(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-
ter, regardless of whether such efforts were carried out 
prior to or after the enactment of this subsection. 
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(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) 
shall address the need for coordination in the implementa-
tion of the following: 
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(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)). 
(3) UPDATED ICD CODES.—The International 
Statistical Classification of Diseases and Related 
Health Problems, 10th revision, Clinical Modifica-
tion (ICD–10–CM) and the International Statistical 
Classification of Diseases and Related Health Prob-
lems, 10th revision, Procedure Coding System 
(ICD–10–PCS) described in section 201. 
(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. 
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(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. 
TITLE 
II—MODERNIZING 
THE 
HEALTH CARE DELIVERY SYS-
TEM 
SEC. 201. RULEMAKING TO UPGRADE ASC X12 AND NCPDP 
STANDARDS AND ICD CODES. 
(a) IN GENERAL.— 
(1) ASC X12
AND
NCPDP
STANDARDS.—Not 
later than April 1, 2009, the Secretary of Health 
and Human Services shall promulgate a final rule 
under section 1174(b) of the Social Security Act (42 
U.S.C. 1320d–3(b)) to provide for the following 
modification of standards: 
(A) ACCREDITED STANDARDS COMMITTEE 
X12 (ASC X12) STANDARD.—The replacement of 
the Accredited Standards Committee X12 (ASC 
X12) version 4010 adopted under section 
1173(a) of such Act (42 U.S.C. 1320d–2(a)), 
including for purposes of part A of title XVIII 
of such Act, with the ASC X12 version 5010, 
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as reviewed by the National Committee on Vital 
Health Statistics. 
(B) NATIONAL
COUNCIL
FOR
PRESCRIP-
TION DRUG PROGRAMS (NCPDP) TELECOMMUNI-
CATIONS STANDARDS.—The replacement of the 
National Council for Prescription Drug Pro-
grams (NCPDP) Telecommunications Stand-
ards version 5.1 adopted under section 1173(a) 
of such Act (42 U.S.C. 1320d–2(a)), including 
for purposes of part A of title XVIII of such 
Act, with NCPDP Telecommunications Stand-
ards version C.3, as approved by such Council 
and reviewed by the National Committee on 
Vital Health Statistics. 
(2) ICD CODES.—Not later than January 1, 
2011, the Secretary of Health and Human Services 
shall promulgate a final rule under section 1174(b) 
of the Social Security Act (42 U.S.C. 1320d–3(b)) 
to provide for the replacement of the International 
Statistical Classification of Diseases and Related 
Health Problems, 9th revision, Clinical Modification 
(ICD–9–CM) under the regulation promulgated 
under section 1173(c) of such Act (42 U.S.C. 
1320d–2(c)), including for purposes of part A of 
title XVIII of such Act, with both of the following: 
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(A) The International Statistical Classi-
fication of Diseases and Related Health Prob-
lems, 10th revision, Clinical Modification (ICD– 
10–CM). 
(B) The International Statistical Classi-
fication of Diseases and Related Health Prob-
lems, 10th revision, Procedure Coding System 
(ICD–10–PCS). 
(b) RULE
OF CONSTRUCTION.—Nothing in sub-
section (a)(2) shall be construed as affecting the applica-
tion of classification methodologies or codes, such as CPT 
or HCPCS codes, other than under the International Sta-
tistical Classification of Diseases and Related Health 
Problems (ICD). 
SEC. 202. 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 
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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-
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 
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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. 
‘‘(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; 
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‘‘(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. 
‘‘(iii) NOTICE OF PROPOSED ADDITION 
OR
MODIFICATION
TO
STANDARDS.—Not 
later than 30 days after the date the Sec-
retary receives a notice from a standard 
setting organization that the organization 
has a proposed addition or modification to 
a standard adopted under section 1173(a) 
that the organization intends to submit 
under subparagraph (D)(iii), the Secretary 
shall publish a notice in the Federal Reg-
ister that contains, with respect to the pro-
posed addition or modification, the infor-
mation required in the notice under clause 
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(ii) with respect to the addition or modi-
fication. 
‘‘(iv) 
CONSTRUCTION.—Nothing 
in 
this paragraph shall be construed as re-
quiring 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 expedited 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 set-
ting organization developed such addition or 
modification in accordance with the require-
ments of subparagraph (D) and the National 
Committee on Vital and Health Statistics rec-
ommends approval of such addition or modifica-
tion under subparagraph (E), the Secretary 
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shall provide for expedited treatment of such 
proposal in accordance 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 organiza-
tion submits to the Secretary a request for 
publication in the Federal Register of a no-
tice described in subparagraph (B)(iii) for 
the proposed addition or modification. 
‘‘(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 
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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 
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). 
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