1298 
‘‘SEC. 3132. TASK FORCE ON COMMUNITY PREVENTIVE 
SERVICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall establish a permanent task force to be 
known as the Task Force on Community Preventive Serv-
ices (in this section referred to as the ‘Task Force’). 
‘‘(b) RESPONSIBILITIES.—The Task Force shall— 
‘‘(1) identify community preventive services for 
review; 
‘‘(2) review the scientific evidence related to the 
benefits, effectiveness, appropriateness, and costs of 
community preventive services identified under para-
graph (1) for the purpose of developing, updating, 
publishing, and disseminating evidence-based rec-
ommendations on the use of such services; 
‘‘(3) as appropriate, take into account health 
disparities in developing, updating, publishing, and 
disseminating evidence-based recommendations on 
the use of such services; 
‘‘(4) identify gaps in community preventive 
services research and evaluation and recommend pri-
ority areas for such research and evaluation; 
‘‘(5) pursuant to section 3143(d), determine 
whether subsidies and rewards are effective; 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01298
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1299 
‘‘(6) as appropriate, consult with the commu-
nity prevention stakeholders board in accordance 
with subsection (f); 
‘‘(7) consult with the Task Force on Clinical 
Preventive Services established under section 3131; 
and 
‘‘(8) as appropriate, in carrying out this sec-
tion, consider the national strategy under section 
3121. 
‘‘(c) ROLE OF AGENCY.—The Secretary shall provide 
ongoing administrative, research, and technical support 
for the operations of the Task Force, including coordi-
nating and supporting the dissemination of the rec-
ommendations of the Task Force. 
‘‘(d) MEMBERSHIP.— 
‘‘(1) 
NUMBER; 
APPOINTMENT.—The 
Task 
Force shall be composed of 30 members, appointed 
by the Secretary. 
‘‘(2) TERMS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
appoint members of the Task Force for a term 
of 6 years and may reappoint such members, 
but the Secretary may not appoint any member 
to serve more than a total of 12 years. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01299
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1300 
‘‘(B) 
STAGGERED
TERMS.—Notwith-
standing subparagraph (A), of the members 
first appointed to serve on the Task Force after 
the enactment of this section— 
‘‘(i) 10 shall be appointed for a term 
of 2 years; 
‘‘(ii) 10 shall be appointed for a term 
of 4 years; and 
‘‘(iii) 10 shall be appointed for a term 
of 6 years. 
‘‘(3) QUALIFICATIONS.—Members of the Task 
Force shall be appointed from among individuals 
who possess expertise in at least one of the following 
areas: 
‘‘(A) Public health. 
‘‘(B) Evaluation of research and system-
atic evidence reviews. 
‘‘(C) Disciplines relevant to community 
preventive services, including health promotion; 
disease prevention; chronic disease; worksite 
health; school-site health; qualitative and quan-
titative analysis; and health economics, policy, 
law, and statistics. 
‘‘(4) REPRESENTATION.—In appointing mem-
bers of the Task Force, the Secretary— 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01300
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1301 
‘‘(A) shall ensure that all areas of exper-
tise described in paragraph (3) are represented; 
‘‘(B) shall ensure that such members in-
clude sufficient representatives of each of— 
‘‘(i) State health officers; 
‘‘(ii) local health officers; 
‘‘(iii) health care practitioners; and 
‘‘(iv) public health practitioners; and 
‘‘(C) shall appoint individuals who have ex-
pertise in health disparities. 
‘‘(e) SUBGROUPS.—As appropriate to maximize effi-
ciency, the Task Force may delegate authority for con-
ducting reviews and making recommendations to sub-
groups consisting of Task Force members, subject to final 
approval by the Task Force. 
‘‘(f) 
COMMUNITY
PREVENTION
STAKEHOLDERS 
BOARD.— 
‘‘(1) IN GENERAL.—The Task Force shall con-
vene a community prevention stakeholders board 
composed of representatives of appropriate public 
and private entities with an interest in community 
preventive services to advise the Task Force on de-
veloping, updating, publishing, and disseminating 
evidence-based recommendations on the use of com-
munity preventive services. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01301
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1302 
‘‘(2) MEMBERSHIP.—The members of the com-
munity prevention stakeholders board shall include 
representatives of the following: 
‘‘(A) Health care consumers and patient 
groups. 
‘‘(B) Providers of community preventive 
services, including community-based providers. 
‘‘(C) Federal departments and agencies, 
including— 
‘‘(i) appropriate health agencies and 
offices in the Department, including the 
Office of the Surgeon General of the Pub-
lic Health Service, the Office of Minority 
Health, the National Center on Minority 
Health and Health Disparities, and the Of-
fice on Women’s Health; and 
‘‘(ii) as appropriate, other Federal de-
partments and agencies whose programs 
have a significant impact upon health (as 
determined by the Secretary). 
‘‘(D) Private health care payors. 
‘‘(3) RESPONSIBILITIES.—In accordance with 
subsection (b)(6), the community prevention stake-
holders board shall— 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01302
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1303 
‘‘(A) recommend community preventive 
services for review by the Task Force; 
‘‘(B) suggest scientific evidence for consid-
eration by the Task Force related to reviews 
undertaken by the Task Force; 
‘‘(C) provide feedback regarding draft rec-
ommendations by the Task Force; and 
‘‘(D) assist with efforts regarding dissemi-
nation of recommendations by the Director of 
the Centers for Disease Control and Prevention. 
‘‘(g) DISCLOSURE AND CONFLICTS OF INTEREST.— 
Members of the Task Force or the community prevention 
stakeholders board shall not be considered employees of 
the Federal Government by reason of service on the Task 
Force or the community prevention stakeholders board, 
except members of the Task Force or the community pre-
vention stakeholders board shall be considered to be spe-
cial Government employees within the meaning of section 
107 of the Ethics in Government Act of 1978 (5 U.S.C. 
App.) and section 208 of title 18, United States Code, for 
the purposes of disclosure and management of conflicts 
of interest under those sections. 
‘‘(h) NO PAY; RECEIPT OF TRAVEL EXPENSES.— 
Members of the Task Force or the community prevention 
stakeholders board shall not receive any pay for service 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01303
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1304 
on the Task Force, but may receive travel expenses, in-
cluding a per diem, in accordance with applicable provi-
sions of subchapter I of chapter 57 of title 5, United 
States Code. 
‘‘(i) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.) except for section 14 of 
such Act shall apply to the Task Force to the extent that 
the provisions of such Act do not conflict with the provi-
sions of this title. 
‘‘(j) REPORT.—The Secretary shall submit to the 
Congress an annual report on the Task Force, including 
with respect to gaps identified and recommendations made 
under subsection (b)(4). 
‘‘Subtitle D—Prevention and 
Wellness Research 
‘‘SEC. 3141. PREVENTION AND WELLNESS RESEARCH ACTIV-
ITY COORDINATION. 
‘‘In conducting or supporting research on prevention 
and wellness, the Director of the Centers for Disease Con-
trol and Prevention, the Director of the National Insti-
tutes of Health, and the heads of other agencies within 
the Department of Health and Human Services con-
ducting or supporting such research, shall take into con-
sideration the national strategy under section 3121 and 
the recommendations of the Task Force on Clinical Pre-
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01304
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1305 
ventive Services under section 3131 and the Task Force 
on Community Preventive Services under section 3132. 
‘‘SEC. 3142. COMMUNITY PREVENTION AND WELLNESS RE-
SEARCH GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall conduct, or award grants to eligible entities 
to conduct, research in priority areas identified by the Sec-
retary in the national strategy under section 3121 or by 
the Task Force on Community Preventive Services as re-
quired by section 3132. 
‘‘(b) ELIGIBILITY.—To be eligible for a grant under 
this section, an entity shall be— 
‘‘(1) a State, local, or tribal department of 
health; 
‘‘(2) a public or private nonprofit entity; or 
‘‘(3) a consortium of 2 or more entities de-
scribed in paragraphs (1) and (2). 
‘‘(c) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program of research 
under this section. 
‘‘SEC. 3143. RESEARCH ON SUBSIDIES AND REWARDS TO 
ENCOURAGE WELLNESS AND HEALTHY BE-
HAVIORS. 
‘‘(a) RESEARCH AND DEMONSTRATION PROJECTS.— 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01305
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1306 
‘‘(1) IN GENERAL.—The Secretary shall con-
duct, or award grants to public or nonprofit private 
entities to conduct, research and demonstration 
projects on the use of financial and in-kind subsidies 
and rewards to encourage individuals and commu-
nities to promote wellness, adopt healthy behaviors, 
and use evidence-based preventive health services. 
‘‘(2) FOCUS.—Research and demonstration 
projects under paragraph (1) shall focus on— 
‘‘(A) tobacco use, obesity, and other pre-
vention and wellness priorities identified by the 
Secretary in the national strategy under section 
3121; 
‘‘(B) the initiation, maintenance, and long- 
term sustainability of wellness promotion; adop-
tion of healthy behaviors; and use of evidence- 
based preventive health services; and 
‘‘(C) populations at high risk of prevent-
able diseases and conditions. 
‘‘(b) FINDINGS; REPORT.— 
‘‘(1) SUBMISSION OF FINDINGS.—The Secretary 
shall submit the findings of research and demonstra-
tion projects under subsection (a) to— 
‘‘(A) the Task Force on Clinical Preventive 
Services established under section 3131 or the 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01306
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1307 
Task Force on Community Preventive Services 
established under section 3132, as appropriate; 
and 
‘‘(B) the Health Benefits Advisory Com-
mittee established by section 223 of the Afford-
able Health Care for America Act. 
‘‘(2) REPORT TO CONGRESS.—Not later than 
18 months after the initiation of research and dem-
onstration projects under subsection (a), the Sec-
retary shall submit a report to the Congress on the 
progress of such research and projects, including 
any preliminary findings. 
‘‘(c) INCLUSION
IN ESSENTIAL BENEFITS PACK-
AGE.—If, on the basis of the findings of research and dem-
onstration projects under subsection (a) or other sources 
consistent with section 3131, the Task Force on Clinical 
Preventive Services determines that a subsidy or reward 
meets the Task Force’s standards for a grade A or B, 
the Secretary shall ensure that the subsidy or reward is 
included in the essential benefits package under section 
222. 
‘‘(d) INCLUSION AS ALLOWABLE USE OF COMMUNITY 
PREVENTION AND WELLNESS SERVICES GRANTS.—If, on 
the basis of the findings of research and demonstration 
projects under subsection (a) or other sources consistent 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01307
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1308 
with section 3132, the Task Force on Community Preven-
tive Services determines that a subsidy or reward is effec-
tive, the Secretary shall ensure that the subsidy or reward 
becomes an allowable use of grant funds under section 
3151. 
‘‘(e) NONDISCRIMINATION; NO TIE TO PREMIUM OR 
COST SHARING.—In carrying out this section, the Sec-
retary shall ensure that any subsidy or reward— 
‘‘(1) does not have a discriminatory effect on 
the basis of any personal characteristic extraneous 
to the provision of high-quality health care or related 
services; and 
‘‘(2) is not tied to the premium or cost sharing 
of an individual under any qualified health benefits 
plan (as defined in section 100(c)). 
‘‘Subtitle E—Delivery of Commu-
nity Prevention and Wellness 
Services 
‘‘SEC. 3151. COMMUNITY PREVENTION AND WELLNESS 
SERVICES GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall establish a program for the delivery of com-
munity prevention and wellness services consisting of 
awarding grants to eligible entities— 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01308
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1309 
‘‘(1) to provide evidence-based, community pre-
vention and wellness services in priority areas identi-
fied by the Secretary in the national strategy under 
section 3121; or 
‘‘(2) to plan such services. 
‘‘(b) ELIGIBILITY.— 
‘‘(1) DEFINITION.—To be eligible for a grant 
under this section, an entity shall be— 
‘‘(A) a State, local, or tribal department of 
health; 
‘‘(B) a public or private entity; or 
‘‘(C) a consortium that— 
‘‘(i) consists of 2 or more entities de-
scribed in subparagraph (A) or (B); and 
‘‘(ii) may be a community partnership 
representing a Health Empowerment Zone. 
‘‘(2) HEALTH EMPOWERMENT ZONE.—In this 
subsection, the term ‘Health Empowerment Zone’ 
means an area— 
‘‘(A) in which multiple community preven-
tion and wellness services are implemented in 
order to address one or more health disparities, 
including those identified by the Secretary in 
the national strategy under section 3121; and 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01309
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1310 
‘‘(B) which is represented by a community 
partnership that demonstrates community sup-
port and coordination with State, local, or tribal 
health departments and includes— 
‘‘(i) a broad cross section of stake-
holders; 
‘‘(ii) residents of the community; and 
‘‘(iii) representatives of entities that 
have a history of working within and serv-
ing the community. 
‘‘(c) PREFERENCES.—In awarding grants under this 
section, the Secretary shall give preference to entities 
that— 
‘‘(1) will address one or more goals or objec-
tives identified by the Secretary in the national 
strategy under section 3121; 
‘‘(2) will address significant health disparities, 
including those identified by the Secretary in the na-
tional strategy under section 3121; 
‘‘(3) will address unmet community prevention 
and wellness needs and avoid duplication of effort; 
‘‘(4) have been demonstrated to be effective in 
communities comparable to the proposed target com-
munity; 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01310
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1311 
‘‘(5) will contribute to the evidence base for 
community prevention and wellness services; 
‘‘(6) demonstrate that the community preven-
tion and wellness services to be funded will be sus-
tainable; and 
‘‘(7) demonstrate coordination or collaboration 
across governmental and nongovernmental partners. 
‘‘(d) HEALTH DISPARITIES.—Of the funds awarded 
under this section for a fiscal year, the Secretary shall 
award not less than 50 percent for planning or imple-
menting community prevention and wellness services 
whose primary purpose is to achieve a measurable reduc-
tion in one or more health disparities, including those 
identified by the Secretary in the national strategy under 
section 3121. 
‘‘(e) EMPHASIS ON RECOMMENDED SERVICES.—For 
fiscal year 2014 and subsequent fiscal years, the Secretary 
shall award grants under this section only for planning 
or implementing services recommended by the Task Force 
on Community Preventive Services under section 3132 or 
deemed effective based on a review of comparable rigor 
(as determined by the Director of the Centers for Disease 
Control and Prevention). 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01311
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1312 
‘‘(f) PROHIBITED USES OF FUNDS.—An entity that 
receives a grant under this section may not use funds pro-
vided through the grant— 
‘‘(1) to build or acquire real property or for 
construction; or 
‘‘(2) for services or planning to the extent that 
payment has been made, or can reasonably be ex-
pected to be made— 
‘‘(A) under any insurance policy; 
‘‘(B) under any Federal or State health 
benefits program (including titles XIX and XXI 
of the Social Security Act); or 
‘‘(C) by an entity which provides health 
services on a prepaid basis. 
‘‘(g) REPORT.—The Secretary shall submit to the 
Congress an annual report on the program of grants 
awarded under this section. 
‘‘(h) DEFINITIONS.—In this section, the term ‘evi-
dence-based’ means that methodologically sound research 
has demonstrated a beneficial health effect, in the judg-
ment of the Director of the Centers for Disease Control 
and Prevention. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01312
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1313 
‘‘Subtitle F—Core Public Health 
Infrastructure 
‘‘SEC. 3161. CORE PUBLIC HEALTH INFRASTRUCTURE FOR 
STATE, LOCAL, AND TRIBAL HEALTH DEPART-
MENTS. 
‘‘(a) PROGRAM.—The Secretary, acting through the 
Director of the Centers for Disease Control and Preven-
tion, shall establish a core public health infrastructure 
program consisting of awarding grants under subsection 
(b). 
‘‘(b) GRANTS.— 
‘‘(1) AWARD.—For the purpose of addressing 
core public health infrastructure needs, the Sec-
retary— 
‘‘(A) shall award a grant to each State 
health department; and 
‘‘(B) may award grants on a competitive 
basis to State, local, or tribal health depart-
ments. 
‘‘(2) ALLOCATION.—Of the total amount of 
funds awarded as grants under this subsection for a 
fiscal year— 
‘‘(A) not less than 50 percent shall be for 
grants to State health departments under para-
graph (1)(A); and 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01313
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1314 
‘‘(B) not less than 30 percent shall be for 
grants to State, local, or tribal health depart-
ments under paragraph (1)(B). 
‘‘(c) USE OF FUNDS.—The Secretary may award a 
grant to an entity under subsection (b)(1) only if the enti-
ty agrees to use the grant to address core public health 
infrastructure needs, including those identified in the ac-
creditation process under subsection (g). 
‘‘(d) FORMULA GRANTS TO STATE HEALTH DEPART-
MENTS.—In making grants under subsection (b)(1)(A), 
the Secretary shall award funds to each State health de-
partment in accordance with— 
‘‘(1) a formula based on population size; burden 
of preventable disease and disability; and core public 
health infrastructure gaps, including those identified 
in the accreditation process under subsection (g); 
and 
‘‘(2) application requirements established by the 
Secretary, including a requirement that the State 
submit a plan that demonstrates to the satisfaction 
of the Secretary that the State’s health department 
will— 
‘‘(A) address its highest priority core pub-
lic health infrastructure needs; and 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01314
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1315 
‘‘(B) as appropriate, allocate funds to local 
health departments within the State. 
‘‘(e) COMPETITIVE GRANTS TO STATE, LOCAL, AND 
TRIBAL
HEALTH
DEPARTMENTS.—In making grants 
under subsection (b)(1)(B), the Secretary shall give pri-
ority to applicants demonstrating core public health infra-
structure needs identified in the accreditation process 
under subsection (g). 
‘‘(f) MAINTENANCE
OF EFFORT.—The Secretary 
may award a grant to an entity under subsection (b) only 
if the entity demonstrates to the satisfaction of the Sec-
retary that— 
‘‘(1) funds received through the grant will be 
expended only to supplement, and not supplant, non- 
Federal and Federal funds otherwise available to the 
entity for the purpose of addressing core public 
health infrastructure needs; and 
‘‘(2) with respect to activities for which the 
grant is awarded, the entity will maintain expendi-
tures of non-Federal amounts for such activities at 
a level not less than the level of such expenditures 
maintained by the entity for the fiscal year pre-
ceding the fiscal year for which the entity receives 
the grant. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01315
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1316 
‘‘(g) ESTABLISHMENT OF A PUBLIC HEALTH AC-
CREDITATION PROGRAM.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall— 
‘‘(A) develop, and periodically review and 
update, standards for voluntary accreditation of 
State, local, or tribal health departments and 
public health laboratories for the purpose of ad-
vancing the quality and performance of such de-
partments and laboratories; and 
‘‘(B) implement a program to accredit 
such health departments and laboratories in ac-
cordance with such standards. 
‘‘(2) COOPERATIVE
AGREEMENT.—The Sec-
retary may enter into a cooperative agreement with 
a private nonprofit entity to carry out paragraph 
(1). 
‘‘(h) REPORT.—The Secretary shall submit to the 
Congress an annual report on progress being made to ac-
credit entities under subsection (g), including— 
‘‘(1) a strategy, including goals and objectives, 
for accrediting entities under subsection (g) and 
achieving the purpose described in subsection (g)(1); 
and 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01316
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1317 
‘‘(2) identification of gaps in research related to 
core public health infrastructure and recommenda-
tions of priority areas for such research. 
‘‘SEC. 3162. CORE PUBLIC HEALTH INFRASTRUCTURE AND 
ACTIVITIES FOR CDC. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall expand and improve the core public health 
infrastructure and activities of the Centers for Disease 
Control and Prevention to address unmet and emerging 
public health needs. 
‘‘(b) REPORT.—The Secretary shall submit to the 
Congress an annual report on the activities funded 
through this section. 
‘‘Subtitle G—General Provisions 
‘‘SEC. 3171. DEFINITIONS. 
‘‘In this title: 
‘‘(1) The term ‘core public health infrastruc-
ture’ includes workforce capacity and competency; 
laboratory systems; health information, health infor-
mation systems, and health information analysis; 
communications; financing; other relevant compo-
nents of organizational capacity; and other related 
activities. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01317
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1318 
‘‘(2) The terms ‘Department’ and ‘depart-
mental’ refer to the Department of Health and 
Human Services. 
‘‘(3) The term ‘health disparities’ includes 
health and health care disparities and means popu-
lation-specific differences in the presence of disease, 
health outcomes, or access to health care. For pur-
poses of the preceding sentence, a population may be 
delineated by race, ethnicity, primary language, sex, 
sexual orientation, gender identity, disability, socio-
economic status, or rural, urban, or other geographic 
setting, and any other population or subpopulation 
determined by the Secretary to experience significant 
gaps in disease, health outcomes, or access to health 
care. 
‘‘(4) The term ‘tribal’ refers to an Indian tribe, 
a Tribal organization, or an Urban Indian organiza-
tion, as such terms are defined in section 4 of the 
Indian Health Care Improvement Act.’’. 
(b) TRANSITION PROVISIONS APPLICABLE TO TASK 
FORCES.— 
(1) FUNCTIONS, PERSONNEL, ASSETS, LIABIL-
ITIES, AND
ADMINISTRATIVE
ACTIONS.—All func-
tions, personnel, assets, and liabilities of, and ad-
ministrative actions applicable to, the Preventive 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01318
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1319 
Services Task Force convened under section 915(a) 
of the Public Health Service Act and the Task Force 
on Community Preventive Services (as such section 
and Task Forces were in existence on the day before 
the date of the enactment of this Act) shall be trans-
ferred to the Task Force on Clinical Preventive 
Services and the Task Force on Community Preven-
tive Services, respectively, established under sections 
3131 and 3132 of the Public Health Service Act, as 
added by subsection (a). 
(2) RECOMMENDATIONS.—All recommendations 
of the Preventive Services Task Force and the Task 
Force on Community Preventive Services, as in ex-
istence on the day before the date of the enactment 
of this Act, shall be considered to be recommenda-
tions of the Task Force on Clinical Preventive Serv-
ices and the Task Force on Community Preventive 
Services, respectively, established under sections 
3131 and 3132 of the Public Health Service Act, as 
added by subsection (a). 
(3) MEMBERS ALREADY SERVING.— 
(A) INITIAL MEMBERS.—The Secretary of 
Health and Human Services may select those 
individuals already serving on the Preventive 
Services Task Force and the Task Force on 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01319
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1320 
Community Preventive Services, as in existence 
on the day before the date of the enactment of 
this Act, to be among the first members ap-
pointed to the Task Force on Clinical Preven-
tive Services and the Task Force on Commu-
nity Preventive Services, respectively, under sec-
tions 3131 and 3132 of the Public Health Serv-
ice Act, as added by subsection (a). 
(B) CALCULATION OF TOTAL SERVICE.—In 
calculating the total years of service of a mem-
ber of a task force for purposes of section 
3131(d)(2)(A) or 3132(d)(2)(A) of the Public 
Health Service Act, as added by subsection (a), 
the Secretary of Health and Human Services 
shall not include any period of service by the 
member on the Preventive Services Task Force 
or the Task Force on Community Preventive 
Services, respectively, as in existence on the day 
before the date of the enactment of this Act. 
(c) PERIOD BEFORE COMPLETION
OF NATIONAL 
STRATEGY.—Pending completion of the national strategy 
under section 3121 of the Public Health Service Act, as 
added by subsection (a), the Secretary of Health and 
Human Services, acting through the relevant agency head, 
may make a judgment about how the strategy will address 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01320
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1321 
an issue and rely on such judgment in carrying out any 
provision of subtitle C, D, E, or F of title XXXI of such 
Act, as added by subsection (a), that requires the Sec-
retary— 
(1) to take into consideration such strategy; 
(2) to conduct or support research or provide 
services in priority areas identified in such strategy; 
or 
(3) to take any other action in reliance on such 
strategy. 
(d) CONFORMING AMENDMENTS.— 
(1) Paragraph (61) of section 3(b) of the In-
dian Health Care Improvement Act (25 U.S.C. 
1602) is amended by striking ‘‘United States Pre-
ventive Services Task Force’’ and inserting ‘‘Task 
Force on Clinical Preventive Services’’. 
(2) Section 126 of the Medicare, Medicaid, and 
SCHIP Benefits Improvement and Protection Act of 
2000 (Appendix F of Public Law 106–554) is 
amended by striking ‘‘United States Preventive 
Services Task Force’’ each place it appears and in-
serting ‘‘Task Force on Clinical Preventive Serv-
ices’’. 
(3) Paragraph (7) of section 317D(a) of the 
Public Health Service Act (42 U.S.C. 247b–5(a)) is 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01321
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1322 
amended by striking ‘‘United States Preventive 
Services Task Force’’ and inserting ‘‘Task Force on 
Clinical Preventive Services’’. 
(4) Section 915 of the Public Health Service 
Act (42 U.S.C. 299b–4) is amended by striking sub-
section (a). 
(5) Subsections (s)(2)(AA)(iii)(II), (xx)(1), and 
(ddd)(1)(B) of section 1861 of the Social Security 
Act (42 U.S.C. 1395x) are amended by striking 
‘‘United States Preventive Services Task Force’’ 
each place it appears and inserting ‘‘Task Force on 
Clinical Preventive Services’’. 
TITLE IV—QUALITY AND 
SURVEILLANCE 
SEC. 2401. IMPLEMENTATION OF BEST PRACTICES IN THE 
DELIVERY OF HEALTH CARE. 
(a) IN GENERAL.—Title IX of the Public Health 
Service Act (42 U.S.C. 299 et seq.) is amended— 
(1) by redesignating part D as part E; 
(2) by redesignating sections 931 through 938 
as sections 941 through 948, respectively; 
(3) in section 948(1), as redesignated, by strik-
ing ‘‘931’’ and inserting ‘‘941’’; and 
(4) by inserting after part C the following: 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01322
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1323 
‘‘PART D—IMPLEMENTATION OF BEST 
PRACTICES IN THE DELIVERY OF HEALTH CARE 
‘‘SEC. 931. CENTER FOR QUALITY IMPROVEMENT. 
‘‘(a) IN GENERAL.—There is established the Center 
for Quality Improvement (referred to in this part as the 
‘Center’), to be headed by the Director. 
‘‘(b) PRIORITIZATION.— 
‘‘(1) 
IN
GENERAL.—The 
Director 
shall 
prioritize areas for the identification, development, 
evaluation, and implementation of best practices (in-
cluding innovative methodologies and strategies) for 
quality improvement activities in the delivery of 
health care services (in this section referred to as 
‘best practices’). 
‘‘(2) CONSIDERATIONS.—In prioritizing areas 
under paragraph (1), the Director shall consider— 
‘‘(A) the priorities established under sec-
tion 1191 of the Social Security Act; and 
‘‘(B) the key health indicators identified by 
the Assistant Secretary for Health Information 
under section 1709. 
‘‘(3) LIMITATIONS.—In conducting its duties 
under this subsection, the Center for Quality Im-
provement shall not develop quality-adjusted life 
year measures or any other methodologies that can 
be used to deny benefits to a beneficiary against the 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01323
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1324 
beneficiary’s wishes on the basis of the beneficiary’s 
age, life expectancy, present or predicted disability, 
or expected quality of life. 
‘‘(c) OTHER RESPONSIBILITIES.—The Director, act-
ing directly or by awarding a grant or contract to an eligi-
ble entity, shall— 
‘‘(1) identify existing best practices under sub-
section (e); 
‘‘(2) develop new best practices under sub-
section (f); 
‘‘(3) evaluate best practices under subsection 
(g); 
‘‘(4) implement best practices under subsection 
(h); 
‘‘(5) ensure that best practices are identified, 
developed, evaluated, and implemented under this 
section consistent with standards adopted by the 
Secretary under section 3004 for health information 
technology used in the collection and reporting of 
quality information (including for purposes of the 
demonstration of meaningful use of certified elec-
tronic health record (EHR) technology by physicians 
and hospitals under the Medicare program (under 
sections 1848(o)(2) and 1886(n)(3), respectively, of 
the Social Security Act)); and 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01324
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1325 
‘‘(6) provide for dissemination of information 
and reporting under subsections (i) and (j). 
‘‘(d) ELIGIBILITY.—To be eligible for a grant or con-
tract under subsection (c), an entity shall— 
‘‘(1) be a nonprofit entity; 
‘‘(2) agree to work with a variety of institu-
tional health care providers, physicians, nurses, and 
other health care practitioners; and 
‘‘(3) if the entity is not the organization holding 
a contract under section 1153 of the Social Security 
Act for the area to be served, agree to cooperate 
with and avoid duplication of the activities of such 
organization. 
‘‘(e) IDENTIFYING EXISTING BEST PRACTICES.—The 
Director shall identify best practices that are— 
‘‘(1) currently utilized by health care providers 
(including hospitals, physician and other clinician 
practices, community cooperatives, and other health 
care entities) that deliver consistently high-quality, 
efficient health care services; and 
‘‘(2) easily adapted for use by other health care 
providers and for use across a variety of health care 
settings. 
‘‘(f) DEVELOPING NEW BEST PRACTICES.—The Di-
rector shall develop best practices that are— 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01325
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1326 
‘‘(1) based on a review of existing scientific evi-
dence; 
‘‘(2) sufficiently detailed for implementation 
and incorporation into the workflow of health care 
providers; and 
‘‘(3) designed to be easily adapted for use by 
health care providers across a variety of health care 
settings. 
‘‘(g) EVALUATION OF BEST PRACTICES.—The Direc-
tor shall evaluate best practices identified or developed 
under this section. Such evaluation— 
‘‘(1) shall include determinations of which best 
practices— 
‘‘(A) most reliably and effectively achieve 
significant progress in improving the quality of 
patient care; and 
‘‘(B) are easily adapted for use by health 
care providers across a variety of health care 
settings; 
‘‘(2) shall include regular review, updating, and 
improvement of such best practices; and 
‘‘(3) may include in-depth case studies or em-
pirical assessments of health care providers (includ-
ing hospitals, physician and other clinician practices, 
community cooperatives, and other health care enti-
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01326
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1327 
ties) and simulations of such best practices for de-
terminations under paragraph (1). 
‘‘(h) IMPLEMENTATION OF BEST PRACTICES.— 
‘‘(1) IN
GENERAL.—The Director shall enter 
into arrangements with entities in a State or region 
to implement best practices identified or developed 
under this section. Such implementation— 
‘‘(A) may include forming collaborative 
multi-institutional teams; and 
‘‘(B) shall include an evaluation of the best 
practices being implemented, including the 
measurement of patient outcomes before, dur-
ing, and after implementation of such best 
practices. 
‘‘(2) PREFERENCES.—In carrying out this sub-
section, the Director shall give priority to health 
care providers implementing best practices that— 
‘‘(A) have the greatest impact on patient 
outcomes and satisfaction; 
‘‘(B) are the most easily adapted for use 
by health care providers across a variety of 
health care settings; 
‘‘(C) promote coordination of health care 
practitioners across the continuum of care; and 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01327
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1328 
‘‘(D) engage patients and their families in 
improving patient care and outcomes. 
‘‘(i) PUBLIC DISSEMINATION
OF INFORMATION.— 
The Director shall provide for the public dissemination of 
information with respect to best practices and activities 
under this section. Such information shall be made avail-
able in appropriate formats and languages to reflect the 
varying needs of consumers and diverse levels of health 
literacy. 
‘‘(j) REPORT.— 
‘‘(1) IN GENERAL.—The Director shall submit 
an annual report to the Congress and the Secretary 
on activities under this section. 
‘‘(2) CONTENT.—Each report under paragraph 
(1) shall include— 
‘‘(A) information on activities conducted 
pursuant to grants and contracts awarded; 
‘‘(B) summary data on patient outcomes 
before, during, and after implementation of best 
practices; and 
‘‘(C) recommendations on the adaptability 
of best practices for use by health providers.’’. 
(b) INITIAL QUALITY IMPROVEMENT ACTIVITIES AND 
INITIATIVES TO BE IMPLEMENTED.—Until the Director 
of the Agency for Healthcare Research and Quality has 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01328
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1329 
established initial priorities under section 931(b) of the 
Public Health Service Act, as added by subsection (a), the 
Director shall, for purposes of such section, prioritize the 
following: 
(1) HEALTH CARE-ASSOCIATED INFECTIONS.— 
Reducing health care-associated infections, including 
infections in nursing homes and outpatient settings. 
(2) SURGERY.—Increasing hospital and out-
patient perioperative patient safety, including reduc-
ing surgical-site infections and surgical errors (such 
as wrong-site surgery and retained foreign bodies). 
(3) EMERGENCY
ROOM.—Improving care in 
hospital emergency rooms, including through the use 
of principles of efficiency of design and delivery to 
improve patient flow. 
(4) OBSTETRICS.—Improving the provision of 
obstetrical and neonatal care, including the identi-
fication of interventions that are effective in reduc-
ing the risk of preterm and premature labor and the 
implementation of best practices for labor and deliv-
ery care. 
(5) PEDIATRICS.—Improving the provision of 
preventive and developmental child health services, 
including interventions that can reduce child health 
disparities (as defined in section 3171 of the Public 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01329
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1330 
Health Service Act, as added by section 2301) and 
reduce the risk of developing chronic health-threat-
ening conditions that affect an individual’s life 
course development. 
(c) REPORT.—Not later than 18 months after the 
date of the enactment of this Act, the Director of the 
Agency for Healthcare Research and Quality shall submit 
a report to the Congress on the impact of the nurse-to- 
patient ratio on the quality of care and patient outcomes, 
including recommendations for further integration into 
quality measurement and quality improvement activities. 
SEC. 2402. ASSISTANT SECRETARY FOR HEALTH INFORMA-
TION. 
(a) ESTABLISHMENT.—Title XVII (42 U.S.C. 300u 
et seq.) is amended— 
(1) by redesignating sections 1709 and 1710 as 
sections 1710 and 1711, respectively; and 
(2) by inserting after section 1708 the fol-
lowing: 
‘‘SEC. 1709. ASSISTANT SECRETARY FOR HEALTH INFORMA-
TION. 
‘‘(a) IN GENERAL.—There is established within the 
Department an Assistant Secretary for Health Informa-
tion (in this section referred to as the ‘Assistant Sec-
retary’), to be appointed by the Secretary. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01330
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1331 
‘‘(b) RESPONSIBILITIES.—The Assistant Secretary 
shall— 
‘‘(1) ensure the collection, collation, reporting, 
and publishing of information (including full and 
complete statistics) on key health indicators regard-
ing the Nation’s health and the performance of the 
Nation’s health care; 
‘‘(2) facilitate and coordinate the collection, col-
lation, reporting, and publishing of information re-
garding the Nation’s health and the performance of 
the Nation’s health care (other than information de-
scribed in paragraph (1)); 
‘‘(3)(A) develop standards for the collection of 
data regarding the Nation’s health and the perform-
ance of the Nation’s health care; and 
‘‘(B) in carrying out subparagraph (A)— 
‘‘(i) ensure appropriate specificity and 
standardization for data collection at the na-
tional, regional, State, and local levels; 
‘‘(ii) include standards, as appropriate, for 
the collection of accurate data on health dis-
parities; 
‘‘(iii) ensure, with respect to data on race 
and ethnicity, consistency with the 1997 Office 
of Management and Budget Standards for 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01331
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1332 
Maintaining, Collecting and Presenting Federal 
Data on Race and Ethnicity (or any successor 
standards); and 
‘‘(iv) in consultation with the Director of 
the Office of Minority Health, and the Director 
of the Office of Civil Rights of the Department, 
develop standards for the collection of data on 
health and health care with respect to primary 
language; 
‘‘(4) provide support to Federal departments 
and agencies whose programs have a significant im-
pact upon health (as determined by the Secretary) 
for the collection and collation of information de-
scribed in paragraphs (1) and (2); 
‘‘(5) ensure the sharing of information de-
scribed in paragraphs (1) and (2) among the agen-
cies of the Department; 
‘‘(6) facilitate the sharing of information de-
scribed in paragraphs (1) and (2) by Federal depart-
ments and agencies whose programs have a signifi-
cant impact upon health (as determined by the Sec-
retary); 
‘‘(7) identify gaps in information described in 
paragraphs (1) and (2) and the appropriate agency 
or entity to address such gaps; 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01332
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1333 
‘‘(8) facilitate and coordinate identification and 
monitoring of health disparities by the agencies of 
the Department to inform program and policy ef-
forts to reduce such disparities, including facilitating 
and funding analyses conducted in cooperation with 
the Social Security Administration, the Bureau of 
the Census, and other appropriate agencies and enti-
ties; 
‘‘(9) consistent with privacy, proprietary, and 
other appropriate safeguards, facilitate public acces-
sibility of datasets (such as de-identified Medicare 
datasets or publicly available data on key health in-
dicators) by means of the Internet; and 
‘‘(10) award grants or contracts for the collec-
tion and collation of information described in para-
graphs (1) and (2) (including through statewide sur-
veys that provide standardized information). 
‘‘(c) KEY HEALTH INDICATORS.— 
‘‘(1) IN GENERAL.—In carrying out subsection 
(b)(1), the Assistant Secretary shall— 
‘‘(A) identify, and reassess at least once 
every 3 years, key health indicators described in 
such subsection; 
‘‘(B) publish statistics on such key health 
indicators for the public— 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01333
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1334 
‘‘(i) not less than annually; and 
‘‘(ii) on a supplemental basis when-
ever warranted by— 
‘‘(I) the rate of change for a key 
health indicator; or 
‘‘(II) the need to inform policy 
regarding the Nation’s health and the 
performance of the Nation’s health 
care; and 
‘‘(C) ensure consistency with the national 
strategy developed by the Secretary under sec-
tion 3121 and consideration of the indicators 
specified in the reports under sections 308, 
903(a)(6), and 913(b)(2). 
‘‘(2) RELEASE OF KEY HEALTH INDICATORS.— 
The regulations, rules, processes, and procedures of 
the Office of Management and Budget governing the 
review, release, and dissemination of key health indi-
cators shall be the same as the regulations, rules, 
processes, and procedures of the Office of Manage-
ment and Budget governing the review, release, and 
dissemination of Principal Federal Economic Indica-
tors (or equivalent statistical data) by the Bureau of 
Labor Statistics. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01334
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1335 
‘‘(d) COORDINATION.—In carrying out this section, 
the Assistant Secretary shall coordinate with— 
‘‘(1) public and private entities that collect and 
disseminate information on health and health care, 
including foundations; and 
‘‘(2) the head of the Office of the National Co-
ordinator for Health Information Technology to en-
sure optimal use of health information technology. 
‘‘(e) REQUEST FOR INFORMATION FROM DEPART-
MENTS AND AGENCIES.—Consistent with applicable law, 
the Assistant Secretary may secure directly from any Fed-
eral department or agency information necessary to enable 
the Assistant Secretary to carry out this section. 
‘‘(f) REPORT.— 
‘‘(1) SUBMISSION.—The Assistant Secretary 
shall submit to the Secretary and the Congress an 
annual report containing— 
‘‘(A) a description of national, regional, or 
State changes in health or health care, as re-
flected by the key health indicators identified 
under subsection (c)(1); 
‘‘(B) a description of gaps in the collection, 
collation, reporting, and publishing of informa-
tion regarding the Nation’s health and the per-
formance of the Nation’s health care; 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01335
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1336 
‘‘(C) recommendations for addressing such 
gaps and identification of the appropriate agen-
cy within the Department or other entity to ad-
dress such gaps; 
‘‘(D) a description of analyses of health 
disparities, including the results of completed 
analyses, the status of ongoing longitudinal 
studies, and proposed or planned research; and 
‘‘(E) a plan for actions to be taken by the 
Assistant Secretary to address gaps described 
in subparagraph (B). 
‘‘(2) CONSIDERATION.—In preparing a report 
under paragraph (1), the Assistant Secretary shall 
take into consideration the findings and conclusions 
in the reports under sections 308, 903(a)(6), and 
913(b)(2). 
‘‘(g) PROPRIETARY AND PRIVACY PROTECTIONS.— 
Nothing in this section shall be construed to affect appli-
cable proprietary or privacy protections. 
‘‘(h) CONSULTATION.—In carrying out this section, 
the Assistant Secretary shall consult with— 
‘‘(1) the heads of appropriate health agencies 
and offices in the Department, including the Office 
of the Surgeon General of the Public Health Service, 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01336
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1337 
the Office of Minority Health, and the Office on 
Women’s Health; and 
‘‘(2) as appropriate, the heads of other Federal 
departments and agencies whose programs have a 
significant impact upon health (as determined by the 
Secretary). 
‘‘(i) DEFINITION.—In this section: 
‘‘(1) The terms ‘agency’ and ‘agencies’ include 
an epidemiology center established under section 214 
of the Indian Health Care Improvement Act. 
‘‘(2) The term ‘Department’ means the Depart-
ment of Health and Human Services. 
‘‘(3) The term ‘health disparities’ has the 
meaning given to such term in section 3171.’’. 
(b) OTHER
COORDINATION
RESPONSIBILITIES.— 
Title III (42 U.S.C. 241 et seq.) is amended— 
(1) in paragraphs (1) and (2) of section 304(c) 
(42 U.S.C. 242b(c)), by inserting ‘‘, acting through 
the Assistant Secretary for Health Information,’’ 
after ‘‘The Secretary’’ each place it appears; and 
(2) in section 306(j) (42 U.S.C. 242k(j)), by in-
serting ‘‘, acting through the Assistant Secretary for 
Health Information,’’ after ‘‘of this section, the Sec-
retary’’. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01337
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1338 
SEC. 2403. AUTHORIZATION OF APPROPRIATIONS. 
Section 799C, as added and amended, is further 
amended by adding at the end the following: 
‘‘(e) QUALITY AND SURVEILLANCE.—For the pur-
pose of carrying out part D of title IX and section 1709, 
in addition to any other amounts authorized to be appro-
priated for such purpose, there are authorized to be appro-
priated, out of any monies in the Public Health Invest-
ment Fund, $300,000,000 for each of fiscal years 2011 
through 2015.’’. 
TITLE V—OTHER PROVISIONS 
Subtitle 
A—Drug 
Discount 
for 
Rural and Other Hospitals; 340B 
Program Integrity 
SEC. 2501. EXPANDED PARTICIPATION IN 340B PROGRAM. 
(a) EXPANSION OF COVERED ENTITIES RECEIVING 
DISCOUNTED PRICES.—Section 340B(a)(4) (42 U.S.C. 
256b(a)(4)) is amended by adding at the end the fol-
lowing: 
‘‘(M) A children’s hospital excluded from 
the Medicare prospective payment system pur-
suant to section 1886(d)(1)(B)(iii) of the Social 
Security Act, or a free-standing cancer hospital 
excluded from the Medicare prospective pay-
ment 
system 
pursuant 
to 
section 
1886(d)(1)(B)(v) of the Social Security Act 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01338
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1339 
that would meet the requirements of subpara-
graph (L), including the disproportionate share 
adjustment 
percentage 
requirement 
under 
clause (ii) of such subparagraph, if the hospital 
were a subsection (d) hospital as defined by sec-
tion 1886(d)(1)(B) of the Social Security Act. 
‘‘(N) An entity that is a critical access hos-
pital (as determined under section 1820(c)(2) 
of the Social Security Act). 
‘‘(O) An entity receiving funds under title 
V of the Social Security Act (relating to mater-
nal and child health) for the provision of health 
services. 
‘‘(P) An entity receiving funds under sub-
part I of part B of title XIX of the Public 
Health Service Act (relating to comprehensive 
mental health services) for the provision of com-
munity mental health services. 
‘‘(Q) An entity receiving funds under sub-
part II of such part B (relating to the preven-
tion and treatment of substance abuse) for the 
provision of treatment services for substance 
abuse. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01339
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1340 
‘‘(R) An entity that is a Medicare-depend-
ent, small rural hospital (as defined in section 
1886(d)(5)(G)(iv) of the Social Security Act). 
‘‘(S) An entity that is a sole community 
hospital 
(as 
defined 
in 
section 
1886(d)(5)(D)(iii) of the Social Security Act). 
‘‘(T) An entity that is classified as a rural 
referral center under section 1886(d)(5)(C) of 
the Social Security Act.’’. 
(b) PROHIBITION ON GROUP PURCHASING ARRANGE-
MENTS.—Section 340B(a) (42 U.S.C. 256b(a)) is amend-
ed— 
(1) in paragraph (4)(L)— 
(A) by adding ‘‘and’’ at the end of clause 
(i); 
(B) by striking ‘‘; and’’ at the end of 
clause (ii) and inserting a period; and 
(C) by striking clause (iii); and 
(2) in paragraph (5), by redesignating subpara-
graphs (C) and (D) as subparagraphs (D) and (E), 
respectively, and by inserting after subparagraph 
(B) the following: 
‘‘(C) PROHIBITING
USE
OF
GROUP
PUR-
CHASING
ARRANGEMENTS.—A 
hospital 
de-
scribed in subparagraph (L), (M), (N), (R), 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01340
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1341 
(S), or (T) of paragraph (4) shall not obtain 
covered outpatient drugs through a group pur-
chasing organization or other group purchasing 
arrangement.’’. 
SEC. 2502. IMPROVEMENTS TO 340B PROGRAM INTEGRITY. 
(a) INTEGRITY IMPROVEMENTS.—Section 340B (42 
U.S.C. 256b) is amended— 
(1) by striking subsections (c) and (d); and 
(2) by inserting after subsection (b) the fol-
lowing: 
‘‘(c) IMPROVEMENTS IN PROGRAM INTEGRITY.— 
‘‘(1) MANUFACTURER COMPLIANCE.— 
‘‘(A) IN GENERAL.—From amounts appro-
priated under paragraph (4), the Secretary 
shall provide for improvements in compliance by 
manufacturers with the requirements of this 
section in order to prevent overcharges and 
other violations of the discounted pricing re-
quirements specified in this section. 
‘‘(B) IMPROVEMENTS.—The improvements 
described in subparagraph (A) shall include the 
following: 
‘‘(i) The establishment of a process to 
enable the Secretary to verify the accuracy 
of ceiling prices calculated by manufactur-
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01341
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1342 
ers under subsection (a)(1) and charged to 
covered entities, which shall include the 
following: 
‘‘(I) Developing and publishing, 
through an appropriate policy or regu-
latory issuance, standards and meth-
odology for the calculation of ceiling 
prices under such subsection. 
‘‘(II) Comparing regularly the 
ceiling prices calculated by the Sec-
retary with the quarterly pricing data 
that is reported by manufacturers to 
the Secretary. 
‘‘(III) Conducting periodic moni-
toring of sales transactions to covered 
entities. 
‘‘(IV) Inquiring into any discrep-
ancies between ceiling prices and 
manufacturer pricing data that may 
be identified and taking, or requiring 
manufacturers to take, corrective ac-
tion in response to such discrepancies, 
including the issuance of refunds pur-
suant to the procedures set forth in 
clause (ii). 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01342
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1343 
‘‘(ii) The establishment of procedures 
for the issuance of refunds to covered enti-
ties by manufacturers in the event that the 
Secretary finds there has been an over-
charge, including the following: 
‘‘(I) Submission to the Secretary 
by manufacturers of an explanation of 
why and how the overcharge occurred, 
how the refunds will be calculated, 
and to whom the refunds will be 
issued. 
‘‘(II) Oversight by the Secretary 
to ensure that the refunds are issued 
accurately and within a reasonable pe-
riod of time. 
‘‘(iii) Notwithstanding any other pro-
vision of law prohibiting the disclosure of 
ceiling prices or data used to calculate the 
ceiling price, the provision of access to cov-
ered entities and State Medicaid agencies 
through an Internet website of the Depart-
ment of Health and Human Services or 
contractor to the applicable ceiling prices 
for covered drugs as calculated and verified 
by the Secretary in a manner that ensures 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01343
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1344 
protection of privileged pricing data from 
unauthorized disclosure. 
‘‘(iv) The development of a mecha-
nism by which— 
‘‘(I) rebates, discounts, or other 
price concessions provided by manu-
facturers to other purchasers subse-
quent to the sale of covered drugs to 
covered entities are reported to the 
Secretary; and 
‘‘(II) appropriate credits and re-
funds are issued to covered entities if 
such rebates, discounts, or other price 
concessions have the effect of lowering 
the applicable ceiling price for the rel-
evant quarter for the drugs involved. 
‘‘(v) In addition to authorities under 
section 1927(b)(3) of the Social Security 
Act, the Secretary may conduct audits of 
manufacturers and wholesalers to ensure 
the integrity of the program under this 
section, including audits on the market 
price of covered drugs. 
‘‘(vi) The establishment of a require-
ment that manufacturers and wholesalers 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01344
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS
1972 
‘‘(1) shall adopt a constitution and bylaws for 
the management of the property of the Foundation 
and the regulation of the affairs of the Foundation; 
‘‘(2) may adopt and alter a corporate seal; 
‘‘(3) may enter into contracts; 
‘‘(4) may acquire (through a gift or otherwise), 
own, lease, encumber, and transfer real or personal 
property as necessary or convenient to carry out the 
purposes of the Foundation; 
‘‘(5) may sue and be sued; and 
‘‘(6) may perform any other act necessary and 
proper to carry out the purposes of the Foundation. 
‘‘(j) PRINCIPAL OFFICE.— 
‘‘(1) IN GENERAL.—The principal office of the 
Foundation shall be in the District of Columbia. 
‘‘(2) ACTIVITIES; OFFICES.—The activities of 
the Foundation may be conducted, and offices may 
be maintained, throughout the United States in ac-
cordance with the constitution and bylaws of the 
Foundation. 
‘‘(k) SERVICE OF PROCESS.—The Foundation shall 
comply with the law on service of process of each State 
in which the Foundation is incorporated and of each State 
in which the Foundation carries on activities. 
VerDate Nov 24 2008 
12:56 Oct 30, 2009
Jkt 089200
PO 00000
Frm 01972
Fmt 6652
Sfmt 6201
E:\BILLS\H3962.IH
H3962
rmajette on DSK29S0YB1PROD with BILLS