fidentiality of individually identifiable health infor-
mation of a patient; 
‘‘(9) promotes the creation and maintenance of 
transportable, secure, Internet-based personal health 
records, including promoting the efforts of health care 
payers and health plan administrators for a health 
plan, such as Federal agencies, private health plans, 
and third party administrators, to provide for such 
records on behalf of members of such a plan; 
‘‘(10) promotes access to and review of the elec-
tronic health record of a patient by such patient; 
‘‘(11) promotes health research and health care 
quality research and assessment; and 
‘‘(12) promotes the efficient and streamlined de-
velopment, submission, and maintenance of electronic 
health care clinical trial data. 
‘‘(c) DUTIES OF THE NATIONAL COORDINATOR.— 
‘‘(1) STRATEGIC PLANNER FOR INTEROPERABLE 
HEALTH INFORMATION TECHNOLOGY.—The National 
Coordinator shall provide for a strategic plan for the 
nationwide implementation of interoperable health 
information technology in both the public and private 
health care sectors consistent with subsection (b). 
‘‘(2) PRINCIPAL ADVISOR TO THE SECRETARY.— 
The National Coordinator shall serve as the principal 
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advisor to the Secretary on the development, applica-
tion, and use of health information technology, and 
shall coordinate the policies and programs of the De-
partment of Health and Human Services for pro-
moting the use of health information technology. 
‘‘(3) INTRAGOVERNMENTAL COORDINATOR.—The 
National Coordinator shall ensure that health infor-
mation technology policies and programs of the De-
partment of Health and Human Services are coordi-
nated with those of relevant executive branch agencies 
and departments with a goal to avoid duplication of 
effort, to align the health information architecture of 
each agency or department toward a common ap-
proach, to ensure that each agency or department con-
ducts programs within the areas of its greatest exper-
tise and its mission in order to create a national 
interoperable health information system capable of 
meeting national public health needs effectively and 
efficiently, and to assist Federal agencies and depart-
ments in security programs, policies, and protections 
to prevent unauthorized access to individually identi-
fiable health information created, maintained, or in 
the temporary possession of that agency or depart-
ment. The coordination authority provided to the Na-
tional Coordinator under the previous sentence shall 
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supercede any such authority otherwise provided to 
any other official of the Department of Health and 
Human Services. For the purposes of this paragraph, 
the term ‘unauthorized access’ means access that is 
not authorized by that agency or department includ-
ing unauthorized employee access. 
‘‘(4) ADVISOR TO OMB.—The National Coordi-
nator shall provide to the Director of the Office of 
Management and Budget comments and advice with 
respect to specific Federal health information tech-
nology programs. 
‘‘(5) PROMOTER
OF
HEALTH
INFORMATION 
TECHNOLOGY IN MEDICALLY UNDERSERVED COMMU-
NITIES.—The National Coordinator shall— 
‘‘(A) identify sources of funds that will be 
made available to promote and support the plan-
ning and adoption of health information tech-
nology in medically underserved communities, 
including in urban and rural areas, either 
through grants or technical assistance; 
‘‘(B) coordinate with the funding sources to 
help such communities connect to identified 
funding; and 
‘‘(C) collaborate with the Agency for 
Healthcare Research and Quality and the Health 
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Services Resources Administration and other 
Federal agencies to support technical assistance, 
knowledge dissemination, and resource develop-
ment, to medically underserved communities 
seeking to plan for and adopt technology and es-
tablish electronic health information networks 
across providers.’’. 
(b) TREATMENT OF EXECUTIVE ORDER 13335.—Exec-
utive Order 13335 shall not have any force or effect after 
the date of the enactment of this Act. 
(c) TRANSITION FROM ONCHIT UNDER EXECUTIVE 
ORDER.— 
(1) IN GENERAL.—All functions, personnel, as-
sets, liabilities, administrative actions, and statutory 
reporting requirements applicable to the old National 
Coordinator or the Office of the old National Coordi-
nator on the date before the date of the enactment of 
this Act shall be transferred, and applied in the same 
manner and under the same terms and conditions, to 
the new National Coordinator and the Office of the 
new National Coordinator as of the date of the enact-
ment of this Act. 
(2) RULE OF CONSTRUCTION.— Nothing in this 
section or the amendment made by this section shall 
be construed as requiring the duplication of Federal 
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efforts with respect to the establishment of the Office 
of the National Coordinator for Health Information 
Technology, regardless of whether such efforts are car-
ried out before or after the date of the enactment of 
this Act. 
(3) ACTING NATIONAL COORDINATOR.—Before the 
appointment of the new National Coordinator, the old 
National Coordinator shall act as the National Coor-
dinator for Health Information Technology until the 
office is filled as provided in section 271(a) of the 
Public Health Service Act, as added by subsection (a). 
The Secretary of Health and Human Services may 
appoint the old National Coordinator as the new Na-
tional Coordinator. 
(4) DEFINITIONS.—For purposes of this sub-
section: 
(A) NEW
NATIONAL
COORDINATOR.—The 
term ‘‘new National Coordinator’’ means the Na-
tional Coordinator for Health Information Tech-
nology appointed under section 271(a) of the 
Public Health Service Act, as added by sub-
section (a). 
(B) OLD
NATIONAL
COORDINATOR.—The 
term ‘‘old National Coordinator’’ means the Na-
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tional Coordinator for Health Information Tech-
nology appointed under Executive Order 13335. 
SEC. 102. REPORT ON THE AMERICAN HEALTH INFORMA-
TION COMMUNITY. 
Not later than one year after the date of the enactment 
of this Act, the Secretary of Health and Human Services 
shall submit to Congress a report on the work conducted 
by the American Health Information Community (in this 
section referred to as ‘‘AHIC’’), as established by the Sec-
retary. Such report shall include the following: 
(1) A description of the accomplishments of 
AHIC, with respect to the promotion of the develop-
ment of national guidelines, the development of a na-
tionwide health information network, and the in-
creased adoption of health information technology. 
(2) Information on how model privacy and secu-
rity policies may be used to protect confidentiality of 
health information, and an assessment of how existing 
policies compare to such model policies. 
(3) Information on the progress in— 
(A) establishing uniform industry-wide 
health information technology standards; 
(B) achieving an internet-based nationwide 
health information network; and 
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(C) achieving interoperable electronic health 
record adoption across health care providers. 
(4) Recommendations for the transition of AHIC 
to a longer-term advisory and facilitation entity, in-
cluding— 
(A) a schedule for such transition; 
(B) options for structuring the entity as ei-
ther a public-private or private sector entity; 
(C) the role of the Federal Government in 
the entity; 
(D) steps for— 
(i) continued leadership in the facilita-
tion of guidelines or standards; 
(ii) the alignment of financial incen-
tives; and 
(iii) the long-term plan for health care 
transformation through information tech-
nology; and 
(E) the elimination or revision of the func-
tions of AHIC during the development of the na-
tionwide health information network. 
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SEC. 103. INTEROPERABILITY PLANNING PROCESS; FED-
ERAL 
INFORMATION 
COLLECTION 
ACTIVI-
TIES. 
Part D of title II of the Public Health Service Act, 
as added by section 101, is amended by adding at the end 
the following new section: 
‘‘SEC. 272. INTEROPERABILITY PLANNING PROCESS; FED-
ERAL 
INFORMATION 
COLLECTION 
ACTIVI-
TIES. 
‘‘(a) STRATEGIC INTEROPERABILITY PLANNING PROC-
ESS.— 
‘‘(1) ASSESSMENT AND ENDORSEMENT OF CORE 
STRATEGIC GUIDELINES.— 
‘‘(A) IN GENERAL.—Not later than Decem-
ber 31, 2006, the National Coordinator shall 
publish a strategic plan, including a schedule, 
for the assessment and the endorsement of core 
interoperability guidelines for significant use 
cases consistent with this subsection. The Na-
tional Coordinator may update such plan from 
time to time. 
‘‘(B) ENDORSEMENT.— 
‘‘(i) IN GENERAL.—Consistent with the 
schedule under this paragraph and not later 
than one year after the publication of such 
schedule, the National Coordinator shall en-
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dorse a subset of core interoperability guide-
lines for significant use cases. The National 
Coordinator shall continue to endorse sub-
sets of core interoperability guidelines for 
significant use cases annually consistent 
with the schedule published pursuant to this 
paragraph, with endorsement of all such 
guidelines completed not later than August 
31, 2009. 
‘‘(ii) CONSULTATION.—All such en-
dorsements shall be in consultation with the 
American Health Information Community 
and other appropriate entities. 
‘‘(iii) VOLUNTARY COMPLIANCE.—Com-
pliance with such guidelines shall be vol-
untary, subject to subsection (b)(1). 
‘‘(C) CONSULTATION
WITH
OTHER
PAR-
TIES.—The National Coordinator shall develop 
and implement such strategic plan in consulta-
tion with the American Health Information 
Community and other appropriate entities. 
‘‘(D) DEFINITIONS.—For purposes of this 
section: 
‘‘(i) INTEROPERABILITY GUIDELINE.— 
The term ‘interoperability guideline’ means 
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a guideline to improve and promote the 
interoperability of health information tech-
nology for purposes of electronically access-
ing and exchanging health information. 
Such term includes named standards, archi-
tectures, software schemes for identification, 
authentication, and security, and other in-
formation needed to ensure the reproducible 
development of common solutions across dis-
parate entities. 
‘‘(ii) CORE INTEROPERABILITY GUIDE-
LINE.—The 
term 
‘core 
interoperability 
guideline’ means an interoperability guide-
line that the National Coordinator deter-
mines is essential and necessary for pur-
poses described in clause (i). 
‘‘(iii) SIGNIFICANT
USE
CASE.—The 
term ‘significant use case’ means a category 
(as specified by the National Coordinator) 
that identifies a significant use or purpose 
for the interoperability of health informa-
tion technology, such as for the exchange of 
laboratory information, drug prescribing, 
clinical research, and electronic health 
records. 
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‘‘(2) NATIONAL SURVEY.— 
‘‘(A) IN GENERAL.—Not later than August 
31, 2008, the National Coordinator shall conduct 
one or more surveys designed to measure the ca-
pability of entities (including Federal agencies, 
State and local government agencies, and private 
sector entities) to exchange electronic health in-
formation by appropriate significant use case. 
Such surveys shall identify the extent to which 
the type of health information, the use for such 
information, or any other appropriate character-
ization of such information may relate to the ca-
pability of such entities to exchange health infor-
mation in a manner that is consistent with 
methods to improve the interoperability of health 
information and with core interoperability 
guidelines. 
‘‘(B) 
DISSEMINATION
OF
SURVEY
RE-
SULTS.—The National Coordinator shall dis-
seminate the results of such surveys in a manner 
so as to— 
‘‘(i) inform the public on the capabili-
ties of entities to exchange electronic health 
information; 
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‘‘(ii) assist in establishing a more 
interoperable information architecture; and 
‘‘(iii) identify the status of health in-
formation systems used in Federal agencies 
and the status of such systems with respect 
to interoperability guidelines. 
‘‘(b) FEDERAL HEALTH INFORMATION COLLECTION 
ACTIVITIES.— 
‘‘(1) REQUIREMENTS.—With respect to a core 
interoperability guideline endorsed under subsection 
(a)(1)(B) for a significant use case, the President 
shall take measures to ensure that Federal activities 
involving the broad collection and submission of 
health information are consistent with such guideline 
within three years after the date of such endorsement. 
‘‘(2) PROMOTING
USE
OF
NON-IDENTIFIABLE 
HEALTH
INFORMATION
TO
IMPROVE
HEALTH
RE-
SEARCH AND HEALTH CARE QUALITY.— 
‘‘(A) IN
GENERAL.—Where feasible, and 
consistent with applicable privacy or security or 
other laws, the President, in consultation with 
the Secretary, shall take measures to allow time-
ly access to useful categories of non-identifiable 
health information in records maintained by the 
Federal government, or maintained by entities 
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under contract with the Federal government, to 
advance health care quality and health research 
where such information is in a form that can be 
used in such research. The President shall con-
sult with appropriate Federal agencies, and so-
licit public comment, on useful categories of in-
formation, and appropriate measures to take. 
The President may consider the administrative 
burden and the potential for improvements in 
health care quality in determining such appro-
priate measures. In addition, the President, in 
consultation with the Secretary, shall encourage 
voluntary private and public sector efforts to 
allow access to such useful categories of non-iden-
tifiable health information to advance health 
care quality and health research. 
‘‘(B) NON-IDENTIFIABLE HEALTH INFORMA-
TION DEFINED.—For purposes of this paragraph, 
the term ‘non-identifiable health information’ 
means information that is not individually iden-
tifiable health information as defined in rules 
promulgated pursuant to section 264(c) of the 
Health Insurance Portability and Accountability 
Act of 1996 (42 U.S.C. 1320d–2 note), and in-
cludes information that has been de-identified so 
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that it is no longer individually identifiable 
health information, as defined in such rules. 
‘‘(3) ANNUAL REVIEW AND REPORT.—For each 
year during the five-year period following the date of 
the enactment of this section, the National Coordi-
nator shall review the operation of health information 
collection by and submission to the Federal govern-
ment and the purchases (and planned purchases) of 
health information technology by the Federal govern-
ment. For each such year and based on the review for 
such year, the National Coordinator shall submit to 
the President and Congress recommendations on 
methods to— 
‘‘(A) streamline (and eliminate redundancy 
in) Federal systems used for the collection and 
submission of health information; 
‘‘(B) improve efficiency in such collection 
and submission; 
‘‘(C) increase the ability to assess health 
care quality; and 
‘‘(D) reduce health care costs.’’. 
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SEC. 104. ENSURING HEALTH CARE PROVIDERS MAY MAIN-
TAIN HEALTH INFORMATION IN ELECTRONIC 
FORM. 
Part D of title II of the Public Health Service Act, 
as added by section 101(a) and amended by section 103, 
is amended by adding at the end the following new section: 
‘‘SEC. 273. ENSURING HEALTH CARE PROVIDERS MAY MAIN-
TAIN HEALTH INFORMATION IN ELECTRONIC 
FORM. 
‘‘(a) IN GENERAL.—Any health care provider that 
participates in a health care program that receives Federal 
funds shall be deemed as meeting any requirement for the 
maintenance of data in paper form under such program 
(whether or not for purposes of management, billing, report-
ing, reimbursement, or otherwise) if the required data is 
maintained in an electronic form. 
‘‘(b) RELATION TO STATE LAWS.—Beginning on the 
date that is one year after the date of the enactment of this 
section, subsection (a) shall supersede any contrary provi-
sion of State law. 
‘‘(c) CONSTRUCTION.—Nothing in this section shall be 
construed as— 
‘‘(1) requiring health care providers to maintain 
or submit data in electronic form; 
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‘‘(2) preventing a State from permitting health 
care providers to maintain or submit data in paper 
form; or 
‘‘(3) preventing a State from requiring health 
care providers to maintain or submit data in elec-
tronic form.’’. 
SEC. 105. STUDY AND REPORT ON STATE, REGIONAL, AND 
COMMUNITY 
HEALTH 
INFORMATION 
EX-
CHANGES. 
(a) STUDY.—The Secretary of Health and Human 
Services shall conduct a study on issues related to the devel-
opment, operation, and implementation of State, regional, 
and community health information exchanges. Such study 
shall include the following, with respect to such health infor-
mation exchanges: 
(1) Profiles detailing the current stages of such 
health information exchanges with respect to the pro-
gression of the development, operation, implementa-
tion, organization, and governance of such exchanges. 
(2) The impact of such exchanges on healthcare 
quality, safety, and efficiency, including— 
(A) any impact on the coordination of 
health information and services across healthcare 
providers and other organizations relevant to 
health care; 
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(B) any impact on the availability of health 
information at the point-of-care to make timely 
medical decisions; 
(C) any benefits with respect to the pro-
motion of wellness, disease prevention, and 
chronic disease management; 
(D) any improvement with respect to public 
health preparedness and response; 
(E) any impact on the widespread adoption 
of interoperable health information technology, 
including electronic health records; 
(F) any contributions to achieving an 
Internet-based national health information net-
work; 
(G) any contribution of health information 
exchanges to consumer access and to consumers’ 
use of their health information; and 
(H) any impact on the operation of— 
(i) the Medicaid program; 
(ii) the State Children’s Health Insur-
ance Program (SCHIP); 
(iii) disproportionate share hospitals 
described in section 1923 of the Social Secu-
rity Act; 
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