(iv) Federally-qualified health centers; 
or 
(v) managed care plans, if a signifi-
cant number of the plan’s enrollees are bene-
ficiaries in the Medicaid program or 
SCHIP. 
(3) 
Best 
practice 
models 
for 
financing, 
incentivizing, and sustaining such health information 
exchanges. 
(4) Information identifying the common prin-
ciples, policies, tools, and standards used (or pro-
posed) in the public and private sectors to support the 
development, operation, and implementation of such 
health information exchanges. 
(5) A description of any areas in which Federal 
government leadership is needed to support growth 
and sustainability of such health information ex-
changes. 
(b) REPORT.—Not later than one year after the date 
of enactment of this Act, the Secretary of Health and 
Human Services shall submit to Congress a report on the 
study described in subsection (a), including such rec-
ommendations as the Secretary determines appropriate to 
facilitate the development, operation, and implementation 
of health information exchanges. 
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SEC. 106. GRANTS TO INTEGRATED HEALTH SYSTEMS TO 
PROMOTE 
HEALTH 
INFORMATION 
TECH-
NOLOGIES TO IMPROVE COORDINATION OF 
CARE FOR THE UNINSURED, UNDERINSURED, 
AND MEDICALLY UNDERSERVED. 
Subpart I of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 330M. GRANTS FOR IMPROVEMENT OF THE COORDI-
NATION OF CARE FOR THE UNINSURED, 
UNDERINSURED, AND MEDICALLY UNDER-
SERVED. 
‘‘(a) IN GENERAL.—The Secretary may make grants 
to integrated health care systems, in accordance with this 
section, for projects to better coordinate the provision of 
health care through the adoption of new health information 
technology, or the significant improvement of existing 
health information technology, to improve the provision of 
health care to uninsured, underinsured, and medically un-
derserved individuals (including in urban and rural areas) 
through health-related information about such individuals, 
throughout such a system and at the point of service. 
‘‘(b) ELIGIBILITY.— 
‘‘(1) APPLICATION.—To be eligible to receive a 
grant under this section, an integrated health care 
system shall prepare and submit to the Secretary an 
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application, at such time, in such manner, and con-
taining such information as the Secretary may re-
quire, including— 
‘‘(A) a description of the project that the 
system will carry out using the funds provided 
under the grant; 
‘‘(B) a description of the manner in which 
the project funded under the grant will advance 
the goal specified in subsection (a); and 
‘‘(C) a description of the populations to be 
served by the adoption or improvement of health 
information technology. 
‘‘(2) OPTIONAL
REPORTING
CONDITION.—The 
Secretary may also condition the provision of a grant 
to an integrated health care system under this section 
for a project on the submission by such system to the 
Secretary of a report on the impact of the health in-
formation technology adopted (or improved) under 
such project on the delivery of health care and the 
quality of care (in accordance with applicable meas-
ures of such quality). Such report shall be at such 
time and in such form and manner as specified by 
the Secretary. 
‘‘(c) INTEGRATED HEALTH CARE SYSTEM DEFINED.— 
For purposes of this section, the term ‘integrated health care 
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system’ means a system of health care providers that is or-
ganized to provide care in a coordinated fashion and has 
a demonstrated commitment to provide uninsured, under-
insured, and medically underserved individuals with access 
to such care. 
‘‘(d) PRIORITIES.—In making grants under this sec-
tion, the Secretary shall give priority to an integrated 
health care system— 
‘‘(1) that can demonstrate past successful com-
munity-wide efforts to improve the quality of care 
provided and the coordination of care for the unin-
sured, underinsured, and medically underserved; or 
‘‘(2) if the project to be funded through such a 
grant— 
‘‘(A) will improve the delivery of health care 
and the quality of care provided; and 
‘‘(B) will demonstrate savings for State or 
Federal health care benefits programs or entities 
legally obligated under Federal law to provide 
health care from the reduction of duplicative 
health care services, administrative costs, and 
medical errors. 
‘‘(e) LIMITATION, MATCHING
REQUIREMENT, AND 
CONDITIONS.— 
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‘‘(1) LIMITATION ON USE OF FUNDS.—None of 
the funds provided under a grant made under this 
section may be used for a project providing for the 
adoption or improvement of health information tech-
nology that is used exclusively for financial record 
keeping, billing, or other non-clinical applications. 
‘‘(2) MATCHING REQUIREMENT.—To be eligible 
for a grant under this section an integrated health 
care system shall contribute non-Federal contributions 
to the costs of carrying out the project for which the 
grant is awarded in an amount equal to $1 for each 
$5 of Federal funds provided under the grant. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated to carry out this section 
$15,000,000 for each of fiscal years 2007 and 2008.’’. 
SEC. 107. DEMONSTRATION PROGRAM. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a demonstration program 
under which the Secretary makes grants to small physician 
practices (including such practices that furnish services to 
individuals with chronic illnesses) that are located in rural 
areas or medically underserved urban areas for the pur-
chase and support of health information technology. 
(b) ELIGIBILITY.—To be eligible to receive a grant 
under this section, an applicant shall prepare and submit 
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to the Secretary of Health and Human Services an applica-
tion, at such time, in such manner, and containing such 
information, as the Secretary may require. 
(c) REPORTING.— 
(1) REQUIRED REPORTS BY SMALL PHYSICIAN 
PRACTICES.—A small physician practice receiving a 
grant under subsection (a) shall submit to the Sec-
retary of Health and Human Services an evaluation 
on the health information technology funded by such 
grant. Such evaluation shall include information 
on— 
(A) barriers to the adoption of health infor-
mation technology by the small physician prac-
tice; 
(B) issues for such practice in the use of 
health information technology; 
(C) the effect health information technology 
will have on the quality of health care furnished 
by such practice; and 
(D) the effect of the rules under sections 
1128A, 1128B, and 1877 of the Social Security 
Act and any medical liability rules on such 
practice. 
(2) REPORT TO CONGRESS.—Not later than Jan-
uary 1, 2009, the Secretary of Health and Human 
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Services shall submit to Congress a report on the re-
sults of the demonstration program under this section. 
(d) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2007 and 2008. 
TITLE II—EXPEDITED MODIFICA-
TION PROCEDURES FOR AND 
ADOPTION 
OF 
TRANS-
ACTIONAL STANDARDS AND 
CODES 
SEC. 201. PROCEDURES TO ENSURE TIMELY UPDATING OF 
STANDARDS THAT ENABLE ELECTRONIC EX-
CHANGES. 
Section 1174(b) of the Social Security Act (42 U.S.C. 
1320d–3(b)) is amended— 
(1) in paragraph (1)— 
(A) in the first sentence, by inserting ‘‘and 
in accordance with paragraph (3)’’ before the pe-
riod; and 
(B) by adding at the end the following new 
sentence: ‘‘For purposes of this subsection and 
section 1173(c)(2), the term ‘modification’ in-
cludes a new version or a version upgrade.’’; and 
(2) by adding at the end the following new para-
graph: 
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‘‘(3) EXPEDITED PROCEDURES FOR ADOPTION OF 
ADDITIONS AND MODIFICATIONS TO STANDARDS.— 
‘‘(A) IN GENERAL.—For purposes of para-
graph (1), the Secretary shall provide for an ex-
pedited upgrade program (in this paragraph re-
ferred to as the ‘upgrade program’), in accord-
ance with this paragraph, to develop and ap-
prove additions and modifications to the stand-
ards adopted under section 1173(a) to improve 
the quality of such standards or to extend the 
functionality of such standards to meet evolving 
requirements in health care. 
‘‘(B) PUBLICATION OF NOTICES.—Under the 
upgrade program: 
‘‘(i) VOLUNTARY NOTICE OF INITIATION 
OF PROCESS.—Not later than 30 days after 
the date the Secretary receives a notice from 
a standard setting organization that the or-
ganization is initiating a process to develop 
an addition or modification to a standard 
adopted under section 1173(a), the Sec-
retary shall publish a notice in the Federal 
Register that— 
‘‘(I) identifies the subject matter 
of the addition or modification; 
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‘‘(II) provides a description of 
how persons may participate in the de-
velopment process; and 
‘‘(III) invites public participation 
in such process. 
‘‘(ii) VOLUNTARY NOTICE OF PRELIMI-
NARY DRAFT OF ADDITIONS OR MODIFICA-
TIONS TO STANDARDS.—Not later than 30 
days after the date of the date the Secretary 
receives a notice from a standard setting or-
ganization that the organization has pre-
pared a preliminary draft of an addition or 
modification to a standard adopted by sec-
tion 1173(a), the Secretary shall publish a 
notice in the Federal Register that— 
‘‘(I) identifies the subject matter 
of (and summarizes) the addition or 
modification; 
‘‘(II) specifies the procedure for 
obtaining the draft; 
‘‘(III) provides a description of 
how persons may submit comments in 
writing and at any public hearing or 
meeting held by the organization on 
the addition or modification; and 
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‘‘(IV) invites submission of such 
comments and participation in such 
hearing or meeting without requiring 
the public to pay a fee to participate. 
‘‘(iii) NOTICE OF PROPOSED ADDITION 
OR
MODIFICATION
TO
STANDARDS.—Not 
later than 30 days after the date of the date 
the Secretary receives a notice from a 
standard setting organization that the orga-
nization has a proposed addition or modi-
fication to a standard adopted under sec-
tion 1173(a) that the organization intends 
to submit under subparagraph (D)(iii), the 
Secretary shall publish a notice in the Fed-
eral Register that contains, with respect to 
the proposed addition or modification, the 
information required in the notice under 
clause (ii) with respect to the addition or 
modification. 
‘‘(iv) CONSTRUCTION.—Nothing in this 
paragraph shall be construed as requiring a 
standard setting organization to request the 
notices described in clauses (i) and (ii) with 
respect to an addition or modification to a 
standard in order to qualify for an expe-
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dited determination under subparagraph 
(C) with respect to a proposal submitted to 
the Secretary for adoption of such addition 
or modification. 
‘‘(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 setting 
organization developed such addition or modi-
fication in accordance with the requirements of 
subparagraph (D) and the National Committee 
on Vital and Health Statistics recommends ap-
proval of such addition or modification under 
subparagraph (E), the Secretary shall provide 
for expedited treatment of such proposal in ac-
cordance 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 organization 
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submits to the Secretary a request for publi-
cation in the Federal Register of a notice 
described in subparagraph (B)(iii) for the 
proposed addition or modification. 
‘‘(ii) PROCESS FOR RECEIPT AND CON-
SIDERATION
OF
PUBLIC
COMMENT.—The 
standard setting organization provides for a 
process through which, after the publication 
of the notice referred to under clause (i), the 
organization— 
‘‘(I) receives and responds to pub-
lic comments submitted on a timely 
basis on the proposed addition or 
modification before submitting such 
proposed addition or modification to 
the National Committee on Vital and 
Health Statistics under clause (iii); 
‘‘(II) makes publicly available a 
written explanation for its response in 
the proposed addition or modification 
to comments submitted on a timely 
basis; and 
‘‘(III) makes public comments re-
ceived under clause (I) available, or 
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