 

11 ‘‘(4) SUBSEQUENT DISCLOSURE.—Paragraph 

12 (1) applies only to the first person that breaches 

13 confidentiality with respect to particular patient 

14 safety work product. 

15 ‘‘(f) RELATION TO HIPAA.—

16 ‘‘(1) IN GENERAL.—For purposes of applying 

17 the regulations promulgated pursuant to section 

18 264(c) of the Health Insurance Portability and Ac19 countability Act of 1996 (Public Law 104–191; 110 

20 Stat. 2033)—

21 ‘‘(A) patient safety organizations shall be 

22 treated as business associates; and 

23 ‘‘(B) activities of such organizations de24 scribed in section 921(4) in relation to a pro-
17

HR 663 RFS 

1 vider are deemed to be health care operations 

2 (as defined in such regulations) of the provider. 

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

4 this section shall be construed to alter or affect the 

5 implementation of such regulations or such section 

6 264(c). 

7 ‘‘(g) NO LIMITATION OF OTHER PRIVILEGES.—

8 Nothing in this section shall be construed to affect privi9 leges, including peer review and confidentiality protec10 tions, that are otherwise available under Federal or State 

11 laws. 

12 ‘‘(h) NO LIMITATION ON CONTRACTS.—Nothing in 

13 this section shall be construed to limit the power of a pro14 vider and a patient safety organization, or a patient safety 

15 organization and the Agency or any National Patient 

16 Safety Database, consistent with the provisions of this Act 

17 and other applicable law, to enter into a contract requiring 

18 greater confidentiality or delegating authority to make an 

19 authorized disclosure. 

20 ‘‘(i) RELATION TO STATE REPORTING REQUIRE21 MENTS.—Nothing in this part shall be construed as pre22 empting or otherwise affecting any State law requiring a 

23 provider to report information, including information de24 scribed in section 921(5)(B), that is not patient safety 

25 work product. 
18

HR 663 RFS 

1 ‘‘(j) CONTINUATION OF PRIVILEGE.—Patient safety 

2 work product of an organization that is certified as a pa3 tient safety organization shall continue to be privileged 

4 and confidential, in accordance with this section, if the or5 ganization’s certification is terminated or revoked or if the 

6 organization otherwise ceases to qualify as a patient safety 

7 organization. 

8 ‘‘(k) REPORTS ON STRATEGIES TO IMPROVE PA9 TIENT SAFETY.—

10 ‘‘(1) DRAFT REPORT.—Not later than the date 

11 that is 18 months after any National Patient Safety 

12 Database is operational, the Secretary, in consulta13 tion with the Director, shall prepare a draft report 

14 on effective strategies for reducing medical errors 

15 and increasing patient safety. The draft report shall 

16 include any measure determined appropriate by the 

17 Secretary to encourage the appropriate use of such 

18 strategies, including use in any federally funded pro19 grams. The Secretary shall make the draft report 

20 available for public comment and submit the draft 

21 report to the Institute of Medicine for review. 

22 ‘‘(2) FINAL REPORT.—Not later than 1 year 

23 after the date described in paragraph (1), the Sec24 retary shall submit a final report to the Congress 

25 that includes, in an appendix, any findings by the 
19

HR 663 RFS 

1 Institute of Medicine concerning research on the 

2 strategies discussed in the draft report and any 

3 modifications made by the Secretary based on such 

4 findings. 

5 ‘‘SEC. 923. NATIONAL PATIENT SAFETY DATABASE. 

6 ‘‘(a) AUTHORITY.—

7 ‘‘(1) IN GENERAL.—In conducting activities 

8 under this part, the Secretary shall provide for the 

9 establishment and maintenance of a database to re10 ceive relevant nonidentifiable patient safety work 

11 product, and may designate entities to collect rel12 evant nonidentifiable patient safety work product 

13 that is voluntarily reported by patient safety organi14 zations upon the request of the Secretary. Any data15 base established or designated under this paragraph 

16 may be referred to as a ‘National Patient Safety 

17 Database’. 

18 ‘‘(2) USE OF INFORMATION.—Information re19 ported to any National Patient Safety Database 

20 shall be used to analyze national and regional statis21 tics, including trends and patterns of health care er22 rors. The information resulting from such analyses 

23 may be included in the annual quality reports pre24 pared under section 913(b)(2). 
20

HR 663 RFS 

1 ‘‘(3) ADVISORY ROLE.—The Secretary shall 

2 provide scientific support to patient safety organiza3 tions, including the dissemination of methodologies 

4 and evidence-based information related to root 

5 causes and quality improvement. 

6 ‘‘(b) STANDARDS.—In establishing or designating a 

7 database under subsection (a)(1), the Secretary shall, in 

8 consultation with representatives of patient safety organi9 zations, the provider community, and the health informa10 tion technology industry, determine common formats for 

11 the voluntary reporting of nonidentifiable patient safety 

12 work product, including necessary elements, common and 

13 consistent definitions, and a standardized computer inter14 face for the processing of the work product. To the extent 

15 practicable, such standards shall be consistent with the 

16 administrative simplification provisions of part C of title 

17 XI of the Social Security Act.

18 ‘‘(c) CERTAIN METHODOLOGIES FOR COLLECTION.—

19 The Secretary shall ensure that the methodologies for the 

20 collection of nonidentifiable patient safety work product 

21 for any National Patient Safety Database include the 

22 methodologies developed or recommended by the Patient 

23 Safety Task Force of the Department of Health and 

24 Human Services. 
21

HR 663 RFS 

1 ‘‘(d) FACILITATION OF INFORMATION EXCHANGE.—

2 To the extent practicable, the Secretary may facilitate the 

3 direct link of information between providers and patient 

4 safety organizations and between patient safety organiza5 tions and any National Patient Safety Database. 

6 ‘‘(e) RESTRICTION ON TRANSFER.—Only nonidentifi7 able information may be transferred to any National Pa8 tient Safety Database. 

9 ‘‘SEC. 924. TECHNICAL ASSISTANCE. 

10 ‘‘(a) IN GENERAL.—The Secretary, acting through 

11 the Director, may—

12 ‘‘(1) provide technical assistance to patient 

13 safety organizations, and to States with reporting 

14 systems for health care errors; and 

15 ‘‘(2) provide guidance on the type of data to be 

16 voluntarily submitted to any National Patient Safety 

17 Database. 

18 ‘‘(b) ANNUAL MEETINGS.—Assistance provided 

19 under subsection (a) may include annual meetings for pa20 tient safety organizations to discuss methodology, commu21 nication, information collection, or privacy concerns. 

22 ‘‘SEC. 925. CERTIFICATION OF PATIENT SAFETY ORGANIZA23 TIONS. 

24 ‘‘(a) IN GENERAL.—Not later than 6 months after 

25 the date of enactment of the Patient Safety and Quality 
22

HR 663 RFS 

1 Improvement Act, the Secretary shall establish a process 

2 for certifying patient safety organizations. 

3 ‘‘(b) PROCESS.—The process established under sub4 section (a) shall include the following: 

5 ‘‘(1) Certification of patient safety organiza6 tions by the Secretary or by such other national or 

7 State governmental organizations as the Secretary 

8 determines appropriate. 

9 ‘‘(2) If the Secretary allows other governmental 

10 organizations to certify patient safety organizations 

11 under paragraph (1), the Secretary shall establish a 

12 process for approving such organizations. Any such 

13 approved organization shall conduct certifications 

14 and reviews in accordance with this section. 

15 ‘‘(3) A review of each certification under para16 graph (1) (including a review of compliance with 

17 each criterion in this section and any related imple18 menting standards as determined by the Secretary 

19 through rulemaking) not less often than every 3 

20 years, as determined by the Secretary. 

21 ‘‘(4) Revocation of any such certification by the 

22 Secretary or other such governmental organization 

23 that issued the certification, upon a showing of 

24 cause. 
23

HR 663 RFS 

1 ‘‘(c) CRITERIA.—A patient safety organization must 

2 meet the following criteria as conditions of certification: 

3 ‘‘(1) The mission of the patient safety organiza4 tion is to conduct activities that are to improve pa5 tient safety and the quality of health care delivery 

6 and is not in conflict of interest with the providers 

7 that contract with the patient safety organization. 

8 ‘‘(2) The patient safety organization has appro9 priately qualified staff, including licensed or certified 

10 medical professionals. 

11 ‘‘(3) The patient safety organization, within any 

12 2 year period, contracts with more than 1 provider 

13 for the purpose of receiving and reviewing patient 

14 safety work product. 

15 ‘‘(4) The patient safety organization is not a 

16 component of a health insurer or other entity that 

17 offers a group health plan or health insurance cov18 erage. 

19 ‘‘(5) The patient safety organization is man20 aged, controlled, and operated independently from 

21 any provider that contracts with the patient safety 

22 organization for reporting patient safety work prod23 uct. 

24 ‘‘(6) To the extent practical and appropriate, 

25 the patient safety organization collects patient safety 
24

HR 663 RFS 

1 work product from providers in a standardized man2 ner that permits valid comparisons of similar cases 

3 among similar providers. 

4 ‘‘(d) ADDITIONAL CRITERIA FOR COMPONENT ORGA5 NIZATIONS.—If a patient safety organization is a compo6 nent of another organization, the patient safety organiza7 tion must, in addition to meeting the criteria described 

8 in subsection (c), meet the following criteria as conditions 

9 of certification: 

10 ‘‘(1) The patient safety organization maintains 

11 patient safety work product separately from the rest 

12 of the organization, and establishes appropriate se13 curity measures to maintain the confidentiality of 

14 the patient safety work product. 

15 ‘‘(2) The patient safety organization does not 

16 make an unauthorized disclosure under this Act of 

17 patient safety work product to the rest of the orga18 nization in breach of confidentiality. 

19 ‘‘(3) The mission of the patient safety organiza20 tion does not create a conflict of interest with the 

21 rest of the organization.’’. 

22 (b) AUTHORIZATION OF APPROPRIATIONS.—Section 

23 937 of the Public Health Service Act (as redesignated by 

24 subsection (a)) is amended by adding at the end the fol25 lowing: 
25

HR 663 RFS 

1 ‘‘(e) PATIENT SAFETY AND QUALITY IMPROVE2 MENT.—For the purpose of carrying out part C, there are 

3 authorized to be appropriated such sums as may be nec4 essary for each of the fiscal years 2004 through 2008.’’. 

5 SEC. 102. PROMOTING THE DIFFUSION AND INTEROPER6 ABILITY OF INFORMATION TECHNOLOGY SYS7 TEMS INVOLVED WITH HEALTH CARE DELIV8 ERY. 

9 (a) VOLUNTARY STANDARDS.—

10 (1) IN GENERAL.—Not later than 18 months 

11 after the date of the enactment of this Act, the Sec12 retary of Health and Human Services (in this sec13 tion referred to as the ‘‘Secretary’’) shall—

14 (A) develop or adopt voluntary national 

15 standards that promote the interoperability of 

16 information technology systems involved with 

17 health care delivery, including but not limited to 

18 computerized physician order entry; 

19 (B) in developing or adopting such stand20 ards, take into account—

21 (i) the ability of such systems to cap22 ture and aggregate clinically specific data 

23 to enable evidence-based medicine and 

24 other applications that promote the elec-
26

HR 663 RFS 

1 tronic exchange of patient medical record 

2 information; and 

3 (ii) the cost that meeting such stand4 ards would have on providing health care 

5 in the United States and the increased effi6 ciencies in providing such care achieved 

7 under the standards; 

8 (C) in developing or adopting such stand9 ards and to the extent practicable, test the effi10 cacy, usability, and scalability of proposed inter11 operability standards within a variety of clinical 

12 settings, including an urban academic medical 

13 center, a rural hospital, a community health 

14 center, and a community hospital; and 

15 (D) submit a report to the Congress con16 taining recommendations on such standards. 

17 (2) CONSULTATION.—In developing or adopting 

18 standards under paragraph (1)(A), the Secretary 

19 shall consider the recommendations of the National 

20 Committee on Vital Health Statistics for the stand21 ardization of message formatting, coding, and vocab22 ulary for interoperability of information technology 

23 systems involved with health care delivery. The Sec24 retary shall consult with representatives of the 

25 health information technology industry and the pro-
27

HR 663 RFS 

1 vider community who are involved with the develop2 ment of interoperability standards. 

3 (b) UPDATES.—The Secretary shall provide for the 

4 ongoing review and periodic updating of the standards de5 veloped under subsection (a). 

6 SEC. 103. REQUIRED USE OF PRODUCT IDENTIFICATION 

7 TECHNOLOGY. 

8 The Federal Food, Drug, and Cosmetic Act (21 

9 U.S.C. 301 et seq.) is amended—

10 (1) in section 502, by adding at the end the fol11 lowing: 

12 ‘‘(w) If it is a drug or biological product, unless it 

13 includes a unique product identifier for the drug or bio14 logical product as required by regulations under section 

15 510(q).’’; and 

16 (2) in section 510, by adding at the end the fol17 lowing: 

18 ‘‘(q)(1) The Secretary shall issue, and may periodi19 cally revise, regulations requiring the manufacturer of any 

20 drug or biological product that is subject to regulation by 

21 the Food and Drug Administration, or the packager or 

22 labeler of a drug or biological product that is subject to 

23 regulation by the Food and Drug Administration, to in24 clude a unique product identifier on the packaging of the 

25 drug or biological product. 
28

HR 663 RFS 

1 ‘‘(2) For purposes of this subsection, the term 

2 ‘unique product identifier’ means an identification that—

3 ‘‘(A) is affixed by the manufacturer, labeler, or 

4 packager to each drug or biological product de5 scribed in paragraph (1) at each packaging level; 

6 ‘‘(B) uniquely identifies the item and meets the 

7 standards required by this section; and 

8 ‘‘(C) can be read by a scanning device or other 

9 technology acceptable to the Secretary. 

10 ‘‘(3) A unique product identifier required by regula11 tions issued or revised under paragraph (1) shall be based 

12 on—

13 ‘‘(A) the National Drug Code maintained by 

14 the Food and Drug Administration; 

15 ‘‘(B) commercially accepted standards estab16 lished by organizations that are accredited by the 

17 American National Standards Institute, such as the 

18 Health Industry Business Communication Council or 

19 the Uniform Code Council; or 

20 ‘‘(C) other identification formats that the Sec21 retary deems appropriate. 

22 ‘‘(4) The Secretary may, at the Secretary’s discre23 tion, waive the requirements of this section, or add addi24 tional provisions that are necessary to safeguard the pub25 lic health.’’. 
29

HR 663 RFS 

1 SEC. 104. GRANTS FOR ELECTRONIC PRESCRIPTION PRO2 GRAMS. 

3 (a) GRANTS.—

4 (1) IN GENERAL.—The Secretary of Health and 

5 Human Services (in this section referred to as the 

6 ‘‘Secretary’’) may make grants to qualified practi7 tioners for the purpose of establishing electronic pre8 scription programs. 

9 (2) MATCHING FUNDS.—

10 (A) IN GENERAL.—With respect to the 

11 costs of establishing an electronic prescription 

12 program, a condition for the receipt of a grant 

13 under paragraph (1) is that the qualified practi14 tioner involved agree to make available (directly 

15 or through donations from public or private en16 tities) non-Federal contributions toward such 

17 costs in an amount that is not less than 50 per18 cent of such costs. 

19 (B) DETERMINATION OF AMOUNT CON20 TRIBUTED.—Non-Federal contributions re21 quired in subparagraph (A) may be in cash or 

22 in kind, fairly evaluated, including equipment or 

23 services. Amounts provided by the Federal Gov24 ernment, or services assisted or subsidized to 

25 any significant extent by the Federal Govern-
30

HR 663 RFS 

1 ment, may not be included in determining the 

2 amount of such non-Federal contributions. 

3 (b) STUDY.—

4 (1) IN GENERAL.—The Secretary, acting 

5 through the Director of the Agency for Healthcare 

6 Research and Quality, shall support a study to as7 sess existing scientific evidence regarding the effec8 tiveness and cost-effectiveness of the use of elec9 tronic prescription programs intended to improve the 

10 efficiency of prescription ordering and the safe and 

11 effective use of prescription drugs. The study shall 

12 address the following: 

13 (A) The ability of such programs to reduce 

14 medical errors and improve the quality and 

15 safety of patient care. 

16 (B) The impact of the use of such pro17 grams on physicians, pharmacists, and patients, 

18 including such factors as direct and indirect 

19 costs, changes in productivity, and satisfaction. 

20 (C) The effectiveness of strategies for over21 coming barriers to the use of electronic pre22 scription programs.

23 (2) REPORT.—The Secretary shall ensure that, 

24 not later than 18 months after the date of the enact25 ment of this Act, a report containing the findings of 
31

HR 663 RFS 

1 the study under paragraph (1) is submitted to the 

2 appropriate committees of the Congress. 

3 (3) DISSEMINATION OF FINDINGS.—The Sec4 retary shall disseminate the findings of the study 

5 under paragraph (1) to appropriate public and pri6 vate entities. 

7 (c) DEVELOPMENT OF MODEL.—The Secretary, act8 ing through the Director of the Agency for Healthcare Re9 search and Quality, may develop an Internet-based mathe10 matical model that simulates the cost and effectiveness of 

11 electronic prescription programs for qualified practi12 tioners. The model may be designed to allow qualified 

13 practitioners to estimate, through an interactive interface, 

14 the impact of electronic prescribing on their practices, in15 cluding the reduction in drug-related health care errors. 

16 (d) DEFINITIONS.—For purposes of this section: 

17 (1) The term ‘‘electronic prescription pro18 gram’’—

19 (A) means a program for the electronic 

20 submission and processing of prescriptions; and 

21 (B) includes the hardware (including com22 puters and other electronic devices) and soft23 ware programs for the electronic submission of 

24 prescriptions to pharmacies, the processing of 
32

HR 663 RFS 

1 such submissions by pharmacies, and decision2 support programs. 

3 (2) The term ‘‘qualified practitioner’’ means a 

4 practitioner licensed by law to administer or dis5 pense prescription drugs. 

6 SEC. 105. GRANTS TO HOSPITALS AND OTHER HEALTH 

7 CARE PROVIDERS FOR INFORMATION TECH8 NOLOGIES. 

9 (a) IN GENERAL.—The Secretary of Health and 

10 Human Services (in this section referred to as the ‘‘Sec11 retary’’) shall make grants to hospitals and other health 

12 care providers (but not more than 1 grant to any 1 hos13 pital or provider) to pay the costs of acquiring or imple14 menting information technologies whose purposes are—

15 (1) to improve quality of care and patient safe16 ty; and 

17 (2) to reduce adverse events and health care 

18 complications resulting from medication errors. 

19 (b) SPECIAL CONSIDERATION.—In making grants 

20 under subsection (a), the Secretary shall give special con21 sideration to applicants who seek to promote the following: 

22 (1) Interoperability across hospital services or 

23 departments using standards developed or adopted 

24 by the Secretary under section 102. 
33

HR 663 RFS 

1 (2) Electronic communication of patient data 

2 across the spectrum of health care delivery. 

3 (3) Computerized physician order entry or bar 

4 coding applications. 

5 (4) Electronic communication of patient data in 

6 hospitals that provide services to underserved or low7 income populations. 

8 (5) Improved clinical decisionmaking through 

9 acquisition and implementation of decision-support 

10 technologies. 

11 (c) CERTAIN GRANT CONDITIONS.—A condition for 

12 the receipt of a grant under subsection (a) is that the ap13 plicant involved meet the following requirements: 

14 (1) The applicant agrees to carry out a pro15 gram to measure, analyze, and report patient safety 

16 and medical errors at the hospital or other health 

17 care provider involved, to submit to the Secretary a 

18 description of the methodology that will be used, and 

19 to have such program in effect as soon as prac20 ticable after the application for the grant is ap21 proved, without regard to whether information tech22 nologies under the grant have been implemented. 

23 (2) The applicant has arranged for an evalua24 tion that addresses the effectiveness and cost-effec25 tiveness of the information technology for which the 
34

HR 663 RFS 

1 grant is provided and its impact on the quality and 

2 safety of patient care, submitted the evaluation plan 

3 to the Secretary, and received approval from the 

4 Secretary of the applicant’s methodology. 

5 (3) The applicant has or is developing a patient 

6 safety evaluation system (as that term is defined in 

7 section 921 of the Public Health Service Act (as 

8 amended by section 101)) for reporting health care 

9 errors to a patient safety organization. 

10 (4) The applicant agrees to provide the Sec11 retary with such information as the Secretary may 

12 require regarding the use of funds under this pro13 gram or its impact. 

14 (5) The applicant provides assurances satisfac15 tory to the Secretary that any information tech16 nology planned, acquired, or implemented with grant 

17 funds under this section will be part of an informa18 tion program that—

19 (A) carries out the purposes described in 

20 subsection (a); and 

21 (B) is comprehensive or will be expanded 

22 to become comprehensive, regardless of whether 

23 Federal assistance is available for such expan24 sion. 
35

HR 663 RFS 

1 (d) TECHNICAL ASSISTANCE TO GRANTEES.—The 

2 Secretary, acting through the Director of the Agency for 

3 Healthcare Research and Quality, shall provide technical 

4 assistance to applicants and grantees to ensure the appro5 priate evaluation of the information technologies for which 

6 grants are awarded under this section, such as—

7 (1) reviewing and providing technical assistance 

8 on the applicant’s proposed evaluation; 

9 (2) developing mechanisms to ensure ongoing 

10 communications between grantees and evaluators to 

11 facilitate the identification and resolution of prob12 lems as they arise, ensure mutual learning, and pro13 mote the rapid dissemination of information; 

14 (3) reviewing the interim and final reports re15 quired under subsection (e); and 

16 (4) disseminating evidence-based information in 

17 interim and final reports to patient safety organiza18 tions, as appropriate. 

19 (e) EVALUATION REPORTS BY GRANTEE.—A condi20 tion for the receipt of a grant under subsection (a) is that 

21 the applicant agree to submit an interim and a final report 

22 to the Secretary in accordance with this subsection.

23 (1) INTERIM REPORT.—Not later than 1 year 

24 after the implementation of information technologies 

25 under the grant is completed, the applicant will sub-
36

HR 663 RFS 

1 mit an interim report to the Secretary describing the 

2 initial effectiveness of such technologies in carrying 

3 out the purposes described in subsection (a). 

4 (2) FINAL REPORT.—Not later than 3 years 

5 after the implementation of information technologies 

6 under the grant is completed, the applicant will sub7 mit a final report to the Secretary describing the ef8 fectiveness and cost-effectiveness of such tech9 nologies and addressing other issues determined to 

10 be important in carrying out the purposes described 

11 in subsection (a). 

12 (3) RELATION TO DISBURSEMENT OF GRANT.—

13 In disbursing a grant under subsection (a), the Secretary shall withhold 1 14 ⁄3 of the grant until the grant15 ee submits to the Secretary the report required in 

16 paragraph (1). 

17 (f) REPORTS BY SECRETARY.—

18 (1) INTERIM REPORTS.—

19 (A) IN GENERAL.—Through the fiscal year 

20 preceding the fiscal year in which the final re21 port under paragraph (2) is prepared, the Sec22 retary shall submit to the Committee on Energy 

23 and Commerce of the House of Representatives 

24 and the Committee on Health, Education, 

25 Labor, and Pensions of the Senate periodic re-
37

HR 663 RFS 

1 ports on the grant program under subsection 

2 (a). Such reports shall be submitted not less 

3 frequently than once each fiscal year, beginning 

4 with fiscal year 2004. 

5 (B) CONTENTS.—A report under subpara6 graph (A) shall include information on—

7 (i) the number of grants made; 

8 (ii) the nature of the projects for 

9 which funding is provided under the grant 

10 program; 

11 (iii) the geographic distribution of 

12 grant recipients; and 

13 (iv) such other matters as the Sec14 retary determines appropriate. 

15 (2) FINAL REPORT.—Not later than 180 days 

16 after the date on which the last of the reports is due 

17 under subsection (e)(2), the Secretary shall submit 

18 a final report to the committees referred to in para19 graph (1)(A) on the grant program under subsection 

20 (a), together with such recommendations for legisla21 tion and administrative action as the Secretary de22 termines appropriate. 

23 (g) DEFINITIONS.—For purposes of this section: 
38

HR 663 RFS 

1 (1) The term ‘‘costs’’, with respect to informa2 tion technologies referred to in subsection (a), in3 cludes total expenditures incurred for—

4 (A) purchasing, leasing, and installing 

5 computer software and hardware, including 

6 hand-held computer technologies; 

7 (B) making improvements to existing com8 puter software and hardware; and 

9 (C) purchasing or leasing communications 

10 capabilities necessary for clinical data access, 

11 storage, and exchange. 

12 (2) The term ‘‘health care provider’’ has the 

13 same meaning given to the term ‘‘provider’’ in sec14 tion 921 of the Public Health Services Act (as 

15 amended by this Act). 

16 (h) TERMINATION OF GRANT AUTHORITIES.—The 

17 authority of the Secretary to make grants under sub18 section (a) terminates upon the expiration of fiscal year 

19 2011. 

20 (i) MATCHING FUNDS.—

21 (1) IN GENERAL.—With respect to the costs of 

22 a grant to be carried out under this section, such 

23 grant may be made only if the applicant agrees to 

24 make available (directly or through donations from 

25 public or private entities) non-Federal contributions 
39

HR 663 RFS 

1 toward such costs in an amount that is not less than 

2 50 percent of such costs ($1 for each $1 of Federal 

3 funds provided in the grant). 

4 (2) DETERMINATION OF AMOUNTS CONTRIB5 UTED.—Amounts provided by the Federal Govern6 ment, or services assisted or subsidized to any sig7 nificant extent by the Federal Government, may not 

8 be included in determining the amount of such non9 Federal contributions. 

10 SEC. 106. AUTHORIZATION OF APPROPRIATIONS FOR 

11 GRANTS UNDER SECTIONS 104 AND 105. 

12 For the purpose of carrying out sections 104 and 

13 105, there are authorized to be appropriated $25,000,000 

14 for each of fiscal years 2004 and 2005. 

15 TITLE II—MEDICAL INFORMA16 TION TECHNOLOGY ADVI17 SORY BOARD. 

18 SEC. 201. MEDICAL INFORMATION TECHNOLOGY ADVISORY 

19 BOARD. 

20 Title XI of the Social Security Act is amended by 

21 adding at the end the following new section: 

22 ‘‘MEDICAL INFORMATION TECHNOLOGY ADVISORY BOARD

23 ‘‘SEC. 1180. (a) ESTABLISHMENT.—

24 ‘‘(1) IN GENERAL.—Not later than 3 months 

25 after the date of the enactment of this section, the 

26 Secretary shall appoint an advisory board to be 
40

HR 663 RFS 

1 known as the ‘Medical Information Technology Advi2 sory Board’ (in this section referred to as the 

3 ‘MITAB’). 

4 ‘‘(2) CHAIRMAN.—The Secretary shall des5 ignate one member as chairman. The chairman shall 

6 be an individual affiliated with an organization hav7 ing expertise creating American National Standards 

8 Institute (ANSI) accepted standards in health care 

9 information technology and a member of the Na10 tional Committee for Vital and Health Statistics. 

11 ‘‘(b) COMPOSITION.—

12 ‘‘(1) IN GENERAL.—The MITAB shall consist 

13 of not more than 17 members that include—

14 ‘‘(A) experts from the fields of medical in15 formation, information technology, medical con16 tinuous quality improvement, medical records 

17 security and privacy, individual and institu18 tional health care clinical providers, health re19 searchers, and health care purchasers; 

20 ‘‘(B) one or more staff experts from each 

21 of the following: the Centers for Medicare & 

22 Medicaid Services, the Agency for Healthcare 

23 Research and Quality, and the Institute of 

24 Medicine of the National Academy of Sciences; 
41

HR 663 RFS 

1 ‘‘(C) representatives of private organiza2 tions with expertise in medical infomatics; 

3 ‘‘(D) a representative of a teaching hos4 pital; and 

5 ‘‘(E) one or more representatives of the 

6 health care information technology industry. 

7 ‘‘(2) TERMS OF APPOINTMENT.—The term of 

8 any appointment under paragraph (1) to the 

9 MITAB shall be for the life of the MITAB. 

10 ‘‘(3) MEETINGS.—The MITAB shall meet at 

11 the call of its chairman or a majority of its mem12 bers. 

13 ‘‘(4) VACANCIES.—A vacancy on the MITAB 

14 shall be filled in the same manner in which the origi15 nal appointment was made not later than 30 days 

16 after the MITAB is given notice of the vacancy and 

17 shall not affect the power of the remaining members 

18 to execute the duties of the MITAB. 

19 ‘‘(5) COMPENSATION.—Members of the MITAB 

20 shall receive no additional pay, allowances, or bene21 fits by reason of their service on the MITAB. 

22 ‘‘(6) EXPENSES.—Each member of the MITAB 

23 shall receive travel expenses and per diem in lieu of 

24 subsistence in accordance with sections 5702 and 

25 5703 of title 5, United States Code. 
42

HR 663 RFS 

1 ‘‘(c) DUTIES.—

2 ‘‘(1) IN GENERAL.—The MITAB shall on an 

3 ongoing basis advise, and make recommendations to, 

4 the Secretary regarding medical information tech5 nology, including the following: 

6 ‘‘(A) The best current practices in medical 

7 information technology. 

8 ‘‘(B) Methods for the adoption (not later 

9 than 2 years after the date of the enactment of 

10 this section) of a uniform health care informa11 tion system interface between and among old 

12 and new computer systems. 

13 ‘‘(C) Recommendations for health care vo14 cabulary, messaging, and other technology 

15 standards (including a common lexicon for com16 puter technology) necessary to achieve the 

17 interoperability of health care information sys18 tems for the purposes described in subpara19 graph (E). 

20 ‘‘(D) Methods of implementing—

21 ‘‘(i) health care information tech22 nology interoperability standardization; 

23 and 

24 ‘‘(ii) records security. 
43

HR 663 RFS 

1 ‘‘(E) Methods to promote information ex2 change among health care providers so that 

3 long-term compatibility among information sys4 tems is maximized, in order to do one or more 

5 of the following: 

6 ‘‘(i) To maximize positive outcomes in 

7 clinical care—

8 ‘‘(I) by providing decision sup9 port for diagnosis and care; and 

10 ‘‘(II) by assisting in the emer11 gency treatment of a patient pre12 senting at a facility where there is no 

13 medical record for the patient. 

14 ‘‘(ii) To contribute to (and be con15 sistent with) the development of the pa16 tient assessment instrument provided for 

17 under section 545 of the Medicare, Med18 icaid, and SCHIP Benefits Improvement 

19 and Protection Act of 2000, and to assist 

20 in minimizing the need for new and dif21 ferent records as patients move from pro22 vider to provider. 

23 ‘‘(iii) To reduce or eliminate the need 

24 for redundant records, paperwork, and the 
44

HR 663 RFS 

1 repetitive taking of patient histories and 

2 administering of tests. 

3 ‘‘(iv) To minimize medical errors, 

4 such as administration of contraindicated 

5 drugs. 

6 ‘‘(v) To provide a compatible informa7 tion technology architecture that facilitates 

8 future quality and cost-saving needs and 

9 that avoids the financing and development 

10 of information technology systems that are 

11 not readily compatible. 

12 ‘‘(2) REPORTS.—

13 ‘‘(A) INITIAL REPORT.—No later than 18 

14 months after the date of the enactment of this 

15 section, the MITAB shall submit to Congress 

16 and the Secretary an initial report concerning 

17 the matters described in paragraph (1). The re18 port shall include—

19 ‘‘(i) the practices described in para20 graph (1)(A), including the status of 

21 health care information technology stand22 ards being developed by private sector and 

23 public-private groups; 
45

HR 663 RFS 

1 ‘‘(ii) recommendations for accelerating 

2 the development of common health care 

3 terminology standards; 

4 ‘‘(iii) recommendations for completing 

5 development of health care information 

6 system messaging standards; and 

7 ‘‘(iv) progress toward meeting the 

8 deadline described in paragraph (1)(B) for 

9 adoption of methods described in such 

10 paragraph. 

11 ‘‘(B) SUBSEQUENT REPORTS.—During 

12 each of the 2 years after the year in which the 

13 report is submitted under subparagraph (A), 

14 the MITAB shall submit to Congress and the 

15 Secretary an annual report relating to addi16 tional recommendations, best practices, results 

17 of information technology improvements, anal18 yses of private sector efforts to implement the 

19 interoperability standards established in section 

20 102 of the Patient Safety and Quality Improve21 ment Act, and such other matters as may help 

22 ensure the most rapid dissemination of best 

23 practices in health care information technology. 

24 ‘‘(d) STAFF AND SUPPORT SERVICES.—

25 ‘‘(1) EXECUTIVE DIRECTOR.—
46

HR 663 RFS 

1 ‘‘(A) APPOINTMENT.—The Chairman shall 

2 appoint an executive director of the MITAB. 

3 ‘‘(B) COMPENSATION.—The executive di4 rector shall be paid the rate of basic pay for 

5 level V of the Executive Schedule. 

6 ‘‘(2) STAFF.—With the approval of the 

7 MITAB, the executive director may appoint such 

8 personnel as the executive director considers appro9 priate. 

10 ‘‘(3) APPLICABILITY OF CIVIL SERVICE LAWS.—

11 The staff of the MITAB shall be appointed without 

12 regard to the provisions of title 5, United States 

13 Code, governing appointments in the competitive 

14 service, and shall be paid without regard to the pro15 visions of chapter 51 and subchapter III of chapter 

16 53 of such title (relating to classification and Gen17 eral Schedule pay rates). 

18 ‘‘(4) EXPERTS AND CONSULTANTS.—With the 

19 approval of the MITAB, the executive director may 

20 procure temporary and intermittent services under 

21 section 3109(b) of title 5, United States Code. 

22 ‘‘(e) POWERS.—

23 ‘‘(1) HEARINGS AND OTHER ACTIVITIES.—For 

24 the purpose of carrying out its duties, the MITAB 

25 may hold such hearings and undertake such other 
47

HR 663 RFS 

1 activities as the MITAB determines to be necessary 

2 to carry out its duties. 

3 ‘‘(2) DETAIL OF FEDERAL EMPLOYEES.—Upon 

4 the request of the MITAB, the head of any Federal 

5 agency is authorized to detail, without reimburse6 ment, any of the personnel of such agency to the 

7 MITAB to assist the MITAB in carrying out its du8 ties. Any such detail shall not interrupt or otherwise 

9 affect the civil service status or privileges of the 

10 Federal employee. 

11 ‘‘(3) TECHNICAL ASSISTANCE.—Upon the re12 quest of the MITAB, the head of a Federal agency 

13 shall provide such technical assistance to the 

14 MITAB as the MITAB determines to be necessary 

15 to carry out its duties. 

16 ‘‘(4) OBTAINING INFORMATION.—The MITAB 

17 may secure directly from any Federal agency infor18 mation necessary to enable it to carry out its duties, 

19 if the information may be disclosed under section 

20 552 of title 5, United States Code. Upon request of 

21 the Chairman of the MITAB, the head of such agen22 cy shall furnish such information to the MITAB. 

23 ‘‘(f) TERMINATION.—The MITAB shall terminate 30 

24 days after the date of submission of its final report under 

25 subsection (c)(2)(B). 
48

HR 663 RFS 

1 ‘‘(g) APPLICABILITY OF FACA.—The provisions of 

2 the Federal Advisory Committee Act (5 U.S.C. App.) shall 

3 apply to the MITAB. 

4 ‘‘(h) FUNDING.—There are authorized to be appro5 priated such sums as are necessary for each fiscal year 

6 to carry out this section.’’.

Passed the House of Representatives March 12, 

2003. 

Attest: JEFF TRANDAHL, 

Clerk.