where clinical decisions will be or are likely to 
be made; 
‘‘(B) enhancement of communication be-
tween patients and health care providers; 
‘‘(C) improvement of quality measurement 
by eligible professionals enabling them to col-
lect, store, measure, and report on the proc-
esses and outcomes of individual and population 
performance and quality of care; 
‘‘(D) improvement of evidence-based deci-
sion support; 
‘‘(E) enhancement of consumer and pa-
tient empowerment; or 
‘‘(F) services that assist with workflow re-
design, training, system configuration, human 
change management and other similar services 
focused on getting the best value from existing 
technology that has already been purchased. 
Such term shall not include information technology 
whose sole use is financial management, mainte-
nance of inventory of basic supplies, or appointment 
scheduling. 
‘‘(2) The term ‘eligible professional’ means any 
of the following: 
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‘‘(A) A physician (as defined in section 
1861(r) of the Social Security Act (42 U.S.C. 
1395x(r))). 
‘‘(B) A practitioner described in section 
1842(b)(18)(C) of that Act. 
‘‘(C) A physical or occupational therapist 
or a qualified speech-language pathologist. 
‘‘(D) A qualified audiologist (as defined in 
section 1861(ll)(3)(B)) of that Act. 
‘‘(E) A State-licensed pharmacist. 
‘‘(F) A State-licensed, a State-certified, or 
a nationally accredited home health care pro-
vider. 
‘‘(3) The term ‘qualified eligible professional’ 
means an eligible professional whose office can be 
classified as a small business concern by the Admin-
istrator for purposes of this Act under size stand-
ards established under section 3 of this Act. 
‘‘(b) LOAN GUARANTEES FOR QUALIFIED ELIGIBLE 
PROFESSIONALS.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
the Administrator may guarantee up to 90 percent 
of the amount of a loan made to a qualified eligible 
professional to be used for the acquisition of health 
information technology for use in such eligible pro-
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fessional’s medical practice and for the costs associ-
ated with the installation of such technology. Except 
as otherwise provided in this section, the terms and 
conditions that apply to loans made under section 
7(a) of this Act shall apply to loan guarantees made 
under this section. 
‘‘(2) LIMITATIONS ON GUARANTEE AMOUNTS.— 
The maximum amount of loan principal guaranteed 
under this subsection may not exceed— 
‘‘(A) $250,000 with respect to any single 
qualified eligible professional; and 
‘‘(B) $500,000 with respect to a single 
group of affiliated qualified eligible profes-
sionals. 
‘‘(c) FEES.—(1) The Administrator may impose a 
guarantee fee on the borrower for the purpose of reducing 
the cost (as defined in section 502(5) of the Federal Credit 
Reform Act of 1990) of the guarantee to zero in an 
amount not to exceed 2 percent of the total guaranteed 
portion of any loan guaranteed under this section. The Ad-
ministrator may also impose annual servicing fees on lend-
ers not to exceed 0.5 percent of the outstanding balance 
of the guarantees on lenders’ books. 
‘‘(2) No service fees, processing fees, origina-
tion fees, application fees, points, brokerage fees, 
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bonus points, or other fees may be charged to a loan 
applicant or recipient by a lender in the case of a 
loan guaranteed under this section. 
‘‘(d) DEFERRAL PERIOD.—Loans guaranteed under 
this section shall carry a deferral period of not less than 
1 year and not more than 3 years. The Administrator shall 
have the authority to subsidize interest during the deferral 
period. 
‘‘(e) EFFECTIVE DATE.—No loan may be guaranteed 
under this section after the date that is 6 months after 
the date of enactment of this section. 
‘‘(f) SUNSET.—No loan may be guaranteed under 
this section after the date that is 10 years after the date 
that is 6 months after the date of enactment of this sec-
tion. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as are nec-
essary for the cost (as defined in section 502(5) of the 
Federal Credit Reform Act of 1990) of guaranteeing 
$25,000,000 in loans under this section. The Adminis-
trator shall determine such program cost separately and 
distinctly from other programs operated by the Adminis-
trator.’’. 
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SEC. 4. CHALLENGE GRANT PROGRAM; DISRUPTIVE TECH-
NOLOGIES PRIZE PROGRAM. 
(a) IN GENERAL.—Subtitle B of title XXX of the 
Public Health Service Act (42 U.S.C. 300jj–31 et. seq.) 
is amended— 
(1) by redesignating sections 3017 and 3018 as 
sections 3019 and 3020, respectively; and 
(2) by inserting after section 3016 the following 
new sections: 
‘‘SEC. 3017. CHALLENGE GRANT PROGRAM. 
‘‘(a) IN GENERAL.—Subject to the availability of ap-
propriations, the Secretary, acting through the National 
Coordinator, shall award competitive grants to eligible en-
tities to carry out the activities described in subsection (d). 
‘‘(b) ELIGIBLE ENTITY DEFINED.—In this section, 
the term ‘eligible entity’ means any individual or entity, 
except for an entity that— 
‘‘(1) has 500 or more employees; and 
‘‘(2) has an annual revenue of $7,000,000 or 
more. 
‘‘(c) APPLICATION.—An eligible entity seeking a 
grant under this section shall submit an application to the 
National Coordinator at such time, in such manner, and 
containing such information as the National Coordinator 
may require, including a description of the product, proc-
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ess, or structure described in subsection (d) for which the 
entity intends to use the grant. 
‘‘(d) USES OF FUNDS.—An eligible entity that re-
ceives a grant under this section shall use such funds to 
develop an effective product, process, or structure that en-
hances the use, particularly by patients, of health informa-
tion technology, by— 
‘‘(1) integrating more than one aspect of health 
information; 
‘‘(2) performing a medical consultation using 
technology; 
‘‘(3) providing health information to physicians 
or patients; 
‘‘(4) allowing better coordination during the de-
livery and follow-up after the delivery of health care; 
or 
‘‘(5) addressing any of the three areas that the 
Commission established under section 3018(e)(1) 
has identified pursuant to its duties under section 
3018(e)(2)(A). 
‘‘(e) PROHIBITED USE OF FUNDS.—An eligible entity 
that receives a grant under this section may not use such 
grant to develop a product, process, or structure that 
meets only the requirements that are necessary to be a 
certified EHR technology. 
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‘‘(f) GRANT AMOUNT.—A grant awarded under this 
section may not be greater than $75,000. 
‘‘(g) REPORT.—Not later than one year after the 
date of receipt of a grant under this section, an eligible 
entity shall submit to the National Coordinator and the 
Administrator of the Centers for Medicare & Medicaid 
Services a report that describes— 
‘‘(1) the progress that the entity has made on 
the product, process, or structure funded by the 
grant; and 
‘‘(2) how patients, health-care providers, and 
other individuals and entities involved in the delivery 
of health care, including the Centers for Medicare & 
Medicaid Services, could use the product, process, or 
structure funded by the grant to enhance the deliv-
ery of and reduce the cost of health care. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2014 through 2016. 
‘‘SEC. 3018. DISRUPTIVE TECHNOLOGIES PRIZE PROGRAM. 
‘‘(a) PRIZE PROGRAM AUTHORIZED.—For purposes 
of rewarding innovation in health information technology, 
the Secretary, acting through the National Coordinator, 
shall carry out a program to award one prize competitively 
in each of the three areas identified by the Commission 
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under subsection (e)(2)(A) using the benchmarks devel-
oped under subsection (e)(2)(B) to select the prize recipi-
ent in each category. 
‘‘(b) ADMINISTRATION OF PROGRAM.—In carrying 
out the program under subsection (a), the following shall 
apply: 
‘‘(1) ADVERTISING.—The National Coordinator 
shall widely advertise the prize competition to en-
courage broad participation. 
‘‘(2) REQUIREMENTS AND REGISTRATION.—The 
National Coordinator shall publish a notice in the 
Federal Register announcing— 
‘‘(A) the rules for being eligible to partici-
pate in the competition; 
‘‘(B) the process for participants to reg-
ister for the competition; 
‘‘(C) the areas of health information tech-
nology that the Commission develops under 
subsection (e)(2)(A) for each prize; and 
‘‘(D) the benchmarks that the Commission 
develops under subsection (e)(2)(B) based on 
which a winner will be selected in each such 
area. 
‘‘(c) ELIGIBILITY.—To be eligible to win a prize 
under this section, an individual or entity— 
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‘‘(1) shall register to participate in the competi-
tion in accordance with any rules promulgated by 
the National Coordinator under subsection (b)(2); 
‘‘(2) in the case of an entity, shall be incor-
porated in and maintain a primary place of business 
in the United States, and in the case of an indi-
vidual, whether participating singly or in a group, 
shall be a citizen or permanent resident of the 
United States; and 
‘‘(3) may not be a Federal entity or Federal 
employee acting within the scope of their employ-
ment; and 
‘‘(4) shall submit an application that includes 
an explanation of the anticipated market viability of 
the technology that such individual or entity would 
develop with funds received under the prize program. 
‘‘(d) PRIZE AMOUNT.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), a 
prize awarded under this section shall be in the 
amount of $10,000,000. 
‘‘(2) ALTERNATIVE RULE.—In the case that the 
amount made available for prize awards under this 
section is less than $33,000,000, the National Coor-
dinator may reserve not more than 10 percent for 
the administrative costs of carrying out this section, 
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and shall divide the remaining amount equally for 
the three prizes awarded under this section. 
‘‘(e) COMMISSION.— 
‘‘(1) IN GENERAL.—There is established a com-
mission to carry out the activities described in para-
graph (2) (referred to in this section as the ‘Com-
mission’). 
‘‘(2) DUTIES.— 
‘‘(A) AREAS
OF
HEALTH
INFORMATION 
TECHNOLOGY.—For the purposes of the prize 
program under subsection (a), the Commission 
shall identify three areas within the field of 
health information technology that are not ade-
quately addressed by certified EHR tech-
nologies and the use of such technologies. Each 
area identified shall be an area that will pro-
mote the development of technologies that 
would be widely useful, would help decrease the 
cost of health care, and would improve the qual-
ity of health care, particularly for patients. 
‘‘(B) 
BENCHMARKS.—The 
Commission 
shall develop the benchmarks that the National 
Coordinator shall use to determine the prize re-
cipient in each area identified under subpara-
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graph (A). The Commission shall identify such 
benchmarks with the goals of— 
‘‘(i) attracting participants from out-
side the health information technology field 
that will take new approaches to address-
ing the areas identified by the Commission 
under subparagraph (A); 
‘‘(ii) solving such challenges; and 
‘‘(iii) promoting the development of 
technologies that will be widely adopted, 
particularly by patients. 
‘‘(C) RESTRICTION
OF
PRIZE
AWARD.— 
The Commission shall determine how to restrict 
the prize recipients’ use of the funds awarded 
as a prize under this section, with respect to 
the development of health information tech-
nology, in order to ensure that the prize recipi-
ents use such funds to further develop the tech-
nologies for which such prize was awarded. 
‘‘(3) MEMBERS.— 
‘‘(A) NUMBER
AND
APPOINTMENT.—The 
Commission shall be composed of 10 members 
appointed by the National Coordinator not later 
than 90 days after the date of the enactment of 
this Act. 
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