I
107TH CONGRESS
2D SESSION
H. R. 5478
To amend title IX of the Public Health Service Act to provide for the
improvement of patient safety and to reduce the incidence of events
that adversely affect patient safety, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
SEPTEMBER 26, 2002
Mr. BILIRAKIS (for himself, Mr. BROWN of Ohio, Mr. TAUZIN, Mr. DINGELL,
Mr. UPTON, Mr. WAXMAN, Mr. GREENWOOD, Mr. BOUCHER, Mr. BURR
of North Carolina, Mr. TOWNS, Mr. WHITFIELD, Mr. PALLONE, Mr.
GANSKE, Mr. DEUTSCH, Mr. NORWOOD, Mr. RUSH, Mr. TERRY, Mr.
ENGEL, Mr. SAWYER, Mr. WYNN, Mr. GREEN of Texas, Ms. MCCARTHY
of Missouri, Ms. DEGETTE, Mr. BARRETT of Wisconsin, Mr. DOYLE, Mr.
JOHN, and Ms. HARMAN) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce
A BILL
To amend title IX of the Public Health Service Act to
provide for the improvement of patient safety and to
reduce the incidence of events that adversely affect pa-
tient safety, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Patient Safety and
Quality Improvement Act’’.
SEC. 2. FINDINGS AND PURPOSES.
(a) FINDINGS.—The Congress finds as follows:
(1) In 1999, the Institute of Medicine released
a report entitled ‘‘To Err Is Human’’ that described
medical errors as the 8th leading cause of death in
the United States, with as many as 98,000 people
dying as a result of medical errors each year.
(2) To address these deaths and injuries due to
medical errors, the health care system must identify
and learn from such errors so that systems of care
can be improved.
(3) Myriad public and private patient safety ini-
tiatives have begun. The Quality Interagency Coordi-
nation Task Force has recommended steps to im-
prove patient safety that may be taken by each Fed-
eral agency involved in health care and activities re-
lating to these steps are ongoing.
(4) The Department of Health and Human
Services has initiated several patient safety projects.
The 
Joint 
Commission 
on 
Accreditation 
of
Healthcare Organizations issued a patient safety
standard that went into effect on July 1, 2001, and
the peer review organizations are conducting ongoing
studies of clinical performance measurement of care
delivered to beneficiaries under the medicare pro-
gram under title XVIII of the Social Security Act.
(5) Several steps can be taken now to improve
patient safety. For example, according to the Cen-
ters for Disease Control and Prevention, hand wash-
ing is the single most important means of preventing
the spread of infection. Repeated studies indicate
that lack of or improper hand washing still contrib-
utes significantly to disease transmission in health
care settings. Working with experts from the private
sector, the Centers for Disease Control and Preven-
tion has drafted ‘‘Guidelines for Hand Hygiene in
Healthcare Settings’’ setting forth recommendations
to promote improved hand hygiene practices and re-
duce transmission of pathogenic microorganisms to
patients and personnel in health care settings.
(6) According to the Centers for Disease Con-
trol and Prevention, nosocomial infections affect ap-
proximately 2 million patients annually in acute care
facilities in the United States at an estimated direct
patient care cost of approximately $3.5 billion each
year.
(7) The Congress encourages the continuation
and acceleration of private sector efforts to take im-
mediate steps to improve patient safety and recog-
nizes the need for action in the public sector to com-
plement these efforts.
(8) The research on patient safety unequivo-
cally calls for a learning environment, where pro-
viders will feel safe to report health care errors, in
order to improve patient safety.
(9) Voluntary data gathering systems are more
supportive than mandatory systems in creating the
learning environment referred to in paragraph (8) as
stated in the Institute of Medicine’s report.
(10) Promising patient safety reporting systems
have been established throughout the United States,
and the best ways to structure and use these sys-
tems are currently being determined, largely through
projects funded by the Agency for Healthcare Re-
search and Quality.
(11) Many organizations currently collecting
patient safety information have expressed a need for
protections that will allow them to review protected
information so that they may collaborate in the de-
velopment and implementation of patient safety im-
provement strategies. Currently, the State peer re-
view protections provide inadequate conditions to
allow the sharing of information to promote patient
safety.
(12) In 2001, the Institute of Medicine released
a report entitled ‘‘Crossing the Quality Chasm’’ that
found that the United States health care system
does not consistently deliver high-quality care to pa-
tients.
(b) PURPOSES.—The purposes of this Act are—
(1) to encourage a culture of safety and quality
in the United States health care system by providing
for a health care errors reporting system that both
protects information and improves patient safety
and quality of health care; and
(2) to ensure accountability by raising stand-
ards and expectations for continuous quality im-
provements in patient safety through the actions of
the Secretary of Health and Human Services.
SEC. 3. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.
(a) IN GENERAL.—Title IX of the Public Health
Service Act (42 U.S.C. 299 et seq.) is amended—
(1) in section 912(c), by inserting ‘‘, in accord-
ance with part C,’’ after ‘‘The Director shall’’;
(2) by redesignating part C as part D;
(3) by redesignating sections 921 through 928,
as sections 931 through 938, respectively;
(4) in section 938(1) (as so redesignated), by
striking ‘‘921’’ and inserting ‘‘931’’; and
(5) by inserting after part B the following:
‘‘PART C—PATIENT SAFETY IMPROVEMENT
‘‘SEC. 921. DEFINITIONS.
‘‘In this part:
‘‘(1) IDENTIFIABLE INFORMATION.—The term
‘identifiable information’ means information that is
presented in a form and manner that allows the
identification of any provider, patient, or reporter of
patient safety work product. With respect to pa-
tients, such information includes any individually
identifiable health information as that term is de-
fined in the regulations promulgated pursuant to
section 264(c) of the Health Insurance Portability
and Accountability Act of 1996 (Public Law 104–
191; 110 Stat. 2033).
‘‘(2) NONIDENTIFIABLE
INFORMATION.—The
term ‘nonidentifiable information’ means informa-
tion that is presented in a form and manner that
prevents the identification of any provider, patient,
or reporter of patient safety work product. With re-
spect to patients, such information must be de-iden-
tified consistent with the regulations promulgated
pursuant to section 264(c) of the Health Insurance
Portability and Accountability Act of 1996 (Public
Law 104–191; 110 Stat. 2033).
‘‘(3) PATIENT SAFETY EVALUATION SYSTEM.—
The term ‘patient safety evaluation system’ means a
process that involves the collection, management, or
analysis of information for submission to or by a pa-
tient safety organization.
‘‘(4) PATIENT
SAFETY
ORGANIZATION.—The
term ‘patient safety organization’ means a private or
public organization or component thereof that is cer-
tified, through a process to be determined by the
Secretary under section 925, to perform each of the
following activities:
‘‘(A) The conduct, as the organization or
component’s primary activity, of efforts to im-
prove patient safety and the quality of health
care delivery.
‘‘(B) The collection and analysis of patient
safety work product that is submitted by pro-
viders.
‘‘(C) The development and dissemination
of evidence-based information to providers with
respect to improving patient safety, such as rec-
ommendations, protocols, or information re-
garding best practices.
‘‘(D) The utilization of patient safety work
product to carry out activities limited to those
described under this paragraph and for the pur-
poses of encouraging a culture of safety and of
providing direct feedback and assistance to pro-
viders to effectively minimize patient risk.
‘‘(E) The maintenance of confidentiality
with respect to identifiable information.
‘‘(F) The provision of appropriate security
measures with respect to patient safety work
product.
‘‘(G) The submission of nonidentifiable in-
formation to the Agency consistent with stand-
ards established by the Secretary under section
923(b) for any National Patient Safety Data-
base.
‘‘(5) PATIENT SAFETY WORK PRODUCT.—
‘‘(A) The term ‘patient safety work prod-
uct’ means any document or communication
(including any information, report, record,
memorandum, analysis, deliberative work, state-
ment, or root cause analysis) that—
‘‘(i) except as provided in subpara-
graph (B), is developed by a provider for
the purpose of reporting to a patient safety
organization, and is reported to a patient
safety organization;
‘‘(ii) is created by a patient safety or-
ganization; or
‘‘(iii) would reveal the deliberations or
analytic process of a patient safety evalua-
tion system (as defined in paragraph (3)).
‘‘(B)(i) Patient safety work product de-
scribed in subparagraph (A)(i)—
‘‘(I) does not include any separate in-
formation described in clause (ii); and
‘‘(II) shall not be construed to include
such separate information merely by rea-
son of inclusion of a copy of the document
or communication involved in a submission
to, or the fact of submission of such a copy
to, a patient safety organization.
‘‘(ii) Separate information described in this
clause is a document or communication (includ-
ing a patient’s medical record or any other pa-
tient or hospital record) that is developed or
maintained, or exists, separately from any pa-
tient safety evaluation system.
‘‘(C) Information available from sources
other than a patient safety work product under
this section may be discovered or admitted in a
civil or administrative proceeding, if discover-
able or admissible under applicable law.
‘‘(6) PROVIDER.—The term ‘provider’ means—
‘‘(A) an individual or entity licensed or
otherwise authorized under State law to provide
health care services, including—
‘‘(i) a hospital, nursing facility, com-
prehensive outpatient rehabilitation facil-
ity, home health agency, and hospice pro-
gram;
‘‘(ii) a physician, physician assistant,
nurse practitioner, clinical nurse specialist,
certified nurse midwife, psychologist, cer-
tified social worker, registered dietitian or
nutrition professional, physical or occupa-
tional therapist, or other individual health
care practitioner;
‘‘(iii) a pharmacist; and
‘‘(iv) a renal dialysis facility, ambula-
tory surgical center, pharmacy, physician
or health care practitioner’s office, long-
term care facility, behavioral health resi-
dential treatment facility, clinical labora-
tory, or community health center; or
‘‘(B) any other person or entity specified
in regulations by the Secretary after public no-
tice and comment.
‘‘(C) required as a condition of accredita-
tion by a national accreditation association.
‘‘(b) REPORTER PROTECTION.—
‘‘(1) IN
GENERAL.—A provider may not use
against an individual in an adverse employment ac-
tion described in paragraph (2) the fact that the in-
dividual in good faith reported information—
‘‘(A) to the provider with the intention of
having the information reported to a patient
safety organization; or
‘‘(B) directly to a patient safety organiza-
tion.
‘‘(2) ADVERSE
EMPLOYMENT
ACTION.—For
purposes of this subsection, an ‘adverse employment
action’ includes—
‘‘(A) the failure to promote an individual
or provide any other employment-related benefit
for which the individual would otherwise be eli-
gible;
‘‘(B) an adverse evaluation or decision
made in relation to accreditation, certification,
credentialing, or licensing of the individual; and
‘‘(C) a personnel action that is adverse to
the individual concerned.
‘‘(3) REMEDIES.—Any provider that violates
this subsection shall be subject to a civil monetary
penalty of not more than $20,000 for each such vio-
lation involved. Such penalty shall be imposed and
collected in the same manner as civil money pen-
alties under subsection (a) of section 1128A of the
Social Security Act are imposed and collected.
‘‘(c) DISCLOSURES.—Nothing in this section pro-
hibits any of the following disclosures:
‘‘(1) Voluntary disclosure of nonidentifiable in-
formation.
‘‘(2) Voluntary disclosure of identifiable infor-
mation by a provider or patient safety organization,
if such disclosure—
‘‘(A) is authorized by the provider for the
purposes of improving quality and safety;
‘‘(B) is to an entity or person subject to
the requirements of section 264(c) of the
Health Insurance Portability and Accountability
Act of 1996 (Public Law 104–191; 110 Stat.
2033), or any regulation promulgated under
such section; and
‘‘(C) is not in conflict with such section or
any regulation promulgated under such section.
‘‘(3) Disclosure as required by law by a pro-
vider to the Food and Drug Administration, or on
a voluntary basis by a provider to a federally estab-
lished patient safety program, with respect to an Ad-
ministration-regulated product or activity for which
that entity has responsibility, for the purposes of ac-
tivities related to the quality, safety, or effectiveness
of such Administration-regulated product or activity.
‘‘(4) Disclosures of patient safety work product
in accordance with this part by a provider to a pa-
tient safety organization.
‘‘(d) EFFECT OF TRANSFER, DISCLOSURE.—The fol-
lowing shall not be treated as a waiver of any privilege
or protection established under this part:
‘‘(1) The transfer of any patient safety work
product between a provider and a patient safety or-
ganization.
‘‘(2) Disclosure of patient safety work product
as described in subsection (c).
‘‘(3) The unauthorized disclosure of patient
safety work product.
‘‘(e) PENALTY.—
‘‘(1) PROHIBITION.—Except as provided in this
part, and subject to paragraphs (2) and (4), it shall
be unlawful for any person to disclose patient safety
work product in violation of this section, if such dis-
closure constitutes a negligent or knowing breach of
confidentiality.
‘‘(2) RELATION
TO
HIPAA.—The penalty
under paragraph (3) for a disclosure in violation of
paragraph (1) does not apply if the person would be
subject to a penalty under section 264(c) of the
Health Insurance Portability and Accountability Act
of 1996 (Public Law 104–191; 110 Stat. 2033), or
any regulation promulgated under such section, for
the same disclosure.
‘‘(3) AMOUNT.—Any person who violates para-
graph (1) shall be subject to a civil monetary penalty
of not more than $10,000 for each such violation in-
volved. Such penalty shall be imposed and collected
in the same manner as civil money penalties under
subsection (a) of section 1128A of the Social Secu-
rity Act are imposed and collected.
‘‘(4) SUBSEQUENT
DISCLOSURE.—Paragraph
(1) applies only to the first person that breaches
confidentiality with respect to particular patient
safety work product.
‘‘(f) RELATION TO HIPAA.—
‘‘(1) IN GENERAL.—For purposes of applying
the regulations promulgated pursuant to section
264(c) of the Health Insurance Portability and Ac-
countability Act of 1996 (Public Law 104–191; 110
Stat. 2033)—
‘‘(A) patient safety organizations shall be
treated as business associates; and
‘‘(B) activities of such organizations de-
scribed in section 921(4) in relation to a pro-
vider are deemed to be health care operations
(as defined in such regulations) of the provider.
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in
this section shall be construed to alter or affect the
implementation of such regulations or such section
264(c).
‘‘(g) NO LIMITATION
OF OTHER PRIVILEGES.—
Nothing in this section shall be construed to affect privi-
leges, including peer review and confidentiality protec-
tions, that are otherwise available under Federal or State
laws.
‘‘(h) NO LIMITATION ON CONTRACTS.—Nothing in
this section shall be construed to limit the power of a pro-
vider and a patient safety organization, or a patient safety
organization and the Agency or any National Patient
Safety Database, consistent with the provisions of this Act
and other applicable law, to enter into a contract requiring
greater confidentiality or delegating authority to make an
authorized disclosure.
‘‘(i) RELATION
TO STATE REPORTING REQUIRE-
MENTS.—Nothing in this part shall be construed as pre-
empting or otherwise affecting any State law requiring a
provider to report information, including information de-
scribed in section 921(5)(B), that is not patient safety
work product.
‘‘(j) CONTINUATION OF PRIVILEGE.—Patient safety
work product of an organization that is certified as a pa-
tient safety organization shall continue to be privileged
and confidential, in accordance with this section, if the or-
ganization’s certification is terminated or revoked or if the
organization otherwise ceases to qualify as a patient safety
organization.
‘‘(k) REPORTS ON STRATEGIES TO IMPROVE PA-
TIENT SAFETY.—
‘‘(1) DRAFT REPORT.—Not later than the date
that is 18 months after any National Patient Safety
Database is operational, the Secretary, in consulta-
tion with the Director, shall prepare a draft report
on effective strategies for reducing medical errors
and increasing patient safety. The draft report shall
include any measure determined appropriate by the
Secretary to encourage the appropriate use of such
strategies, including use in any federally funded pro-
grams. The Secretary shall make the draft report
available for public comment and submit the draft
report to the Institute of Medicine for review.
‘‘(2) FINAL REPORT.—Not later than 1 year
after the date described in paragraph (1), the Sec-
retary shall submit a final report to the Congress
that includes, in an appendix, any findings by the
Institute of Medicine concerning research on the
strategies discussed in the draft report and any
modifications made by the Secretary based on such
findings.
‘‘SEC. 923. NATIONAL DATABASE.
‘‘(a) AUTHORITY.—
‘‘(1) IN
GENERAL.—In conducting activities
under this part, the Secretary shall provide for the
establishment and maintenance of a database to re-
ceive relevant nonidentifiable patient safety work
product, and may designate entities to collect rel-
evant nonidentifiable patient safety work product
that is voluntarily reported by patient safety organi-
zations upon the request of the Secretary. Any data-
base established or designated under this paragraph
may be referred to as a ‘National Patient Safety
Database’.
‘‘(2) USE OF INFORMATION.—Information re-
ported to any National Patient Safety Database
shall be used to analyze national and regional statis-
tics, including trends and patterns of health care er-
rors. The information resulting from such analyses
may be included in the annual quality reports pre-
pared under section 913(b)(2).
‘‘(3) ADVISORY
ROLE.—The Secretary shall
provide scientific support to patient safety organiza-
tions, including the dissemination of methodologies
and evidence-based information related to root
causes and quality improvement.
‘‘(b) STANDARDS.—In establishing or designating a
database under subsection (a)(1), the Secretary shall, in
consultation with representatives of patient safety organi-
zations, the provider community, and the health informa-
tion technology industry, determine common formats for
the voluntary reporting of nonidentifiable patient safety
work product, including necessary elements, common and
consistent definitions, and a standardized computer inter-
face for the processing of the work product. To the extent
practicable, such standards shall be consistent with the
administrative simplification provisions of part C of title
XI of the Social Security Act.
‘‘(c) CERTAIN METHODOLOGIES FOR COLLECTION.—
The Secretary shall ensure that the methodologies for the
collection of nonidentifiable patient safety work product
for any National Patient Safety Database include the
methodologies developed or recommended by the Patient
Safety Task Force of the Department of Health and
Human Services.
‘‘(d) FACILITATION OF INFORMATION EXCHANGE.—
To the extent practicable, the Secretary may facilitate the
direct link of information between providers and patient
safety organizations and between patient safety organiza-
tions and any National Patient Safety Database.
‘‘(e) RESTRICTION ON TRANSFER.—Only nonidentifi-
able information may be transferred to any National Pa-
tient Safety Database.
‘‘SEC. 924. TECHNICAL ASSISTANCE.
‘‘(a) IN GENERAL.—The Secretary, acting through
the Director, may—
‘‘(1) provide technical assistance to patient
safety organizations, and to States with reporting
systems for health care errors; and
‘‘(2) provide guidance on the type of data to be
voluntarily submitted to any National Patient Safety
Database.
‘‘(b) 
ANNUAL
MEETINGS.—Assistance 
provided
under subsection (a) may include annual meetings for pa-
tient safety organizations to discuss methodology, commu-
nication, information collection, or privacy concerns.
‘‘SEC. 925. CERTIFICATION OF PATIENT SAFETY ORGANIZA-
TIONS.
‘‘(a) IN GENERAL.—Not later than 6 months after
the date of enactment of the Patient Safety and Quality
Improvement Act, the Secretary shall establish a process
for certifying patient safety organizations.
‘‘(b) PROCESS.—The process established under sub-
section (a) shall include the following:
‘‘(1) Certification of patient safety organiza-
tions by the Secretary or by such other national or
State governmental organizations as the Secretary
determines appropriate.
‘‘(2) If the Secretary allows other governmental
organizations to certify patient safety organizations
under paragraph (1), the Secretary shall establish a
process for approving such organizations. Any such
approved organization shall conduct certifications
and reviews in accordance with this section.
‘‘(3) A review of each certification under para-
graph (1) (including a review of compliance with
each criterion in this section and any related imple-
menting standards as determined by the Secretary
through rulemaking) not less often than every 3
years, as determined by the Secretary.
‘‘(4) Revocation of any such certification by the
Secretary or other such governmental organization
that issued the certification, upon a showing of
cause.
‘‘(c) CRITERIA.—A patient safety organization must
meet the following criteria as conditions of certification:
‘‘(1) The mission of the patient safety organiza-
tion is to conduct activities that are to improve pa-
tient safety and the quality of health care delivery
and is not in conflict of interest with the providers
that contract with the patient safety organization.
‘‘(2) The patient safety organization has appro-
priately qualified staff, including licensed or certified
medical professionals.
‘‘(3) The patient safety organization, within any
2 year period, contracts with more than 1 provider
for the purpose of receiving and reviewing patient
safety work product.
‘‘(4) The patient safety organization is not a
component of a health insurer or other entity that
offers a group health plan or health insurance cov-
erage.
‘‘(5) The patient safety organization is man-
aged, controlled, and operated independently from
any provider that contracts with the patient safety
organization for reporting patient safety work prod-
uct.
‘‘(6) To the extent practical and appropriate,
the patient safety organization collects patient safety
work product from providers in a standardized man-
ner that permits valid comparisons of similar cases
among similar providers.
‘‘(d) ADDITIONAL CRITERIA FOR COMPONENT ORGA-
NIZATIONS.—If a patient safety organization is a compo-
nent of another organization, the patient safety organiza-
tion must meet the following criteria as conditions of cer-
tification:
‘‘(1) The patient safety organization maintains
patient safety work product separately from the rest
of the organization, and establishes appropriate se-
curity measures to maintain the confidentiality of
the patient safety work product.
‘‘(2) The patient safety organization does not
make an unauthorized disclosure under this Act of
patient safety work product to the rest of the orga-
nization in breach of confidentiality.
‘‘(3) The mission of the patient safety organiza-
tion does not create a conflict of interest with the
rest of the organization.’’.
(b) AUTHORIZATION OF APPROPRIATIONS.—Section
937 of the Public Health Service Act (as redesignated by
subsection (a)) is amended by adding at the end the fol-
lowing:
‘‘(e) PATIENT SAFETY
AND QUALITY IMPROVE-
MENT.—For the purpose of carrying out part C, there are
authorized to be appropriated such sums as may be nec-
essary for each of the fiscal years 2003 through 2012.’’.
SEC. 4. PROMOTING THE DIFFUSION AND INTEROPER-
ABILITY OF INFORMATION TECHNOLOGY SYS-
TEMS INVOLVED WITH HEALTH CARE DELIV-
ERY.
(a) VOLUNTARY STANDARDS.—
(1) IN GENERAL.—Not later than 18 months
after the date of the enactment of this Act, the Sec-
retary of Health and Human Services (in this sec-
tion referred to as the ‘‘Secretary’’) shall—
(A) develop or adopt voluntary national
standards that promote the interoperability of
information technology systems involved with
health care delivery, including but not limited to
computerized physician order entry;
(B) in developing or adopting such stand-
ards, take into account—
(i) the ability of such systems to cap-
ture and aggregate clinically specific data
to enable evidence-based medicine and
other applications that promote the elec-
tronic exchange of patient medical record
information; and
(ii) the cost that meeting such stand-
ards would have on providing health care
in the United States and the increased effi-
ciencies in providing such care achieved
under the standards;
(C) in developing or adopting such stand-
ards and to the extent practicable, test the effi-
cacy, usability, and scalability of proposed inter-
operability standards within a variety of clinical
settings, including an urban academic medical
center, a rural hospital, a community health
center, and a community hospital; and
(D) submit a report to the Congress con-
taining recommendations on such standards.
(2) CONSULTATION.—In developing or adopting
standards under paragraph (1)(A), the Secretary
shall consider the recommendations of the National
Committee on Vital Health Statistics for the stand-
ardization of message formatting, coding, and vocab-
ulary for interoperability of information technology
systems involved with health care delivery. The Sec-
retary shall consult with representatives of the
health information technology industry and the pro-
vider community who are involved with the develop-
ment of interoperability standards.
(b) UPDATES.—The Secretary shall provide for the
ongoing review and periodic updating of the standards de-
veloped under subsection (a).
SEC. 5. GRANTS FOR ELECTRONIC PRESCRIPTION PRO-
GRAMS.
(a) GRANTS.—
(1) IN GENERAL.—The Secretary of Health and
Human Services (in this section referred to as the
‘‘Secretary’’) may make grants to qualified practi-
tioners for the purpose of establishing electronic pre-
scription programs.
(2) MATCHING FUNDS.—
(A) IN
GENERAL.—With respect to the
costs of establishing an electronic prescription
program, a condition for the receipt of a grant
under paragraph (1) is that the qualified practi-
tioner involved agree to make available (directly
or through donations from public or private en-
tities) non-Federal contributions toward such
costs in an amount that is not less than 50 per-
cent of such costs.
(B) DETERMINATION
OF
AMOUNT
CON-
TRIBUTED.—Non-Federal 
contributions 
re-
quired in subparagraph (A) may be in cash or
in kind, fairly evaluated, including equipment or
services. Amounts provided by the Federal Gov-
ernment, or services assisted or subsidized to
any significant extent by the Federal Govern-
ment, may not be included in determining the
amount of such non-Federal contributions.
(b) STUDY.—
(1) 
IN
GENERAL.—The 
Secretary, 
acting
through the Director of the Agency for Healthcare
Research and Quality, shall support a study to as-
sess existing scientific evidence regarding the effec-
tiveness and cost-effectiveness of the use of elec-
tronic prescription programs intended to improve the
efficiency of prescription ordering and the safe and
effective use of prescription drugs. The study shall
address the following:
(A) The ability of such programs to reduce
medical errors and improve the quality and
safety of patient care.
(B) The impact of the use of such pro-
grams on physicians, pharmacists, and patients,
including such factors as direct and indirect
costs, changes in productivity, and satisfaction.
(C) The effectiveness of strategies for over-
coming barriers to the use of electronic pre-
scription programs.
(2) REPORT.—The Secretary shall ensure that,
not later than 18 months after the date of the enact-
ment of this Act, a report containing the findings of
the study under paragraph (1) is submitted to the
appropriate committees of the Congress.
(3) DISSEMINATION OF FINDINGS.—The Sec-
retary shall disseminate the findings of the study
under paragraph (1) to appropriate public and pri-
vate entities.
(c) DEVELOPMENT OF MODEL.—The Secretary, act-
ing through the Director of the Agency for Healthcare Re-
search and Quality, may develop an Internet-based mathe-
matical model that simulates the cost and effectiveness of
electronic prescription programs for qualified practi-
tioners. The model may be designed to allow qualified
practitioners to estimate, through an interactive interface, 
the impact of electronic prescribing on their practices, in-
cluding the reduction in drug-related health care errors. 
(d) DEFINITIONS.—For purposes of this section: 
(1) The term ‘‘electronic prescription pro-
gram’’—
(A) means a program for the electronic 
submission of prescriptions to pharmacies or 
pharmacy benefit managers and the processing 
of such submissions by pharmacies; and 
(B) includes the hardware (including com-
puters and other electronic devices) and soft-
ware programs for the electronic submission of 
prescriptions to pharmacies, the processing of 
such submissions by pharmacies, and decision-
support programs. 
(2) The term ‘‘qualified practitioner’’ means a 
practitioner licensed by law to administer prescrip-
tion drugs. 
SEC. 6. GRANTS TO HOSPITALS AND OTHER HEALTH CARE 
PROVIDERS 
FOR 
INFORMATION 
TECH-
NOLOGIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall make grants to hospitals and other health
care providers (but not more than 1 grant to any 1 hos-
pital or provider) to pay the costs of acquiring or imple-
menting information technologies whose purposes are—
(1) to improve quality of care and patient safe-
ty; and
(2) to reduce adverse events and health care
complications resulting from medication errors.
(b) SPECIAL CONSIDERATION.—In making grants
under subsection (a), the Secretary shall give special con-
sideration to applicants who seek to promote the following:
(1) Interoperability across hospital services or
departments using standards developed or adopted
by the Secretary under section 4.
(2) Electronic communication of patient data
across the spectrum of health care delivery.
(3) Computerized physician order entry or bar
coding applications.
(4) Electronic communication of patient data in
hospitals that provide services to underserved or low-
income populations.
(5) Improved clinical decisionmaking through
acquisition and implementation of decision-support
technologies.