I 
110TH CONGRESS 
1ST SESSION H. R. 1368 
To establish a program to provide financial incentives to encourage the 
adoption and use of interactive personal health records. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 7, 2007 
Mr. KENNEDY (for himself, Mr. REICHERT, and Mr. SMITH of Washington) 
introduced the following bill; which was referred to the Committee on En-
ergy 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 jurisdic-
tion of the committee concerned 
A BILL 
To establish a program to provide financial incentives to 
encourage the adoption and use of interactive personal 
health records. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Personalized Health 
Information Act of 2007’’. 
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SEC. 2. PERSONAL HEALTH RECORD (PHR) INCENTIVE 
PROGRAM. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall establish a program (in this section referred 
to as the ‘‘program’’) to provide financial incentives for 
the use of interactive qualifying personal health records 
by Medicare and other patients and their health care pro-
viders in order to— 
(1) provide patients (or their authorized rep-
resentatives) access to and control over their per-
sonal health data and information and educational 
information so as to become healthier and more in-
formed and engaged health care consumers; 
(2) make available to authorized health care 
providers a more accurate minimum data set of pa-
tient information at all points of care; 
(3) protect patient security and privacy; 
(4) improve patients’ adherence to evidence- 
based care guidelines, preventive care, and screening 
protocols, thereby improving health outcomes and 
lowering health care costs; 
(5) improve medication adherence by patients, 
thereby improving health outcomes and lowering 
health care costs; 
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(6) provide patients with more accurate, timely, 
and appropriate information related to their health 
care benefits and related administrative information; 
(7) improve the quality and efficiency of com-
munication between health care providers and pa-
tients; 
(8) create a direct communications channel to 
patients in the event of health emergencies; and 
(9) provide access with appropriate privacy 
safeguards to de-identified health care information 
to evaluate and advance public health and health re-
search goals. 
(b) INCENTIVE PAYMENTS.— 
(1) IN
GENERAL.—Under the program, each 
qualified physician (as defined in subsection (c)) 
that has a qualifying patient (as defined in sub-
section (d)) shall receive an incentive payment from 
the PHR Incentive Fund established under sub-
section (f). In the case of such a patient of more 
than one physician, each such physician (who does 
not share in the same group practice, as defined by 
the Secretary, with another qualifying physician of 
that patient) may receive such a payment. 
(2) AMOUNT OF PAYMENT.— 
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(A) IN
GENERAL.—Except as otherwise 
provided, the amount of the incentive payment 
to a qualifying physician under the program 
shall be at least $3 per year for each qualifying 
patient of the physician. 
(B) ADJUSTMENT; LIMITATION.—The Sec-
retary shall annually retrospectively set the in-
centive payment amount based on the amount 
of the contributions into the PHR Incentive 
Fund. The Secretary shall pay PHR incentives 
payments only from such Fund. 
(C) ANNUAL LIMITATION.—The Secretary 
shall establish a maximum annual payment 
under this section to any qualifying physician. 
(3) DURATION.—Payments shall be made under 
the program during a 3-year period beginning on the 
date of implementation of the program, except that 
the Secretary may continue the program for an addi-
tional two years if the Secretary determines that 
continuation of the program for such period would 
be a cost-effective way of achieving the goals of this 
Act. 
(4) PROGRAM EDUCATION.— 
(A) PUBLICATION OF NAMES QUALIFYING 
PHYSICIANS.—In order to assist patients in 
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identifying health care providers that use quali-
fying personal health records, Secretary shall 
publish on the official website for the Centers 
for Medicare & Medicaid Services (CMS), or 
other online locations of the Secretary’s choos-
ing, a list of qualifying physicians who partici-
pate in the Medicare program and who have re-
ceived incentive payments under this section. 
(B) EDUCATION.— 
(i) PATIENT
EDUCATION.—The Sec-
retary shall, in consultation with appro-
priate organizations that represent health 
care consumers, take steps to educate 
Medicare beneficiaries and other patients 
about the health and convenience benefits 
of qualifying personal health records. 
(ii) PROVIDER EDUCATION.—The Sec-
retary shall take steps to educate Medicare 
providers about the patient, provider and 
overall health care benefits of using quali-
fying personal health records. 
(c) QUALIFIED PHYSICIAN DEFINED.—For purposes 
of this section, the term ‘‘qualified physician’’ means a li-
censed physician (or other licensed health care provider, 
such as a clinic, designated by the Secretary) that meets 
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the following requirements, with respect to a qualifying 
patient of that physician and the qualifying personal 
health record of that patient: 
(1) The physician (or provider), or authorized 
representative, uses the QPHR for patient registra-
tion for encounters, including taking demographic 
information, insurance information, medication list, 
problems list, family history, and other information 
included within the QPHR. 
(2) The physician (or provider), or authorized 
representative or a QPHR service provider (as de-
fined in subsection (e)(2)), updates the diagnosis 
and medication list (including all current medica-
tions and new medications prescribed or provided as 
samples) in the QPHR after each patient encounter, 
if appropriate and authorized by the patient, either 
by direct entry or through a data sharing arrange-
ment using an appropriate electronic means, such as 
an electronic medical record or e-prescribing. 
(3) The physician (or provider), or authorized 
representative, uses the QPHR as appropriate and 
authorized by the patient to communicate appro-
priate patient education and care management mes-
sages. 
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(4) There is submitted to the Secretary by the 
physician (or by the administrator of the QPHR on 
the physician’s behalf) on a regular basis, but no 
less frequently than annually, a report documenting 
the number of such qualifying patients of the physi-
cian (or provider) and the use of QPHRs of such pa-
tients. 
(5) The physician (or provider) meets other re-
quirements as the Secretary may establish. 
(d) QUALIFYING PATIENT DEFINED.—For purposes 
of this section, the term ‘‘qualifying patient’’ means an 
individual for whom a qualifying personal health record 
has been established and is in operation under the pro-
gram and who is a Medicare beneficiary or is covered 
under a health benefits or other plan the sponsor of which 
is participating as a Fund partner under this section. 
(e) QUALIFYING
PERSONAL
HEALTH
RECORD 
(QPHR); QPHR SERVICE PROVIDER.— 
(1) DEFINITION.—For purposes of this section, 
the terms ‘‘qualifying personal health record’’ and 
‘‘QPHR’’ mean a record of health care related infor-
mation that meets the following requirements: 
(A) ACCESS TO THE RECORD.— 
(i) ACCESS
RIGHTS.—Access to the 
record is controlled solely by the patient 
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(or the patient’s authorized representa-
tive), with the patient (or the patient’s au-
thorized representative) able to access on-
line, print, copy to electronic media, or 
provide online access to authorized third 
parties, including health care providers, to 
all individually identifiable health informa-
tion held in the record at any time. 
(ii) 
TERMINATION
RIGHTS.—The 
record allows a patient (or the patient’s 
authorized representative) to terminate the 
further use of the record service at any 
time, including elimination of the patient’s 
personal health information in the control 
of the QPHR service provider. Nothing in 
this clause shall require a health care pro-
vider to eliminate a patient’s personal 
health information included in the QPHR 
that is in a medical record maintained by 
the provider. 
(iii) TRANSPORTABILITY.—The pa-
tient’s rights to control access to the 
record under this subparagraph are not af-
fected by changes in relationships with 
particular providers or health plans. 
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(B) SECURITY.—The record meets min-
imum security standards, including the rules 
promulgated under section 264(c) of the Health 
Insurance Portability and Accountability Act of 
1996 (HIPAA) and other such minimum stand-
ards as identified by the Secretary under para-
graph (3), and the QPHR service provider com-
plies with any security and privacy standards, 
policies, and practices adopted under such para-
graph. 
(C) INTEROPERABILITY.—The record is 
capable of exchanging standards-based clinical 
and patient data with other sources and users 
of health data, including other QPHRs, elec-
tronic health records used by hospitals and phy-
sicians and other providers, pharmacies, phar-
macy benefit managers, and health plans. 
(D) WEB-BASED.—The record is web- 
based and capable of sharing information be-
tween patients and their providers, and ena-
bling patient-provider communication. 
(E) MESSAGING CAPABILITIES.— 
(i) EDUCATION REMINDERS.—Subject 
to clause (v), the QPHR service provider is 
capable of sending patient-specific patient 
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education, reminders, and clinical messages 
to patients based upon data in the QPHR, 
but such messages shall not be sent unless 
such messages comply with standards 
adopted under paragraph (4). The Sec-
retary shall work with the Secretary of 
Homeland Security and the Director of the 
Centers for Disease Control and Preven-
tion to optimize the public health and 
emergency response capabilities of the net-
works created by QPHRs. 
(ii) FEDERAL
REMINDERS.—Subject 
to clause (v), the QPHR service provider 
provides for the sending on behalf of Fed-
eral agencies of objective, accurate, pa-
tient-specific messages to patients con-
cerning their health care or benefits, but 
such messages shall not be sent unless the 
messages comply with standards adopted 
under paragraph (4). 
(iii) FUND
PARTNER
MESSAGES.— 
Subject to clause (v), the QPHR service 
provider provides for the sending, on be-
half of Fund partners who contribute to 
the Fund, appropriate patient-specific mes-
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sages to consumers (with whom such part-
ners have pre-existing relationships) con-
cerning the patients’ health care, medica-
tions, treatments, medical devices or bene-
fits, but such messages shall not be sent 
unless such messages comply with stand-
ards adopted under paragraph (4). A fund 
partner may not send a message to a pa-
tient about a product or service unless that 
product or service has already been pre-
scribed or recommended to the patient by 
a health care provider. 
(iv) HEALTH PLAN NOTIFICATION.— 
The QPHR service provider notifies, no 
less frequently than quarterly, each Fund 
partner that operates a health benefit plan 
of the individuals who have received mes-
sages sent on behalf of the Fund partner 
under this section. 
(v) LIMITATION ON COMMERCIAL SO-
LICITATION.—The QPHR service provider 
does not allow messages to be sent to pa-
tients unless— 
(I) the patient is a patient or 
beneficiary of the sender or source of 
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the message, uses the sender’s or 
source’s product with a prescription 
or recommendation of a provider, or 
has some other pre-existing relation-
ship (as defined by the Secretary) 
with the sender or source, or the 
sender or source is a public health 
agency; 
(II) the message contains infor-
mation directly related to the patient’s 
health or health care and does not in-
clude marketing or commercial solici-
tations; 
(III) the message complies with 
standards adopted under paragraph 
(3); and 
(IV) the message clearly identi-
fies the source of the content and the 
sender of the message. 
(vi) PATIENT OPT-OUT.—The QPHR 
service provider allows a patient (or pa-
tient’s authorized representative) to opt 
out of receiving messages entirely or from 
particular sources. 
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(F) PUBLIC HEALTH ANALYSIS AND RE-
SEARCH.—The QPHR service provider is capa-
ble of providing de-identified data for public 
health analysis and for research purposes. The 
Secretary shall consult with the Commissioner 
of the Food and Drug Administration, the Di-
rector of the National Institutes of Health, the 
Director of the Centers for Disease Control and 
Prevention, and the Administrator of the Agen-
cy for Healthcare Research and Quality to opti-
mize the public health and post-market surveil-
lance capabilities of QPHRs. 
(G) AUTHENTICATION.—The record in-
cludes functionality to authenticate the pa-
tient’s identity prior to the record’s use to re-
ceive electronic data feeds of personal health in-
formation (other than actual authentication in-
formation) from third party sources, such as 
pharmacies, pharmacy benefit managers, lab-
oratories, and health plans, including the Medi-
care program. 
(2) QPHR SERVICE PROVIDER DEFINED.—For 
purposes of this section, the term ‘‘QPHR service 
provider’’ means an entity that operates or admin-
isters a QPHR or part of a QPHR and has access 
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to patients’ individually identifiable health informa-
tion contained in the QPHR. 
(3) PRIVACY
AND
CONSUMER
PROTECTION 
STANDARDS.— 
(A) IN GENERAL.—The Secretary shall set 
minimum security, privacy and data use stand-
ards for QPHRs, in addition to such standards 
as required under regulations promulgated 
under section 264(c) of the Health Insurance 
Portability and Accountability Act of 1996 
(HIPAA), in order to optimally protect and 
safeguard patient health care information. Such 
standards shall include a required plain lan-
guage notice of patients’ privacy rights with re-
spect to personal health records. 
(B) TREATMENT OF QPHR SERVICE PRO-
VIDER AS COVERED ENTITY.—A QPHR service 
provider shall be treated as a covered entity for 
purposes of applying the HIPAA regulations re-
ferred to in subparagraph (A). 
(C) CONSUMER PROTECTION BOARD.—The 
Secretary shall establish a consumer protection 
board, a majority of whose members represent 
health care consumers, including individuals 
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