(1) Provide assistance and support for adoption 
and implementation efforts and effective use of 
interoperable health information technology. 
(2) Serve as a forum for the exchange of knowl-
edge and experience. 
(3) Accelerate the transmission of knowledge 
from existing health information initiatives in both 
the private and public sectors. 
(4) Support the establishment of regional and 
local health information networks to facilitate the 
interoperability of health care data across health 
care settings. 
(5) Develop solutions to barriers to electronic 
health information exchange. 
(6) Provide technical assistance and tools to 
help health information exchanges develop a path to-
ward financial sustainability. 
(7) Establish a longitudinal database to meas-
ure the business sustainability of health information 
exchange and evaluate the impact of health informa-
tion exchange on community health outcomes and 
value. 
(b) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require the duplication of Fed-
eral efforts with respect to the establishment of the Cen-
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ter, regardless of whether such efforts were carried out 
prior to or after the enactment of this subsection. 
(c) TRANSITION FROM NATIONAL RESOURCE CEN-
TER FOR HEALTH INFORMATION TECHNOLOGY UNDER 
AHRQ.—All functions, personnel, assets, and liabilities 
applicable to the National Resource Center for Health In-
formation Technology under the Agency for Healthcare 
Research and Quality as of the day before the date of the 
enactment of this Act shall be transferred, and applied 
in the same manner and under the same terms and condi-
tions, to the Health Information Technology Resource 
Center under the Office of the National Coordinator for 
Health Information Technology established under sub-
section (a) as of the date of the enactment of this Act. 
SEC. 104. STRATEGIC PLAN FOR COORDINATING IMPLE-
MENTATION 
OF 
HEALTH 
INFORMATION 
TECHNOLOGY. 
(a) IN GENERAL.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services, in consultation with entities involved 
in the area of health information technology, shall develop 
a strategic plan related to the need for coordination in 
such area. 
(b) COORDINATION OF SPECIFIC IMPLEMENTATION 
PROCESSES.—The strategic plan under subsection (a) 
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shall address the need for coordination in the implementa-
tion of the following: 
(1) 
HEALTH
INFORMATION
TECHNOLOGY 
STANDARDS.—Health information technology stand-
ards approved under section 101(c)(3)(B)(i). 
(2) HIPAA TRANSACTION STANDARDS.—Trans-
action standards under section 1173(a) of the Social 
Security Act (42 U.S.C. 1320d–2(d)). 
(c) COORDINATION AMONG SPECIFIC FEDERAL EN-
TITIES.—The strategic plan under subsection (a) shall ad-
dress any methods to coordinate, with respect to the elec-
tronic exchange of health information, actions taken by 
the following entities: 
(1) The Office of the National Coordinator for 
Health Information Technology. 
(2) AHIC 2.0 established under section 102. 
(3) The Office of Electronic Standards and Se-
curity of the Centers for Medicare and Medicaid 
Services. 
(4) The National Committee on Vital Health 
Statistics. 
(5) Any other entity involved in the electronic 
exchange of health information that the Secretary 
determines appropriate. 
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TITLE 
II—MODERNIZING 
THE 
HEALTH CARE DELIVERY SYS-
TEM 
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 
period; 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 
paragraph: 
‘‘(3) EXPEDITED PROCEDURES FOR ADOPTION 
OF
ADDITIONS
AND
MODIFICATIONS
TO
STAND-
ARDS.— 
‘‘(A) IN GENERAL.—For purposes of para-
graph (1), the Secretary shall provide for an ex-
pedited upgrade program (in this paragraph re-
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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
INITI-
ATION
OF
PROCESS.—Not later than 30 
days after the date the Secretary receives 
a notice from a standard setting organiza-
tion that the organization is initiating a 
process to develop an addition or modifica-
tion to a standard adopted under section 
1173(a), the Secretary shall publish a no-
tice in the Federal Register that— 
‘‘(I) identifies the subject matter 
of the addition or modification; 
‘‘(II) provides a description of 
how persons may participate in the 
development process; and 
‘‘(III) invites public participation 
in such process. 
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‘‘(ii) VOLUNTARY
NOTICE
OF
PRE-
LIMINARY DRAFT OF ADDITIONS OR MODI-
FICATIONS
TO
STANDARDS.—Not later 
than 30 days after the date the Secretary 
receives a notice from a standard setting 
organization 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 
‘‘(IV) invites submission of such 
comments and participation in such 
hearing or meeting without requiring 
the public to pay a fee to participate. 
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‘‘(ii) PROCESS
FOR
RECEIPT
AND 
CONSIDERATION
OF
PUBLIC
COMMENT.— 
The standard setting organization provides 
for a process through which, after the pub-
lication of the notice referred to under 
clause (i), the organization— 
‘‘(I) receives and responds to 
public comments submitted on a time-
ly 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 
provides access to such comments, to 
the Secretary. 
‘‘(iii) SUBMITTAL
OF
FINAL
PRO-
POSED
ADDITION
OR
MODIFICATION
TO 
NCVHS.—After completion of the process 
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under clause (ii), the standard setting or-
ganization submits the proposed addition 
or modification to the National Committee 
on Vital and Health Statistics for review 
and consideration under subparagraph (E). 
Such submission shall include information 
on the organization’s compliance with the 
notice and comment requirements (and re-
sponses to those comments) under clause 
(ii). 
‘‘(E) HEARING
AND
RECOMMENDATIONS 
BY
NATIONAL
COMMITTEE
ON
VITAL
AND 
HEALTH STATISTICS.—Under the upgrade pro-
gram, upon receipt of a proposal submitted by 
a standard setting organization under subpara-
graph (D)(iii) for the adoption of an addition or 
modification to a standard, the National Com-
mittee on Vital and Health Statistics shall pro-
vide notice to the public and a reasonable op-
portunity for public testimony at a hearing on 
such addition or modification. The Secretary 
may participate in such hearing in such capac-
ity (including presiding ex officio) as the Sec-
retary shall determine appropriate. Not later 
than 90 days after the date of receipt of the 
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proposal, the Committee shall submit to the 
Secretary its recommendation to adopt (or not 
adopt) the proposed addition or modification. 
‘‘(F) DETERMINATION BY SECRETARY TO 
ACCEPT OR REJECT NATIONAL COMMITTEE ON 
VITAL AND HEALTH STATISTICS RECOMMENDA-
TION.— 
‘‘(i) 
TIMELY
DETERMINATION.— 
Under the upgrade program, if the Na-
tional Committee on Vital and Health Sta-
tistics submits to the Secretary a rec-
ommendation under subparagraph (E) to 
adopt a proposed addition or modification, 
not later than 90 days after the date of re-
ceipt of such recommendation the Sec-
retary shall make a determination to ac-
cept or reject the recommendation and 
shall publish notice of such determination 
in the Federal Register not later than 30 
days after the date of the determination. 
‘‘(ii) CONTENTS OF NOTICE.—If the 
determination is to reject the recommenda-
tion, such notice shall include the reasons 
for the rejection. If the determination is to 
accept the recommendation, as part of 
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such notice the Secretary shall promulgate 
the modified standard (including the ac-
cepted proposed addition or modification 
accepted). 
‘‘(iii) 
LIMITATION
ON
CONSIDER-
ATION.—The Secretary shall not consider a 
proposal under this subparagraph unless 
the Secretary determines that the require-
ments of subparagraph (D) (including pub-
lication of notice and opportunity for pub-
lic comment) have been met with respect to 
the proposal. 
‘‘(G) EXEMPTION FROM PAPERWORK RE-
DUCTION ACT.—Chapter 35 of title 44, United 
States Code, shall not apply to a final rule pro-
mulgated under subparagraph (F).’’. 
SEC. 202. FEDERAL PURCHASING AND DATA COLLECTION. 
(a) COORDINATION OF FEDERAL SPENDING.— 
(1) IN GENERAL.—Subject to section 203(c), 
not later than 1 year after the date of the approval 
of 
an 
applicable 
standard 
under 
section 
101(c)(3)(B)(i), no Federal funds may be used for 
the purchase of any health information technology or 
health information technology system for clinical 
care or for the electronic retrieval, storage, or ex-
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change of health information unless such technology 
or 
system 
has 
been 
certified 
under 
section 
101(c)(3)(B)(ii) with respect to compliance with 
such standard. 
(2) RULE
OF
CONSTRUCTION.—Nothing in 
paragraph (1) shall be construed to restrict the pur-
chase of minor (as determined by the Secretary) 
hardware or software components in order to mod-
ify, correct a deficiency in, or extend the life of exist-
ing hardware or software. 
(b) COORDINATION
OF FEDERAL DATA COLLEC-
TION.—Subject to section 203(c), not later than 3 years 
after the date of the approval of an applicable standard 
under section 101(c)(3)(B)(i), all Federal agencies col-
lecting health data in an electronic format for the pur-
poses of quality reporting, surveillance, epidemiology, ad-
verse event reporting, research, or for other purposes de-
termined appropriate by the Secretary of Health and 
Human Services, shall comply with such standard. 
SEC. 203. STUDY TO IMPROVE PRESERVATION AND PRO-
TECTION 
OF 
SECURITY 
AND 
CONFIDEN-
TIALITY OF HEALTH INFORMATION. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall conduct a study of current Federal 
security and confidentiality standards to determine the 
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strengths and weaknesses of such standards for purposes 
of protecting the security and confidentiality of individ-
ually identifiable health information while taking into ac-
count the need for timely and efficient exchanges of health 
information to improve quality of care and ensure the 
availability of health information necessary to make med-
ical decisions at the location in which the medical care in-
volved is provided. 
(b) REPORT.—Not later than 24 months after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services shall submit to Congress a report 
on the study under subsection (a) and shall include in such 
report recommendations for improving the current Federal 
security and confidentiality standards, including rec-
ommendations for a mechanism to track breaches to the 
security or confidentiality of individually identifiable 
health information and for appropriate penalties to apply 
in the case of such a breach. 
(c) PRESERVATION
OF CURRENT SECURITY
AND 
CONFIDENTIALITY STANDARDS BEFORE SUBMITTAL OF 
REPORT.—None of the provisions of this Act or amend-
ments made by this Act may limit, or require issuance of 
a regulation that would limit, the effect of a current Fed-
eral security and confidentiality standard before the date 
of the submittal of the report under subsection (b). 
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(d) CURRENT FEDERAL SECURITY AND CONFIDEN-
TIALITY STANDARDS DEFINED.—For purposes of this sec-
tion, the term ‘‘current Federal security and confiden-
tiality standards’’ means the Federal privacy standards es-
tablished pursuant to section 264(c) of the Health Insur-
ance Portability and Accountability Act of 1996 (42 
U.S.C. 1320d–2 note) and security standards established 
under section 1173(d) of the Social Security Act. 
TITLE III—INCENTIVIZING 
ADOPTION OF HEALTH IT 
SEC. 301. INCENTIVES FOR MEDICAL CARE PROVIDERS TO 
ADOPT HEALTH CARE INFORMATION TECH-
NOLOGY. 
(a) IN GENERAL.—Subsection (b) of section 179 of 
the Internal Revenue Code of 1986 is amended by adding 
at the end the following new paragraph: 
‘‘(8) INCREASED
LIMITATION
FOR
HEALTH 
CARE INFORMATION TECHNOLOGY.— 
‘‘(A) IN GENERAL.—In the case of a med-
ical care provider for any taxable year begin-
ning after December 31, 2008, and before Jan-
uary 1, 2014— 
‘‘(i) the dollar amount in effect under 
paragraph (1) shall be increased by the 
lesser of— 
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PWALKER on PROD1PC71 with BILLS
‘‘(I) $250,000, or 
‘‘(II) the cost of qualified health 
care information technology placed in 
service by such provider during the 
taxable year, and 
‘‘(ii) the dollar amount in effect under 
paragraph (2) shall be increased by the 
lesser of— 
‘‘(I) $800,000, or 
‘‘(II) the cost of qualified health 
care information technology placed in 
service by such provider during the 
taxable year. 
‘‘(B) DEFINITIONS.—For purposes of this 
subsection— 
‘‘(i) QUALIFIED HEALTH CARE INFOR-
MATION
TECHNOLOGY.—The term ‘quali-
fied health care information technology’ 
means section 179 property which— 
‘‘(I) has been certified pursuant 
to section 101(c)(3)(B)(ii) of the Pro-
moting Health Information Tech-
nology Act of 2009, and 
‘‘(II) is used primarily for the 
electronic creation, maintenance, and 
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exchange of medical care information 
to improve the quality or efficiency of 
medical care. 
‘‘(ii) MEDICAL CARE PROVIDER.—The 
term ‘medical care provider’ means any 
person engaged in the trade or business of 
providing medical care. 
‘‘(iii) 
MEDICAL
CARE.—The 
term 
‘medical care’ has the meaning given such 
term by section 213(d).’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to property placed in service after 
December 31, 2008. 
SEC. 302. ELIMINATION OF SUNSET APPLICABLE TO STARK 
EXCEPTION 
FOR 
ELECTRONIC 
HEALTH 
RECORDS ARRANGEMENTS. 
In applying section 1877(e) of the Social Security Act 
(42 U.S.C. 1395(e)), with respect to a regulation imple-
menting such section by providing an exception to the pro-
hibition against making certain physician referrals in the 
case of the offering or payment of nonmonetary remunera-
tion (consisting of items and services in the form of soft-
ware or information technology and training services) nec-
essary and used predominantly to create, maintain, trans-
mit, or receive electronic health records, the Secretary of 
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Health and Human Services shall not limit the period in 
which such an exception under such a regulation applies. 
SEC. 303. PROMOTION OF TELEHEALTH SERVICES. 
(a) FACILITATING THE PROVISION OF TELEHEALTH 
SERVICES ACROSS STATE LINES.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall, in coordination with physi-
cians, health care practitioners, patient advocates, 
and representatives of States, encourage and facili-
tate the adoption of State reciprocity agreements for 
practitioner licensure in order to expedite the provi-
sion across State lines of telehealth services. 
(2) REPORT.—Not later than 18 months after 
the date of the enactment of this Act, the Secretary 
of Health and Human Services shall submit to Con-
gress a report on the actions taken to carry out 
paragraph (1). 
(3) STATE
DEFINED.—For purposes of this 
subsection, the term ‘‘State’’ has the meaning given 
that term for purposes of title XVIII of the Social 
Security Act. 
(b) STUDY AND REPORT ON EXPANSION OF HOME 
HEALTH-RELATED TELEHEALTH SERVICES.— 
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(1) STUDY.—The Secretary of Health and 
Human Services shall conduct a study to determine 
the feasibility, advisability, and the costs of— 
(A) including coverage and payment for 
home health-related telehealth services as part 
of home health services under title XVIII of the 
Social Security Act; and 
(B) expanding the list of sites described in 
paragraph (4)(C)(ii) of section 1834(m) of the 
Social Security Act (42 U.S.C. 1395m(m)) to 
include county mental health clinics or other 
publicly funded mental health facilities for the 
purpose of payment under such section for the 
provision of telehealth services at such clinics or 
facilities. 
(2) SPECIFICS
OF
STUDY.—Such study shall 
demonstrate whether the changes described in sub-
paragraphs (A) and (B) of paragraph (1) are likely 
to result in the following: 
(A) Enhanced health outcomes for individ-
uals with one or more chronic conditions. 
(B) Health outcomes for individuals fur-
nished telehealth services or home health-re-
lated telehealth services that are at least com-
parable to the health outcomes for individuals 
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