‘‘(2) For purposes of this subsection, the term
‘unique product identifier’ means an identification that—
‘‘(A) is affixed by the manufacturer, labeler, or
packager to each drug or biological product de-
scribed in paragraph (1) at each packaging level;
‘‘(B) uniquely identifies the item and meets the
standards required by this section; and
‘‘(C) can be read by a scanning device or other
technology acceptable to the Secretary.
‘‘(3) A unique product identifier required by regula-
tions issued or revised under paragraph (1) shall be based
on—
‘‘(A) the National Drug Code maintained by
the Food and Drug Administration;
‘‘(B) commercially accepted standards estab-
lished by organizations that are accredited by the
American National Standards Institute, such as the
Health Industry Business Communication Council or
the Uniform Code Council; or
‘‘(C) other identification formats that the Sec-
retary deems appropriate.
‘‘(4) The Secretary may, at the Secretary’s discre-
tion, waive the requirements of this section, or add addi-
tional provisions that are necessary to safeguard the pub-
lic health.’’.
SEC. 104. 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
program’’—
(A) means a program for the electronic
submission and processing of prescriptions; 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 or dis-
pense prescription drugs.
SEC. 105. 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 102.
(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.
(c) CERTAIN GRANT CONDITIONS.—A condition for
the receipt of a grant under subsection (a) is that the ap-
plicant involved meet the following requirements:
(1) The applicant agrees to carry out a pro-
gram to measure, analyze, and report patient safety
and medical errors at the hospital or other health
care provider involved, to submit to the Secretary a
description of the methodology that will be used, and
to have such program in effect as soon as prac-
ticable after the application for the grant is ap-
proved, without regard to whether information tech-
nologies under the grant have been implemented.
(2) The applicant has arranged for an evalua-
tion that addresses the effectiveness and cost-effec-
tiveness of the information technology for which the
grant is provided and its impact on the quality and
safety of patient care, submitted the evaluation plan
to the Secretary, and received approval from the
Secretary of the applicant’s methodology.
(3) The applicant has or is developing a patient
safety evaluation system (as that term is defined in
section 921 of the Public Health Service Act (as
amended by section 101)) for reporting health care
errors to a patient safety organization.
(4) The applicant agrees to provide the Sec-
retary with such information as the Secretary may
require regarding the use of funds under this pro-
gram or its impact.
(5) The applicant provides assurances satisfac-
tory to the Secretary that any information tech-
nology planned, acquired, or implemented with grant
funds under this section will be part of an informa-
tion program that—
(A) carries out the purposes described in
subsection (a); and
(B) is comprehensive or will be expanded
to become comprehensive, regardless of whether
Federal assistance is available for such expan-
sion.
(d) TECHNICAL ASSISTANCE TO GRANTEES.—The
Secretary, acting through the Director of the Agency for
Healthcare Research and Quality, shall provide technical
assistance to applicants and grantees to ensure the appro-
priate evaluation of the information technologies for which
grants are awarded under this section, such as—
(1) reviewing and providing technical assistance
on the applicant’s proposed evaluation;
(2) developing mechanisms to ensure ongoing
communications between grantees and evaluators to
facilitate the identification and resolution of prob-
lems as they arise, ensure mutual learning, and pro-
mote the rapid dissemination of information;
(3) reviewing the interim and final reports re-
quired under subsection (e); and
(4) disseminating evidence-based information in
interim and final reports to patient safety organiza-
tions, as appropriate.
(e) EVALUATION REPORTS BY GRANTEE.—A condi-
tion for the receipt of a grant under subsection (a) is that
the applicant agree to submit an interim and a final report
to the Secretary in accordance with this subsection.
(1) INTERIM REPORT.—Not later than 1 year
after the implementation of information technologies
under the grant is completed, the applicant will sub-
mit an interim report to the Secretary describing the
initial effectiveness of such technologies in carrying
out the purposes described in subsection (a).
(2) FINAL REPORT.—Not later than 3 years
after the implementation of information technologies
under the grant is completed, the applicant will sub-
mit a final report to the Secretary describing the ef-
fectiveness and cost-effectiveness of such tech-
nologies and addressing other issues determined to
be important in carrying out the purposes described
in subsection (a).
(3) RELATION TO DISBURSEMENT OF GRANT.—
In disbursing a grant under subsection (a), the Sec-
retary shall withhold 1⁄3 of the grant until the grant-
ee submits to the Secretary the report required in
paragraph (1).
(f) REPORTS BY SECRETARY.—
(1) INTERIM REPORTS.—
(A) IN GENERAL.—Through the fiscal year
preceding the fiscal year in which the final re-
port under paragraph (2) is prepared, the Sec-
retary shall submit to the Committee on Energy
and Commerce of the House of Representatives
and the Committee on Health, Education,
Labor, and Pensions of the Senate periodic re-
ports on the grant program under subsection
(a). Such reports shall be submitted not less
frequently than once each fiscal year, beginning
with fiscal year 2004.
(B) CONTENTS.—A report under subpara-
graph (A) shall include information on—
(i) the number of grants made;
(ii) the nature of the projects for
which funding is provided under the grant
program;
(iii) the geographic distribution of
grant recipients; and
(iv) such other matters as the Sec-
retary determines appropriate.
(2) FINAL REPORT.—Not later than 180 days
after the date on which the last of the reports is due
under subsection (e)(2), the Secretary shall submit
a final report to the committees referred to in para-
graph (1)(A) on the grant program under subsection
(a), together with such recommendations for legisla-
tion and administrative action as the Secretary de-
termines appropriate.
(g) DEFINITIONS.—For purposes of this section:
(1) The term ‘‘costs’’, with respect to informa-
tion technologies referred to in subsection (a), in-
cludes total expenditures incurred for—
(A) purchasing, leasing, and installing
computer software and hardware, including
hand-held computer technologies;
(B) making improvements to existing com-
puter software and hardware; and
(C) purchasing or leasing communications
capabilities necessary for clinical data access,
storage, and exchange.
(2) The term ‘‘health care provider’’ has the
same meaning given to the term ‘‘provider’’ in sec-
tion 921 of the Public Health Services Act (as
amended by this Act).
(h) TERMINATION OF GRANT AUTHORITIES.—The
authority of the Secretary to make grants under sub-
section (a) terminates upon the expiration of fiscal year
2011.
(i) MATCHING FUNDS.—
(1) IN GENERAL.—With respect to the costs of
a grant to be carried out under this section, such
grant may be made only if the applicant agrees to
make available (directly or through donations from
public or private entities) non-Federal contributions
toward such costs in an amount that is not less than
50 percent of such costs ($1 for each $1 of Federal
funds provided in the grant).
(2) DETERMINATION
OF
AMOUNTS
CONTRIB-
UTED.—Amounts provided by the Federal Govern-
ment, or services assisted or subsidized to any sig-
nificant extent by the Federal Government, may not
be included in determining the amount of such non-
Federal contributions.
SEC. 
106. 
AUTHORIZATION 
OF 
APPROPRIATIONS 
FOR
GRANTS UNDER SECTIONS 104 AND 105.
For the purpose of carrying out sections 104 and
105, there are authorized to be appropriated $25,000,000
for each of fiscal years 2004 and 2005.
TITLE 
II—MEDICAL 
INFORMA-
TION 
TECHNOLOGY 
ADVI-
SORY BOARD.
SEC. 201. MEDICAL INFORMATION TECHNOLOGY ADVISORY
BOARD.
Title XI of the Social Security Act is amended by
adding at the end the following new section:
‘‘MEDICAL INFORMATION TECHNOLOGY ADVISORY BOARD
‘‘SEC. 1180. (a) ESTABLISHMENT.—
‘‘(1) IN GENERAL.—Not later than 3 months
after the date of the enactment of this section, the
Secretary shall appoint an advisory board to be
known as the ‘Medical Information Technology Advi-
sory Board’ (in this section referred to as the
‘MITAB’).
‘‘(2) CHAIRMAN.—The Secretary shall des-
ignate one member as chairman. The chairman shall
be an individual affiliated with an organization hav-
ing expertise creating American National Standards
Institute (ANSI) accepted standards in health care
information technology and a member of the Na-
tional Committee for Vital and Health Statistics.
‘‘(b) COMPOSITION.—
‘‘(1) IN GENERAL.—The MITAB shall consist
of not more than 17 members that include—
‘‘(A) experts from the fields of medical in-
formation, information technology, medical con-
tinuous quality improvement, medical records
security and privacy, individual and institu-
tional health care clinical providers, health re-
searchers, and health care purchasers;
‘‘(B) one or more staff experts from each
of the following: the Centers for Medicare &
Medicaid Services, the Agency for Healthcare
Research and Quality, and the Institute of
Medicine of the National Academy of Sciences;
‘‘(C) representatives of private organiza-
tions with expertise in medical infomatics;
‘‘(D) a representative of a teaching hos-
pital; and
‘‘(E) one or more representatives of the
health care information technology industry.
‘‘(2) TERMS OF APPOINTMENT.—The term of
any appointment under paragraph (1) to the
MITAB shall be for the life of the MITAB.
‘‘(3) MEETINGS.—The MITAB shall meet at
the call of its chairman or a majority of its mem-
bers.
‘‘(4) VACANCIES.—A vacancy on the MITAB
shall be filled in the same manner in which the origi-
nal appointment was made not later than 30 days
after the MITAB is given notice of the vacancy and
shall not affect the power of the remaining members
to execute the duties of the MITAB.
‘‘(5) COMPENSATION.—Members of the MITAB
shall receive no additional pay, allowances, or bene-
fits by reason of their service on the MITAB.
‘‘(6) EXPENSES.—Each member of the MITAB
shall receive travel expenses and per diem in lieu of
subsistence in accordance with sections 5702 and
5703 of title 5, United States Code.
‘‘(c) DUTIES.—
‘‘(1) IN GENERAL.—The MITAB shall on an
ongoing basis advise, and make recommendations to,
the Secretary regarding medical information tech-
nology, including the following:
‘‘(A) The best current practices in medical
information technology.
‘‘(B) Methods for the adoption (not later
than 2 years after the date of the enactment of
this section) of a uniform health care informa-
tion system interface between and among old
and new computer systems.
‘‘(C) Recommendations for health care vo-
cabulary, messaging, and other technology
standards (including a common lexicon for com-
puter technology) necessary to achieve the
interoperability of health care information sys-
tems for the purposes described in subpara-
graph (E).
‘‘(D) Methods of implementing—
‘‘(i) health care information tech-
nology 
interoperability 
standardization;
and
‘‘(ii) records security.
‘‘(E) Methods to promote information ex-
change among health care providers so that
long-term compatibility among information sys-
tems is maximized, in order to do one or more
of the following:
‘‘(i) To maximize positive outcomes in
clinical care—
‘‘(I) by providing decision sup-
port for diagnosis and care; and
‘‘(II) by assisting in the emer-
gency treatment of a patient pre-
senting at a facility where there is no
medical record for the patient.
‘‘(ii) To contribute to (and be con-
sistent with) the development of the pa-
tient assessment instrument provided for
under section 545 of the Medicare, Med-
icaid, and SCHIP Benefits Improvement
and Protection Act of 2000, and to assist
in minimizing the need for new and dif-
ferent records as patients move from pro-
vider to provider.
‘‘(iii) To reduce or eliminate the need
for redundant records, paperwork, and the
repetitive taking of patient histories and
administering of tests.
‘‘(iv) To minimize medical errors,
such as administration of contraindicated
drugs.
‘‘(v) To provide a compatible informa-
tion technology architecture that facilitates
future quality and cost-saving needs and
that avoids the financing and development
of information technology systems that are
not readily compatible.
‘‘(2) REPORTS.—
‘‘(A) INITIAL REPORT.—No later than 18
months after the date of the enactment of this
section, the MITAB shall submit to Congress
and the Secretary an initial report concerning
the matters described in paragraph (1). The re-
port shall include—
‘‘(i) the practices described in para-
graph (1)(A), including the status of
health care information technology stand-
ards being developed by private sector and
public-private groups;
‘‘(ii) recommendations for accelerating
the development of common health care
terminology standards;
‘‘(iii) recommendations for completing
development of health care information
system messaging standards; and
‘‘(iv) progress toward meeting the
deadline described in paragraph (1)(B) for
adoption of methods described in such
paragraph.
‘‘(B) 
SUBSEQUENT
REPORTS.—During
each of the 2 years after the year in which the
report is submitted under subparagraph (A),
the MITAB shall submit to Congress and the
Secretary an annual report relating to addi-
tional recommendations, best practices, results
of information technology improvements, anal-
yses of private sector efforts to implement the
interoperability standards established in section
102 of the Patient Safety and Quality Improve-
ment Act, and such other matters as may help
ensure the most rapid dissemination of best
practices in health care information technology.
‘‘(d) STAFF AND SUPPORT SERVICES.—
‘‘(1) EXECUTIVE DIRECTOR.—
‘‘(A) APPOINTMENT.—The Chairman shall
appoint an executive director of the MITAB.
‘‘(B) COMPENSATION.—The executive di-
rector shall be paid the rate of basic pay for
level V of the Executive Schedule.
‘‘(2) 
STAFF.—With 
the 
approval 
of 
the
MITAB, the executive director may appoint such
personnel as the executive director considers appro-
priate.
‘‘(3) APPLICABILITY OF CIVIL SERVICE LAWS.—
The staff of the MITAB shall be appointed without
regard to the provisions of title 5, United States
Code, governing appointments in the competitive
service, and shall be paid without regard to the pro-
visions of chapter 51 and subchapter III of chapter
53 of such title (relating to classification and Gen-
eral Schedule pay rates).
‘‘(4) EXPERTS AND CONSULTANTS.—With the
approval of the MITAB, the executive director may
procure temporary and intermittent services under
section 3109(b) of title 5, United States Code.
‘‘(e) POWERS.—
‘‘(1) HEARINGS AND OTHER ACTIVITIES.—For
the purpose of carrying out its duties, the MITAB
may hold such hearings and undertake such other
‘‘(g) APPLICABILITY OF FACA.—The provisions of
the Federal Advisory Committee Act (5 U.S.C. App.) shall
apply to the MITAB.
‘‘(h) FUNDING.—There are authorized to be appro-
priated such sums as are necessary for each fiscal year
to carry out this section.’’.
Passed the House of Representatives March 12,
2003.
Attest:
Clerk.