into consideration the full range of appro-
priate methodologies, including randomized 
control trials, practical clinical trials, ob-
servation studies, and synthesis of existing 
research. 
‘‘(iii) To make recommendations on 
how findings resulting from research fund-
ed under this section should be described, 
presented, and disseminated. 
‘‘(iv) To make recommendations to 
the Congress and the Secretary, not later 
than 2 years after the date of the enact-
ment of the Enhanced Health Care Value 
for All Act of 2007, regarding the estab-
lishment of one or more federally-funded 
research and development centers. 
‘‘(v) To identify, consistent with sub-
paragraph (C)(i), highest priorities (such 
as treatments that are highly utilized or 
are for high-cost, chronic illnesses) for re-
search, demonstrations, and evaluations to 
support and improve Federal health care 
programs. 
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‘‘(vi) To ensure that such priorities 
are in accordance with the principles de-
scribed in subparagraph (F). 
‘‘(vii) To establish a clinical peer re-
view advisory panel (comprised of meth-
odologists, health service researchers, and 
medical experts) for each such priority to 
advise the Secretary on validating the 
science and methods used to conduct com-
parative effectiveness studies. 
‘‘(F) PRINCIPLES.—Research conducted or 
supported under this section shall be in accord-
ance with the following principles: 
‘‘(i) INDEPENDENCE.—The setting of 
the agenda and use of the research shall be 
insulated from inappropriate political or 
stakeholder influence. 
‘‘(ii) SCIENTIFIC
CREDIBILITY.—The 
methods for conducting the research shall 
be scientifically based. 
‘‘(iii) TRANSPARENCY.—All aspects of 
the prioritization of research, the conduct 
of the research, and any recommendations 
based on the research shall be carried out 
in a transparent manner. 
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‘‘(iv) INCLUSION
OF
INPUT
FROM 
STAKEHOLDERS.—Patients, 
providers, 
health 
care 
consumer 
representatives, 
health industry representatives, and law-
makers shall be consulted regarding prior-
ities and dissemination of the research.’’; 
(3) in paragraph (3)(C), by adding at the end 
the following: 
‘‘(iii) UPDATES.—The Secretary shall 
make available and disseminate updated 
evaluations, syntheses, and findings under 
this subparagraph not less than every 6 
months.’’; and 
(4) in paragraph (4)(A), by striking ‘‘the pro-
grams established under titles XVIII, XIX, and XXI 
of the Social Security Act’’ and inserting ‘‘the Fed-
eral health care programs’’. 
(b) REPORTS TO CONGRESS.—Such section is further 
amended— 
(1) by redesignating subsection (e) as sub-
section (f); and 
(2) by inserting after subsection (d) the fol-
lowing: 
‘‘(e) REPORTS.—Not later than 1 year after the date 
of the enactment of the Enhanced Health Care Value for 
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All Act of 2007, and annually thereafter, the Secretary, 
in consultation with the Comparative Effectiveness Advi-
sory Board, shall submit to Congress a report on the ac-
tivities conducted under this section. The report submitted 
under this subsection in 2012 shall include a description 
of the total activities conducted under this section since 
the date of the enactment of the Enhanced Health Care 
Value for All Act of 2007, including— 
‘‘(1) an evaluation of the return on the invest-
ment in the program conducted under this section, 
including the overall cost of the program, the sci-
entific knowledge created through the program, and 
the ways in which such knowledge has been used; 
‘‘(2) an evaluation of any backlog of unfunded 
research projects; and 
‘‘(3) an assessment of— 
‘‘(A) how the program is working; 
‘‘(B) the governance structure of the pro-
gram; 
‘‘(C) the ability of the program to include 
public comment and patient perspectives in pri-
ority setting; and 
‘‘(D) the ability of the program to dissemi-
nate findings and conclusions.’’. 
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SEC. 3. HEALTH CARE COMPARATIVE EFFECTIVENESS RE-
SEARCH 
TRUST 
FUND; 
FINANCING 
FOR 
TRUST FUND. 
(a) ESTABLISHMENT OF TRUST FUND.— 
(1) IN GENERAL.—Subchapter A of chapter 98 
of the Internal Revenue Code of 1986 (relating to 
trust fund code) is amended by adding at the end 
the following new section: 
‘‘SEC. 9511. HEALTH CARE COMPARATIVE EFFECTIVENESS 
RESEARCH TRUST FUND. 
‘‘(a) CREATION OF TRUST FUND.—There is estab-
lished in the Treasury of the United States a trust fund 
to be known as the ‘Health Care Comparative Effective-
ness Research Trust Fund’ (hereinafter in this section re-
ferred to as the ‘Trust Fund’), consisting of such amounts 
as may be appropriated or credited to such Trust Fund 
as provided in this section and section 9602(b). 
‘‘(b) TRANSFERS TO FUND.—There are hereby ap-
propriated to the Trust Fund the following: 
‘‘(1) Amounts equivalent to the net revenues re-
ceived in the Treasury from the fees imposed under 
subchapter B of chapter 34 (relating to fees on 
health insurance and self-insured plans). 
‘‘(2) Subject to subsection (c)(2), for each fiscal 
year beginning with fiscal year 2008, amounts deter-
mined by the Secretary of Health and Human Serv-
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ices to be equivalent to fair share amount deter-
mined under subsection (c) multiplied by the average 
number of individuals entitled to benefits under part 
A, or enrolled under part B, of title XVIII of the So-
cial Security Act during such fiscal year. 
The amounts appropriated under paragraph (2) shall be 
transferred from the Federal Hospital Insurance Trust 
Fund (established under section 1817 of the Social Secu-
rity Act) and from the Federal Supplementary Medical In-
surance Trust Fund (established under section 1841 of 
such Act), and from the Medicare Prescription Drug Ac-
count within such Trust Fund, in proportion (as estimated 
by the Secretary) to the total expenditures during such 
fiscal year that are made under title XVIIII of such Act 
from the respective trust fund or account. 
‘‘(c) FAIR SHARE AMOUNT.— 
‘‘(1) IN GENERAL.—The Secretary of Health 
and Human Services shall compute for each fiscal 
year (beginning with fiscal year 2008) a fair share 
amount under this subsection that is an amount 
that, when applied under this section and subchapter 
B of chapter 34 of the Internal Revenue Code of 
1986, will result in revenues to the Trust Fund (tak-
ing into account any outstanding balance in the 
Trust Fund) for the fiscal year as follows: 
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‘‘(A) for fiscal year 2008, $100,000,000; 
‘‘(B) for fiscal year 2009, $200,000,000; 
and 
‘‘(C) for each of fiscal years 2010 through 
2012, $900,000,000. 
‘‘(2) LIMITATION ON MEDICARE FUNDING.—In 
no case shall the amount transferred under sub-
section 
(b)(2) 
for 
any 
fiscal 
year 
exceed 
$200,000,000. 
‘‘(d) EXPENDITURES FROM FUND.—Amounts in the 
Trust Fund are available to the Secretary of Health and 
Human Services for carrying out section 1013 of the 
Medicare Prescription Drug, Improvement, and Mod-
ernization Act of 2003. 
‘‘(e) NET REVENUES.—For purposes of this section, 
the term ‘net revenues’ means the amount estimated by 
the Secretary based on the excess of— 
‘‘(1) the fees received in the Treasury under 
subchapter B of chapter 34, over 
‘‘(2) the decrease in the tax imposed by chapter 
1 resulting from the fees imposed by such sub-
chapter.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions for such subchapter A is amended by adding 
at the end thereof the following new item: 
‘‘Sec. 9511. Health Care Comparative Effectiveness Research Trust Fund.’’. 
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(b) FINANCING FOR FUND FROM FEES ON INSURED 
AND SELF-INSURED HEALTH PLANS.— 
(1) GENERAL RULE.—Chapter 34 of the Inter-
nal Revenue Code of 1986 is amended by adding at 
the end the following new subchapter: 
‘‘Subchapter B—Insured and Self-Insured 
Health Plans 
‘‘Sec. 4375. Health insurance. 
‘‘Sec. 4376. Self-insured health plans. 
‘‘Sec. 4377. Definitions and special rules. 
‘‘SEC. 4375. HEALTH INSURANCE. 
‘‘(a) IMPOSITION OF FEE.—There is hereby imposed 
on each specified health insurance policy for each policy 
year a fee equal to the fair share amount determined 
under section 9511(c)(1) multiplied by the average num-
ber of lives covered under the policy. 
‘‘(b) LIABILITY FOR FEE.—The fee imposed by sub-
section (a) shall be paid by the issuer of the policy. 
‘‘(c) SPECIFIED HEALTH INSURANCE POLICY.—For 
purposes of this section— 
‘‘(1) IN GENERAL.—Except as otherwise pro-
vided in this section, the term ‘specified health in-
surance policy’ means any accident or health insur-
ance policy issued with respect to individuals resid-
ing in the United States. 
‘‘(2) EXEMPTION OF CERTAIN POLICIES.—The 
term ‘specified health insurance policy’ does not in-
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clude any insurance policy if substantially all of the 
coverage provided under such policy relates to— 
‘‘(A) liabilities incurred under workers’ 
compensation laws, 
‘‘(B) tort liabilities, 
‘‘(C) liabilities relating to ownership or use 
of property, 
‘‘(D) credit insurance, 
‘‘(E) medicare supplemental coverage, or 
‘‘(F) such other similar liabilities as the 
Secretary may specify by regulations. 
‘‘(3) TREATMENT OF PREPAID HEALTH COV-
ERAGE ARRANGEMENTS.— 
‘‘(A) IN GENERAL.—In the case of any ar-
rangement described in subparagraph (B)— 
‘‘(i) such arrangement shall be treated 
as a specified health insurance policy, and 
‘‘(ii) the person referred to in such 
subparagraph shall be treated as the 
issuer. 
‘‘(B) DESCRIPTION OF ARRANGEMENTS.— 
An arrangement is described in this subpara-
graph if under such arrangement fixed pay-
ments or premiums are received as consider-
ation for any person’s agreement to provide or 
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arrange for the provision of accident or health 
coverage to residents of the United States, re-
gardless of how such coverage is provided or ar-
ranged to be provided. 
‘‘SEC. 4376. SELF-INSURED HEALTH PLANS. 
‘‘(a) IMPOSITION OF FEE.—In the case of any appli-
cable self-insured health plan for each plan year, there is 
hereby imposed a fee equal to the fair share amount deter-
mined under section 9511(c)(1) multiplied by the average 
number of lives covered under the plan. 
‘‘(b) LIABILITY FOR FEE.— 
‘‘(1) IN GENERAL.—The fee imposed by sub-
section (a) shall be paid by the plan sponsor. 
‘‘(2) PLAN SPONSOR.—For purposes of para-
graph (1) the term ‘plan sponsor’ means— 
‘‘(A) the employer in the case of a plan es-
tablished or maintained by a single employer, 
‘‘(B) the employee organization in the case 
of a plan established or maintained by an em-
ployee organization, 
‘‘(C) in the case of— 
‘‘(i) a plan established or maintained 
by 2 or more employers or jointly by 1 or 
more employers and 1 or more employee 
organizations, 
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‘‘(ii) a multiple employer welfare ar-
rangement, or 
‘‘(iii) a voluntary employees’ bene-
ficiary association described in section 
501(c)(9), 
the association, committee, joint board of trust-
ees, or other similar group of representatives of 
the parties who establish or maintain the plan, 
or 
‘‘(D) the cooperative or association de-
scribed in subsection (c)(2)(F) in the case of a 
plan established or maintained by such a coop-
erative or association. 
‘‘(c) APPLICABLE SELF-INSURED HEALTH PLAN.— 
For purposes of this section, the term ‘applicable self-in-
sured health plan’ means any plan for providing accident 
or health coverage if— 
‘‘(1) any portion of such coverage is provided 
other than through an insurance policy, and 
‘‘(2) such plan is established or maintained— 
‘‘(A) by one or more employers for the 
benefit of their employees or former employees, 
‘‘(B) by one or more employee organiza-
tions for the benefit of their members or former 
members, 
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