I 
111TH CONGRESS 
1ST SESSION H. R. 1039 
To encourage and enhance the adoption of interoperable health information 
technology to improve health care quality, reduce medical errors, and 
increase the efficiency of care. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 12, 2009 
Mr. SAM JOHNSON of Texas (for himself, Mr. BRADY of Texas, Ms. GINNY 
BROWN-WAITE of Florida, Mr. REICHERT, Mr. ROSKAM, and Mr. 
BOUSTANY) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee 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 encourage and enhance the adoption of interoperable 
health information technology to improve health care 
quality, reduce medical errors, and increase the efficiency 
of care. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Promoting Health Information Technology Act of 2009’’. 
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(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—STRATEGIC PLAN TOWARDS NATIONWIDE 
INTEROPERABILITY 
Sec. 101. Office of the National Coordinator for Health Information Tech-
nology. 
Sec. 102. Successor to the American Health Information Community. 
Sec. 103. Health Information Technology Resource Center. 
Sec. 104. Strategic plan for coordinating implementation of health information 
technology. 
TITLE II—MODERNIZING THE HEALTH CARE DELIVERY SYSTEM 
Sec. 201. Procedures to ensure timely updating of standards that enable elec-
tronic exchanges. 
Sec. 202. Federal purchasing and data collection. 
Sec. 203. Study to improve preservation and protection of security and con-
fidentiality of health information. 
TITLE III—INCENTIVIZING ADOPTION OF HEALTH IT 
Sec. 301. Incentives for medical care providers to adopt health care information 
technology. 
Sec. 302. Elimination of sunset applicable to Stark exception for electronic 
health records arrangements. 
Sec. 303. Promotion of telehealth services. 
Sec. 304. FQHCs included in electronic health records demonstration. 
Sec. 305. Interest-free loan program for hospitals to adopt health information 
technology. 
TITLE I—STRATEGIC PLAN TO-
WARDS NATIONWIDE INTER-
OPERABILITY 
SEC. 101. OFFICE OF THE NATIONAL COORDINATOR FOR 
HEALTH INFORMATION TECHNOLOGY. 
(a) ESTABLISHMENT.—There is established within 
the Department of Health and Human Services an Office 
of the National Coordinator for Health Information Tech-
nology that shall be headed by the National Coordinator 
for Health Information Technology (referred to in this 
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section as the ‘‘National Coordinator’’). The National Co-
ordinator shall be appointed by the President and shall 
report directly to the Secretary of Health and Human 
Services. The National Coordinator shall be paid at a rate 
equal to the rate of basic pay for level IV of the Executive 
Schedule. 
(b) 
GOALS
OF
NATIONWIDE
INTEROPERABLE 
HEALTH
INFORMATION
TECHNOLOGY
INFRASTRUC-
TURE.—The National Coordinator shall perform the du-
ties under subsection (c) in a manner consistent with the 
development of a nationwide interoperable health informa-
tion technology infrastructure that— 
(1) improves health care quality, reduces med-
ical errors, increases the efficiency of care, and ad-
vances the delivery of appropriate, evidence-based 
health care services; 
(2) promotes wellness, disease prevention, and 
management of chronic illnesses by increasing the 
availability and transparency of information related 
to the health care needs of an individual for such in-
dividual; 
(3) ensures that appropriate information nec-
essary to make medical decisions is available in a us-
able form at the time and in the location that the 
medical service involved is provided; 
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(4) produces greater value for health care ex-
penditures by reducing health care costs that result 
from inefficiency, medical errors, inappropriate care, 
and incomplete information; 
(5) promotes a more effective marketplace, 
greater competition, greater systems analysis, in-
creased choice, enhanced quality, and improved out-
comes in health care services; 
(6) improves the coordination of information 
and the provision of such services through an effec-
tive infrastructure for the secure and authorized ex-
change and use of health care information; and 
(7) ensures that the confidentiality of individ-
ually identifiable health information of a patient is 
secure and protected. 
(c) DUTIES OF NATIONAL COORDINATOR.— 
(1) STRATEGIC PLANNER FOR INTEROPERABLE 
HEALTH
INFORMATION
TECHNOLOGY.—The Na-
tional Coordinator shall maintain, direct, and over-
see the continuous improvement of a strategic plan 
to guide the nationwide implementation of interoper-
able health information technology in both the public 
and private health care sectors consistent with sub-
section (b). 
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(2) PRINCIPAL
ADVISOR
TO
HHS.—The Na-
tional Coordinator shall serve as the principal advi-
sor of the Secretary of Health and Human Services 
on the development, application, and use of health 
information technology, and coordinate the health 
information technology programs of the Department 
of Health and Human Services. 
(3) COORDINATOR OF FEDERAL GOVERNMENT 
ACTIVITIES.— 
(A) IN GENERAL.—The National Coordi-
nator shall serve as the coordinator of Federal 
Government activities relating to health infor-
mation technology. 
(B) 
SPECIFIC
COORDINATION
FUNC-
TIONS.—In carrying out subparagraph (A), the 
National Coordinator shall provide for— 
(i) the approval of standards devel-
oped and recommended by AHIC 2.0 
under section 102 (which may include 
standards relating to the interoperability, 
privacy, and security of health information 
technology) to be used in the electronic 
creation, maintenance, or exchange of 
health information; and 
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(ii) the certification and inspection of 
health information technology products, ex-
changes, and architectures to ensure that 
such products, exchanges, and architec-
tures conform to the applicable standards 
approved under clause (i). 
Any standard approved or health information 
technology product, exchange, or architecture 
certified pursuant to Executive Order 13335 as 
of the day before the date of the enactment of 
this Act shall be deemed to be a standard ap-
proved or product, exchange, or architecture 
certified, respectively, pursuant to this subpara-
graph as of such date of enactment. 
(C) USE OF PRIVATE ENTITIES.—The Na-
tional Coordinator shall, to the maximum extent 
possible, contract with or recognize private enti-
ties in carrying out subparagraph (B). 
(D) UNIFORM
APPLICATION
OF
STAND-
ARDS.—A standard approved under subpara-
graph (B)(i) for use in the electronic creation, 
maintenance, or exchange of health information 
shall preempt a standard adopted under State 
law, regulation, or rule for such a use. 
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(4) INTRAGOVERNMENTAL COORDINATOR.—The 
National Coordinator shall ensure that health infor-
mation technology policies and programs of the De-
partment of Health and Human Services are coordi-
nated with those of relevant executive branch agen-
cies and departments with a goal to avoid duplica-
tion of effort and to ensure that each agency or de-
partment conducts programs within the areas of its 
greatest expertise and its mission in order to create 
a national interoperable health information system 
capable of meeting national public health needs ef-
fectively and efficiently. 
(5) ADVISOR TO OMB.—The National Coordi-
nator shall provide to the Director of the Office of 
Management and Budget comments and advice with 
respect to specific Federal health information tech-
nology programs. 
(d) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to carry out this section for each of fiscal years 
2009 through 2013. 
(e) TREATMENT OF EXECUTIVE ORDER 13335.—Ex-
ecutive Order 13335 shall not have any force or effect 
after the date of the enactment of this Act. 
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(f) TRANSITION FROM ONCHIT UNDER EXECUTIVE 
ORDER.— 
(1) IN GENERAL.—All functions, personnel, as-
sets, liabilities, administrative actions, and statutory 
reporting requirements applicable to the old Na-
tional Coordinator or the Office of the old National 
Coordinator on the date before the date of the enact-
ment of this Act shall be transferred, and applied in 
the same manner and under the same terms and 
conditions, to the new National Coordinator and the 
Office of the new National Coordinator as of the 
date of the enactment of this Act. 
(2) ACTING NATIONAL COORDINATOR.—Before 
the appointment of the new National Coordinator, 
the old National Coordinator shall act as the Na-
tional Coordinator for Health Information Tech-
nology until the office is filled as provided in sub-
section (a). The President may appoint the old Na-
tional Coordinator as the new National Coordinator. 
(3) DEFINITIONS.—For purposes of this sub-
section: 
(A) NEW NATIONAL COORDINATOR.—The 
term ‘‘new National Coordinator’’ means the 
National Coordinator for Health Information 
Technology appointed under subsection (a). 
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(B) OLD
NATIONAL
COORDINATOR.—The 
term ‘‘old National Coordinator’’ means the 
National Coordinator for Health Information 
Technology appointed under Executive Order 
13335. 
SEC. 102. SUCCESSOR TO THE AMERICAN HEALTH INFOR-
MATION COMMUNITY. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall (through a grant, contract, or coop-
erative agreement) ensure the establishment and provide 
for the operation of an entity described in subsection (b) 
(in this Act to be referred to as ‘‘AHIC 2.0’’) for purposes 
of developing and recommending standards described in 
section 101(c)(3)(B)(i) for approval under such section. 
(b) STRUCTURE AND PROCEDURES OF ENTITY.—An 
entity described in this subsection is an entity— 
(1) in the operation of which there is broad par-
ticipation by a variety of public and private stake-
holders, (whether through membership or through 
other means); 
(2) that uses a consensus approach and a fair 
and open process to support the development of 
standards under subsection (a); and 
(3) that has a business plan and a published set 
of governance rules that enables the entity to be 
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self-sustaining and to fulfill the purposes described 
in subsection (a). 
(c) CONSULTATION.—In establishing AHIC 2.0, the 
entity awarded a grant, contract, or cooperative agreement 
pursuant to subsection (a), shall consult with a wide vari-
ety of private and public stakeholders that are knowledge-
able with respect to standards to be developed by AHIC 
2.0 or that would be potentially affected by the rec-
ommendations of AHIC 2.0. 
(d) FUNDING.— 
(1) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to carry out 
this section $13,000,000, to remain available until 
expended. 
(2) FURTHER FEDERAL FUNDING OTHER THAN 
DUES PROHIBITED.—Except as otherwise provided 
by this subsection, and except for such dues as may 
be paid by a Federal agency for membership or 
other participation in AHIC 2.0, no Federal agency 
may provide funding to the entity. There are author-
ized to be appropriated to such agencies such 
amounts as are necessary to pay the dues described 
in the previous sentence. 
(e) NONDUPLICATION OF EFFORTS TO ESTABLISH 
AHIC 2.0.—Nothing in this section shall be construed as 
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requiring the duplication of Federal efforts (such as 
awarding a grant, contract, or cooperative agreement) 
that were carried out before the date of the enactment 
of this Act, with respect to the establishment of an entity 
to support the development and recommendation of stand-
ards under subsection (a). 
(f) TREATMENT OF STANDARDS DEVELOPED OR AP-
PROVED BY AHIC.—For purposes of this title, a standard 
developed or approved (or in a stage of development or 
approval) by the American Health Information Commu-
nity established pursuant to Executive Order 13335 (or 
the AHIC Successor, Inc. doing business as the National 
eHealth Collaborative) as of the day before the date of 
the enactment of this Act shall be deemed to be a standard 
developed or approved, respectively, (or in such stage of 
development or approval) by AHIC 2.0 as of such date 
of enactment. 
SEC. 103. HEALTH INFORMATION TECHNOLOGY RESOURCE 
CENTER. 
(a) IN GENERAL.—There is established within the 
Office of the National Coordinator for Health Information 
Technology the Health Information Technology Resource 
Center (referred to in this section as the ‘‘Center’’) to 
carry out the following functions: 
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‘‘(C) PROVISION
OF
EXPEDITED
DETER-
MINATION.—Under the upgrade program and 
with respect to a proposal by a standard setting 
organization for an addition or modification to 
a standard adopted under section 1173(a), if 
the Secretary determines that the standard set-
ting organization developed such addition or 
modification in accordance with the require-
ments of subparagraph (D) and the National 
Committee on Vital and Health Statistics rec-
ommends approval of such addition or modifica-
tion under subparagraph (E), the Secretary 
shall provide for expedited treatment of such 
proposal in accordance with subparagraph (F). 
‘‘(D) REQUIREMENTS.—The requirements 
under this subparagraph with respect to a pro-
posed addition or modification to a standard by 
a standard setting organization are the fol-
lowing: 
‘‘(i) REQUEST FOR PUBLICATION OF 
NOTICE.—The standard setting organiza-
tion submits to the Secretary a request for 
publication in the Federal Register of a no-
tice described in subparagraph (B)(iii) for 
the proposed addition or modification. 
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