TITLE I—IMPROVING THE INTEROPERABILITY OF HEALTH 
INFORMATION TECHNOLOGY 
Sec. 101. Improving health care quality, safety, and efficiency. 
‘‘TITLE XXX—HEALTH INFORMATION TECHNOLOGY AND 
QUALITY 
‘‘Sec. 3001. Definitions; reference. 
‘‘Sec. 3002. Office of the National Coordinator of Health Information 
Technology. 
‘‘Sec. 3003. Partnership for Health Care Improvement—standards and 
technology. 
‘‘Sec. 3004. American Health Information Community policies. 
‘‘Sec. 3005. Federal purchasing and data collection. 
‘‘Sec. 3006. Quality and efficiency reports. 
‘‘Sec. 3007. Research access to health care data and reporting on perform-
ance. 
TITLE II—FACILITATING THE WIDESPREAD ADOPTION OF 
INTEROPERABLE HEALTH INFORMATION TECHNOLOGY 
Sec. 201. Facilitating the widespread adoption of interoperable health informa-
tion technology. 
‘‘Sec. 3008. Facilitating the widespread adoption of interoperable health 
information technology. 
‘‘Sec. 3009. Demonstration program to integrate information technology 
into clinical education. 
TITLE III—IMPROVING THE QUALITY OF HEALTH CARE 
Sec. 301. Consensus process for the adoption of quality measures for use in the 
nationwide interoperable health information technology infra-
structure. 
‘‘Sec. 3010. Fostering development and use of health care quality meas-
ures. 
‘‘Sec. 3011. Adoption and use of quality measures; reporting. 
TITLE IV—PRIVACY AND SECURITY 
Sec. 401. Privacy and security. 
‘‘Sec. 3012. Ensuring privacy and security. 
TITLE V—MISCELLANEOUS PROVISIONS 
Sec. 501. GAO study. 
Sec. 502. Health Information Technology Resource Center. 
Sec. 503. Facilitating the provision of telehealth services across State lines. 
‘‘Sec. 330L Telemedicine; incentive grants regarding coordination among 
States. 
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TITLE 
I—IMPROVING 
THE 
INTEROPERABILITY 
OF 
HEALTH INFORMATION TECH-
NOLOGY 
SEC. 101. IMPROVING HEALTH CARE QUALITY, SAFETY, 
AND EFFICIENCY. 
The Public Health Service Act (42 U.S.C. 201 et 
seq.) is amended by adding at the end the following: 
‘‘TITLE XXX—HEALTH INFORMA-
TION 
TECHNOLOGY 
AND 
QUALITY 
‘‘SEC. 3001. DEFINITIONS; REFERENCE. 
‘‘(a) IN GENERAL.—In this title: 
‘‘(1) COMMUNITY.—The term ‘Community’ 
means the American Health Information Community 
established under section 3004. 
‘‘(2) HEALTH
CARE
PROVIDER.—The term 
‘health care provider’ means a hospital, skilled nurs-
ing facility, home health entity, health care clinic, 
federally qualified health center, group practice (as 
defined in section 1877(h)(4) of the Social Security 
Act), a pharmacist, a pharmacy, a laboratory, a phy-
sician (as defined in section 1861(r) of the Social 
Security Act), a practitioner (as defined in section 
1842(b)(18)(C) of the Social Security Act), a health 
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facility operated by or pursuant to a contract with 
the Indian Health Service, a rural health clinic, and 
any other category of facility or clinician determined 
appropriate by the Secretary. 
‘‘(3) HEALTH INFORMATION.—The term ‘health 
information’ has the meaning given such term in 
section 1171(4) of the Social Security Act. 
‘‘(4) HEALTH INSURANCE PLAN.— 
‘‘(A) IN GENERAL.—The term ‘health in-
surance plan’ means— 
‘‘(i) a health insurance issuer (as de-
fined in section 2791(b)(2)); 
‘‘(ii) a group health plan (as defined 
in section 2791(a)(1)); and 
‘‘(iii) a health maintenance organiza-
tion (as defined in section 2791(b)(3)); or 
‘‘(iv) a safety net health plan. 
‘‘(B) SAFETY
NET
HEALTH
PLAN.—The 
term ‘safety net health plan’ means a managed 
care 
organization, 
as 
defined 
in 
section 
1932(a)(1)(B)(i) of the Social Security Act— 
‘‘(i) that is exempt from or not sub-
ject to Federal income tax, or that is 
owned by an entity or entities exempt from 
or not subject to Federal income tax; and 
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‘‘(ii) for which not less than 75 per-
cent of the enrolled population receives 
benefits under a Federal health care pro-
gram (as defined in section 1128B(f)(1) of 
the Social Security Act) or a health care 
plan or program which is funded, in whole 
or in part, by a State (other than a pro-
gram for government employees). 
‘‘(C) REFERENCES.—All references in this 
title to the term ‘health plan’ shall be deemed 
to be references to a health insurance plan. 
‘‘(5) INDIVIDUALLY IDENTIFIABLE HEALTH IN-
FORMATION.—The term ‘individually identifiable 
health information’ has the meaning given such term 
in section 1171 of the Social Security Act. 
‘‘(6) LABORATORY.—The term ‘laboratory’ has 
the meaning given such term in section 353. 
‘‘(7) NATIONAL COORDINATOR.—The term ‘Na-
tional Coordinator’ means the National Coordinator 
of Health Information Technology appointed pursu-
ant to section 3002. 
‘‘(8) PARTNERSHIP.—The term ‘Partnership’ 
means the Partnership for Health Care Improve-
ment established under section 3003. 
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‘‘(9) QUALIFIED HEALTH INFORMATION TECH-
NOLOGY.—The term ‘qualified health information 
technology’ means a computerized system (including 
hardware, software, or provision of service) that— 
‘‘(A) protects the privacy and security of 
health information; 
‘‘(B) maintains and provides permitted ac-
cess to health information in an electronic for-
mat; 
‘‘(C) complies with the standards adopted 
by the Federal Government under section 3003; 
‘‘(D) has the ability to transmit and ex-
change information to other health information 
technology systems and, to the extent feasible, 
public health information technology systems; 
‘‘(E) allows for the electronic capture and 
reporting of quality measures adopted under 
section 3011; and 
‘‘(F) has been certified by the Secretary or 
a designee of the Secretary to be in compliance 
with any applicable standards and implementa-
tion specifications adopted by the Secretary on 
or prior to the date of the enactment of this 
title. 
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‘‘(10) INTEROPERABILITY.—The term ‘inter-
operability’ means the ability of different informa-
tion technology systems and software applications to 
communicate, exchange data accurately, effectively, 
and consistently, and use the information that has 
been exchanged. 
‘‘(11) STATE.—The term ‘State’ means each of 
the several States, the District of Columbia, Puerto 
Rico, the Virgin Islands, Guam, American Samoa, 
and the Northern Mariana Islands. 
‘‘(b) REFERENCES TO SOCIAL SECURITY ACT.—Any 
reference in this section to the Social Security Act shall 
be deemed to be a reference to such Act as in effect on 
the date of the enactment of this title. 
‘‘SEC. 3002. OFFICE OF THE NATIONAL COORDINATOR OF 
HEALTH INFORMATION TECHNOLOGY. 
‘‘(a) ESTABLISHMENT.—There is established within 
the office of the Secretary the Office of the National Coor-
dinator of Health Information Technology, to be headed 
by the National Coordinator of Health Information Tech-
nology. The National Coordinator shall be appointed by 
the Secretary in consultation with the President, and shall 
report directly to the Secretary. 
‘‘(b) PURPOSE.—The National Coordinator shall be 
responsible for— 
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‘‘(D) publishes quality measures; 
‘‘(E) identifies sources of funds that will 
be made available to facilitate the purchase of, 
or enhance the utilization of, health information 
technology systems, either through grants or 
technical assistance; and 
‘‘(F) publishes a plan for a transition of 
any functions of the Office of the National Co-
ordinator of Health Information Technology 
that should be continued after September 30, 
2014; 
‘‘(3) prepare a report on the lessons learned 
from major public and private health care systems 
that have implemented health information tech-
nology systems, including an explanation of whether 
the systems and practices developed by such systems 
may be applicable to and usable in whole or in part 
by other health care providers; and 
‘‘(4) assess the impact of health information 
technology in communities with health disparities 
and identify practices to increase the adoption of 
such technology by health care providers in such 
communities. 
‘‘(e) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed as requiring the duplication of Fed-
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eral efforts with respect to the establishment of the Office 
of the National Coordinator of Health Information Tech-
nology, regardless of whether such efforts are carried out 
before or after the date of the enactment of this title. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2008 through 2012. 
‘‘(g) SUNSET.—The provisions of this section shall 
not apply after September 30, 2014. 
‘‘SEC. 3003. PARTNERSHIP FOR HEALTH CARE IMPROVE-
MENT—STANDARDS AND TECHNOLOGY. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN GENERAL.—There is established a pub-
lic-private Partnership for Health Care Improvement 
to— 
‘‘(A) provide advice to the Secretary and 
the Nation and recommend specific actions to 
achieve a nationwide interoperable health infor-
mation technology infrastructure; 
‘‘(B) make recommendations concerning 
standards, implementation specifications, and 
certification criteria for the electronic exchange 
of health information (including for the report-
ing of quality data under section 3011) for 
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adoption by the Federal Government and vol-
untary adoption by private entities; 
‘‘(C) serve as a forum for the participation 
of a broad range of stakeholders with specific 
technical expertise in the development of stand-
ards, implementation specifications, and certifi-
cation criteria to provide input on the effective 
implementation of health information tech-
nology systems; and 
‘‘(D) develop and maintain an Internet 
website that— 
‘‘(i) publishes established governance 
rules (including a subsequent appointment 
process); 
‘‘(ii) publishes a business plan; 
‘‘(iii) publishes meeting notices at 
least 14 days prior to each meeting; 
‘‘(iv) publishes meeting agendas at 
least 7 days prior to each meeting; and 
‘‘(v) publishes meeting materials at 
least 3 days prior to each meeting. 
‘‘(2) LIMITATION.—The Partnership shall not 
meet or take any action until an advisory committee 
charter has been filed with the Secretary and with 
the appropriate committees of the Senate and House 
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of Representatives for the Community described in 
section 3004. 
‘‘(b) MEMBERSHIP.— 
‘‘(1) APPOINTMENTS.— 
‘‘(A) IN GENERAL.—The Partnership shall 
be composed of members to be appointed as fol-
lows: 
‘‘(i) 2 members shall be appointed by 
the Secretary. 
‘‘(ii) 1 member shall be appointed by 
the majority leader of the Senate. 
‘‘(iii) 1 member shall be appointed by 
the minority leader of the Senate. 
‘‘(iv) 1 member shall be appointed by 
the Speaker of the House of Representa-
tives. 
‘‘(v) 1 member shall be appointed by 
the minority leader of the House of Rep-
resentatives. 
‘‘(vi) 7 members shall be appointed by 
the Comptroller General of the United 
States of whom— 
‘‘(I) 1 member shall be a rep-
resentative of consumer or patient or-
ganizations; 
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‘‘(II) 1 member shall be a rep-
resentative of organizations with ex-
pertise in privacy; 
‘‘(III) 1 member shall be a rep-
resentative of organizations with ex-
pertise in security; 
‘‘(IV) 1 member shall be a rep-
resentative of health care providers; 
‘‘(V) 1 member shall be a rep-
resentative of health plans or other 
third party payers; 
‘‘(VI) 1 member shall be a rep-
resentative of information technology 
vendors; and 
‘‘(VII) 1 member shall be a rep-
resentative of purchasers or employ-
ers. 
‘‘(B) NATIONAL COORDINATOR.—The Na-
tional Coordinator shall be a member of the 
Partnership and act as a liaison among the 
Partnership, the Community, and the Federal 
Government. 
‘‘(2) CHAIRPERSON AND VICE CHAIRPERSON.— 
The Partnership shall designate 1 member to serve 
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as the chairperson and 1 member to serve as the 
vice chairperson of the Partnership. 
‘‘(3) BALANCE.—In appointing members under 
paragraph (1)(A)(vi), the Comptroller General of the 
United States shall ensure a balance among various 
sectors of the health care system so that no single 
sector unduly influences the recommendations of the 
Partnership. 
‘‘(4) TERMS.—Members appointed under para-
graph (1)(A) shall serve for 3-year terms, except 
that any member appointed to fill a vacancy for an 
unexpired term shall be appointed for the remainder 
of such term. A member may serve for not to exceed 
180 days after the expiration of such member’s term 
or until a successor has been appointed. 
‘‘(5) OUTSIDE
INVOLVEMENT.—The Partner-
ship shall ensure an adequate opportunity for the 
participation of outside advisors, including individ-
uals with expertise in— 
‘‘(A) health information privacy; 
‘‘(B) health information security; 
‘‘(C) health care quality and patient safety, 
including individuals with expertise in utilizing 
health information technology to improve health 
care quality and patient safety; 
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‘‘(D) medical and clinical research data ex-
change; and 
‘‘(E) developing health information tech-
nology standards and new health information 
technology. 
‘‘(6) QUORUM.—Two-thirds of the members of 
the Partnership shall constitute a quorum for the 
purpose of conducting votes. 
‘‘(c) STANDARDS AND IMPLEMENTATION SPECIFICA-
TIONS.— 
‘‘(1) SCHEDULE.—Not later than 90 days after 
the date of the enactment of this title, the Partner-
ship shall develop a schedule for the assessment of 
standards and implementation specifications under 
this section. The Partnership shall update such 
schedule annually. The Secretary shall publish such 
schedule in the Federal Register and on the Internet 
website of the Department of Health and Human 
Services. 
‘‘(2) FIRST
YEAR
RECOMMENDATIONS.—Con-
sistent with the schedule published under paragraph 
(1) and not later than 1 year after the date of the 
enactment of this title, the Partnership shall rec-
ommend, and the Secretary shall review, such stand-
ards and implementation specifications. 
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‘‘(3) ONGOING RECOMMENDATIONS.—The Part-
nership shall review and modify, as appropriate but 
at least annually, adopted standards and implemen-
tation specifications and continue to recommend ad-
ditional standards and implementation specifications, 
consistent with the schedule published pursuant to 
paragraph (1). The Secretary shall review such 
modifications and recommendations. 
‘‘(4) FOCUS OF RECOMMENDATIONS.—The rec-
ommendations for standards and implementation 
specifications under paragraphs (2) and (3) shall 
focus on health care information technologies that 
have the greatest potential to improve the quality 
and efficiency of health care, including— 
‘‘(A) technologies that protect the privacy 
of health information and promote security; 
‘‘(B) 
interoperable 
electronic 
health 
records; 
‘‘(C) replacement of paper forms with elec-
tronic alternatives; 
‘‘(D) self-service technologies that facilitate 
the provision of patient information and reduce 
wait times; 
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‘‘(E) telemedicine technologies that reduce 
travel requirements for patients in remote 
areas; 
‘‘(F) technologies that facilitate home 
health care and the monitoring of patients 
recuperating at home; 
‘‘(G) technologies that help reduce medical 
errors; 
‘‘(H) technologies that facilitate the con-
tinuity of care among health settings; and 
‘‘(I) any other technology that the Partner-
ship finds to be among the technologies with 
the greatest potential to improve the quality 
and efficiency of health care. 
‘‘(5) RECOGNITION
OF
PRIVATE
ENTITIES.— 
The Partnership, in consultation with the Secretary, 
may recognize a private entity or entities for the 
purpose of developing and updating standards and 
implementation specifications to achieve uniform and 
consistent implementation of the standards adopted 
by the President under paragraph (9). Such entity 
or entities shall make recommendations to the Part-
nership consistent with this section. 
‘‘(6) 
PUBLICATION.—All 
recommendations 
made by the Partnership pursuant to this section 
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shall be published in the Federal Register and on 
the Internet website of the Office of the National 
Coordinator of Health Information Technology. 
‘‘(7) PILOT TESTING.—The Secretary may con-
duct, or recognize a private entity or entities to con-
duct, a pilot project to test the standards and imple-
mentation specifications developed under this sub-
section before the Partnership issues recommenda-
tions on such standards and implementation speci-
fications in order to provide for the efficient imple-
mentation of such standards and implementation 
specifications. 
‘‘(8) PUBLIC
INPUT.—The Partnership shall 
conduct open public meetings and develop a process 
to allow for public comment on the schedule and rec-
ommendations described in this subsection. Such 
process shall ensure that such comments will be sub-
mitted within 30 days after the publication of a rec-
ommendation under this subsection. 
‘‘(9) FEDERAL
ACTION.—Not later than 90 
days after the issuance of a recommendation from 
the Partnership under this subsection, the Secretary, 
the Secretary of Veterans Affairs, and the Secretary 
of Defense, in collaboration with representatives of 
other relevant Federal agencies as determined ap-
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propriate by the President, shall jointly review such 
recommendation. If appropriate, the President shall 
provide for the adoption by the Federal Government 
of any standard or implementation specification con-
tained in such recommendation. Such determination 
shall be published in the Federal Register and on 
the Internet website of the Office of the National 
Coordinator of Health Information Technology with-
in 30 days after such determination is made. 
‘‘(10) CONSISTENCY.—The standards and im-
plementation specifications described in this sub-
section shall be consistent with the standards for in-
formation transactions and data elements developed 
pursuant to the regulations promulgated under sec-
tion 264(c) of the Health Insurance Portability and 
Accountability Act of 1996. 
‘‘(d) CERTIFICATION.— 
‘‘(1) DEVELOPING
CRITERIA.—The Partner-
ship, in consultation with the Secretary, may recog-
nize a private entity or entities for the purpose of 
developing and recommending to the Partnership 
criteria to certify that appropriate categories of 
health information technology products that claim to 
be in compliance with applicable standards and im-
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plementation specifications adopted under this title 
have established such compliance. 
‘‘(2) ADOPTION OF CRITERIA.—The Secretary, 
based upon the recommendations of the Partnership, 
shall review and, if appropriate, adopt such criteria. 
‘‘(3) CONDUCTING CERTIFICATION.—The Sec-
retary may recognize a private entity or entities to 
conduct the certifications described in paragraph (1) 
using the criteria adopted by the Secretary under 
this subsection. 
‘‘(e) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed as disrupting existing activities de-
scribed in subsection (c) or (d). 
‘‘(f) REQUIREMENT
TO CONSIDER RECOMMENDA-
TIONS.—In carrying out the activities described in sub-
sections (c) and (d), the Partnership shall adopt and inte-
grate the recommendations of the Community that are 
adopted by the Secretary. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2008 through 2012. 
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‘‘SEC. 3004. AMERICAN HEALTH INFORMATION COMMUNITY 
POLICIES. 
‘‘(a) ESTABLISHMENT.—There is established a com-
mittee to be known as the American Health Information 
Community. The Community shall— 
‘‘(1) provide advice to the Secretary and the 
heads of any relevant Federal agencies concerning 
the policy considerations related to health informa-
tion technology; 
‘‘(2) not later than 1 year after the date of the 
enactment of this title, and annually thereafter, 
make recommendations concerning a policy frame-
work for the development and adoption of a nation-
wide interoperable health information technology in-
frastructure; 
‘‘(3) not later than 1 year after the date of the 
enactment of this title, and annually thereafter, 
make recommendations concerning national policies 
for adoption by the Federal Government, and vol-
untary adoption by private entities, to support the 
widespread adoption of health information tech-
nology, including— 
‘‘(A) the protection of individually identifi-
able health information, including policies con-
cerning the individual’s ability to control the ac-
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quisition, uses, and disclosures of individually 
identifiable health information; 
‘‘(B) methods to protect individually iden-
tifiable health information from improper use 
and disclosures and methods to notify patients 
if their individually identifiable health informa-
tion is wrongfully disclosed; 
‘‘(C) methods to facilitate secure access to 
such individual’s individually identifiable health 
information; 
‘‘(D) the appropriate uses of a nationwide 
health information network including— 
‘‘(i) the collection of quality data and 
public reporting; 
‘‘(ii) biosurveillance and public health; 
‘‘(iii) medical and clinical research; 
and 
‘‘(iv) drug safety; 
‘‘(E) fostering the public understanding of 
health information technology; 
‘‘(F) strategies to enhance the use of 
health information technology in preventing and 
managing chronic disease; 
‘‘(G) policies to incorporate the input of 
employees of health care providers in the design 
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and implementation of health information tech-
nology systems; and 
‘‘(H) other policies determined to be nec-
essary by the Community; and 
‘‘(4) serve as a forum for the participation of 
a broad range of stakeholders to provide input on 
improving the effective implementation of health in-
formation technology systems. 
‘‘(b) PUBLICATION.—All recommendations made by 
the Community pursuant to this section shall be published 
in the Federal Register and on the Internet website of the 
National Coordinator. The Secretary shall review all such 
recommendations, determine which such recommendations 
should be endorsed by the Federal Government, and pub-
lish such determinations on the Internet website of the Of-
fice of the National Coordinator of Health Information 
Technology within 30 days after the date on which each 
such determination is made. 
‘‘(c) MEMBERSHIP.— 
‘‘(1) IN GENERAL.—The Community shall be 
composed of members to be appointed as follows: 
‘‘(A) 3 members shall be appointed by the 
Secretary, 1 of whom shall be appointed to rep-
resent the Department of Health and Human 
Services. 
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‘‘(B) 1 member shall be appointed by the 
Secretary of Veterans Affairs to represent the 
Department of Veterans Affairs. 
‘‘(C) 1 member shall be appointed by the 
Secretary of Defense to represent the Depart-
ment of Defense. 
‘‘(D) 1 member shall be appointed by the 
majority leader of the Senate. 
‘‘(E) 1 member shall be appointed by the 
minority leader of the Senate. 
‘‘(F) 1 member shall be appointed by the 
Speaker of the House of Representatives. 
‘‘(G) 1 member shall be appointed by the 
minority leader of the House of Representa-
tives. 
‘‘(H) 9 members shall be appointed by the 
Comptroller General of the United States of 
whom— 
‘‘(i) 1 member shall be an advocate 
for patients or consumers; 
‘‘(ii) 1 member shall represent health 
care providers; 
‘‘(iii) 1 member shall be from a labor 
organization 
representing 
health 
care 
workers; 
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‘‘(iv) 1 member shall have expertise in 
privacy and security; 
‘‘(v) 1 member shall have expertise in 
improving the health of vulnerable popu-
lations; 
‘‘(vi) 1 member shall represent health 
plans or other third-party payers; 
‘‘(vii) 1 member shall represent infor-
mation technology vendors; 
‘‘(viii) 1 member shall represent pur-
chasers or employers; and 
‘‘(ix) 1 member shall have expertise in 
health care quality measurement and re-
porting. 
‘‘(2) CHAIRPERSON AND VICE CHAIRPERSON.— 
The Community shall designate 1 member to serve 
as the chairperson and 1 member to serve as the 
vice chairperson of the Community. 
‘‘(3) NATIONAL COORDINATOR.—The National 
Coordinator shall be a member of the Community 
and act as a liaison among the Community, the 
partnership, and the Federal Government. 
‘‘(4) PARTICIPATION.—The members of the 
Community appointed under paragraph (1) shall 
represent a balance among various sectors of the 
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health care system so that no single sector unduly 
influences the recommendations of the Community. 
‘‘(5) TERMS.— 
‘‘(A) IN GENERAL.—The terms of mem-
bers of the Community shall be 3 years except 
that the Comptroller General of the United 
States shall designate staggered terms for the 
members first appointed under paragraph 
(1)(H). 
‘‘(B) VACANCIES.—Any member appointed 
to fill a vacancy in the membership of the Com-
munity that occurs prior to the expiration of 
the term for which the member’s predecessor 
was appointed shall be appointed only for the 
remainder of that term. A member may serve 
after the expiration of that member’s term until 
a successor has been appointed. A vacancy in 
the Community shall be filled in the manner in 
which the original appointment was made. 
‘‘(6) OUTSIDE
INVOLVEMENT.—The Commu-
nity shall ensure an adequate opportunity for the 
participation of outside advisors, including individ-
uals with expertise in— 
‘‘(A) health information privacy and secu-
rity; 
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‘‘(B) improving the health of vulnerable 
populations; 
‘‘(C) health care quality and patient safety, 
including individuals with expertise in measure-
ment and the use of health information tech-
nology to capture data to improve health care 
quality and patient safety; 
‘‘(D) medical ethics; 
‘‘(E) medical and clinical research data ex-
change; and 
‘‘(F) developing health information tech-
nology standards and new health information 
technology. 
‘‘(7) QUORUM.—Ten members of the Commu-
nity shall constitute a quorum for purposes of vot-
ing, but a lesser number of members may meet and 
hold hearings. 
‘‘(d) FEDERAL AGENCIES.— 
‘‘(1) STAFF OF OTHER FEDERAL AGENCIES.— 
Upon the request of the Community, the head of any 
Federal agency may detail, without reimbursement, 
any of the personnel of such agency to the Commu-
nity to assist in carrying out the duties of the Com-
munity. Any such detail shall not interrupt or other-
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wise affect the civil service status or privileges of the 
Federal employee involved. 
‘‘(2) TECHNICAL
ASSISTANCE.—Upon the re-
quest of the Community, the head of a Federal 
agency shall provide such technical assistance to the 
Community as the Community determines to be nec-
essary to carry out its duties. 
‘‘(3) OTHER
RESOURCES.—The Community 
shall have reasonable access to materials, resources, 
statistical data, and other information from the Li-
brary of Congress and agencies and elected rep-
resentatives of the executive and legislative branches 
of the Federal Government. The chairperson or vice 
chairperson of the Community shall make requests 
for such access in writing when necessary. 
‘‘(e) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.) shall apply to the Commu-
nity, except that the term provided for under section 
14(a)(2) of such Act shall be not longer than 7 years. 
‘‘(f) SUNSET.—The provisions of this section shall 
not apply after September 20, 2014. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2008 through 2012. 
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‘‘SEC. 3005. FEDERAL PURCHASING AND DATA COLLEC-
TION. 
‘‘(a) COORDINATION OF FEDERAL SPENDING.— 
‘‘(1) IN GENERAL.—Not later than 1 year after 
the adoption by the President of a recommendation 
under section 3003(c)(9), a Federal agency shall not 
expend Federal funds for the purchase of any new 
health information technology or health information 
technology system for clinical care or for the elec-
tronic retrieval, storage, or exchange of health infor-
mation if such technology or system is not consistent 
with applicable standards adopted by the Federal 
Government under such section. 
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
paragraph (1) shall be construed to restrict the pur-
chase of minor (as determined by the Secretary) 
hardware or software components in order to mod-
ify, correct a deficiency in, or extend the life of exist-
ing hardware or software. 
‘‘(b) VOLUNTARY ADOPTION.— 
‘‘(1) IN GENERAL.—Any standards and imple-
mentation specifications adopted by the Federal 
Government under section 3003(c)(9) shall be vol-
untary with respect to private entities. 
‘‘(2) 
REQUIREMENT.—Private 
entities 
that 
enter into a contract with the Federal Government 
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shall adopt the standards and implementation speci-
fications adopted by the Federal Government under 
section 3003 for the purpose of activities under such 
Federal contract. 
‘‘(3) RULE
OF
CONSTRUCTION.—Nothing in 
this section shall be construed to require that a pri-
vate entity that enters into a contract with the Fed-
eral Government adopt the standards and implemen-
tation specifications adopted by the Federal Govern-
ment under this section with respect to activities not 
related to the contract. 
‘‘(c) COORDINATION OF FEDERAL DATA COLLEC-
TION.—Not later than 3 years after the adoption by the 
Federal Government of a recommendation as provided for 
in section 3003(c)(9), all Federal agencies collecting 
health data in an electronic format for the purposes of 
quality reporting, surveillance, epidemiology, adverse event 
reporting, research, or for other purposes determined ap-
propriate by the Secretary, shall comply with the stand-
ards and implementation specifications adopted under 
such section. 
‘‘SEC. 3006. QUALITY AND EFFICIENCY REPORTS. 
‘‘(a) PURPOSE.—The purpose of this section is to 
provide for the development of reports based on Federal 
health care data and private data that is publicly available 
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or is provided by the entity making the request for the 
report in order to— 
‘‘(1) improve the quality and efficiency of 
health care and advance health care research; 
‘‘(2) enhance the education and awareness of 
consumers for evaluating health care services; and 
‘‘(3) provide the public with reports on national, 
regional, and provider- and supplier-specific per-
formance, which may be in a provider- or supplier- 
identifiable format. 
‘‘(b) PROCEDURES FOR THE DEVELOPMENT OF RE-
PORTS.— 
‘‘(1) IN
GENERAL.—Notwithstanding section 
552(b)(6) or 552a(b) of title 5, United States Code, 
not later than 12 months after the date of the enact-
ment of this title, the Secretary, in accordance with 
the purpose described in subsection (a), shall estab-
lish and implement procedures under which an enti-
ty may submit a request to a Health Quality Organi-
zation for the Organization to develop a report based 
on— 
‘‘(A) Federal health care data disclosed to 
the Organization under subsection (c); and 
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‘‘(B) private data that is publicly available 
or is provided to the Organization by the entity 
making the request for the report. 
‘‘(2) DEFINITIONS.—In this section: 
‘‘(A) FEDERAL HEALTH CARE DATA.—The 
term ‘Federal health care data’ means— 
‘‘(i) de-identified patient enrollment 
data, reimbursement claims, and survey 
data maintained by the Secretary or enti-
ties under programs, contracts, grants, or 
memoranda of understanding administered 
by the Secretary; and 
‘‘(ii) where feasible, other de-identified 
patient enrollment data, reimbursement 
claims, and survey data maintained by the 
Federal Government or entities under con-
tract with the Federal Government. 
‘‘(B) HEALTH QUALITY ORGANIZATION.— 
The term ‘Health Quality Organization’ means 
an entity with a contract under subsection (d). 
‘‘(c) ACCESS TO FEDERAL HEALTH CARE DATA.— 
‘‘(1) IN GENERAL.—The procedures established 
under subsection (b)(1) shall provide for the secure 
disclosure of Federal health care data to each 
Health Quality Organization. 
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‘‘(2) UPDATE OF INFORMATION.—Not less than 
every 6 months, the Secretary shall update the infor-
mation disclosed under paragraph (1) to Health 
Quality Organizations. 
‘‘(d) HEALTH QUALITY ORGANIZATIONS.— 
‘‘(1) IN GENERAL.— 
‘‘(A) THREE CONTRACTS.—Subject to sub-
paragraph (B), the Secretary shall enter into a 
contract with 3 private entities to serve as 
Health Quality Organizations under which an 
entity shall— 
‘‘(i) store the Federal health care data 
that is to be disclosed under subsection (c); 
and 
‘‘(ii) develop and release reports pur-
suant to subsection (e). 
‘‘(B) ADDITIONAL
CONTRACTS.—If the 
Secretary determines that reports are not being 
developed and released within 6 months of the 
receipt of the request for the report, the Sec-
retary shall enter into contracts with additional 
private entities in order to ensure that such re-
ports are developed and released in a timely 
manner. 
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‘‘(2) QUALIFICATIONS.—The Secretary shall 
enter into a contract with an entity under paragraph 
(1) only if the Secretary determines that the enti-
ty— 
‘‘(A) has the research capability to conduct 
and complete reports under this section; 
‘‘(B) has in place— 
‘‘(i) an information technology infra-
structure to support the database of Fed-
eral health care data that is to be disclosed 
to the entity; and 
‘‘(ii) operational standards to provide 
security for such database; 
‘‘(C) has experience with, and expertise on, 
the development of reports on health care qual-
ity and efficiency; and 
‘‘(D) has a significant business presence in 
the United States. 
‘‘(3) CONTRACT
REQUIREMENTS.—Each con-
tract with an entity under paragraph (1) shall con-
tain the following requirements: 
‘‘(A) ENSURING BENEFICIARY PRIVACY.— 
‘‘(i) HIPAA.—The entity shall meet 
the requirements imposed on a covered en-
tity for purposes of applying part C of title 
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XI of the Social Security Act and all regu-
latory provisions promulgated thereunder, 
including regulations (relating to privacy) 
adopted pursuant to the authority of the 
Secretary under section 264(c) of the 
Health Insurance Portability and Account-
ability Act of 1996. 
‘‘(ii) PRIVACY.—The entity shall pro-
vide assurances that the entity will not use 
the Federal health care data disclosed 
under subsection (c) in a manner that vio-
lates sections 552 or 552a of title 5, 
United States Code, with regard to the pri-
vacy of individually identifiable health in-
formation. 
‘‘(B) PROPRIETARY
INFORMATION.—The 
entity shall provide assurances that the entity 
will not disclose any negotiated price conces-
sions, such as discounts, direct or indirect sub-
sidies, rebates, and direct or indirect remunera-
tions, obtained by health care providers or sup-
pliers or health care plans, or any other propri-
etary cost information. 
‘‘(C) DISCLOSURE.—The entity shall dis-
close— 
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‘‘(i) any financial, reporting, or con-
tractual relationship between the entity 
and any health care provider or supplier or 
health care plan; and 
‘‘(ii) if applicable, the fact that the 
entity is managed, controlled, or operated 
by any health care provider or supplier or 
health care plan. 
‘‘(D) COMPONENT OF ANOTHER ORGANIZA-
TION.—If the entity is a component of another 
organization— 
‘‘(i) the entity shall maintain Federal 
health care data and reports separately 
from the rest of the organization and es-
tablish appropriate security measures to 
maintain the confidentiality and privacy of 
the Federal health care data and reports; 
and 
‘‘(ii) the entity shall not make an un-
authorized disclosure to the rest of the or-
ganization of Federal health care data or 
reports in breach of such confidentiality 
and privacy requirement. 
‘‘(E) TERMINATION OR NONRENEWAL.—If 
a contract under this section is terminated or 
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review the contract with a Health Quality Organiza-
tion under this section in the event of a merger or 
acquisition of the Organization in order to ensure 
that the requirements under this section will con-
tinue to be met. 
‘‘(e) DEVELOPMENT
AND RELEASE
OF REPORTS 
BASED ON REQUESTS.— 
‘‘(1) REQUEST FOR A REPORT.— 
‘‘(A) REQUEST.— 
‘‘(i) IN
GENERAL.—The procedures 
established under subsection (b)(1) shall 
include a process for an entity to submit a 
request to a Health Quality Organization 
for a report based on Federal health care 
data and private data that is publicly avail-
able or is provided by the entity making 
the request for the report. Such request 
shall comply with the purpose described in 
subsection (a). 
‘‘(ii) REQUEST FOR SPECIFIC METH-
ODOLOGY.—The 
process 
described 
in 
clause (i) shall permit an entity making a 
request for a report to request that a spe-
cific methodology, including appropriate 
risk adjustment, be used by the Health 
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Quality Organization in developing the re-
port. The Organization shall work with the 
entity making the request to finalize the 
methodology to be used. 
‘‘(iii) REQUEST
FOR
A
SPECIFIC 
HEALTH
QUALITY
ORGANIZATION.—The 
process described in clause (i) shall permit 
an entity to submit the request for a re-
port to any Health Quality Organization. 
‘‘(B) RELEASE
TO
PUBLIC.—The proce-
dures established under subsection (b)(1) shall 
provide that at the time a request for a report 
is finalized under subparagraph (A) by a 
Health Quality Organization, the Organization 
shall make available to the public, through the 
Internet website of the Department of Health 
and Human Services and other appropriate 
means, a brief description of both the requested 
report and the methodology to be used to de-
velop such report. 
‘‘(2) DEVELOPMENT
AND
RELEASE
OF
RE-
PORT.— 
‘‘(A) DEVELOPMENT.— 
‘‘(i) IN GENERAL.—If the request for 
a report complies with the purpose de-
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scribed in subsection (a), the Health Qual-
ity Organization may develop the report 
based on the request. 
‘‘(ii) REQUIREMENT.—A report devel-
oped under clause (i) shall include a de-
tailed description of the standards, meth-
odologies, and measures of quality used in 
developing the report. 
‘‘(B) REVIEW OF REPORT BY SECRETARY 
TO
ENSURE
COMPLIANCE
WITH
PRIVACY
RE-
QUIREMENT.—Prior to a Health Quality Orga-
nization releasing a report under subparagraph 
(C), the Secretary shall review the report to en-
sure that the report complies with the Federal 
regulations (concerning the privacy of individ-
ually identifiable beneficiary health information) 
promulgated under section 264(c) of the Health 
Insurance Portability and Accountability Act of 
1996 and sections 552 or 552a of title 5, 
United States Code, with regard to the privacy 
of individually identifiable beneficiary health in-
formation. The Secretary shall act within 30 
business days of receiving such report. 
‘‘(C) RELEASE OF REPORT.— 
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‘‘(i) RELEASE TO ENTITY MAKING RE-
QUEST.—If the Secretary finds that the re-
port complies with the provisions described 
in subparagraph (B), the Health Quality 
Organization shall release the report to the 
entity that made the request for the re-
port. 
‘‘(ii) RELEASE TO PUBLIC.—The pro-
cedures established under subsection (b)(1) 
shall provide for the following: 
‘‘(I) UPDATED
DESCRIPTION.— 
At the time of the release of a report 
by a Health Quality Organization 
under clause (i), the entity shall make 
available to the public, through the 
Internet website of the Department of 
Health and Human Services and 
other appropriate means, an updated 
brief description of both the requested 
report and the methodology used to 
develop such report. 
‘‘(II) COMPLETE
REPORT.—Not 
later than 1 year after the date of the 
release of a report under clause (i), 
the report shall be made available to 
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the 
public 
through 
the 
Internet 
website of the Department of Health 
and Human Services and other appro-
priate means. 
‘‘(f) ANNUAL REVIEW
OF REPORTS
AND TERMI-
NATION OF CONTRACTS.— 
‘‘(1) ANNUAL
REVIEW
OF
REPORTS.—The 
Comptroller General of the United States shall re-
view reports released under subsection (e)(2)(C) to 
ensure that such reports comply with the purpose 
described in subsection (a) and annually submit a 
report to the Secretary on such review. 
‘‘(2) TERMINATION OF CONTRACTS.—The Sec-
retary may terminate a contract with a Health Qual-
ity Organization if the Secretary determines that 
there is a pattern of reports being released by the 
Organization that do not comply with the purpose 
described in subsection (a). 
‘‘(g) FEES.— 
‘‘(1) FEES
FOR
SECRETARY.—The Secretary 
shall charge a Health Quality Organization a fee 
for— 
‘‘(A) disclosing the data under subsection 
(c); and 
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‘‘(B) conducting the review under sub-
section (e)(2)(B). 
The Secretary shall ensure that such fees are suffi-
cient to cover the costs of the activities described in 
subparagraphs (A) and (B). 
‘‘(2) FEES FOR HQO.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graphs (B) and (C), a Health Quality Organiza-
tion may charge an entity making a request for 
a report a reasonable fee for the development 
and release of the report. 
‘‘(B) DISCOUNT FOR SMALL ENTITIES.—In 
the case of an entity making a request for a re-
port (including a not-for-profit entity) that has 
annual 
revenue 
that 
does 
not 
exceed 
$10,000,000, the Health Quality Organization 
shall reduce the reasonable fee charged to such 
entity under subparagraph (A) by an amount 
equal to 10 percent of such fee. 
‘‘(C) INCREASE
FOR
LARGE
ENTITIES 
THAT DO NOT AGREE TO RELEASE REPORTS 
WITHIN 6 MONTHS.—In the case of an entity 
making a request for a report that is not de-
scribed in subparagraph (B) and that does not 
agree to the report being released to the public 
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under clause (ii)(II) of subsection (e)(2)(C) 
within 6 months of the date of the release of 
the report to the entity under clause (i) of such 
subsection, the Health Quality Organization 
shall increase the reasonable fee charged to 
such entity under subparagraph (A) by an 
amount equal to 10 percent of such fee. 
‘‘(D) RULE OF CONSTRUCTION.—Nothing 
in this paragraph shall be construed to effect 
the requirement that a report be released to the 
public under clause (ii)(II) of subsection 
(e)(2)(C) by not later than 1 year after the date 
of the release of the report to the requesting en-
tity under clause (i) of such subsection. 
‘‘(h) COORDINATION.—Not later than 1 year after 
the date of the enactment of this title, the Secretary shall 
submit a report (including recommendations) to the ap-
propriate committees of Congress concerning the coordina-
tion of existing Federal health care quality initiatives. 
‘‘(i) REGULATIONS.—Not later than 6 months after 
the date of the enactment of this title, the Secretary shall 
prescribe regulations to carry out this section. 
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‘‘SEC. 3007. RESEARCH ACCESS TO HEALTH CARE DATA 
AND REPORTING ON PERFORMANCE. 
‘‘The Secretary shall permit researchers that meet 
criteria used to evaluate the appropriateness of the release 
data for research purposes (as established by the Sec-
retary) to— 
‘‘(1) have access to all Federal health care data 
(as defined in section 3006(b)(2)(A)); and 
‘‘(2) report on the performance of health care 
providers and suppliers, including reporting in a 
provider- or supplier-identifiable format.’’. 
TITLE 
II—FACILITATING 
THE 
WIDESPREAD ADOPTION OF 
INTEROPERABLE HEALTH IN-
FORMATION TECHNOLOGY 
SEC. 201. FACILITATING THE WIDESPREAD ADOPTION OF 
INTEROPERABLE 
HEALTH 
INFORMATION 
TECHNOLOGY. 
Title XXX of the Public Health Service Act, as added 
by section 101, is amended by adding at the end the fol-
lowing: 
‘‘SEC. 3008. FACILITATING THE WIDESPREAD ADOPTION OF 
INTEROPERABLE 
HEALTH 
INFORMATION 
TECHNOLOGY. 
‘‘(a) COMPETITIVE
GRANTS
FOR
ADOPTION
OF 
TECHNOLOGY.— 
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‘‘(1) IN GENERAL.—The Secretary may award 
competitive grants to eligible entities to facilitate the 
purchase and enhance the utilization of qualified 
health information technology systems to improve 
the quality and efficiency of health care. 
‘‘(2) ELIGIBILITY.—To be eligible to receive a 
grant under paragraph (1) an entity shall— 
‘‘(A) submit to the Secretary an applica-
tion at such time, in such manner, and con-
taining such information as the Secretary may 
require; 
‘‘(B) submit to the Secretary a strategic 
plan for the implementation of data sharing 
and interoperability measures; 
‘‘(C) adopt the standards adopted by the 
Federal Government under section 3003; 
‘‘(D) implement the measures adopted 
under section 3011 and report to the Secretary 
on such measures; 
‘‘(E) agree to notify individuals if their in-
dividually identifiable health information is 
wrongfully disclosed; 
‘‘(F) take into account the input of em-
ployees and staff who are directly involved in 
patient care of such health care providers in the 
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design, implementation, and use of qualified 
health information technology systems; 
‘‘(G) 
demonstrate 
significant 
financial 
need; 
‘‘(H) provide matching funds in accord-
ance with paragraph (4); and 
‘‘(I) be a— 
‘‘(i) public or not-for-profit hospital; 
‘‘(ii) federally qualified health center 
(as defined in section 1861(aa)(4) of the 
Social Security Act); 
‘‘(iii) individual or group practice (or 
a consortium thereof); or 
‘‘(iv) another health care provider not 
described in clause (i) or (ii); 
that serves medically underserved communities. 
‘‘(3) USE OF FUNDS.—Amounts received under 
a grant under this subsection shall be used to— 
‘‘(A) facilitate the purchase of qualified 
health information technology systems; 
‘‘(B) train personnel in the use of such 
systems; 
‘‘(C) enhance the utilization of qualified 
health information technology systems (which 
may include activities to increase the awareness 
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among consumers of health care privacy protec-
tions); or 
‘‘(D) improve the prevention and manage-
ment of chronic disease. 
‘‘(4) MATCHING REQUIREMENT.—To be eligible 
for a grant under this subsection, an entity shall 
contribute non-Federal contributions to the costs of 
carrying out the activities for which the grant is 
awarded in an amount equal to $1 for each $3 of 
Federal funds provided under the grant. 
‘‘(5) PREFERENCE IN AWARDING GRANTS.—In 
awarding grants under this subsection the Secretary 
shall give preference to— 
‘‘(A) eligible entities that will improve the 
degree to which such entity will link the quali-
fied health information system to local or re-
gional health information plan or plans; and 
‘‘(B) with respect to awards made for the 
purpose of providing care in an outpatient med-
ical setting, entities that organize their prac-
tices as a patient-centered medical home. 
‘‘(b) COMPETITIVE GRANTS FOR THE DEVELOPMENT 
OF STATE LOAN PROGRAMS TO FACILITATE THE WIDE-
SPREAD ADOPTION
OF HEALTH INFORMATION TECH-
NOLOGY.— 
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‘‘(1) IN GENERAL.—The Secretary may award 
competitive grants to States for the establishment of 
State programs for loans to health care providers to 
facilitate the purchase and enhance the utilization of 
qualified health information technology. 
‘‘(2) ESTABLISHMENT OF FUND.—To be eligi-
ble to receive a competitive grant under this sub-
section, a State shall establish a qualified health in-
formation technology loan fund (referred to in this 
subsection as a ‘State loan fund’) and comply with 
the other requirements contained in this subsection. 
Amounts received under a grant under this sub-
section shall be deposited in the State loan fund es-
tablished by the State. No funds authorized by other 
provisions of this title to be used for other purposes 
specified in this title shall be deposited in any such 
State loan fund. 
‘‘(3) ELIGIBILITY.—To be eligible to receive a 
grant under paragraph (1), a State shall— 
‘‘(A) submit to the Secretary an applica-
tion at such time, in such manner, and con-
taining such information as the Secretary may 
require; 
‘‘(B) submit to the Secretary a strategic 
plan in accordance with paragraph (4); 
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‘‘(C) establish a qualified health informa-
tion technology loan fund in accordance with 
paragraph (2); 
‘‘(D) require that health care providers re-
ceiving loans under the grant— 
‘‘(i) link, to the extent practicable, the 
qualified health information system to a 
local or regional health information net-
work; 
‘‘(ii) consult, as needed, with the 
Health Information Technology Resource 
Center established in section 914(d) to ac-
cess the knowledge and experience of exist-
ing initiatives regarding the successful im-
plementation and effective use of health in-
formation technology; 
‘‘(iii) agree to notify individuals if 
their individually identifiable health infor-
mation is wrongfully disclosed; and 
‘‘(iv) take into account the input of 
employees and staff who are directly in-
volved in patient care of such health care 
providers in the design and implementation 
and use of qualified health information 
technology systems; 
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‘‘(E) require that health care providers re-
ceiving loans under the grant adopt the stand-
ards adopted by the Federal Government under 
section 3003; 
‘‘(F) require that health care providers re-
ceiving loans under the grant implement the 
measures adopted under section 3011 and re-
port to the Secretary on such measures; and 
‘‘(G) provide matching funds in accordance 
with paragraph (8). 
‘‘(4) STRATEGIC PLAN.— 
‘‘(A) IN GENERAL.—A State that receives 
a grant under this subsection shall annually 
prepare a strategic plan that identifies the in-
tended uses of amounts available to the State 
loan fund of the State. 
‘‘(B) CONTENTS.—A strategic plan under 
subparagraph (A) shall include— 
‘‘(i) a list of the projects to be as-
sisted through the State loan fund in the 
first fiscal year that begins after the date 
on which the plan is submitted; 
‘‘(ii) a description of the criteria and 
methods established for the distribution of 
funds from the State loan fund; 
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‘‘(iii) a description of the financial 
status of the State loan fund and the 
short-term and long-term goals of the 
State loan fund; and 
‘‘(iv) a description of the strategies 
the State will use to address challenges in 
the adoption of health information tech-
nology due to limited broadband access. 
‘‘(5) USE OF FUNDS.— 
‘‘(A) IN GENERAL.—Amounts deposited in 
a State loan fund, including loan repayments 
and interest earned on such amounts, shall be 
used only for awarding loans or loan guaran-
tees, or as a source of reserve and security for 
leveraged loans, the proceeds of which are de-
posited in the State loan fund established under 
paragraph (1). Loans under this section may be 
used by a health care provider to— 
‘‘(i) facilitate the purchase of qualified 
health information technology systems; 
‘‘(ii) enhance the utilization of quali-
fied health information technology systems 
(which may include activities to increase 
the awareness among consumers of health 
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care of privacy protections and privacy 
rights); or 
‘‘(iii) train personnel in the use of 
such systems. 
‘‘(B) LIMITATION.—Amounts received by a 
State under this subsection may not be used— 
‘‘(i) for the purchase or other acquisi-
tion of any health information technology 
system that is not a qualified health infor-
mation technology system; 
‘‘(ii) to conduct activities for which 
Federal funds are expended under other 
provisions of this title or the amendments 
made by the Promoting Health Informa-
tion Technology Act; or 
‘‘(iii) for any purpose other than mak-
ing loans to eligible entities under this sec-
tion. 
‘‘(6) TYPES OF ASSISTANCE.—Except as other-
wise limited by applicable State law, amounts depos-
ited into a State loan fund under this subsection 
may only be used for the following: 
‘‘(A) To award loans that comply with the 
following: 
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‘‘(i) The interest rate for each loan 
shall be less than or equal to the market 
interest rate. 
‘‘(ii) The principal and interest pay-
ments on each loan shall commence not 
later than 1 year after the date on which 
the loan was awarded, and each loan shall 
be fully amortized not later than 10 years 
after such date. 
‘‘(iii) The State loan fund shall be 
credited with all payments of principal and 
interest on each loan awarded from the 
fund. 
‘‘(B) To guarantee, or purchase insurance 
for, a local obligation (all of the proceeds of 
which finance a project eligible for assistance 
under this subsection) if the guarantee or pur-
chase would improve credit market access or re-
duce the interest rate applicable to the obliga-
tion involved. 
‘‘(C) As a source of revenue or security for 
the payment of principal and interest on rev-
enue or general obligation bonds issued by the 
State if the proceeds of the sale of the bonds 
will be deposited into the State loan fund. 
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‘‘(D) To earn interest on the amounts de-
posited into the State loan fund. 
‘‘(7) 
ADMINISTRATION
OF
STATE
LOAN 
FUNDS.— 
‘‘(A) COMBINED FINANCIAL ADMINISTRA-
TION.—A State may (as a convenience and to 
avoid unnecessary administrative costs) com-
bine, in accordance with State law, the financial 
administration of a State loan fund established 
under this subsection with the financial admin-
istration of any other revolving fund established 
by the State if not otherwise prohibited by the 
law under which the State loan fund was estab-
lished. 
‘‘(B) COST
OF
ADMINISTERING
FUND.— 
Each State may annually use not to exceed 4 
percent of the funds provided to the State 
under a grant under this subsection to pay the 
reasonable costs of the administration of the 
programs under this section, including the re-
covery of reasonable costs expended to establish 
a State loan fund which are incurred after the 
date of the enactment of this title. 
‘‘(C) GUIDANCE AND REGULATIONS.—The 
Secretary shall publish guidance and promul-
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gate regulations as may be necessary to carry 
out the provisions of this subsection, includ-
ing— 
‘‘(i) provisions to ensure that each 
State commits and expends funds allotted 
to the State under this subsection as effi-
ciently as possible in accordance with this 
title and applicable State laws; and 
‘‘(ii) guidance to prevent waste, fraud, 
and abuse. 
‘‘(D) PRIVATE SECTOR CONTRIBUTIONS.— 
‘‘(i) IN GENERAL.—A State loan fund 
established under this subsection may ac-
cept contributions from private sector enti-
ties, except that such entities may not 
specify the recipient or recipients of any 
loan issued under this subsection. 
‘‘(ii) 
AVAILABILITY
OF
INFORMA-
TION.—A State shall make publicly avail-
able the identity of, and amount contrib-
uted by, any private sector entity under 
clause (i) and may issue letters of com-
mendation or make other awards (that 
have no financial value) to any such entity. 
‘‘(8) MATCHING REQUIREMENTS.— 
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‘‘(v) a plan to ensure the privacy and 
security of individually identifiable health 
information that is consistent with Federal 
and State law; 
‘‘(vi) a governance plan that defines 
the manner in which the stakeholders will 
jointly make policy and operational deci-
sions on an ongoing basis; 
‘‘(vii) a financial or business plan that 
describes— 
‘‘(I) the sustainability of the 
plan; 
‘‘(II) the financial costs and ben-
efits of the plan; and 
‘‘(III) the entities to which such 
costs and benefits will accrue; 
‘‘(viii) a description of whether the 
State in which the entity resides has re-
ceived a grant under section 319D, alone 
or as a part of a consortium, and if the 
State has received such a grant, how the 
entity will coordinate the activities funded 
under section 319D with the system under 
this section; and 
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