I 
110TH CONGRESS 
2D SESSION 
H. R. 7038 
To establish a Health Care Services Commission to enhance the quality, 
appropriateness, and effectiveness of health care services, and access 
to such services, through the establishment of a broad base of scientific 
research and through the promotion of improvements in clinical practice 
and in the organization, financing, and delivery of health care services. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 24, 2008 
Mr. RYAN of Wisconsin introduced the following bill; which was referred to 
the Committee on Energy and Commerce, and in addition to the Com-
mittee on Ways and Means, 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 establish a Health Care Services Commission to enhance 
the quality, appropriateness, and effectiveness of health 
care services, and access to such services, through the 
establishment of a broad base of scientific research and 
through the promotion of improvements in clinical prac-
tice and in the organization, financing, and delivery of 
health care services. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Health Care Services Commission Act’’. 
(b) TABLE OF CONTENTS.— 
Sec. 1. Short Titlte; table of Contents. 
TITLE I—ESTABLISHMENT AND GENERAL DUTIES 
Sec. 101. Establishment. 
Sec. 102. General authorities and duties. 
Sec. 103. Dissemination. 
TITLE II—FORUM FOR QUALITY AND EFFECTIVENESS IN 
HEALTH CARE 
Sec. 201. Establishment of office. 
Sec. 202. Membership. 
Sec. 203. Duties. 
Sec. 204. Adoption and enforcement of guidelines and standards. 
Sec. 205. Additional requirements. 
TITLE III—GENERAL PROVISIONS 
Sec. 301. Certain administrative authorities. 
Sec. 302. Funding. 
Sec. 303. Definitions. 
TITLE IV—TERMINATIONS AND TRANSITION 
Sec. 401. Termination of Agency for Healthcare Research and Quality. 
Sec. 402. Transition. 
TITLE V—INDEPENDENT HEALTH RECORD TRUST 
Sec. 501. Title V short title. 
Sec. 502. Purpose. 
Sec. 503. Definitions. 
Sec. 504. Establishment, certification, and membership of independent health 
record trusts. 
Sec. 505. Duties of IHRT to IHRT participants. 
Sec. 506. Availability and use of information from records in IHRT consistent 
with privacy protections and agreements. 
Sec. 507. Voluntary nature of trust participation and information sharing. 
Sec. 508. Financing of activities. 
Sec. 509. Regulatory oversight. 
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TITLE I—ESTABLISHMENT AND 
GENERAL DUTIES 
SEC. 101. ESTABLISHMENT. 
(a) IN GENERAL.—There is hereby established a 
Health Care Services Commission (in this Act, referred 
to as the ‘‘Commission’’) to be composed of five commis-
sioners (in this Act referred to as the ‘‘Commissioners’’) 
to be appointed by the President by and with the advice 
and consent of the Senate. Not more than three of such 
commissioners shall be members of the same political 
party, and in making appointments members of different 
political parties shall be appointed alternately as nearly 
as may be practicable. No commissioner shall engage in 
any other business, vocation, or employment than that of 
serving as commissioner. Each commissioner shall hold of-
fice for a term of five years and until his successor is ap-
pointed and has qualified, except that he shall not so con-
tinue to serve beyond the expiration of the next session 
of Congress subsequent to the expiration of said fixed 
term of office, and except (1) any commissioner appointed 
to fill a vacancy occurring prior to the expiration of the 
term for which his predecessor was appointed shall be ap-
pointed for the remainder of such term, and (2) the terms 
of office of the commissioners first taking office after the 
enactment of this Act shall expire as designated by the 
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President at the time of nomination, one at the end of 
one year, one at the end of two years, one at the end of 
three years, one at the end of four years, and one at the 
end of five years, after the date of the enactment of this 
Act. 
(b) PURPOSE.—The purpose of the Commission is to 
enhance the quality, appropriateness, and effectiveness of 
health care services, and access to such services, through 
the establishment of a broad base of scientific research 
and through the promotion of improvements in clinical 
practice and in the organization, financing, and delivery 
of health care services. 
(c) APPOINTMENT
OF CHAIRMAN.—The President 
shall, from among the Commissioners appointed under 
subsection (a), designate an individual to serve as the 
Chairman of the Commission. 
SEC. 102. GENERAL AUTHORITIES AND DUTIES. 
(a) IN GENERAL.—In carrying out section 101(b), 
the Commissioners shall conduct and support research, 
demonstration projects, evaluations, training, guideline de-
velopment, and the dissemination of information, on 
health care services and on systems for the delivery of 
such services, including activities with respect to— 
(1) the effectiveness, efficiency, and quality of 
health care services; 
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(2) the outcomes of health care services and 
procedures; 
(3) clinical practice, including primary care and 
practice-oriented research; 
(4) health care technologies, facilities, and 
equipment; 
(5) health care costs, productivity, and market 
forces; 
(6) health promotion and disease prevention; 
(7) health statistics and epidemiology; and 
(8) medical liability. 
(b) REQUIREMENTS
WITH
RESPECT
TO
RURAL 
AREAS AND UNDERSERVED POPULATIONS.—In carrying 
out subsection (a), the Commissioners shall undertake and 
support research, demonstration projects, and evaluations 
with respect to— 
(1) the delivery of health care services in rural 
areas (including frontier areas); and 
(2) the health of low-income groups, minority 
groups, and the elderly. 
SEC. 103. DISSEMINATION. 
(a) IN GENERAL.—The Commissioners shall— 
(1) promptly publish, make available, and oth-
erwise disseminate, in a form understandable and on 
as broad a basis as practicable so as to maximize its 
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