I 

108TH CONGRESS 

1ST SESSION H. R. 877

To amend title XI of the Social Security Act to improve patient safety. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 25, 2003

Mrs. JOHNSON of Connecticut (for herself, Mr. STARK, Mr. THOMAS, Mr. 

CAMP, Mr. LEWIS of Kentucky, Mr. MCINNIS, Mr. HOUGHTON, Mr. 

HERGER, Mr. WELLER, Mr. SMITH of New Jersey, Mr. ENGLISH, and 

Mr. PETERSON of Pennsylvania) introduced the following bill; which was 

referred to the Committee on Ways and Means, and in addition to the 

Committee on Energy and Commerce, 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 amend title XI of the Social Security Act to improve 

patient safety.

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; TABLE OF CONTENTS. 

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

5 ‘‘Patient Safety Improvement Act of 2003’’. 

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

7 this Act is as follows:

Sec. 1. Short title; table of contents. 

Sec. 2. Patient safety improvements. 
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‘‘PART D—PATIENT SAFETY IMPROVEMENTS

‘‘Sec. 1181. Voluntary reporting of patient safety data; definitions. 

‘‘Sec. 1182. Confidentiality and peer review protections. 

‘‘Sec. 1183. Center for Quality Improvement and Patient Safety. 

‘‘Sec. 1184. Interoperability standards for health care information technology systems. 

‘‘Sec. 1185. Voluntary adoption of methods to improve patient safety. 

‘‘Sec. 1186. Evaluation and report. 

Sec. 3. Medical Information Technology Advisory Board.

1 SEC. 2. PATIENT SAFETY IMPROVEMENTS. 

2 Title XI of the Social Security Act is amended by 

3 adding at the end the following new part: 

4 ‘‘PART D—PATIENT SAFETY IMPROVEMENTS

5 ‘‘VOLUNTARY REPORTING OF PATIENT SAFETY DATA; 

6 DEFINITIONS

7 ‘‘SEC. 1181. (a) COLLECTION AND VOLUNTARY RE8 PORTING OF PATIENT SAFETY DATA.—In order to im9 prove patient safety and the quality of health care delivery, 

10 a health care provider (as defined in subsection (d)) may 

11 voluntarily collect and develop patient safety data (as de12 fined in subsection (e)) and report such data to one or 

13 more patient safety organizations (as defined in subsection 

14 (f)) in a manner that is confidential and privileged (as 

15 described in section 1182). 

16 ‘‘(b) USE OF PATIENT SAFETY DATA BY PATIENT

17 SAFETY ORGANIZATIONS.—Patient safety organizations 

18 shall analyze the patient safety data reported and develop 

19 (and report back to health care providers) information to 

20 improve patient safety and the quality of health care deliv21 ery and shall submit non-identifiable information derived 
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1 from such data in a uniform manner to the Center for 

2 Quality Improvement and Patient Safety (for inclusion in 

3 the Patient Safety Database, if applicable). Such non4 identifiable information may be disclosed and shared with 

5 other patient safety organizations. Identifiable patient 

6 safety data may be disclosed to other patient safety orga7 nizations with the explicit authorization for each such dis8 closure by the reporting provider involved. 

9 ‘‘(c) FUNCTIONS OF CENTER.—The Center for Qual10 ity Improvement and Patient Safety conducts patient safe11 ty activities consistent with section 1183.

12 ‘‘(d) HEALTH CARE PROVIDERS COVERED.—For 

13 purposes of this part, the term ‘health care provider’ 

14 means a provider of services (as defined in section 1861(u) 

15 and including a hospital, skilled nursing facility, home 

16 health agency, and hospice program) that provides services 

17 for which payment may be made under part A of title 

18 XVIII and the provider’s employees, and includes physi19 cians insofar as they furnish health care services in the 

20 health care provider. 

21 ‘‘(e) PATIENT SAFETY DATA COVERED.—

22 ‘‘(1) IN GENERAL.—For purposes of this part, 

23 the term ‘patient safety data’ means any data, re24 ports, records, memoranda, analyses, deliberative 

25 work, statements, or root cause analyses that are 
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1 collected or developed to improve patient safety or 

2 health care quality and that— 

3 ‘‘(A) are collected or developed by a health 

4 care provider for the purpose of reporting to a 

5 patient safety organization and that are re6 ported on a timely basis to such an organiza7 tion; 

8 ‘‘(B) are collected or developed by a pa9 tient safety organization or by (or on behalf of) 

10 the Center for Quality Improvement and Pa11 tient Safety, regardless of whether the data are 

12 transmitted to the health care provider that re13 ported the original data; or 

14 ‘‘(C) describes corrective actions taken by 

15 a health care provider in response to the pro16 vider’s reporting of data to that organization, 

17 regardless of whether the organization has 

18 transmitted under subsection (f)(2) information 

19 to the health care provider that reported the 

20 original data, and that are reported on a timely 

21 basis to such an organization. 

22 ‘‘(2) CONSTRUCTION REGARDING USE OF

23 DATA.—

24 ‘‘(A) INTERNAL USE PERMITTED TO IM25 PROVE PATIENT SAFETY, QUALITY, AND EFFI-
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1 CIENCY.—Nothing in this part shall be con2 strued to limit or discourage a health care pro3 vider from developing and using patient safety 

4 data within the provider to improve patient 

5 safety, health care quality, or administrative ef6 ficiency of the provider. 

7 ‘‘(B) TREATMENT.—Information that is 

8 collected or developed as patient safety data is 

9 not disqualified from being treated as patient 

10 safety data because of its development or use 

11 for the purposes described in subparagraph (A) 

12 and such development or use shall not con13 stitute a waiver of any privilege or protection 

14 established under section 1182 or under State 

15 law. 

16 ‘‘(f) QUALIFICATIONS OF PATIENT SAFETY ORGANI17 ZATIONS.—

18 ‘‘(1) IN GENERAL.—For purposes of this part, 

19 the term ‘patient safety organization’ means a pri20 vate or public organization that conducts activities 

21 to improve patient safety and the quality of health 

22 care delivery by assisting health care providers that 

23 report to such organizations and that has been cer24 tified by the Secretary as—
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1 ‘‘(A) performing each of the activities de2 scribed in paragraph (2); and 

3 ‘‘(B) meets the other requirements of para4 graphs (3) through (5). 

5 ‘‘(2) ACTIVITIES DESCRIBED.—The activities 

6 referred to in paragraph (1)(A) are the following: 

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

8 safety data that are voluntarily reported by 

9 more than one health care provider on a local, 

10 regional, State, or national basis. 

11 ‘‘(B) The development and dissemination 

12 of information to health care providers and 

13 other patient safety organizations with respect 

14 to improving patient safety, such as rec15 ommendations, protocols, or information re16 garding best practices. 

17 ‘‘(C) The utilization of patient safety data 

18 to carry out activities under this paragraph to 

19 improve patient safety and to provide assistance 

20 to health care providers to minimize patient 

21 risk.

22 ‘‘(3) CONDUCT OF ACTIVITIES.—In conducting 

23 activities under paragraph (2), a patient safety orga24 nization shall—
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1 ‘‘(A) maintain confidentiality with respect 

2 to individually identifiable health information; 

3 ‘‘(B) submit non-identifiable information 

4 to the Center for Quality Improvement and Pa5 tient Safety in a format established by the Sec6 retary; and 

7 ‘‘(C) maintain appropriate security meas8 ures with respect to patient safety data. 

9 ‘‘(4) ORGANIZATION REQUIREMENTS.—The re10 quirements of this paragraph for an organization are 

11 that—

12 ‘‘(A) the organization is managed, con13 trolled, and operated independently from health 

14 care providers which report patient safety data 

15 to it under this part; 

16 ‘‘(B) if the organization no longer qualifies 

17 as a patient safety organization, with respect to 

18 any patient safety data that it received from a 

19 health care provider, the organization shall do 

20 one of the following: 

21 ‘‘(i) with the approval of the provider 

22 and another patient safety organization, 

23 transfer such data to such other organiza24 tion; 
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1 ‘‘(ii) if practicable, return the data to 

2 the provider; or 

3 ‘‘(iii) destroy the patient safety data; 

4 ‘‘(C) if the organization charges a fee for 

5 the activities it performs with respect to health 

6 care providers, the fee shall be uniform among 

7 all classes or types of health care providers 

8 (taking into account the size of the health care 

9 provider); 

10 ‘‘(D) the organization seeks to collect data 

11 from health care providers in a standardized 

12 manner that permits valid comparisons of simi13 lar cases among similar health care providers; 

14 and 

15 ‘‘(E) the organization meets such other re16 quirements as the Secretary may by regulation 

17 require. 

18 For purposes of subparagraph (A), an organization 

19 is controlled by a health care provider if the provider 

20 is able to significantly influence or direct the actions 

21 or policies of the organization. 

22 ‘‘(5) LIMITATION ON USE OF PATIENT SAFETY

23 DATA BY PATIENT SAFETY ORGANIZATIONS.—A pa24 tient safety organization may not use patient safety 

25 data reported by a health care provider in accord-
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1 ance with this part to take regulatory or enforce2 ment actions it otherwise performs (or is responsible 

3 for performing) in relation to such provider. 

4 ‘‘(6) TECHNICAL ASSISTANCE.—The Secretary 

5 may provide technical assistance to patient safety or6 ganizations in providing recommendations and ad7 vice to health care providers reporting patient safety 

8 data under this part. Such assistance shall include 

9 advice with respect to methodology, communication, 

10 dissemination of information, data collection, secu11 rity, and confidentiality concerns. 

12 ‘‘(g) CONSTRUCTION.—Nothing in this part shall be 

13 construed to limit or discourage the reporting of informa14 tion relating to patient safety within a health care pro15 vider. 

16 ‘‘CONFIDENTIALITY AND PEER REVIEW PROTECTIONS

17 ‘‘SEC. 1182. (a) IN GENERAL.—Notwithstanding any 

18 other provision of law, patient safety data shall be privi19 leged and confidential in accordance with this section. 

20 ‘‘(b) SCOPE OF PRIVILEGE.—Subject to the suc21 ceeding provisions of this section, such data shall not be—

22 ‘‘(1) subject to a civil or administrative sub23 poena; 

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

25 civil or administrative proceeding; 
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1 ‘‘(3) disclosed pursuant to section 552 of title 

2 5, United States Code (commonly known as the 

3 Freedom of Information Act) or any other similar 

4 Federal or State law; or 

5 ‘‘(4) admitted as evidence or otherwise disclosed 

6 in any civil or administrative proceeding. 

7 ‘‘(c) CLARIFICATION OF SCOPE.—The privilege estab8 lished by this section with respect to patient safety data 

9 described in section 1181(e)(1)(A) shall apply to informa10 tion, such as records of a patient’s medical diagnosis and 

11 treatment, other primary health care information, and 

12 other information, to the extent that such information was 

13 collected or developed for the purpose specified in such 

14 section and is reported in accordance with such section. 

15 Such privilege shall not apply to information merely by 

16 reason of its inclusion, or the fact of its submission, in 

17 a report under such section. Information available from 

18 sources other than a report made under such section may 

19 be discovered or admitted in a civil or administrative pro20 ceeding, if discoverable or admissible under applicable 

21 state law. 

22 ‘‘(d) INFORMATION NOT SUBJECT TO PRIVILEGE.—

23 The privilege established by this section shall not apply 

24 to one or more of the following: 
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1 ‘‘(1) MEDICAL RECORDS AND OTHER PRIMARY

2 HEALTH RECORDS.—Records of a patient’s medical 

3 diagnosis and treatment and other primary health 

4 records of a health care provider. Such privilege 

5 shall not apply to such information by reason of its 

6 inclusion within patient safety data. 

7 ‘‘(2) NON-IDENTIFIABLE INFORMATION USED

8 BY DATABASE.—Non-identifiable information from a 

9 patient safety organization to the Patient Safety 

10 Database and the further disclosure of such data by 

11 the Center for Quality Improvement and Patient 

12 Safety. 

13 ‘‘(e) REPORTER PROTECTION.—

14 ‘‘(1) IN GENERAL.—A health care provider may 

15 not use against an individual in an adverse employ16 ment action described in paragraph (2) the fact that 

17 the individual in good faith reported—

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

19 having it reported to a patient safety organiza20 tion, or 

21 ‘‘(B) directly to a patient safety organiza22 tion, information that would constitute patient 

23 safety data under section 1181(e)(1)(A) if the 

24 provider were to have submitted it on a timely 
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1 basis to a patient safety organization in accord2 ance with such section. 

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

4 purposes of this subsection, an ‘adverse employment 

5 action’ includes—

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

7 or provide any other employment-related benefit 

8 for which the individual would otherwise be eli9 gible; 

10 ‘‘(B) an evaluation or decision made in re11 lation to accreditation, certification, 

12 credentialing or licensing of the individual; and 

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

14 the individual concerned. 

15 ‘‘(3) REMEDIES.—The provisions of the first 

16 sentence of section 1128A(a) shall apply with re17 spect to a health care provider’s violation of para18 graph (1) in the same manner as they apply to an 

19 act referred to in section 1128A(a)(7). 

20 ‘‘(f) PENALTY.—It is unlawful for any person to dis21 close any patient safety data in violation of the provisions 

22 of this section. Any person violating such provisions shall 

23 be subject to the same sanctions under section 1160(c) 

24 (relating to, upon conviction, a fine of not more than 

25 $1,000, imprisonment for not more than 6 months, or 
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1 both, per disclosure and payment of the costs of prosecu2 tion) as a person who discloses any information described 

3 in section 1160(a). 

4 ‘‘(g) RULES OF CONSTRUCTION.—

5 ‘‘(1) NO LIMITATION OF OTHER PRIVILEGES.—

6 Subject to paragraph (2), nothing in this section 

7 shall be construed as affecting other privileges that 

8 are available under Federal or State laws that pro9 vide greater peer review or confidentiality protec10 tions than the peer review and confidentiality protec11 tions provided for in this section. 

12 ‘‘(2) NO EFFECT ON STATE MANDATORY RE13 PORTING REQUIREMENTS.—Nothing in this part 

14 shall be construed as preempting or otherwise affect15 ing any State law mandatory reporting requirement 

16 for health care providers. 

17 ‘‘(h) APPLICATION OF PRIVACY REGULATIONS.—For 

18 purposes of applying the regulations promulgated pursu19 ant to section 264(c) of the Health Insurance Portability 

20 and Accountability Act of 1996 (Public Law 104–191; 110 

21 Stat. 2033)—

22 ‘‘(1) patient safety organizations shall be treat23 ed as business associates; 

24 ‘‘(2) activities of such organizations described 

25 in section 1181(f)(2)(A) in relation to a health care 
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1 provider are deemed to be health care operations of 

2 the provider; and 

3 ‘‘(3) the disclosure of identifiable information 

4 under the voluntary program under this part by 

5 such an organization shall be treated as necessary 

6 for the proper management and administration of 

7 the organization. 

8 Nothing in this section shall be construed to alter or affect 

9 the implementation of such regulation or such section 

10 264(c). 

11 ‘‘(i) WAIVERS.—Nothing in this part shall be con12 strued as precluding a health care provider from waiving 

13 the privilege or confidentiality protections under this sec14 tion. 

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

16 data of an organization that is certified as a patient safety 

17 organization shall continue to be privileged and confiden18 tial, in accordance with this section, if the organization’s 

19 certification is terminated or revoked or if the organization 

20 otherwise ceases to qualify as a patient safety organization 

21 until the data are otherwise disposed of in accordance with 

22 section 1181(f)(4). 

23 ‘‘(k) SURVEY AND REPORT.— 

24 ‘‘(1) SURVEY.—The Comptroller General of the 

25 United States shall conduct a survey of State laws 
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1 that relate to patient safety data peer review sys2 tems, including laws that establish an evidentiary 

3 privilege applicable to data developed in such sys4 tems, and shall review the manner in which such 

5 laws have been interpreted by the courts and the ef6 fectiveness of such laws in promoting patient safety. 

7 ‘‘(2) REPORT.—Not later than 9 months after 

8 the date of enactment of this section, the Comp9 troller General shall prepare and submit to Congress 

10 a report concerning the results of the survey con11 ducted under paragraph (1).

12 ‘‘CENTER FOR QUALITY IMPROVEMENT AND PATIENT

13 SAFETY

14 ‘‘SEC. 1183. (a) IN GENERAL.—The Secretary shall 

15 ensure that the Center for Quality Improvement and Pa16 tient Safety (in this section referred to as the ‘Center’) 

17 supports public and private sector initiatives to improve 

18 patient safety for items and services furnished through 

19 health care providers. 

20 ‘‘(b) DUTIES.—

21 ‘‘(1) IN GENERAL.—The Secretary shall ensure 

22 that the Center carries out the following duties: 

23 ‘‘(A) Provide for the certification and re24 certification of patient safety organizations in 

25 accordance with subsection (d). 
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1 ‘‘(B) Collect and disseminate information 

2 related to patient safety. 

3 ‘‘(C) Establish a Patient Safety Database 

4 to collect, support, and coordinate the analysis 

5 of non-identifiable information submitted to the 

6 Database in accordance with subsection (e). 

7 ‘‘(D) Facilitate the development of con8 sensus among health care providers, patients, 

9 and other interested parties concerning patient 

10 safety and recommendations to improve patient 

11 safety. 

12 ‘‘(E) Provide technical assistance to States 

13 that have (or are developing) medical errors re14 porting systems, assist States in developing 

15 standardized methods for data collection, and 

16 collect data from State reporting systems for 

17 inclusion in the Patient Safety Database. 

18 ‘‘(2) CONSULTATION.—In carrying out the du19 ties under paragraph (1) (including the establish20 ment of the Database), the Secretary shall consult 

21 with and develop partnerships, as appropriate, with 

22 health care organizations, health care providers, 

23 public and private sector entities, patient safety or24 ganizations, health care consumers, and other rel25 evant experts to improve patient safety. 
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1 ‘‘(c) CERTIFICATION AND RECERTIFICATION PROC2 ESS.—

3 ‘‘(1) IN GENERAL.—The initial certification and 

4 recertification of a patient safety organization under 

5 subsection (b)(1)(A) shall be made under a process 

6 that is approved by the Secretary and is consistent 

7 with criteria published by the Secretary. 

8 ‘‘(2) REVOCATION.—Such a certification or re9 certification may be revoked by the Secretary upon 

10 a showing of cause (including the disclosure of data 

11 in violation of section 1182). 

12 ‘‘(3) TERMINATION.—Such a certification pro13 vided for a patient safety organization shall termi14 nate (subject to recertification) on the earlier of—

15 ‘‘(A) the date that is 3 years after the date 

16 on which such certification was provided; or 

17 ‘‘(B) the date on which the Secretary re18 vokes the certification. 

19 ‘‘(d) IMPLEMENTATION AND CONSULTATION.—In 

20 carrying out subsection (c)(1), the Secretary shall—

21 ‘‘(1) facilitate the development of patient safety 

22 goals and track the progress made in meeting those 

23 goals; and 

24 ‘‘(2) ensure that data submitted by a patient 

25 safety organization to the Patient Safety Database, 
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1 as provided for under subsection (e), are comparable 

2 and useful for research and analysis and that the re3 search findings and patient safety alerts that result 

4 from such analyses are presented in clear and con5 sistent formats that enhance the usefulness of such 

6 alerts. 

7 ‘‘(e) PATIENT SAFETY DATABASE.—

8 ‘‘(1) IN GENERAL.—The Secretary shall—

9 ‘‘(A) establish a Patient Safety Database 

10 to collect non-identifiable information con11 cerning patient safety that is reported on a vol12 untary basis; and 

13 ‘‘(B) establish common formats for the vol14 untary reporting of data under subparagraph 

15 (A), including the establishment of necessary 

16 data elements, common and consistent defini17 tions, and a standardized computer interface 

18 for the processing of such data. 

19 ‘‘(2) DATABASE.—In carrying out this sub20 section, the Secretary— 

21 ‘‘(A) shall establish and modify as nec22 essary criteria to determine the organizations 

23 that may voluntarily contribute to, and the data 

24 that comprises, the Patient Safety Database; 
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1 ‘‘(B) shall ensure that the Patient Safety 

2 Database is only used by qualified entities or 

3 individuals as determined appropriate by the 

4 Secretary in accordance with criteria applied by 

5 the Secretary; and 

6 ‘‘(C) may enter into contracts for the ad7 ministration of the Database with private and 

8 public entities with experience in the adminis9 tration of similar databases. 

10 ‘‘(3) NON-IDENTIFIABLE INFORMATION.—For 

11 purposes of this part, the term ‘non-identifiable in12 formation’ means information that is presented in a 

13 form and manner that prevents the identification of 

14 any health care provider, patient, and the reporter 

15 of the information. 

16 ‘‘(f) FUNDING.—The Secretary shall transfer from 

17 the Federal Hospital Insurance Trust Fund established 

18 under section 1817 such sums as are necessary for each 

19 fiscal year to carry out this section. 

20 ‘‘INTEROPERABILITY STANDARDS FOR HEALTH CARE

21 INFORMATION TECHNOLOGY SYSTEMS

22 ‘‘SEC. 1184. (a) IN GENERAL.—By not later than 2 

23 years after the date of the enactment of this part, the Sec24 retary shall develop or adopt (and shall periodically review 

25 and update) voluntary, national standards that promote 

26 the interoperability of health care information technology 
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1 systems across all health care settings. In promulgating 

2 regulations to carry out this section, the Secretary shall 

3 take into account the cost that meeting such standards 

4 would have on providing health care in the United States 

5 and the increased efficiencies in providing such care 

6 achieved under the standards. 

7 ‘‘(b) CONSULTATION AND COORDINATION.—The Sec8 retary shall develop and update such standards in con9 sultation with (and with coordination between)—

10 ‘‘(1) the National Committee for Vital and 

11 Health Statistics, and 

12 ‘‘(2) the Medical Information Technology Advi13 sory Board (established under section 3 of the Pa14 tient Safety Improvement Act of 2003). 

15 ‘‘(c) DISSEMINATION.—The Secretary shall provide 

16 for the dissemination of the standards developed and up17 dated under this section. 

18 ‘‘(d) FUNDING.—The Secretary shall transfer from 

19 the Federal Hospital Insurance Trust Fund established 

20 under section 1817 such sums as are necessary for each 

21 fiscal year to carry out this section. 

22 ‘‘VOLUNTARY ADOPTION OF METHODS TO IMPROVE

23 PATIENT SAFETY

24 ‘‘SEC. 1185. The Secretary shall encourage health 

25 care providers to adopt appropriate evidence-based meth-
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1 ods to improve patient safety. Such methods shall not con2 stitute national practice guidelines. 

3 ‘‘EVALUATION AND REPORT

4 ‘‘SEC. 1186. (a) EVALUATION.—The Comptroller 

5 General of the United States shall conduct a comprehen6 sive evaluation of the implementation of this part. Such 

7 evaluation shall include an examination of the following: 

8 ‘‘(1) The health care providers that reported 

9 patient safety data under this part and the patient 

10 safety organizations to which they reported the in11 formation. 

12 ‘‘(2) What types of events were so reported on. 

13 ‘‘(3) The usefulness of the analyses, informa14 tion, and recommendations provided by patient safe15 ty organizations in response to such reported infor16 mation. 

17 ‘‘(4) The response of health care providers to 

18 such analyses, information, and recommendations, 

19 including a survey of providers to obtain estimates 

20 of the percentage of providers by category who have 

21 adopted specific error-reduction methods and, if ap22 plicable, reasons for not adopting specific practices. 

23 ‘‘(5) The effectiveness of the program under 

24 this part in reducing medical errors. 

25 ‘‘(b) REPORT.—Not later than 5 years after the date 

26 the provisions of this part are first implemented, the 
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1 Comptroller General shall submit to Congress a report on 

2 the evaluation conducted under subsection (a).’’. 

3 SEC. 3. MEDICAL INFORMATION TECHNOLOGY ADVISORY 

4 BOARD. 

5 (a) ESTABLISHMENT.—

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

7 after the date of the enactment of this Act, the Sec8 retary of Health and Human Services (in this sec9 tion referred to as the ‘‘Secretary’’) shall appoint an 

10 advisory board to be known as the ‘‘Medical Infor11 mation Technology Advisory Board’’ (in this section 

12 referred to as the ‘‘MITAB’’). 

13 (2) CHAIRMAN.—The Secretary shall designate 

14 one member as chairman. The chairman shall be an 

15 individual affiliated with an organization having ex16 pertise creating American National Standards Insti17 tute (ANSI) accepted standards in health care infor18 mation technology and a member of the National 

19 Committee for Vital and Health Statistics. 

20 (b) COMPOSITION.—

21 (1) IN GENERAL.—The MITAB shall consist of 

22 not more than 17 members that include—

23 (A) experts from the fields of medical in24 formation, information technology, medical con25 tinuous quality improvement, medical records 
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1 security and privacy, individual and institu2 tional health care clinical providers, health re3 searchers, and health care purchasers; 

4 (B) one or more staff experts from each of 

5 the following: the Centers for Medicare & Med6 icaid Services, the Agency for Healthcare Re7 search and Quality, and the Institute of Medi8 cine of the National Academy of Sciences; 

9 (C) representatives of private organizations 

10 with expertise in medical infomatics; 

11 (D) a representative of a teaching hospital; 

12 and 

13 (E) one or more representatives of the 

14 health care information technology industry. 

15 (2) TERMS OF APPOINTMENT.—The term of 

16 any appointment under paragraph (1) to the 

17 MITAB shall be for the life of the MITAB.

18 (3) MEETINGS.—The MITAB shall meet at the 

19 call of its chairman or a majority of its members. 

20 (4) VACANCIES.—A vacancy on the MITAB 

21 shall be filled in the same manner in which the origi22 nal appointment was made not later than 30 days 

23 after the MITAB is given notice of the vacancy and 

24 shall not affect the power of the remaining members 

25 to execute the duties of the MITAB. 
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1 (5) COMPENSATION.—Members of the MITAB 

2 shall receive no additional pay, allowances, or bene3 fits by reason of their service on the MITAB. 

4 (6) EXPENSES.—Each member of the MITAB 

5 shall receive travel expenses and per diem in lieu of 

6 subsistence in accordance with sections 5702 and 

7 5703 of title 5, United States Code. 

8 (c) DUTIES.—

9 (1) IN GENERAL.—The MITAB shall on an on10 going basis advise, and make recommendations to, 

11 the Secretary regarding medical information tech12 nology, including the following: 

13 (A) The best current practices in medical 

14 information technology. 

15 (B) Methods for the adoption (not later 

16 than 2 years after the date of the enactment of 

17 this section) of a uniform health care informa18 tion system interface between and among old 

19 and new computer systems. 

20 (C) Recommendations for health care vo21 cabulary, messaging, and other technology 

22 standards (including a common lexicon for com23 puter technology) necessary to achieve the 

24 interoperability of health care information sys-
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1 tems for the purposes described in subpara2 graph (E). 

3 (D) Methods of implementing—

4 (i) health care information technology 

5 interoperability standardization; and 

6 (ii) records security. 

7 (E) Methods to promote information ex8 change among health care providers so that 

9 long-term compatibility among information sys10 tems is maximized, in order to do one or more 

11 of the following: 

12 (i) To maximize positive outcomes in 

13 clinical care—

14 (I) by providing decision support 

15 for diagnosis and care; and 

16 (II) by assisting in the emer17 gency treatment of a patient pre18 senting at a facility where there is no 

19 medical record for the patient. 

20 (ii) To contribute to (and be con21 sistent with) the development of the pa22 tient assessment instrument provided for 

23 under section 545 of the Medicare, Med24 icaid, and SCHIP Benefits Improvement 

25 and Protection Act of 2000, and to assist 
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1 in minimizing the need for new and dif2 ferent records as patients move from pro3 vider to provider. 

4 (iii) To reduce or eliminate the need 

5 for redundant records, paperwork, and the 

6 repetitive taking of patient histories and 

7 administering of tests. 

8 (iv) To minimize medical errors, such 

9 as administration of contraindicated drugs. 

10 (v) To provide a compatible informa11 tion technology architecture that facilitates 

12 future quality and cost-saving needs and 

13 that avoids the financing and development 

14 of information technology systems that are 

15 not readily compatible. 

16 (2) REPORTS.—

17 (A) INITIAL REPORT.—No later than 18 

18 months after the date of the enactment of this 

19 Act, the MITAB shall submit to Congress and 

20 the Secretary an initial report concerning the 

21 matters described in paragraph (1). The report 

22 shall include—

23 (i) the practices described in para24 graph (1)(A), including the status of 

25 health care information technology stand-
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1 ards being developed by private sector and 

2 public-private groups; 

3 (ii) recommendations for accelerating 

4 the development of common health care 

5 terminology standards; 

6 (iii) recommendations for completing 

7 development of health care information 

8 system messaging standards; and 

9 (iv) progress toward meeting the 

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

11 adoption of methods described in such 

12 paragraph. 

13 (B) SUBSEQUENT REPORTS.—During each 

14 of the 2 years after the year in which the report 

15 is submitted under subparagraph (A), the 

16 MITAB shall submit to Congress and the Sec17 retary an annual report relating to additional 

18 recommendations, best practices, results of in19 formation technology improvements, analyses of 

20 private sector efforts to implement the inter21 operability standards established in section 

22 1184 of the Social Security Act, and such other 

23 matters as may help ensure the most rapid dis24 semination of best practices in health care in25 formation technology. 
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1 (d) STAFF AND SUPPORT SERVICES.—

2 (1) EXECUTIVE DIRECTOR.—

3 (A) APPOINTMENT.—The Chairman shall 

4 appoint an executive director of the MITAB. 

5 (B) COMPENSATION.—The executive direc6 tor shall be paid the rate of basic pay for level 

7 V of the Executive Schedule. 

8 (2) STAFF.—With the approval of the MITAB, 

9 the executive director may appoint such personnel as 

10 the executive director considers appropriate. 

11 (3) APPLICABILITY OF CIVIL SERVICE LAWS.—

12 The staff of the MITAB shall be appointed without 

13 regard to the provisions of title 5, United States 

14 Code, governing appointments in the competitive 

15 service, and shall be paid without regard to the pro16 visions of chapter 51 and subchapter III of chapter 

17 53 of such title (relating to classification and Gen18 eral Schedule pay rates). 

19 (4) EXPERTS AND CONSULTANTS.—With the 

20 approval of the MITAB, the executive director may 

21 procure temporary and intermittent services under 

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

23 (e) POWERS.—

24 (1) HEARINGS AND OTHER ACTIVITIES.—For 

25 the purpose of carrying out its duties, the MITAB 
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1 may hold such hearings and undertake such other 

2 activities as the MITAB determines to be necessary 

3 to carry out its duties. 

4 (2) DETAIL OF FEDERAL EMPLOYEES.—Upon 

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

6 agency is authorized to detail, without reimburse7 ment, any of the personnel of such agency to the 

8 MITAB to assist the MITAB in carrying out its du9 ties. Any such detail shall not interrupt or otherwise 

10 affect the civil service status or privileges of the 

11 Federal employee. 

12 (3) TECHNICAL ASSISTANCE.—Upon the re13 quest of the MITAB, the head of a Federal agency 

14 shall provide such technical assistance to the 

15 MITAB as the MITAB determines to be necessary 

16 to carry out its duties. 

17 (4) OBTAINING INFORMATION.—The MITAB 

18 may secure directly from any Federal agency infor19 mation necessary to enable it to carry out its duties, 

20 if the information may be disclosed under section 

21 552 of title 5, United States Code. Upon request of 

22 the Chairman of the MITAB, the head of such agen23 cy shall furnish such information to the MITAB. 
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1 (f) TERMINATION.—The MITAB shall terminate 30 

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

3 subsection (c)(2)(B). 

4 (g) APPLICABILITY OF FACA.—The provisions of the 

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

6 apply to the MITAB. 

7 (h) FUNDING.—The Secretary shall transfer from the 

8 Federal Hospital Insurance Trust Fund established under 

9 section 1817 of the Social Security Act (42 U.S.C. 1395i) 

10 such sums as are necessary for each fiscal year to carry 

11 out this section.

Æ