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‘‘(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 
timely access to useful categories of non-identi-
fiable health information in records maintained 
by the Federal government, or maintained by 
entities under contract with the Federal govern-
ment, to advance health care quality and health 
research where such information is in a form 
that can be used in such research. The Presi-
dent shall consult with appropriate Federal 
agencies, and solicit public comment, on useful 
categories of information, and appropriate 
measures to take. The President may consider 
the administrative burden and the potential for 
improvements in health care quality in deter-
mining such appropriate measures. In addition, 
the President, in consultation with the Sec-
retary, shall encourage voluntary private and 
public sector efforts to allow access to such use-
ful categories of non-identifiable health infor-
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mation to advance health care quality and 
health research. 
‘‘(B) NON-IDENTIFIABLE HEALTH INFOR-
MATION DEFINED.—For purposes of this para-
graph, the term ‘non-identifiable health infor-
mation’ means information that is not individ-
ually identifiable health information as defined 
in rules promulgated pursuant to section 264(c) 
of the Health Insurance Portability and Ac-
countability Act of 1996 (42 U.S.C. 1320d–2 
note), and includes information that has been 
de-identified so 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 informa-
tion collection by and submission to the Federal gov-
ernment and the purchases (and planned purchases) 
of health information technology by the Federal gov-
ernment. For each such year and based on the re-
view for such year, the National Coordinator shall 
submit to the President and Congress recommenda-
tions on methods to— 
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‘‘(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.’’. 
SEC. 104. GRANTS TO INTEGRATED HEALTH SYSTEMS TO 
PROMOTE 
HEALTH 
INFORMATION 
TECH-
NOLOGIES TO IMPROVE COORDINATION OF 
CARE FOR THE UNINSURED, UNDERINSURED, 
AND MEDICALLY UNDERSERVED. 
Subpart I of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 330M. GRANTS FOR IMPROVEMENT OF THE COORDI-
NATION OF CARE FOR THE UNINSURED, 
UNDERINSURED, AND MEDICALLY UNDER-
SERVED. 
‘‘(a) IN GENERAL.—The Secretary may make grants 
to integrated health care systems, in accordance with this 
section, for projects to better coordinate the provision of 
health care through the adoption of new health informa-
tion technology, or the significant improvement of existing 
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health information technology, to improve the provision of 
health care to uninsured, underinsured, and medically un-
derserved individuals (including in urban and rural areas) 
through health-related information about such individuals, 
throughout such a system and at the point of service. 
‘‘(b) ELIGIBILITY.— 
‘‘(1) APPLICATION.—To be eligible to receive a 
grant under this section, an integrated health care 
system shall prepare and submit to the Secretary an 
application, at such time, in such manner, and con-
taining such information as the Secretary may re-
quire, including— 
‘‘(A) a description of the project that the 
system will carry out using the funds provided 
under the grant; 
‘‘(B) a description of the manner in which 
the project funded under the grant will advance 
the goal specified in subsection (a); and 
‘‘(C) a description of the populations to be 
served by the adoption or improvement of 
health information technology. 
‘‘(2) OPTIONAL REPORTING CONDITION.—The 
Secretary may also condition the provision of a 
grant to an integrated health care system under this 
section for a project on the submission by such sys-
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tem to the Secretary of a report on the impact of 
the health information technology adopted (or im-
proved) under such project on the delivery of health 
care and the quality of care (in accordance with ap-
plicable measures of such quality). Such report shall 
be at such time and in such form and manner as 
specified by the Secretary. 
‘‘(c) INTEGRATED
HEALTH
CARE
SYSTEM
DE-
FINED.—For purposes of this section, the term ‘integrated 
health care system’ means a system of health care pro-
viders that is organized to provide care in a coordinated 
fashion and has a demonstrated commitment to provide 
uninsured, underinsured, and medically underserved indi-
viduals with access to such care. 
‘‘(d) PRIORITIES.—In making grants under this sec-
tion, the Secretary shall give priority to an integrated 
health care system— 
‘‘(1) that can demonstrate past successful com-
munity-wide efforts to improve the quality of care 
provided and the coordination of care for the unin-
sured, underinsured, and medically underserved; 
‘‘(2) if the project to be funded through such a 
grant— 
‘‘(A) will improve the delivery of health 
care and the quality of care provided; and 
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‘‘(B) will demonstrate savings for State or 
Federal health care benefits programs or enti-
ties legally obligated under Federal law to pro-
vide health care from the reduction of duplica-
tive health care services, administrative costs, 
and medical errors; or 
‘‘(3) if the project to be funded through such a 
grant will emphasize the improvement of access to 
medical care and medical care for medically under-
served populations which are geographically isolated 
or located in underserved urban areas. 
‘‘(e) LIMITATION, MATCHING REQUIREMENT, AND 
CONDITIONS.— 
‘‘(1) LIMITATION ON USE OF FUNDS.—None of 
the funds provided under a grant made under this 
section may be used for a project providing for the 
adoption or improvement of health information tech-
nology that is used exclusively for financial record 
keeping, billing, or other non-clinical applications. 
‘‘(2) MATCHING REQUIREMENT.—To be eligible 
for a grant under this section an integrated health 
care system shall contribute non-Federal contribu-
tions to the costs of carrying out the project for 
which the grant is awarded in an amount equal to 
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$1 for each $5 of Federal funds provided under the 
grant. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$15,000,000 for each of fiscal years 2007 and 2008.’’. 
SEC. 105. SMALL PHYSICIAN PRACTICE DEMONSTRATION 
GRANTS. 
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. SMALL PHYSICIAN PRACTICE DEMONSTRATION 
GRANTS. 
‘‘(a) IN GENERAL.—The Secretary shall establish a 
demonstration program under which the Secretary makes 
grants to small physician practices (including such prac-
tices that furnish services to individuals with chronic ill-
nesses) that are located in rural areas or medically under-
served urban areas for the purchase and support of health 
information technology. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under this section, an applicant shall prepare and submit 
to the Secretary an application, at such time, in such man-
ner, and containing such information, as the Secretary 
may require. 
‘‘(c) REPORTING.— 
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‘‘(1) REQUIRED REPORTS BY SMALL PHYSICIAN 
PRACTICES.—A small physician practice receiving a 
grant under subsection (a) shall submit to the Sec-
retary an evaluation on the health information tech-
nology funded by such grant. Such evaluation shall 
include information on— 
‘‘(A) barriers to the adoption of health in-
formation technology by the small physician 
practice; 
‘‘(B) issues for such practice in the use of 
health information technology; 
‘‘(C) the effect health information tech-
nology will have on the quality of health care 
furnished by such practice; and 
‘‘(D) the effect of any medical liability 
rules on such practice. 
‘‘(2) REPORT TO CONGRESS.—Not later than 
January 1, 2009, the Secretary shall submit to Con-
gress a report on the results of the demonstration 
program under this section. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2007 and 2008.’’. 
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TITLE II—TRANSACTION STAND-
ARDS, CODES, AND INFORMA-
TION 
SEC. 201. PROCEDURES TO ENSURE TIMELY UPDATING OF 
STANDARDS THAT ENABLE ELECTRONIC EX-
CHANGES. 
Section 1174(b) of the Social Security Act (42 U.S.C. 
1320d–3(b)) is amended— 
(1) in paragraph (1)— 
(A) in the first sentence, by inserting ‘‘and 
in accordance with paragraph (3)’’ before the 
period; and 
(B) by adding at the end the following new 
sentence: ‘‘For purposes of this subsection and 
section 1173(c)(2), the term ‘modification’ in-
cludes a new version or a version upgrade.’’; 
and 
(2) by adding at the end the following new 
paragraph: 
‘‘(3) EXPEDITED PROCEDURES FOR ADOPTION 
OF
ADDITIONS
AND
MODIFICATIONS
TO
STAND-
ARDS.— 
‘‘(A) IN GENERAL.—For purposes of para-
graph (1), the Secretary shall provide for an ex-
pedited upgrade program (in this paragraph re-
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ferred to as the ‘upgrade program’), in accord-
ance with this paragraph, to develop and ap-
prove additions and modifications to the stand-
ards adopted under section 1173(a) to improve 
the quality of such standards or to extend the 
functionality of such standards to meet evolving 
requirements in health care. 
‘‘(B) PUBLICATION
OF
NOTICES.—Under 
the upgrade program: 
‘‘(i) VOLUNTARY
NOTICE
OF
INITI-
ATION
OF
PROCESS.—Not later than 30 
days after the date the Secretary receives 
a notice from a standard setting organiza-
tion that the organization is initiating a 
process to develop an addition or modifica-
tion to a standard adopted under section 
1173(a), the Secretary shall publish a no-
tice in the Federal Register that— 
‘‘(I) identifies the subject matter 
of the addition or modification; 
‘‘(II) provides a description of 
how persons may participate in the 
development process; and 
‘‘(III) invites public participation 
in such process. 
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‘‘(ii) VOLUNTARY
NOTICE
OF
PRE-
LIMINARY DRAFT OF ADDITIONS OR MODI-
FICATIONS
TO
STANDARDS.—Not later 
than 30 days after the date of the date the 
Secretary receives a notice from a standard 
setting organization that the organization 
has prepared a preliminary draft of an ad-
dition or modification to a standard adopt-
ed by section 1173(a), the Secretary shall 
publish a notice in the Federal Register 
that— 
‘‘(I) identifies the subject matter 
of (and summarizes) the addition or 
modification; 
‘‘(II) specifies the procedure for 
obtaining the draft; 
‘‘(III) provides a description of 
how persons may submit comments in 
writing and at any public hearing or 
meeting held by the organization on 
the addition or modification; and 
‘‘(IV) invites submission of such 
comments and participation in such 
hearing or meeting without requiring 
the public to pay a fee to participate. 
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‘‘(iii) NOTICE OF PROPOSED ADDITION 
OR
MODIFICATION
TO
STANDARDS.—Not 
later than 30 days after the date of the 
date the Secretary receives a notice from a 
standard setting organization that the or-
ganization has a proposed addition or 
modification to a standard adopted under 
section 1173(a) that the organization in-
tends to submit under subparagraph 
(D)(iii), the Secretary shall publish a no-
tice in the Federal Register that contains, 
with respect to the proposed addition or 
modification, the information required in 
the notice under clause (ii) with respect to 
the addition or modification. 
‘‘(iv) 
CONSTRUCTION.—Nothing 
in 
this paragraph shall be construed as re-
quiring a standard setting organization to 
request the notices described in clauses (i) 
and (ii) with respect to an addition or 
modification to a standard in order to 
qualify for an expedited determination 
under subparagraph (C) with respect to a 
proposal submitted to the Secretary for 
adoption of such addition or modification. 
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‘‘(C) PROVISION
OF
EXPEDITED
DETER-
MINATION.—Under the upgrade program and 
with respect to a proposal by a standard setting 
organization for an addition or modification to 
a standard adopted under section 1173(a), if 
the Secretary determines that the standard set-
ting organization developed such addition or 
modification in accordance with the require-
ments of subparagraph (D) and the National 
Committee on Vital and Health Statistics rec-
ommends approval of such addition or modifica-
tion under subparagraph (E), the Secretary 
shall provide for expedited treatment of such 
proposal in accordance with subparagraph (F). 
‘‘(D) REQUIREMENTS.—The requirements 
under this subparagraph with respect to a pro-
posed addition or modification to a standard by 
a standard setting organization are the fol-
lowing: 
‘‘(i) REQUEST FOR PUBLICATION OF 
NOTICE.—The standard setting organiza-
tion submits to the Secretary a request for 
publication in the Federal Register of a no-
tice described in subparagraph (B)(iii) for 
the proposed addition or modification. 
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‘‘(ii) PROCESS
FOR
RECEIPT
AND 
CONSIDERATION
OF
PUBLIC
COMMENT.— 
The standard setting organization provides 
for a process through which, after the pub-
lication of the notice referred to under 
clause (i), the organization— 
‘‘(I) receives and responds to 
public comments submitted on a time-
ly basis on the proposed addition or 
modification before submitting such 
proposed addition or modification to 
the National Committee on Vital and 
Health Statistics under clause (iii); 
‘‘(II) makes publicly available a 
written explanation for its response in 
the proposed addition or modification 
to comments submitted on a timely 
basis; and 
‘‘(III) makes public comments re-
ceived under clause (I) available, or 
provides access to such comments, to 
the Secretary. 
‘‘(iii) SUBMITTAL
OF
FINAL
PRO-
POSED
ADDITION
OR
MODIFICATION
TO 
NCVHS.—After completion of the process 
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under clause (ii), the standard setting or-
ganization submits the proposed addition 
or modification to the National Committee 
on Vital and Health Statistics for review 
and consideration under subparagraph (E). 
Such submission shall include information 
on the organization’s compliance with the 
notice and comment requirements (and re-
sponses to those comments) under clause 
(ii). 
‘‘(E) HEARING
AND
RECOMMENDATIONS 
BY
NATIONAL
COMMITTEE
ON
VITAL
AND 
HEALTH STATISTICS.—Under the upgrade pro-
gram, upon receipt of a proposal submitted by 
a standard setting organization under subpara-
graph (D)(iii) for the adoption of an addition or 
modification to a standard, the National Com-
mittee on Vital and Health Statistics shall pro-
vide notice to the public and a reasonable op-
portunity for public testimony at a hearing on 
such addition or modification. The Secretary 
may participate in such hearing in such capac-
ity (including presiding ex officio) as the Sec-
retary shall determine appropriate. Not later 
than 120 days after the date of receipt of the 
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proposal, the Committee shall submit to the 
Secretary its recommendation to adopt (or not 
adopt) the proposed addition or modification. 
‘‘(F) DETERMINATION BY SECRETARY TO 
ACCEPT OR REJECT NATIONAL COMMITTEE ON 
VITAL AND HEALTH STATISTICS RECOMMENDA-
TION.— 
‘‘(i) 
TIMELY
DETERMINATION.— 
Under the upgrade program, if the Na-
tional Committee on Vital and Health Sta-
tistics submits to the Secretary a rec-
ommendation under subparagraph (E) to 
adopt a proposed addition or modification, 
not later than 90 days after the date of re-
ceipt of such recommendation the Sec-
retary shall make a determination to ac-
cept or reject the recommendation and 
shall publish notice of such determination 
in the Federal Register not later than 30 
days after the date of the determination. 
‘‘(ii) CONTENTS OF NOTICE.—If the 
determination is to reject the recommenda-
tion, such notice shall include the reasons 
for the rejection. If the determination is to 
accept the recommendation, as part of 
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such notice the Secretary shall promulgate 
the modified standard (including the ac-
cepted proposed addition or modification 
accepted) as a final rule under this sub-
section without any further notice or public 
comment period. 
‘‘(iii) 
LIMITATION
ON
CONSIDER-
ATION.—The Secretary shall not consider a 
proposal under this subparagraph unless 
the Secretary determines that the require-
ments of subparagraph (D) (including pub-
lication of notice and opportunity for pub-
lic comment) have been met with respect to 
the proposal. 
‘‘(G) EXEMPTION FROM PAPERWORK RE-
DUCTION ACT.—Chapter 35 of title 44, United 
States Code, shall not apply to a final rule pro-
mulgated under subparagraph (F). 
‘‘(H) TREATMENT
AS
SATISFYING
RE-
QUIREMENTS
FOR
NOTICE-AND-COMMENT.— 
Any requirements under section 553 of title 5, 
United States Code, relating to notice and an 
opportunity for public comment with respect to 
a final rule promulgated under subparagraph 
(F) shall be treated as having been met by 
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meeting the requirements of the notice and op-
portunity for public comment provided under 
provisions of subparagraphs (B)(iii), (D), and 
(E). 
‘‘(I) NO JUDICIAL REVIEW.—A final rule 
promulgated under subparagraph (F) shall not 
be subject to judicial review.’’. 
SEC. 202. UPGRADING ASC X12 AND NCPDP STANDARDS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall provide by notice published in the 
Federal Register for the following replacements of stand-
ards to apply to transactions occurring on or after April 
1, 2009: 
(1) ACCREDITED STANDARDS COMMITTEE X12 
(ASC X12) STANDARD.—The replacement of the Ac-
credited Standards Committee X12 (ASC X12) 
version 4010 adopted under section 1173(a) of such 
Act (42 U.S.C. 1320d–2(a)) with the ASC X12 
version 5010, as reviewed by the National Com-
mittee on Vital Health Statistics. 
(2) NATIONAL
COUNCIL
FOR
PRESCRIPTION 
DRUG
PROGRAMS
(NCPDP)
TELECOMMUNICATIONS 
STANDARDS.—The replacement of the National 
Council for Prescription Drug Programs (NCPDP) 
Telecommunications Standards version 5.1 adopted 
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under section 1173(a) of such Act (42 U.S.C. 
1320d–2(a)) with whichever is the latest version of 
the NCPDP Telecommunications Standards that has 
been approved by such Council and reviewed by the 
National Committee on Vital Health Statistics as of 
April 1, 2007. 
(b) NO JUDICIAL REVIEW.—The implementation of 
subsection (a), including the determination of the latest 
version under subsection (a)(2), shall not be subject to ju-
dicial review. 
SEC. 203. UPGRADING ICD CODES; CODING AND DOCU-
MENTATION 
OF 
NON-MEDICAL 
INFORMA-
TION. 
(a) UPGRADING ICD CODES.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall provide by notice published in 
the Federal Register for the replacement of the 
International Classification of Diseases, 9th revision, 
Clinical Modification (ICD–9-CM) under the regula-
tion promulgated under section 1173(c) of the Social 
Security Act (42 U.S.C. 1320d–2(c)), including for 
purposes of part A of title XVIII of such Act, with 
both of the following: 
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(A) The International Classification of 
Diseases, 10th revision, Clinical Modification 
(ICD–10-CM). 
(B) The International Classification of 
Diseases, 10th revision, Procedure Coding Sys-
tem (ICD–10-PCS). 
(2) APPLICATION.—The replacement made by 
paragraph (1) shall apply, for purposes of section 
1175(b)(2) of the Social Security Act (42 U.S.C. 
1320d–4(b)(2)), to services furnished on or after Oc-
tober 1, 2010. 
(3) RULES
OF
CONSTRUCTION.—Nothing in 
paragraph (1) shall be construed— 
(A) as affecting the application of classi-
fication methodologies or codes, such as CPT or 
HCPCS codes, other than under the Inter-
national Classification of Diseases (ICD); or 
(B) as superseding the authority of the 
Secretary of Health and Human Services to 
maintain and modify the coding set for ICD– 
10-CM and ICD–10-PCS, including under the 
amendments made by section 201. 
(b) CODING AND DOCUMENTATION OF NON-MEDICAL 
INFORMATION.—In any regulation or other action imple-
menting the International Classification of Diseases, 10th 
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revision, Clinical Modification (ICD–10-CM), the Inter-
national Classification of Diseases, 10th revision, Proce-
dure Coding System (ICD–10-PCS), or other version of 
the International Classification of Diseases, 10th revision, 
the Secretary of Health and Human Services shall ensure 
that no health care provider is required to code to a level 
of specificity that would require documentation of non- 
medical information on the external cause of any given 
type of injury. 
SEC. 204. STRATEGIC PLAN FOR COORDINATING IMPLE-
MENTATION OF TRANSACTION STANDARDS 
AND ICD CODES. 
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, in consultation with relevant public 
and private entities, shall develop a strategic plan with re-
spect to the need for coordination in the implementation 
of— 
(1) transaction standards under section 1173(a) 
of the Social Security Act, including modifications to 
such standards under section 1174(b)(3) of such 
Act, as added by section 201; and 
(2) any updated versions of the International 
Classification of Diseases (ICD), including the re-
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placement of ICD–9 provided for under section 
203(a). 
SEC. 205. STUDY AND REPORT TO DETERMINE IMPACT OF 
VARIATION AND COMMONALITY IN STATE 
HEALTH INFORMATION LAWS AND REGULA-
TIONS. 
Part C of title XI of the Social Security Act is amend-
ed by adding at the end the following new section: 
‘‘STUDY AND REPORT TO DETERMINE IMPACT OF VARI-
ATION AND COMMONALITY IN STATE HEALTH INFOR-
MATION LAWS AND REGULATIONS 
‘‘SEC. 1180. (a) STUDY.—For purposes of promoting 
the development of a nationwide interoperable health in-
formation technology infrastructure consistent with sec-
tion 271(b) of the Public Health Service Act, the Sec-
retary shall conduct a study of the impact of variation in 
State security and confidentiality laws and current Fed-
eral security and confidentiality standards on the timely 
exchanges of health information in order to ensure the 
availability of health information necessary to make med-
ical decisions at the location in which the medical care in-
volved is provided. Such study shall examine— 
‘‘(1)(A) the degree of variation and com-
monality among the requirements of such laws for 
States; and 
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‘‘(B) the degree of variation and commonality 
between the requirements of such laws and the cur-
rent Federal standards; 
‘‘(2) insofar as there is variation among and be-
tween such requirements, the strengths and weak-
nesses of such requirements; and 
‘‘(3) the extent to which such variation may ad-
versely impact the secure, confidential, and timely 
exchange of health information among States, the 
Federal government, and public and private entities, 
or may otherwise impact the reliability of such infor-
mation. 
‘‘(b) REPORT.—Not later than 18 months after the 
date of the enactment of this section, the Secretary shall 
submit to Congress a report on the study under subsection 
(a) and shall include in such report the following: 
‘‘(1) ANALYSIS OF NEED FOR GREATER COM-
MONALITY.—A determination by the Secretary on 
the extent to which there is a need for greater com-
monality of the requirements of State security and 
confidentiality laws and current Federal security and 
confidentiality standards to better protect, strength-
en, or otherwise improve the secure, confidential, 
and timely exchange of health information among 
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States, the Federal government, and public and pri-
vate entities. 
‘‘(2) RECOMMENDATIONS FOR GREATER COM-
MONALITY.—Insofar as the Secretary determines 
under paragraph (1) that there is a need for greater 
commonality of such requirements, recommendations 
on the extent to which (and how) the current Fed-
eral security and confidentiality standards should be 
changed in order to provide the commonality needed 
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.— 
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‘‘(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 
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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 
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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.’’. 
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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. 
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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 
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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: 
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‘‘(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-
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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 
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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. 
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(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). 
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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— 
‘‘(I) limits or restricts the use of 
the health information technology to 
services provided by the physician to 
individuals receiving services at the 
specified entity; 
‘‘(II) limits or restricts the use of 
the health information technology in 
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conjunction with other health informa-
tion technology; 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 parties involved (or their represent-
atives) and that specifies the remuneration 
made and states that the provision of such 
remuneration is made for the primary pur-
pose of better coordination of care or im-
provement of health quality, efficiency, or 
research; and 
‘‘(iii) the specified entity (or a rep-
resentative 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 
interoperability. 
‘‘(B) HEALTH INFORMATION TECHNOLOGY 
DEFINED.—For purposes of this paragraph, the 
term ‘health information technology’ means 
hardware, software, license, right, intellectual 
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