H. R. 3590—461 
by the Bureau of Labor Statistics and the Bureau of the Census) 
collects and reports, to the extent practicable— 
‘‘(A) data on race, ethnicity, sex, primary language, 
and disability status for applicants, recipients, or partici-
pants; 
‘‘(B) data at the smallest geographic level such as 
State, local, or institutional levels if such data can be 
aggregated; 
‘‘(C) sufficient data to generate statistically reliable 
estimates by racial, ethnic, sex, primary language, and 
disability status subgroups for applicants, recipients or 
participants using, if needed, statistical oversamples of 
these subpopulations; and 
‘‘(D) any other demographic data as deemed appro-
priate by the Secretary regarding health disparities. 
‘‘(2) COLLECTION STANDARDS.—In collecting data described 
in paragraph (1), the Secretary or designee shall— 
‘‘(A) use Office of Management and Budget standards, 
at a minimum, for race and ethnicity measures; 
‘‘(B) develop standards for the measurement of sex, 
primary language, and disability status; 
‘‘(C) develop standards for the collection of data 
described in paragraph (1) that, at a minimum— 
‘‘(i) collects self-reported data by the applicant, 
recipient, or participant; and 
‘‘(ii) collects data from a parent or legal guardian 
if the applicant, recipient, or participant is a minor 
or legally incapacitated; 
‘‘(D) survey health care providers and establish other 
procedures in order to assess access to care and treatment 
for individuals with disabilities and to identify— 
‘‘(i) locations where individuals with disabilities 
access primary, acute (including intensive), and long- 
term care; 
‘‘(ii) the number of providers with accessible facili-
ties and equipment to meet the needs of the individuals 
with disabilities, including medical diagnostic equip-
ment that meets the minimum technical criteria set 
forth in section 510 of the Rehabilitation Act of 1973; 
and 
‘‘(iii) the number of employees of health care pro-
viders trained in disability awareness and patient care 
of individuals with disabilities; and 
‘‘(E) require that any reporting requirement imposed 
for purposes of measuring quality under any ongoing or 
federally conducted or supported health care or public 
health program, activity, or survey includes requirements 
for the collection of data on individuals receiving health 
care items or services under such programs activities by 
race, ethnicity, sex, primary language, and disability status. 
‘‘(3) DATA MANAGEMENT.—In collecting data described in 
paragraph (1), the Secretary, acting through the National 
Coordinator for Health Information Technology shall— 
‘‘(A) develop national standards for the management 
of data collected; and 
‘‘(B) develop interoperability and security systems for 
data management.
H. R. 3590—462 
‘‘(b) DATA ANALYSIS.— 
‘‘(1) IN GENERAL.—For each federally conducted or sup-
ported health care or public health program or activity, the 
Secretary shall analyze data collected under paragraph (a) to 
detect and monitor trends in health disparities (as defined 
for purposes of section 485E) at the Federal and State levels. 
‘‘(c) DATA REPORTING AND DISSEMINATION.— 
‘‘(1) IN GENERAL.—The Secretary shall make the analyses 
described in (b) available to— 
‘‘(A) the Office of Minority Health; 
‘‘(B) the National Center on Minority Health and 
Health Disparities; 
‘‘(C) the Agency for Healthcare Research and Quality; 
‘‘(D) the Centers for Disease Control and Prevention; 
‘‘(E) the Centers for Medicare & Medicaid Services; 
‘‘(F) the Indian Health Service and epidemiology cen-
ters funded under the Indian Health Care Improvement 
Act; 
‘‘(G) the Office of Rural health; 
‘‘(H) other agencies within the Department of Health 
and Human Services; and 
‘‘(I) other entities as determined appropriate by the 
Secretary. 
‘‘(2) REPORTING OF DATA.—The Secretary shall report data 
and analyses described in (a) and (b) through— 
‘‘(A) public postings on the Internet websites of the 
Department of Health and Human Services; and 
‘‘(B) any other reporting or dissemination mechanisms 
determined appropriate by the Secretary. 
‘‘(3) AVAILABILITY OF DATA.—The Secretary may make data 
described in (a) and (b) available for additional research, anal-
yses, and dissemination to other Federal agencies, non-govern-
mental entities, and the public, in accordance with any Federal 
agency’s data user agreements. 
‘‘(d) LIMITATIONS ON USE OF DATA.—Nothing in this section 
shall be construed to permit the use of information collected under 
this section in a manner that would adversely affect any individual. 
‘‘(e) PROTECTION AND SHARING OF DATA.— 
‘‘(1) PRIVACY AND OTHER SAFEGUARDS.—The Secretary shall 
ensure (through the promulgation of regulations or otherwise) 
that— 
‘‘(A) all data collected pursuant to subsection (a) is 
protected— 
‘‘(i) under privacy protections that are at least 
as broad as those that the Secretary applies to other 
health data under the regulations promulgated under 
section 264(c) of the Health Insurance Portability and 
Accountability Act of 1996 (Public Law 104–191; 110 
Stat. 2033); and 
‘‘(ii) from all inappropriate internal use by any 
entity that collects, stores, or receives the data, 
including use of such data in determinations of eligi-
bility (or continued eligibility) in health plans, and 
from other inappropriate uses, as defined by the Sec-
retary; and
H. R. 3590—463 
‘‘(B) all appropriate information security safeguards 
are used in the collection, analysis, and sharing of data 
collected pursuant to subsection (a). 
‘‘(2) DATA SHARING.—The Secretary shall establish proce-
dures for sharing data collected pursuant to subsection (a), 
measures relating to such data, and analyses of such data, 
with other relevant Federal and State agencies including the 
agencies, centers, and entities within the Department of Health 
and Human Services specified in subsection (c)(1).. 
‘‘(f) DATA ON RURAL UNDERSERVED POPULATIONS.—The Sec-
retary shall ensure that any data collected in accordance with 
this section regarding racial and ethnic minority groups are also 
collected regarding underserved rural and frontier populations. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of 
carrying out this section, there are authorized to be appropriated 
such sums as may be necessary for each of fiscal years 2010 through 
2014. 
‘‘(h) REQUIREMENT
FOR
IMPLEMENTATION.—Notwithstanding 
any other provision of this section, data may not be collected under 
this section unless funds are directly appropriated for such purpose 
in an appropriations Act. 
‘‘(i) CONSULTATION.—The Secretary shall consult with the 
Director of the Office of Personnel Management, the Secretary 
of Defense, the Secretary of Veterans Affairs, the Director of the 
Bureau of the Census, the Commissioner of Social Security, and 
the head of other appropriate Federal agencies in carrying out 
this section.’’. 
(b) ADDRESSING HEALTH CARE DISPARITIES IN MEDICAID AND 
CHIP.— 
(1) STANDARDIZED COLLECTION REQUIREMENTS INCLUDED IN 
STATE PLANS.— 
(A) MEDICAID.—Section 1902(a) of the Social Security 
Act (42 U.S.C. 1396a(a)), as amended by section 2001(d), 
is amended— 
(i) in paragraph 4), by striking ‘‘and’’ at the end; 
(ii) in paragraph (75), by striking the period at 
the end and inserting ‘‘; and’’; and 
(iii) by inserting after paragraph (75) the following 
new paragraph: 
‘‘(76) provide that any data collected under the State plan 
meets the requirements of section 3101 of the Public Health 
Service Act.’’. 
(B) CHIP.—Section 2108(e) of the Social Security Act 
(42 U.S.C. 1397hh(e)) is amended by adding at the end 
the following new paragraph: 
‘‘(7) Data collected and reported in accordance with section 
3101 of the Public Health Service Act, with respect to individ-
uals enrolled in the State child health plan (and, in the case 
of enrollees under 19 years of age, their parents or legal guard-
ians), including data regarding the primary language of such 
individuals, parents, and legal guardians.’’. 
(2) EXTENDING
MEDICARE
REQUIREMENT
TO
ADDRESS 
HEALTH DISPARITIES DATA COLLECTION TO MEDICAID AND CHIP.— 
Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), 
as amended by section 2703 is amended by adding at the 
end the following new section:
H. R. 3590—464 
‘‘SEC. 1946. ADDRESSING HEALTH CARE DISPARITIES. 
‘‘(a) EVALUATING DATA COLLECTION APPROACHES.—The Sec-
retary shall evaluate approaches for the collection of data under 
this title and title XXI, to be performed in conjunction with existing 
quality reporting requirements and programs under this title and 
title XXI, that allow for the ongoing, accurate, and timely collection 
and evaluation of data on disparities in health care services and 
performance on the basis of race, ethnicity, sex, primary language, 
and disability status. In conducting such evaluation, the Secretary 
shall consider the following objectives: 
‘‘(1) Protecting patient privacy. 
‘‘(2) Minimizing the administrative burdens of data collec-
tion and reporting on States, providers, and health plans 
participating under this title or title XXI. 
‘‘(3) Improving program data under this title and title 
XXI on race, ethnicity, sex, primary language, and disability 
status. 
‘‘(b) REPORTS TO CONGRESS.— 
‘‘(1) REPORT ON EVALUATION.—Not later than 18 months 
after the date of the enactment of this section, the Secretary 
shall submit to Congress a report on the evaluation conducted 
under subsection (a). Such report shall, taking into consider-
ation the results of such evaluation— 
‘‘(A) identify approaches (including defining methodolo-
gies) for identifying and collecting and evaluating data 
on health care disparities on the basis of race, ethnicity, 
sex, primary language, and disability status for the pro-
grams under this title and title XXI; and 
‘‘(B) include recommendations on the most effective 
strategies and approaches to reporting HEDIS quality 
measures as required under section 1852(e)(3) and other 
nationally recognized quality performance measures, as 
appropriate, on such bases. 
‘‘(2) REPORTS ON DATA ANALYSES.—Not later than 4 years 
after the date of the enactment of this section, and 4 years 
thereafter, the Secretary shall submit to Congress a report 
that includes recommendations for improving the identification 
of health care disparities for beneficiaries under this title and 
under title XXI based on analyses of the data collected under 
subsection (c). 
‘‘(c) IMPLEMENTING EFFECTIVE APPROACHES.—Not later than 
24 months after the date of the enactment of this section, the 
Secretary shall implement the approaches identified in the report 
submitted under subsection (b)(1) for the ongoing, accurate, and 
timely collection and evaluation of data on health care disparities 
on the basis of race, ethnicity, sex, primary language, and disability 
status.’’. 
SEC. 4303. CDC AND EMPLOYER-BASED WELLNESS PROGRAMS. 
Title III of the Public Health Service Act (42 U.S.C. 241 et 
seq.), by section 4102, is further amended by adding at the end 
the following: