166 
gardless of how such coverage is provided or ar-
ranged to be provided. 
‘‘SEC. 4376. DEFINITIONS AND SPECIAL RULES. 
‘‘(a) DEFINITIONS.—For purposes of this sub-
chapter— 
‘‘(1) ACCIDENT AND HEALTH COVERAGE.—The 
term ‘accident and health coverage’ means any cov-
erage which, if provided by an insurance policy, 
would cause such policy to be a specified health in-
surance policy (as defined in section 4375(c)). 
‘‘(2) INSURANCE POLICY.—The term ‘insurance 
policy’ means any policy or other instrument where-
by a contract of insurance is issued, renewed, or ex-
tended. 
‘‘(3) UNITED
STATES.—The term ‘United 
States’ includes any possession of the United States. 
‘‘(b) TREATMENT OF GOVERNMENTAL ENTITIES.— 
‘‘(1) IN GENERAL.—For purposes of this sub-
chapter— 
‘‘(A) the term ‘person’ includes any gov-
ernmental entity, and 
‘‘(B) notwithstanding any other law or rule 
of law, governmental entities shall not be ex-
empt from the fees imposed by this subchapter 
except as provided in paragraph (2). 
VerDate Aug 31 2005 
05:58 Jul 10, 2008
Jkt 069200
PO 00000
Frm 00166
Fmt 6652
Sfmt 6201
E:\BILLS\H6444.IH
H6444
jbell on PROD1PC69 with BILLS
167 
‘‘(2) TREATMENT OF EXEMPT GOVERNMENTAL 
PROGRAMS.—In the case of an exempt governmental 
program, no fee shall be imposed under section 4375 
or section 4376 on any covered life under such pro-
gram. 
‘‘(3) EXEMPT
GOVERNMENTAL
PROGRAM
DE-
FINED.—For purposes of this subchapter, the term 
‘exempt governmental program’ means— 
‘‘(A) any insurance program established 
under title XVIII of the Social Security Act, 
‘‘(B) the medical assistance program es-
tablished by title XIX or XXI of the Social Se-
curity Act, 
‘‘(C) any program established by Federal 
law for providing medical care (other than 
through insurance policies) to individuals (or 
the spouses and dependents thereof) by reason 
of such individuals being— 
‘‘(i) members of the Armed Forces of 
the United States, or 
‘‘(ii) veterans, and 
‘‘(D) any program established by Federal 
law for providing medical care (other than 
through insurance policies) to members of In-
VerDate Aug 31 2005 
05:58 Jul 10, 2008
Jkt 069200
PO 00000
Frm 00167
Fmt 6652
Sfmt 6201
E:\BILLS\H6444.IH
H6444
jbell on PROD1PC69 with BILLS
168 
dian tribes (as defined in section 4(d) of the In-
dian Health Care Improvement Act). 
‘‘(c) TREATMENT AS TAX.—For purposes of subtitle 
F, the fees imposed by this subchapter shall be treated 
as if they were taxes. 
‘‘(d) NO COVER OVER TO POSSESSIONS.—Notwith-
standing any other provision of law, no amount collected 
under this subchapter shall be covered over to any posses-
sion of the United States.’’ 
(2) CLERICAL
AMENDMENT.—Chapter 34 of 
such Code is amended by striking the chapter head-
ing and inserting the following: 
‘‘CHAPTER 34—TAXES ON CERTAIN 
INSURANCE POLICIES 
‘‘SUBCHAPTER A. POLICIES ISSUED BY FOREIGN INSURERS 
‘‘SUBCHAPTER B. INSURED HEALTH PLANS 
‘‘Subchapter A—Policies Issued By Foreign 
Insurers’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this section shall apply with respect to policies 
and plans for portions or policy or plan years begin-
ning on or after October 1, 2007. 
SEC. 804. COORDINATION OF HEALTH SERVICES RE-
SEARCH. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services shall establish a permanent council (in 
VerDate Aug 31 2005 
05:58 Jul 10, 2008
Jkt 069200
PO 00000
Frm 00168
Fmt 6652
Sfmt 6201
E:\BILLS\H6444.IH
H6444
jbell on PROD1PC69 with BILLS
169 
this section referred to as the ‘‘Council’’) for the purpose 
of assisting the offices and agencies of the Department 
of Health and Human Services, the Department of Vet-
erans Affairs, the Department of Defense, and any other 
department or agency to coordinate the conduct or sup-
port of health services research. Such coordination shall 
include advising each such office and agency— 
(1) on clarifying its policies regarding public ac-
cess to data resulting from research conducted or 
supported by the office or agency, including the pro-
vision of reasons for not permitting any such data 
to be publicly disclosed; 
(2) on making such policies, as clarified, pub-
licly available; and 
(3) on updating the publicly available versions 
of such policies to reflect any subsequent modifica-
tions. 
(b) MEMBERSHIP.— 
(1) NUMBER AND APPOINTMENT.—The Council 
shall be composed of 20 members. One member shall 
be the Director of the Agency for Healthcare Re-
search and Quality. The Director shall appoint the 
other members not later than 30 days after the en-
actment of this Act. 
(2) QUALIFICATIONS.— 
VerDate Aug 31 2005 
22:33 Jul 10, 2008
Jkt 069200
PO 00000
Frm 00169
Fmt 6652
Sfmt 6201
E:\BILLS\H6444.IH
H6444
jbell on PROD1PC69 with BILLS
170 
(A) IN
GENERAL.—The members of the 
Council shall include one senior official from 
each of the following agencies: 
(i) The Veterans Health Administra-
tion. 
(ii) The Department of Defense Mili-
tary Health Care System. 
(iii) The Centers for Disease Control 
and Prevention. 
(iv) The National Center for Health 
Statistics. 
(v) The National Institutes of Health. 
(vi) The Center for Medicare & Med-
icaid Services. 
(vii) The Federal Employees Health 
Benefits Program. 
(B) NATIONAL, PHILANTHROPIC FOUNDA-
TIONS.—The members of the Council shall in-
clude 4 senior leaders from major national, 
philanthropic foundations that fund and use 
health services research. 
(C) 
STAKEHOLDERS.—The 
remaining 
members of the Council shall be representatives 
of other stakeholders in health services re-
search, including private purchasers, health 
VerDate Aug 31 2005 
05:58 Jul 10, 2008
Jkt 069200
PO 00000
Frm 00170
Fmt 6652
Sfmt 6201
E:\BILLS\H6444.IH
H6444
jbell on PROD1PC69 with BILLS
171 
plans, hospitals and other health facilities, and 
health consumer groups. 
(D) PERIOD OF APPOINTMENT.—Members 
of the Council shall be appointed for the life of 
the Council. Any vacancies shall not affect the 
power and duties of the Council and shall be 
filled in the same manner as the original ap-
pointment. 
(c) LEADERSHIP.—The Secretary of Health and 
Human Services shall appoint the chair of the Council. 
Not later than 15 days after the date on which all mem-
bers of the Council have been appointed under section 
(b)(1), the Council chair shall designate a co-chair of the 
Council. The co-chair shall be the leader of a national 
foundation that funds health services research. 
(d) SUBCOMMITTEES.—The Council may establish 
subcommittees to assist in carrying out its duties. 
(e) DUTIES.— 
(1) PUBLIC
MEETINGS.—Not later than 120 
days after the designation of a co-chairperson under 
subsection (c), the Council shall hold public meetings 
with producers and users of health services research 
to examine— 
(A) the major infrastructure challenges 
facing the field of health services research; 
VerDate Aug 31 2005 
05:58 Jul 10, 2008
Jkt 069200
PO 00000
Frm 00171
Fmt 6652
Sfmt 6201
E:\BILLS\H6444.IH
H6444
jbell on PROD1PC69 with BILLS
172 
(B) the field’s research priorities over the 
next 5 years; 
(C) the current portfolio of health services 
research being funded; 
(D) ways to stimulate innovation in the 
field of health services research; and 
(E) ways in which the field of health serv-
ices research might help to transform the health 
care system by 2020. 
(2) ADDITIONAL MEETINGS.—The Council may 
hold additional public meetings on subjects other 
than those listed in the paragraph (1) so long as the 
meetings are determined to be necessary by the 
Council in carrying out its duties. Additional meet-
ings are not required to be completed within the 
time period specified in paragraph (1). 
(3) DEVELOP A STRATEGIC PLAN.—Not later 
than 2 years after the meetings described in para-
graph (1) and (2) are completed, the Council shall 
prepare and make public through the Internet and 
other channels a strategic plan for the field of health 
services research, which plan shall include the fol-
lowing: 
VerDate Aug 31 2005 
05:58 Jul 10, 2008
Jkt 069200
PO 00000
Frm 00172
Fmt 6652
Sfmt 6201
E:\BILLS\H6444.IH
H6444
jbell on PROD1PC69 with BILLS
173 
(A) A health services research agenda to 
address the Nation’s evolving health care prior-
ities. 
(B) A plan for addressing the infrastruc-
ture needs of the field of health services re-
search, including professional development for 
the next generation of researchers and improved 
methods and data. 
(C) A plan for fostering innovation in the 
field of health services research. 
(D) A uniform definition of health services 
research and standard research categories to be 
used across the funders of health services re-
search in developing research budgets and re-
porting research expenditures. 
(f) ANNUAL REPORT.—Not later than 1 year after 
the publication of the Council’s strategic plan under sub-
section (e)(3), and annually thereafter, the Council shall 
report to the Congress on, and make public a detailed de-
scription of, the following: 
(1) The Council’s progress in implementing the 
strategic plan. 
(2) Organizational expenditures in health serv-
ices research by the Federal agencies specified in 
subsection (b)(2)(A) according to the uniform defini-
VerDate Aug 31 2005 
05:58 Jul 10, 2008
Jkt 069200
PO 00000
Frm 00173
Fmt 6652
Sfmt 6201
E:\BILLS\H6444.IH
H6444
jbell on PROD1PC69 with BILLS
174 
tion and standard research categories developed by 
the Council. 
(g) DETAIL OF EMPLOYEES.—Each Federal agency 
represented on the Council may, on a non-reimbursable 
basis, detail one employee to the Council. Each such detail 
shall last no more than 2 years. Any detail of an employee 
shall be without interruption or loss of civil services status 
or privilege. 
(h) CONTRACTING.—The Director of the Agency for 
Healthcare Research and Quality may contract with an 
outside entity to assist the Council in holding public meet-
ings, developing the strategic plan for the field of health 
services research, and fulfilling annual reporting require-
ments. 
TITLE 
IX—CONTAINING 
MED-
ICAL COSTS AND GETTING 
MORE 
VALUE 
FOR 
THE 
HEALTH CARE DOLLAR 
SEC. 901. COST-CONTAINMENT RESULTS OF THE HEALTHY 
AMERICANS ACT. 
Congress finds that the Healthy Americans Act will 
result in the following: 
(1) Private insurance companies will be forced 
to hold down costs and will slow the rate of growth 
VerDate Aug 31 2005 
05:58 Jul 10, 2008
Jkt 069200
PO 00000
Frm 00174
Fmt 6652
Sfmt 6201
E:\BILLS\H6444.IH
H6444
jbell on PROD1PC69 with BILLS
175 
because they are required to offer standardized 
Healthy American Private Insurance plans. 
(2) Administrative savings will be derived from 
decoupling employers from the health care infra-
structure and reducing employers’ and insurers’ ad-
ministrative costs. 
(3) Private insurance companies will implement 
uniform billing and common claims forms. 
(4) Congress will reclaim Medicare and Med-
icaid disproportionate share hospital (DSH) pay-
ments because previously uninsured persons will go 
to providers on an outpatient basis instead of an 
emergency department. 
(5) State and local governments will save 
money on programs they operated for the uninsured 
before enactment of this Act. 
(6) The Federal Government will save money 
on Federal tax subsidies that reward inefficient care 
and are regressive. 
(7) The Federal Government and the private 
sector will save money if the Food and Drug Admin-
istration determines whether products provide new 
value. 
(8) Reducing medical errors will save the gov-
ernment and the private sector money. 
VerDate Aug 31 2005 
05:58 Jul 10, 2008
Jkt 069200
PO 00000
Frm 00175
Fmt 6652
Sfmt 6201
E:\BILLS\H6444.IH
H6444
jbell on PROD1PC69 with BILLS
176 
(9) Requiring hospitals to send large bills to pa-
tients for their review will reduce errors in medical 
billing and force major providers to be more cost 
conscious. 
(10) Requiring insurers to reimburse for quality 
and cost effective services will hold down private sec-
tor costs. 
(11) Reduction of Medicare’s restriction on bar-
gaining power for prescription drugs will reduce 
costs for sole source drugs and other medications. 
(12) 
Establishment 
of 
electronic 
medical 
records by insurers will create savings. 
(13) Publication of cost and quality data will 
enable people to look up by zip code affordable high- 
quality providers. 
Æ 
VerDate Aug 31 2005 
05:58 Jul 10, 2008
Jkt 069200
PO 00000
Frm 00176
Fmt 6652
Sfmt 6301
E:\BILLS\H6444.IH
H6444
jbell on PROD1PC69 with BILLS