‘‘(E) HEARING
AND
RECOMMENDATIONS 
BY
NATIONAL
COMMITTEE
ON
VITAL
AND 
HEALTH STATISTICS.—Under the upgrade pro-
gram, upon receipt of a proposal submitted by 
a standard setting organization under subpara-
graph (D)(iii) for the adoption of an addition or 
modification to a standard, the National Com-
mittee on Vital and Health Statistics shall pro-
vide notice to the public and a reasonable op-
portunity for public testimony at a hearing on 
such addition or modification. The Secretary 
may participate in such hearing in such capac-
ity (including presiding ex officio) as the Sec-
retary shall determine appropriate. Not later 
than 90 days after the date of receipt of the 
proposal, the Committee shall submit to the 
Secretary its recommendation to adopt (or not 
adopt) the proposed addition or modification. 
‘‘(F) DETERMINATION BY SECRETARY TO 
ACCEPT OR REJECT NATIONAL COMMITTEE ON 
VITAL AND HEALTH STATISTICS RECOMMENDA-
TION.— 
‘‘(i) 
TIMELY
DETERMINATION.— 
Under the upgrade program, if the Na-
tional Committee on Vital and Health Sta-
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tistics submits to the Secretary a rec-
ommendation under subparagraph (E) to 
adopt a proposed addition or modification, 
not later than 90 days after the date of re-
ceipt of such recommendation the Sec-
retary shall make a determination to ac-
cept or reject the recommendation and 
shall publish notice of such determination 
in the Federal Register not later than 30 
days after the date of the determination. 
‘‘(ii) CONTENTS OF NOTICE.—If the 
determination is to reject the recommenda-
tion, such notice shall include the reasons 
for the rejection. If the determination is to 
accept the recommendation, as part of 
such notice the Secretary shall promulgate 
the modified standard (including the ac-
cepted proposed addition or modification 
accepted). 
‘‘(iii) 
LIMITATION
ON
CONSIDER-
ATION.—The Secretary shall not consider a 
proposal under this subparagraph unless 
the Secretary determines that the require-
ments of subparagraph (D) (including pub-
lication of notice and opportunity for pub-
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lic comment) have been met with respect to 
the proposal. 
‘‘(G) EXEMPTION FROM PAPERWORK RE-
DUCTION ACT.—Chapter 35 of title 44, United 
States Code, shall not apply to a final rule pro-
mulgated under subparagraph (F).’’. 
SEC. 203. FEDERAL PURCHASING AND DATA COLLECTION. 
(a) COORDINATION OF FEDERAL SPENDING.— 
(1) IN GENERAL.—Subject to section 204(c), 
not later than 1 year after the date of the approval 
of 
an 
applicable 
standard 
under 
section 
101(c)(3)(B)(i), no Federal funds may be used for 
the purchase of any health information technology or 
health information technology system for clinical 
care or for the electronic retrieval, storage, or ex-
change of health information unless such technology 
or 
system 
has 
been 
certified 
under 
section 
101(c)(3)(B)(ii) with respect to compliance with 
such standard. 
(2) RULE
OF
CONSTRUCTION.—Nothing in 
paragraph (1) shall be construed to restrict the pur-
chase of minor (as determined by the Secretary) 
hardware or software components in order to mod-
ify, correct a deficiency in, or extend the life of exist-
ing hardware or software. 
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(b) COORDINATION
OF FEDERAL DATA COLLEC-
TION.—Subject to section 204(c), not later than 3 years 
after the date of the approval of an applicable standard 
under section 101(c)(3)(B)(i), all Federal agencies col-
lecting health data in an electronic format for the pur-
poses of quality reporting, surveillance, epidemiology, ad-
verse event reporting, research, or for other purposes de-
termined appropriate by the Secretary of Health and 
Human Services, shall comply with such standard. 
SEC. 204. STUDY TO IMPROVE PRESERVATION AND PRO-
TECTION 
OF 
SECURITY 
AND 
CONFIDEN-
TIALITY OF HEALTH INFORMATION. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall conduct a study of current Federal 
security and confidentiality standards to determine the 
strengths and weaknesses of such standards for purposes 
of protecting the security and confidentiality of individ-
ually identifiable health information while taking into ac-
count the need for timely and efficient exchanges of health 
information to improve quality of care and ensure the 
availability of health information necessary to make med-
ical decisions at the location in which the medical care in-
volved is provided. 
(b) REPORT.—Not later than 24 months after the 
date of the enactment of this Act, the Secretary of Health 
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and Human Services shall submit to Congress a report 
on the study under subsection (a) and shall include in such 
report recommendations for improving the current Federal 
security and confidentiality standards, including rec-
ommendations for a mechanism to track breaches to the 
security or confidentiality of individually identifiable 
health information and for appropriate penalties to apply 
in the case of such a breach. 
(c) PRESERVATION
OF CURRENT SECURITY
AND 
CONFIDENTIALITY STANDARDS BEFORE SUBMITTAL OF 
REPORT.—None of the provisions of this Act or amend-
ments made by this Act may limit, or require issuance of 
a regulation that would limit, the effect of a current Fed-
eral security and confidentiality standard before the date 
of the submittal of the report under subsection (b). 
(d) CURRENT FEDERAL SECURITY AND CONFIDEN-
TIALITY STANDARDS DEFINED.—For purposes of this sec-
tion, the term ‘‘current Federal security and confiden-
tiality standards’’ means the Federal privacy standards es-
tablished pursuant to section 264(c) of the Health Insur-
ance Portability and Accountability Act of 1996 (42 
U.S.C. 1320d–2 note) and security standards established 
under section 1173(d) of the Social Security Act. 
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TITLE III—INCENTIVIZING 
ADOPTION OF HEALTH IT 
SEC. 301. PHYSICIAN INCENTIVES TO ADOPT HEALTH IT. 
(a) PURCHASE OF QUALIFIED HEALTH CARE INFOR-
MATION TECHNOLOGY.—Section 179 of the Internal Rev-
enue Code of 1986 (relating to election to expense certain 
depreciable assets) is amended by adding at the end the 
following new subsection: 
‘‘(e) HEALTH CARE INFORMATION TECHNOLOGY.— 
‘‘(1) IN
GENERAL.—In the case of qualified 
health care information technology purchased by a 
medical care provider and placed in service during a 
taxable year— 
‘‘(A) subsection (b)(1) shall be applied by 
substituting ‘$250,000’ for ‘$100,000’, 
‘‘(B) subsection (b)(2) shall be applied by 
substituting ‘$600,000’ for ‘$400,000’, and 
‘‘(C) subsection (b)(5)(A) shall be applied 
by substituting ‘$250,000 and $600,000’ for 
‘$100,000 and $400,000’. 
‘‘(2) DEFINITIONS.—For purposes of this sub-
section— 
‘‘(A) QUALIFIED HEALTH CARE INFORMA-
TION TECHNOLOGY.—The term ‘qualified health 
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care information technology’ means section 179 
property which— 
‘‘(i) has been certified pursuant to 
section 101(c)(3)(B)(ii) of the Promoting 
Health Information Technology Act of 
2008, and 
‘‘(ii) is used primarily for the elec-
tronic creation, maintenance, and exchange 
of medical care information to improve the 
quality or efficiency of medical care. 
‘‘(B) MEDICAL
CARE
PROVIDER.—The 
term ‘medical care provider’ means any person 
engaged in the trade or business of providing 
medical care. 
‘‘(C) MEDICAL CARE.—The term ‘medical 
care’ has the meaning given such term by sec-
tion 213(d).’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to property placed in service on 
or after the date of the enactment of this Act. 
SEC. 302. ELIMINATION OF SUNSET APPLICABLE TO STARK 
EXCEPTION 
FOR 
ELECTRONIC 
HEALTH 
RECORDS ARRANGEMENTS. 
In applying section 1877(e) of the Social Security Act 
(42 U.S.C. 1395(e)), with respect to a regulation imple-
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menting such section by providing an exception to the pro-
hibition against making certain physician referrals in the 
case of the offering or payment of nonmonetary remunera-
tion (consisting of items and services in the form of soft-
ware or information technology and training services) nec-
essary and used predominantly to create, maintain, trans-
mit, or receive electronic health records, the Secretary of 
Health and Human Services shall not limit the period in 
which such an exception under such a regulation applies. 
SEC. 303. PROMOTION OF TELEHEALTH SERVICES. 
(a) FACILITATING THE PROVISION OF TELEHEALTH 
SERVICES ACROSS STATE LINES.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall, in coordination with physi-
cians, health care practitioners, patient advocates, 
and representatives of States, encourage and facili-
tate the adoption of State reciprocity agreements for 
practitioner licensure in order to expedite the provi-
sion across State lines of telehealth services. 
(2) REPORT.—Not later than 18 months after 
the date of the enactment of this Act, the Secretary 
of Health and Human Services shall submit to Con-
gress a report on the actions taken to carry out 
paragraph (1). 
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(3) STATE
DEFINED.—For purposes of this 
subsection, the term ‘‘State’’ has the meaning given 
that term for purposes of title XVIII of the Social 
Security Act. 
(b) STUDY AND REPORT ON EXPANSION OF HOME 
HEALTH-RELATED TELEHEALTH SERVICES.— 
(1) STUDY.—The Secretary of Health and 
Human Services shall conduct a study to determine 
the feasibility, advisability, and the costs of— 
(A) including coverage and payment for 
home health-related telehealth services as part 
of home health services under title XVIII of the 
Social Security Act; and 
(B) expanding the list of sites described in 
paragraph (4)(C)(ii) of section 1834(m) of the 
Social Security Act (42 U.S.C. 1395m(m)) to 
include county mental health clinics or other 
publicly funded mental health facilities for the 
purpose of payment under such section for the 
provision of telehealth services at such clinics or 
facilities. 
(2) SPECIFICS
OF
STUDY.—Such study shall 
demonstrate whether the changes described in sub-
paragraphs (A) and (B) of paragraph (1) are likely 
to result in the following: 
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(A) Enhanced health outcomes for individ-
uals with one or more chronic conditions. 
(B) Health outcomes for individuals fur-
nished telehealth services or home health-re-
lated telehealth services that are at least com-
parable to the health outcomes for individuals 
furnished similar items and services by a health 
care provider at the same location of the indi-
vidual or at the home of the individual, respec-
tively. 
(C) Facilitation of communication of more 
accurate clinical information between health 
care providers. 
(D) Closer monitoring of individuals by 
health care providers. 
(E) Overall reduction in expenditures for 
health care items and services. 
(F) Improved access to health care. 
(3) HOME
HEALTH-RELATED
TELEHEALTH 
SERVICES
DEFINED.—For purposes of this sub-
section, the term ‘‘home health-related telehealth 
services’’ means technology-based professional con-
sultations, patient monitoring, patient training serv-
ices, clinical observation, patient assessment, and 
any other health services that utilize telecommuni-
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cations technologies. Such term does not include a 
telecommunication that consists solely of a telephone 
audio conversation, facsimile, electronic text mail, or 
consultation between two health care providers. 
(4) REPORT.—Not later than 18 months after 
the date of the enactment of this Act, the Secretary 
of Health and Human Services shall submit to Con-
gress a report on the study conducted under para-
graph (1) and shall include in such report such rec-
ommendations for legislation or administration ac-
tion as the Secretary determines appropriate. 
(c) STUDY AND REPORT ON STORE AND FORWARD 
TECHNOLOGY FOR TELEHEALTH.— 
(1) STUDY.—The Secretary of Health and 
Human Services, acting through the Director of the 
Office for the Advancement of Telehealth, shall con-
duct a study on the use of store and forward tech-
nologies (that provide for the asynchronous trans-
mission of health care information in single or multi-
media formats) in the provision of telehealth serv-
ices. Such study shall include an assessment of the 
feasibility, advisability, and the costs of expanding 
the use of such technologies for use in the diagnosis 
and treatment of certain health conditions, as speci-
fied by the Secretary. 
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(2) REPORT.—Not later than 18 months after 
the date of the enactment of this Act, the Secretary 
of Health and Human Services shall submit to Con-
gress a report on the study conducted under para-
graph (1) and shall include in such report such rec-
ommendations for legislation or administration ac-
tion as the Secretary determines appropriate. 
SEC. 304. FQHCS INCLUDED IN ELECTRONIC HEALTH 
RECORDS DEMONSTRATION. 
Effective as of the date of the enactment of this Act, 
in developing and implementing a demonstration initiative 
to foster the implementation and adoption of electronic 
health records and health information technology, the 
Centers of Medicare & Medicaid Services shall provide for 
the eligibility of Federally qualified health centers (as de-
fined in section 1861(aa)(4) of the Social Security Act (42 
U.S.C. 1395x(aa)(4)) to participate in such demonstra-
tion. 
Æ 
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