to better protect, strengthen, or otherwise improve 
the secure, confidential, and timely exchange of 
health information. 
‘‘(3) SPECIFIC RECOMMENDATION ON LEGISLA-
TIVE
CHANGES
FOR
GREATER
COMMONALITY.—A 
specific recommendation on the extent to which and 
how such standards should supersede State laws, in 
order to provide the commonality needed to better 
protect or strengthen the security and confidentiality 
of health information in the timely exchange of such 
information and legislative language in the form of 
a bill to effectuate such specific recommendation. 
‘‘(c) CONGRESSIONAL CONSIDERATION OF LEGISLA-
TION PROVIDING FOR GREATER COMMONALITY.—
‘‘(1) RULES OF HOUSE OF REPRESENTATIVES 
AND SENATE.—This subsection is enacted by the 
Congress—
‘‘(A) as an exercise of the rulemaking 
power of the House of Representatives and the 
Senate, respectively, and as such they are 
deemed a part of the rules of each House, re-
spectively, but applicable only with respect to 
the procedure to be followed in that House in 
the case of a greater commonality bill defined 
in paragraph (4), and they supersede other
rules only to the extent that they are incon-
sistent therewith; and 
‘‘(B) with full recognition of the constitu-
tional right of either House to change the rules 
(so far as relating to the procedure of that 
House) at any time, in the same manner and 
to the same extent as in the case of any other 
rule of that House. 
‘‘(2) INTRODUCTION.—On the date on which 
the final report is submitted under subsection 
(b)(3)—
‘‘(A) a greater commonality bill shall be in-
troduced (by request) in the House by the ma-
jority leader of the House, for himself and the 
minority leader of the House, or by Members of 
the House designated by the majority leader 
and minority leader of the House; and 
‘‘(B) a greater commonality bill shall be 
introduced (by request) in the Senate by the 
majority leader of the Senate, for himself and 
the minority leader of the Senate, or by Mem-
bers of the Senate designated by the majority 
leader and minority leader of the Senate. 
If either House is not in session on the day on which 
such a report is submitted, the greater commonality
bill shall be introduced in that House, as provided 
in the preceding sentence, on the first day thereafter 
on which the House is in session. 
‘‘(3) REFERRAL.—A greater commonality bill 
shall be referred by the Presiding Officers of the re-
spective House to the appropriate committee (or 
committees) of such House, in accordance with the 
rules of that House. 
‘‘(4) GREATER COMMONALITY BILL DEFINED.—
For purposes of this section, the term ‘greater com-
monality bill’ means a bill—
‘‘(A) the title of which is the following: ‘A 
Bill to provide the commonality needed to bet-
ter protect, strengthen, or otherwise improve 
the secure, confidential, and timely exchange of 
health information’; and 
‘‘(B) the text of which, as introduced, con-
sists of the text of the bill included in the re-
port submitted under subsection (b)(3). 
‘‘(d) DEFINITIONS.—For purposes of this section: 
‘‘(1) CURRENT FEDERAL SECURITY AND CON-
FIDENTIALITY STANDARDS.—The term ‘current Fed-
eral security and confidentiality standards’ means 
the Federal privacy standards established pursuant 
to section 264(c) of the Health Insurance 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. 
‘‘(2) STATE.—The term ‘State’ has the mean-
ing given such term when used in title XI of the So-
cial Security Act, as provided under section 1101(a) 
of such Act (42 U.S.C. 1301(a)). 
‘‘(3) STATE SECURITY AND CONFIDENTIALITY 
LAWS.—The term ‘State security and confidentiality 
laws’ means State laws and regulations relating to 
the privacy and confidentiality of health information 
or to the security of such information.’’. 
SEC. 206. REPORT ON APPROPRIATENESS OF CLASSIFICA-
TION METHODOLOGIES AND CODES FOR AD-
DITIONAL PURPOSES. 
Not later than the date that is 180 days after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services shall submit to Congress a report 
that evaluates—
(1) the applicability of health care classification 
methodologies and codes for purposes beyond the 
coding of services for diagnostic documentation or 
billing purposes;
(2) the usefulness, accuracy, and completeness 
of such methodologies and codes for such purposes; 
and 
(3) the capacity of such methodologies and 
codes to produce erroneous or misleading informa-
tion, with respect to such purposes. 
TITLE III—PROMOTING THE USE 
OF 
HEALTH 
INFORMATION 
TECHNOLOGY TO BETTER CO-
ORDINATE HEALTH CARE 
SEC. 301. SAFE HARBORS TO ANTIKICKBACK CIVIL PEN-
ALTIES AND CRIMINAL PENALTIES FOR PRO-
VISION OF HEALTH INFORMATION TECH-
NOLOGY AND TRAINING SERVICES. 
(a) FOR CIVIL PENALTIES.—Section 1128A of the 
Social Security Act (42 U.S.C. 1320a-7a) is amended—
(1) in subsection (b), by adding at the end the 
following new paragraph: 
‘‘(4) For purposes of this subsection, inducements to 
reduce or limit services described in paragraph (1) shall 
not include the practical or other advantages resulting 
from health information technology or related installation, 
maintenance, support, or training services.’’; and 
(2) in subsection (i), by adding at the end the 
following new paragraph:
‘‘(8) The term ‘health information technology’ 
means hardware, software, license, right, intellectual 
property, equipment, or other information tech-
nology (including new versions, upgrades, and 
connectivity) designed or provided primarily for the 
electronic creation, maintenance, or exchange of 
health information to better coordinate care or im-
prove health care quality, efficiency, or research.’’. 
(b) FOR CRIMINAL PENALTIES.—Section 1128B of 
such Act (42 U.S.C. 1320a-7b) is amended—
(1) in subsection (b)(3)—
(A) in subparagraph (G), by striking 
‘‘and’’ at the end; 
(B) in the subparagraph (H) added by sec-
tion 237(d) of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 
(Public Law 108–173; 117 Stat. 2213)—
(i) by moving such subparagraph 2 
ems to the left; and 
(ii) by striking the period at the end 
and inserting a semicolon; 
(C) in the subparagraph (H) added by sec-
tion 431(a) of such Act (117 Stat. 2287)—
(i) by redesignating such subpara-
graph as subparagraph (I);
(ii) by moving such subparagraph 2 
ems to the left; and 
(iii) by striking the period at the end 
and inserting ‘‘; and’’; and 
(D) by adding at the end the following new 
subparagraph: 
‘‘(J) any nonmonetary remuneration (in the 
form of health information technology, as defined in 
section 1128A(i)(8), or related installation, mainte-
nance, support or training services) made to a per-
son by a specified entity (as defined in subsection 
(g)) if—
‘‘(i) the provision of such remuneration is 
without an agreement between the parties or 
legal condition that—
‘‘(I) limits or restricts the use of the 
health information technology to services 
provided by the physician to individuals re-
ceiving services at the specified entity; 
‘‘(II) limits or restricts the use of the 
health information technology in conjunc-
tion with other health information tech-
nology; or
‘‘(III) conditions the provision of such 
remuneration on the referral of patients or 
business to the specified entity; 
‘‘(ii) such remuneration is arranged for in 
a written agreement that is signed by the par-
ties involved (or their representatives) and that 
specifies the remuneration solicited or received 
(or offered or paid) and states that the provi-
sion of such remuneration is made for the pri-
mary purpose of better coordination of care or 
improvement of health quality, efficiency, or re-
search; and 
‘‘(iii) the specified entity providing the re-
muneration (or a representative of such entity) 
has not taken any action to disable any basic 
feature of any hardware or software component 
of such remuneration that would permit inter-
operability.’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(g) SPECIFIED ENTITY DEFINED.—For purposes of 
subsection (b)(3)(J), the term ‘specified entity’ means an 
entity that is a hospital, group practice, prescription drug 
plan sponsor, a Medicare Advantage organization, or any 
other such entity specified by the Secretary, considering
the goals and objectives of this section, as well as the goals 
to better coordinate the delivery of health care and to pro-
mote the adoption and use of health information tech-
nology.’’. 
(c) EFFECTIVE DATE
AND EFFECT
ON STATE 
LAWS.—
(1) EFFECTIVE DATE.—The amendments made 
by subsections (a) and (b) shall take effect on the 
date that is 120 days after the date of the enact-
ment of this Act. 
(2) PREEMPTION OF STATE LAWS.—No State 
(as defined in section 1101(a) of the Social Security 
Act (42 U.S.C. 1301(a)) for purposes of title XI of 
such Act) shall have in effect a State law that im-
poses a criminal or civil penalty for a transaction de-
scribed 
in 
section 
1128A(b)(4) 
or 
section 
1128B(b)(3)(J) of such Act, as added by subsections 
(a)(1) and (b), respectively, if the conditions de-
scribed in the respective provision, with respect to 
such transaction, are met. 
(d) STUDY AND REPORT TO ASSESS EFFECT OF 
SAFE HARBORS ON HEALTH SYSTEM.—
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall conduct a study to determine 
the impact of each of the safe harbors described in
paragraph (3). In particular, the study shall examine 
the following: 
(A) The effectiveness of each safe harbor 
in increasing the adoption of health information 
technology. 
(B) The types of health information tech-
nology provided under each safe harbor. 
(C) The extent to which the financial or 
other business relationships between providers 
under each safe harbor have changed as a re-
sult of the safe harbor in a way that adversely 
affects or benefits the health care system or 
choices available to consumers. 
(D) The impact of the adoption of health 
information technology on health care quality, 
cost, and access under each safe harbor. 
(2) REPORT.—Not later than three years after 
the effective date described in subsection (c)(1), the 
Secretary of Health and Human Services shall sub-
mit to Congress a report on the study under para-
graph (1). 
(3) SAFE HARBORS DESCRIBED.—For purposes 
of paragraphs (1) and (2), the safe harbors de-
scribed in this paragraph are—
(A) 
the 
safe 
harbor 
under 
section 
1128A(b)(4) of such Act (42 U.S.C. 1320a-
7a(b)(4)), as added by subsection (a)(1); and 
(B) 
the 
safe 
harbor 
under 
section 
1128B(b)(3)(J) of such Act (42 U.S.C. 1320a-
7b(b)(3)(J)), as added by subsection (b). 
SEC. 302. EXCEPTION TO LIMITATION ON CERTAIN PHYSI-
CIAN REFERRALS (UNDER STARK) FOR PRO-
VISION OF HEALTH INFORMATION TECH-
NOLOGY 
AND 
TRAINING 
SERVICES 
TO 
HEALTH CARE PROFESSIONALS. 
(a) IN GENERAL.—Section 1877(b) of the Social Se-
curity Act (42 U.S.C. 1395nn(b)) is amended by adding 
at the end the following new paragraph: 
‘‘(6) INFORMATION TECHNOLOGY AND TRAIN-
ING SERVICES.—
‘‘(A) IN GENERAL.—Any nonmonetary re-
muneration (in the form of health information 
technology or related installation, maintenance, 
support or training services) made by a speci-
fied entity to a physician if—
‘‘(i) the provision of such remunera-
tion is without an agreement between the 
parties or legal condition that—