234 
reuse of such information by such third party, 
including a provision requiring that such trans-
fer and reuse is not in violation of any privacy 
or transfer restrictions placed by the partici-
pant on the independent health record of such 
participant; and 
(D) under which the trust provides assur-
ances that the trust will not transfer, disclose, 
or provide access to the record (or any portion 
of the record) in violation of the parameters es-
tablished in the agreement or to any person or 
entity who has not agreed to use and transfer 
such record (or portion of such record) in ac-
cordance with such agreement. 
(2) TREATMENT OF STATE LAWS.— 
(A) IN
GENERAL.—Except as provided 
under subparagraph (B), the provisions of a 
privacy protection agreement entered into be-
tween an IHRT and an IHRT participant shall 
preempt any provision of State law (or any 
State regulation) relating to the privacy and 
confidentiality of individually identifiable health 
information or to the security of such health in-
formation. 
VerDate Nov 24 2008 
03:23 May 22, 2009
Jkt 079200
PO 00000
Frm 00234
Fmt 6652
Sfmt 6201
E:\BILLS\H2520.IH
H2520
jbell on PROD1PC69 with BILLS
235 
(B) EXCEPTION FOR PRIVILEGED INFOR-
MATION.—The provisions of a privacy protec-
tion agreement shall not preempt any provision 
of State law (or any State regulation) that rec-
ognizes privileged communications between phy-
sicians, health care practitioners, and patients 
of such physicians or health care practitioners, 
respectively. 
(C) STATE
DEFINED.—For purposes of 
this section, the term ‘‘State’’ has the meaning 
given such term when used in title XI of the 
Social Security Act, as provided under section 
1101(a) of such Act (42 U.S.C. 1301(a)). 
SEC. 847. VOLUNTARY NATURE OF TRUST PARTICIPATION 
AND INFORMATION SHARING. 
(a) IN GENERAL.—Participation in an independent 
health record trust, or authorizing access to information 
from such a trust, is voluntary. No employer, health insur-
ance issuer, group health plan, health care provider, or 
other person may require, as a condition of employment, 
issuance of a health insurance policy, coverage under a 
group health plan, the provision of health care services, 
payment for such services, or otherwise, that an individual 
participate in, or authorize access to information from, an 
independent health record trust. 
VerDate Nov 24 2008 
03:23 May 22, 2009
Jkt 079200
PO 00000
Frm 00235
Fmt 6652
Sfmt 6201
E:\BILLS\H2520.IH
H2520
jbell on PROD1PC69 with BILLS
236 
(b) ENFORCEMENT.—The penalties provided for in 
subsection (a) of section 1177 of the Social Security Act 
(42 U.S.C. 1320d–6) shall apply to a violation of sub-
section (a) in the same manner as such penalties apply 
to a person in violation of subsection (a) of such section. 
SEC. 848. FINANCING OF ACTIVITIES. 
(a) IN GENERAL.—Except as provided in subsection 
(b), an IHRT may generate revenue to pay for the oper-
ations of the IHRT through— 
(1) charging IHRT participants account fees 
for use of the trust; 
(2) charging authorized EHR data users for ac-
cessing electronic health records maintained in the 
trust; 
(3) the sale of information contained in the 
trust (as provided for in section 846(a)(3)(A)); and 
(4) any other activity determined appropriate 
by the Federal Trade Commission. 
(b) PROHIBITION
AGAINST
ACCESS
FEES
FOR 
HEALTH CARE PROVIDERS.—For purposes of providing 
incentives to health care providers to access information 
maintained in an IHRT, as authorized by the IHRT par-
ticipants involved, the IHRT may not charge a fee for 
services specified by the IHRT. Such services shall include 
the transmittal of information from a health care provider 
VerDate Nov 24 2008 
03:23 May 22, 2009
Jkt 079200
PO 00000
Frm 00236
Fmt 6652
Sfmt 6201
E:\BILLS\H2520.IH
H2520
jbell on PROD1PC69 with BILLS
237 
to be included in an independent electronic health record 
maintained by the IHRT (or permitting such provider to 
input such information into the record), including the 
transmission of or access to information described in sec-
tion 846(a)(2)(C)(ii) by appropriate emergency respond-
ers. 
(c) REQUIRED
DISCLOSURES.—The sources and 
amounts of revenue derived under subsection (a) for the 
operations of an IHRT shall be fully disclosed to each 
IHRT participant of such IHRT and to the public. 
(d) TREATMENT OF INCOME.—For purposes of the 
Internal Revenue Code of 1986, any revenue described in 
subsection (a) shall not be included in gross income of any 
IHRT, IHRT participant, or authorized EHR data user. 
SEC. 849. REGULATORY OVERSIGHT. 
(a) IN GENERAL.—In carrying out this subtitle, the 
Federal Trade Commission shall promulgate regulations 
for independent health record trusts. 
(b) ESTABLISHMENT
OF INTERAGENCY STEERING 
COMMITTEE.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall establish an Interagency 
Steering Committee in accordance with this sub-
section. 
VerDate Nov 24 2008 
03:23 May 22, 2009
Jkt 079200
PO 00000
Frm 00237
Fmt 6652
Sfmt 6201
E:\BILLS\H2520.IH
H2520
jbell on PROD1PC69 with BILLS
238 
(2) CHAIRPERSON.—The Secretary of Health 
and Human Services shall serve as the chairperson 
of the Interagency Steering Committee. 
(3) MEMBERSHIP.—The members of the Inter-
agency Steering Committee shall consist of the At-
torney General, the Chairperson of the Federal 
Trade Commission, the Chairperson for the National 
Committee for Vital and Health Statistics, a rep-
resentative of the Federal Reserve, and other Fed-
eral officials determined appropriate by the Sec-
retary of Health and Human Services. 
(4) DUTIES.—The Interagency Steering Com-
mittee shall coordinate the implementation of this 
title, including the implementation of policies de-
scribed in subsection (d) based upon the rec-
ommendations provided under such subsection, and 
regulations promulgated under this subtitle. 
(c) FEDERAL ADVISORY COMMITTEE.— 
(1) IN GENERAL.—The National Committee for 
Vital and Health Statistics shall serve as an advisory 
committee for the IHRTs. The membership of such 
advisory committee shall include a representative 
from the Federal Trade Commission and the chair-
person of the Interagency Steering Committee. Not 
less than 60 percent of such membership shall con-
VerDate Nov 24 2008 
03:23 May 22, 2009
Jkt 079200
PO 00000
Frm 00238
Fmt 6652
Sfmt 6201
E:\BILLS\H2520.IH
H2520
jbell on PROD1PC69 with BILLS