H. R. 3590—885 
‘‘(ii) in the case of contracts entered into under section 
338B, accept a minimum service obligation of 2 years with 
an award amount equal to 50 percent of the amount that 
would otherwise be payable for full-time service; and’’; and 
(C) in paragraph (3), by striking ‘‘In evaluating a dem-
onstration project described in paragraph (1)’’ and inserting 
‘‘In evaluating waivers issued under paragraph (1)’’. 
(2) Subsection (j) of section 331 of the Public Health Service 
Act (42 U.S.C. 254d) is amended by adding at the end the following: 
‘‘(5) The terms ‘full time’ and ‘full-time’ mean a minimum 
of 40 hours per week in a clinical practice, for a minimum 
of 45 weeks per year. 
‘‘(6) The terms ‘half time’ and ‘half-time’ mean a minimum 
of 20 hours per week (not to exceed 39 hours per week) in 
a clinical practice, for a minimum of 45 weeks per year.’’. 
(3) Section 337(b)(1) of the Public Health Service Act (42 U.S.C. 
254j(b)(1)) is amended by striking ‘‘Members may not be reappointed 
to the Council.’’. 
(4) Section 338B(g)(2)(A) of the Public Health Service Act (42 
U.S.C. 254l–1(g)(2)(A)) is amended by striking ‘‘$35,000’’ and 
inserting ‘‘$50,000, plus, beginning with fiscal year 2012, an amount 
determined by the Secretary on an annual basis to reflect inflation,’’. 
(5) Subsection (a) of section 338C of the Public Health Service 
Act (42 U.S.C. 254m), as amended by section 5508, is amended— 
(A) by striking the second sentence and inserting the fol-
lowing: ‘‘The Secretary may treat teaching as clinical practice 
for up to 20 percent of such period of obligated service.’’; and 
(B) by adding at the end the following: ‘‘Notwithstanding 
the preceding sentence, with respect to a member of the Corps 
participating in the teaching health centers graduate medical 
education program under section 340H, for the purpose of calcu-
lating time spent in full-time clinical practice under this section, 
up to 50 percent of time spent teaching by such member may 
be counted toward his or her service obligation.’’. 
SEC. 10502. INFRASTRUCTURE TO EXPAND ACCESS TO CARE. 
(a) APPROPRIATION.—There are authorized to be appropriated, 
and there are appropriated to the Department of Health and Human 
Services, $100,000,000 for fiscal year 2010, to remain available 
for obligation until September 30, 2011, to be used for debt service 
on, or direct construction or renovation of, a health care facility 
that provides research, inpatient tertiary care, or outpatient clinical 
services. Such facility shall be affiliated with an academic health 
center at a public research university in the United States that 
contains a State’s sole public academic medical and dental school. 
(b) REQUIREMENT.—Amount appropriated under subsection (a) 
may only be made available by the Secretary of Health and Human 
Services upon the receipt of an application from the Governor 
of a State that certifies that— 
(1) the new health care facility is critical for the provision 
of greater access to health care within the State; 
(2) such facility is essential for the continued financial 
viability of the State’s sole public medical and dental school 
and its academic health center; 
(3) the request for Federal support represents not more 
than 40 percent of the total cost of the proposed new facility; 
and
H. R. 3590—886 
(4) the State has established a dedicated funding mecha-
nism to provide all remaining funds necessary to complete 
the construction or renovation of the proposed facility. 
SEC. 10503. COMMUNITY HEALTH CENTERS AND THE NATIONAL 
HEALTH SERVICE CORPS FUND. 
(a) PURPOSE.—It is the purpose of this section to establish 
a Community Health Center Fund (referred to in this section as 
the ‘‘CHC Fund’’), to be administered through the Office of the 
Secretary of the Department of Health and Human Services to 
provide for expanded and sustained national investment in commu-
nity health centers under section 330 of the Public Health Service 
Act and the National Health Service Corps. 
(b) FUNDING.—There is authorized to be appropriated, and there 
is appropriated, out of any monies in the Treasury not otherwise 
appropriated, to the CHC Fund— 
(1) to be transferred to the Secretary of Health and Human 
Services to provide enhanced funding for the community health 
center program under section 330 of the Public Health Service 
Act— 
(A) $700,000,000 for fiscal year 2011; 
(B) $800,000,000 for fiscal year 2012; 
(C) $1,000,000,000 for fiscal year 2013; 
(D) $1,600,000,000 for fiscal year 2014; and 
(E) $2,900,000,000 for fiscal year 2015; and 
(2) to be transferred to the Secretary of Health and Human 
Services to provide enhanced funding for the National Health 
Service Corps— 
(A) $290,000,000 for fiscal year 2011; 
(B) $295,000,000 for fiscal year 2012; 
(C) $300,000,000 for fiscal year 2013; 
(D) $305,000,000 for fiscal year 2014; and 
(E) $310,000,000 for fiscal year 2015. 
(c) CONSTRUCTION.—There is authorized to be appropriated, 
and there is appropriated, out of any monies in the Treasury 
not otherwise appropriated, $1,500,000,000 to be available for fiscal 
years 2011 through 2015 to be used by the Secretary of Health 
and Human Services for the construction and renovation of commu-
nity health centers. 
(d) USE OF FUND.—The Secretary of Health and Human Serv-
ices shall transfer amounts in the CHC Fund to accounts within 
the Department of Health and Human Services to increase funding, 
over the fiscal year 2008 level, for community health centers and 
the National Health Service Corps. 
(e) AVAILABILITY.—Amounts appropriated under subsections (b) 
and (c) shall remain available until expended. 
SEC. 10504. DEMONSTRATION PROJECT TO PROVIDE ACCESS TO 
AFFORDABLE CARE. 
(a) IN GENERAL.—Not later than 6 months after the date of 
enactment of this Act, the Secretary of Health and Human Services 
(referred to in this section as the ‘‘Secretary’’), acting through the 
Health Resources and Services Administration, shall establish a 
3 year demonstration project in up to 10 States to provide access 
to comprehensive health care services to the uninsured at reduced 
fees. The Secretary shall evaluate the feasibility of expanding the 
project to additional States.
H. R. 3590—887 
(b) ELIGIBILITY.—To be eligible to participate in the demonstra-
tion project, an entity shall be a State-based, nonprofit, public- 
private partnership that provides access to comprehensive health 
care services to the uninsured at reduced fees. Each State in which 
a participant selected by the Secretary is located shall receive 
not more than $2,000,000 to establish and carry out the project 
for the 3-year demonstration period. 
(c) AUTHORIZATION.—There is authorized to be appropriated 
such sums as may be necessary to carry out this section. 
Subtitle F—Provisions Relating to Title VI 
SEC. 10601. REVISIONS TO LIMITATION ON MEDICARE EXCEPTION TO 
THE PROHIBITION ON CERTAIN PHYSICIAN REFERRALS 
FOR HOSPITALS. 
(a) IN GENERAL.—Section 1877(i) of the Social Security Act, 
as added by section 6001(a), is amended— 
(1) in paragraph (1)(A)(i), by striking ‘‘February 1, 2010’’ 
and inserting ‘‘August 1, 2010’’; and 
(2) in paragraph (3)(A)— 
(A) in clause (iii), by striking ‘‘August 1, 2011’’ and 
inserting ‘‘February 1, 2012’’; and 
(B) in clause (iv), by striking ‘‘July 1, 2011’’ and 
inserting ‘‘January 1, 2012’’. 
(b) CONFORMING AMENDMENT.—Section 6001(b)(2) of this Act 
is amended by striking ‘‘November 1, 2011’’ and inserting ‘‘May 
1, 2012’’. 
SEC. 10602. CLARIFICATIONS TO PATIENT-CENTERED OUTCOMES 
RESEARCH. 
Section 1181 of the Social Security Act (as added by section 
6301) is amended— 
(1) in subsection (d)(2)(B)— 
(A) in clause (ii)(IV)— 
(i) by inserting ‘‘, as described in subparagraph 
(A)(ii),’’ after ‘‘original research’’; and 
(ii) by inserting ‘‘, as long as the researcher enters 
into a data use agreement with the Institute for use 
of the data from the original research, as appropriate’’ 
after ‘‘publication’’; and 
(B) by amending clause (iv) to read as follows: 
‘‘(iv) SUBSEQUENT USE OF THE DATA.—The Institute 
shall not allow the subsequent use of data from original 
research in work-for-hire contracts with individuals, 
entities, or instrumentalities that have a financial 
interest in the results, unless approved under a data 
use agreement with the Institute.’’; 
(2) in subsection (d)(8)(A)(iv), by striking ‘‘not be construed 
as mandates for’’ and inserting ‘‘do not include’’; and 
(3) in subsection (f)(1)(C), by amending clause (ii) to read 
as follows: 
‘‘(ii) 7 members representing physicians and pro-
viders, including 4 members representing physicians 
(at least 1 of whom is a surgeon), 1 nurse, 1 State- 
licensed integrative health care practitioner, and 1 rep-
resentative of a hospital.’’.
H. R. 3590—888 
SEC. 10603. STRIKING PROVISIONS RELATING TO INDIVIDUAL PRO-
VIDER APPLICATION FEES. 
(a) IN GENERAL.—Section 1866(j)(2)(C) of the Social Security 
Act, as added by section 6401(a), is amended— 
(1) by striking clause (i); 
(2) by redesignating clauses (ii) through (iv), respectively, 
as clauses (i) through (iii); and 
(3) in clause (i), as redesignated by paragraph (2), by 
striking ‘‘clause (iii)’’ and inserting ‘‘clause (ii)’’. 
(b) TECHNICAL CORRECTION.—Section 6401(a)(2) of this Act is 
amended to read as follows: 
‘‘(2) by redesignating paragraph (2) as paragraph (8); and’’. 
SEC. 10604. TECHNICAL CORRECTION TO SECTION 6405. 
Paragraphs (1) and (2) of section 6405(b) are amended to read 
as follows: 
‘‘(1) PART A.—Section 1814(a)(2) of the Social Security Act 
(42 U.S.C. 1395(a)(2)) is amended in the matter preceding 
subparagraph (A) by inserting ‘, or, in the case of services 
described in subparagraph (C), a physician enrolled under sec-
tion 1866(j),’ after ‘in collaboration with a physician,’. 
‘‘(2) PART B.—Section 1835(a)(2) of the Social Security Act 
(42 U.S.C. 1395n(a)(2)) is amended in the matter preceding 
subparagraph (A) by inserting ‘, or, in the case of services 
described in subparagraph (A), a physician enrolled under sec-
tion 1866(j),’ after ‘a physician’.’’. 
SEC. 10605. CERTAIN OTHER PROVIDERS PERMITTED TO CONDUCT 
FACE TO FACE ENCOUNTER FOR HOME HEALTH SERV-
ICES. 
(a) PART A.—Section 1814(a)(2)(C) of the Social Security Act 
(42 U.S.C. 1395f(a)(2)(C)), as amended by section 6407(a)(1), is 
amended by inserting ‘‘, or a nurse practitioner or clinical nurse 
specialist (as those terms are defined in section 1861(aa)(5)) who 
is working in collaboration with the physician in accordance with 
State law, or a certified nurse-midwife (as defined in section 
1861(gg)) as authorized by State law, or a physician assistant 
(as defined in section 1861(aa)(5)) under the supervision of the 
physician,’’ after ‘‘himself or herself’’. 
(b) PART B.—Section 1835(a)(2)(A)(iv) of the Social Security 
Act, as added by section 6407(a)(2), is amended by inserting ‘‘, 
or a nurse practitioner or clinical nurse specialist (as those terms 
are defined in section 1861(aa)(5)) who is working in collaboration 
with the physician in accordance with State law, or a certified 
nurse-midwife (as defined in section 1861(gg)) as authorized by 
State law, or a physician assistant (as defined in section 1861(aa)(5)) 
under the supervision of the physician,’’ after ‘‘must document that 
the physician’’. 
SEC. 10606. HEALTH CARE FRAUD ENFORCEMENT. 
(a) FRAUD SENTENCING GUIDELINES.— 
(1) DEFINITION.—In this subsection, the term ‘‘Federal 
health care offense’’ has the meaning given that term in section 
24 of title 18, United States Code, as amended by this Act. 
(2) REVIEW AND AMENDMENTS.—Pursuant to the authority 
under section 994 of title 28, United States Code, and in accord-
ance with this subsection, the United States Sentencing 
Commission shall—
H. R. 3590—889 
(A) review the Federal Sentencing Guidelines and 
policy statements applicable to persons convicted of Federal 
health care offenses; 
(B) amend the Federal Sentencing Guidelines and 
policy statements applicable to persons convicted of Federal 
health care offenses involving Government health care pro-
grams to provide that the aggregate dollar amount of 
fraudulent bills submitted to the Government health care 
program shall constitute prima facie evidence of the amount 
of the intended loss by the defendant; and 
(C) amend the Federal Sentencing Guidelines to pro-
vide— 
(i) a 2-level increase in the offense level for any 
defendant convicted of a Federal health care offense 
relating to a Government health care program which 
involves a loss of not less than $1,000,000 and less 
than $7,000,000; 
(ii) a 3-level increase in the offense level for any 
defendant convicted of a Federal health care offense 
relating to a Government health care program which 
involves a loss of not less than $7,000,000 and less 
than $20,000,000; 
(iii) a 4-level increase in the offense level for any 
defendant convicted of a Federal health care offense 
relating to a Government health care program which 
involves a loss of not less than $20,000,000; and 
(iv) if appropriate, otherwise amend the Federal 
Sentencing Guidelines and policy statements applicable 
to persons convicted of Federal health care offenses 
involving Government health care programs. 
(3) REQUIREMENTS.—In carrying this subsection, the United 
States Sentencing Commission shall— 
(A) ensure that the Federal Sentencing Guidelines and 
policy statements— 
(i) reflect the serious harms associated with health 
care fraud and the need for aggressive and appropriate 
law enforcement action to prevent such fraud; and 
(ii) provide increased penalties for persons con-
victed of health care fraud offenses in appropriate cir-
cumstances; 
(B) consult with individuals or groups representing 
health care fraud victims, law enforcement officials, the 
health care industry, and the Federal judiciary as part 
of the review described in paragraph (2); 
(C) ensure reasonable consistency with other relevant 
directives and with other guidelines under the Federal 
Sentencing Guidelines; 
(D) account for any aggravating or mitigating cir-
cumstances that might justify exceptions, including cir-
cumstances for which the Federal Sentencing Guidelines, 
as in effect on the date of enactment of this Act, provide 
sentencing enhancements; 
(E) make any necessary conforming changes to the 
Federal Sentencing Guidelines; and 
(F) ensure that the Federal Sentencing Guidelines ade-
quately meet the purposes of sentencing.
H. R. 3590—890 
(b) INTENT REQUIREMENT FOR HEALTH CARE FRAUD.—Section 
1347 of title 18, United States Code, is amended— 
(1) by inserting ‘‘(a)’’ before ‘‘Whoever knowingly’’; and 
(2) by adding at the end the following: 
‘‘(b) With respect to violations of this section, a person need 
not have actual knowledge of this section or specific intent to 
commit a violation of this section.’’. 
(c) HEALTH CARE FRAUD OFFENSE.—Section 24(a) of title 18, 
United States Code, is amended— 
(1) in paragraph (1), by striking the semicolon and inserting 
‘‘or section 1128B of the Social Security Act (42 U.S.C. 1320a– 
7b); or’’; and 
(2) in paragraph (2)— 
(A) by inserting ‘‘1349,’’ after ‘‘1343,’’; and 
(B) by inserting ‘‘section 301 of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 331), or section 501 of the 
Employee Retirement Income Security Act of 1974 (29 
U.S.C. 1131),’’ after ‘‘title,’’. 
(d) SUBPOENA AUTHORITY RELATING TO HEALTH CARE.— 
(1) SUBPOENAS UNDER THE HEALTH INSURANCE PORTABILITY 
AND ACCOUNTABILITY ACT OF 1996.—Section 1510(b) of title 18, 
United States Code, is amended— 
(A) in paragraph (1), by striking ‘‘to the grand jury’’; 
and 
(B) in paragraph (2)— 
(i) in subparagraph (A), by striking ‘‘grand jury 
subpoena’’ and inserting ‘‘subpoena for records’’; and 
(ii) in the matter following subparagraph (B), by 
striking ‘‘to the grand jury’’. 
(2) SUBPOENAS UNDER THE CIVIL RIGHTS OF INSTITUTIONAL-
IZED PERSONS ACT.—The Civil Rights of Institutionalized Per-
sons Act (42 U.S.C. 1997 et seq.) is amended by inserting 
after section 3 the following: 
‘‘SEC. 3A. SUBPOENA AUTHORITY. 
‘‘(a) AUTHORITY.—The Attorney General, or at the direction 
of the Attorney General, any officer or employee of the Department 
of Justice may require by subpoena access to any institution that 
is the subject of an investigation under this Act and to any docu-
ment, record, material, file, report, memorandum, policy, procedure, 
investigation, video or audio recording, or quality assurance report 
relating to any institution that is the subject of an investigation 
under this Act to determine whether there are conditions which 
deprive persons residing in or confined to the institution of any 
rights, privileges, or immunities secured or protected by the Con-
stitution or laws of the United States. 
‘‘(b) ISSUANCE AND ENFORCEMENT OF SUBPOENAS.— 
‘‘(1) ISSUANCE.—Subpoenas issued under this section— 
‘‘(A) shall bear the signature of the Attorney General 
or any officer or employee of the Department of Justice 
as designated by the Attorney General; and 
‘‘(B) shall be served by any person or class of persons 
designated by the Attorney General or a designated officer 
or employee for that purpose. 
‘‘(2) ENFORCEMENT.—In the case of contumacy or failure 
to obey a subpoena issued under this section, the United States 
district court for the judicial district in which the institution
H. R. 3590—891 
is located may issue an order requiring compliance. Any failure 
to obey the order of the court may be punished by the court 
as a contempt that court. 
‘‘(c) PROTECTION OF SUBPOENAED RECORDS AND INFORMATION.— 
Any document, record, material, file, report, memorandum, policy, 
procedure, investigation, video or audio recording, or quality assur-
ance report or other information obtained under a subpoena issued 
under this section— 
‘‘(1) may not be used for any purpose other than to protect 
the rights, privileges, or immunities secured or protected by 
the Constitution or laws of the United States of persons who 
reside, have resided, or will reside in an institution; 
‘‘(2) may not be transmitted by or within the Department 
of Justice for any purpose other than to protect the rights, 
privileges, or immunities secured or protected by the Constitu-
tion or laws of the United States of persons who reside, have 
resided, or will reside in an institution; and 
‘‘(3) shall be redacted, obscured, or otherwise altered if 
used in any publicly available manner so as to prevent the 
disclosure of any personally identifiable information.’’. 
SEC. 10607. STATE DEMONSTRATION PROGRAMS TO EVALUATE ALTER-
NATIVES TO CURRENT MEDICAL TORT LITIGATION. 
Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.), as amended by this Act, is further amended by 
adding at the end the following: 
‘‘SEC. 399V–4. STATE DEMONSTRATION PROGRAMS TO EVALUATE 
ALTERNATIVES TO CURRENT MEDICAL TORT LITIGA-
TION. 
‘‘(a) IN GENERAL.—The Secretary is authorized to award dem-
onstration grants to States for the development, implementation, 
and evaluation of alternatives to current tort litigation for resolving 
disputes over injuries allegedly caused by health care providers 
or health care organizations. In awarding such grants, the Secretary 
shall ensure the diversity of the alternatives so funded. 
‘‘(b) DURATION.—The Secretary may award grants under sub-
section (a) for a period not to exceed 5 years. 
‘‘(c) CONDITIONS FOR DEMONSTRATION GRANTS.— 
‘‘(1) REQUIREMENTS.—Each State desiring a grant under 
subsection (a) shall develop an alternative to current tort litiga-
tion that— 
‘‘(A) allows for the resolution of disputes over injuries 
allegedly caused by health care providers or health care 
organizations; and 
‘‘(B) promotes a reduction of health care errors by 
encouraging the collection and analysis of patient safety 
data related to disputes resolved under subparagraph (A) 
by organizations that engage in efforts to improve patient 
safety and the quality of health care. 
‘‘(2) ALTERNATIVE
TO
CURRENT
TORT
LITIGATION.—Each 
State desiring a grant under subsection (a) shall demonstrate 
how the proposed alternative described in paragraph (1)(A)— 
‘‘(A) makes the medical liability system more reliable 
by increasing the availability of prompt and fair resolution 
of disputes; 
‘‘(B) encourages the efficient resolution of disputes; 
‘‘(C) encourages the disclosure of health care errors;
H. R. 3590—892 
‘‘(D) enhances patient safety by detecting, analyzing, 
and helping to reduce medical errors and adverse events; 
‘‘(E) improves access to liability insurance; 
‘‘(F) fully informs patients about the differences in 
the alternative and current tort litigation; 
‘‘(G) provides patients the ability to opt out of or volun-
tarily withdraw from participating in the alternative at 
any time and to pursue other options, including litigation, 
outside the alternative; 
‘‘(H) would not conflict with State law at the time 
of the application in a way that would prohibit the adoption 
of an alternative to current tort litigation; and 
‘‘(I) would not limit or curtail a patient’s existing legal 
rights, ability to file a claim in or access a State’s legal 
system, or otherwise abrogate a patient’s ability to file 
a medical malpractice claim. 
‘‘(3) SOURCES OF COMPENSATION.—Each State desiring a 
grant under subsection (a) shall identify the sources from and 
methods by which compensation would be paid for claims 
resolved under the proposed alternative to current tort litiga-
tion, which may include public or private funding sources, 
or a combination of such sources. Funding methods shall to 
the extent practicable provide financial incentives for activities 
that improve patient safety. 
‘‘(4) SCOPE.— 
‘‘(A) IN GENERAL.—Each State desiring a grant under 
subsection (a) shall establish a scope of jurisdiction (such 
as Statewide, designated geographic region, a designated 
area of health care practice, or a designated group of health 
care providers or health care organizations) for the pro-
posed alternative to current tort litigation that is sufficient 
to evaluate the effects of the alternative. No scope of juris-
diction shall be established under this paragraph that is 
based on a health care payer or patient population. 
‘‘(B) NOTIFICATION OF PATIENTS.—A State shall dem-
onstrate how patients would be notified that they are 
receiving health care services that fall within such scope, 
and the process by which they may opt out of or voluntarily 
withdraw from participating in the alternative. The deci-
sion of the patient whether to participate or continue 
participating in the alternative process shall be made at 
any time and shall not be limited in any way. 
‘‘(5) PREFERENCE IN AWARDING DEMONSTRATION GRANTS.— 
In awarding grants under subsection (a), the Secretary shall 
give preference to States— 
‘‘(A) that have developed the proposed alternative 
through substantive consultation with relevant stake-
holders, including patient advocates, health care providers 
and health care organizations, attorneys with expertise 
in representing patients and health care providers, medical 
malpractice insurers, and patient safety experts; 
‘‘(B) that make proposals that are likely to enhance 
patient safety by detecting, analyzing, and helping to 
reduce medical errors and adverse events; and 
‘‘(C) that make proposals that are likely to improve 
access to liability insurance. 
‘‘(d) APPLICATION.—
H. R. 3590—893 
‘‘(1) IN GENERAL.—Each State desiring a grant under sub-
section (a) shall submit to the Secretary an application, at 
such time, in such manner, and containing such information 
as the Secretary may require. 
‘‘(2) REVIEW PANEL.— 
‘‘(A) IN
GENERAL.—In reviewing applications under 
paragraph (1), the Secretary shall consult with a review 
panel composed of relevant experts appointed by the Comp-
troller General. 
‘‘(B) COMPOSITION.— 
‘‘(i) NOMINATIONS.—The Comptroller General shall 
solicit nominations from the public for individuals to 
serve on the review panel. 
‘‘(ii) 
APPOINTMENT.—The 
Comptroller 
General 
shall appoint, at least 9 but not more than 13, highly 
qualified and knowledgeable individuals to serve on 
the review panel and shall ensure that the following 
entities receive fair representation on such panel: 
‘‘(I) Patient advocates. 
‘‘(II) Health care providers and health care 
organizations. 
‘‘(III) Attorneys with expertise in representing 
patients and health care providers. 
‘‘(IV) Medical malpractice insurers. 
‘‘(V) State officials. 
‘‘(VI) Patient safety experts. 
‘‘(C) CHAIRPERSON.—The Comptroller General, or an 
individual within the Government Accountability Office 
designated by the Comptroller General, shall be the chair-
person of the review panel. 
‘‘(D) AVAILABILITY OF INFORMATION.—The Comptroller 
General shall make available to the review panel such 
information, personnel, and administrative services and 
assistance as the review panel may reasonably require 
to carry out its duties. 
‘‘(E) INFORMATION FROM AGENCIES.—The review panel 
may request directly from any department or agency of 
the United States any information that such panel con-
siders necessary to carry out its duties. To the extent 
consistent with applicable laws and regulations, the head 
of such department or agency shall furnish the requested 
information to the review panel. 
‘‘(e) REPORTS.— 
‘‘(1) BY STATE.—Each State receiving a grant under sub-
section (a) shall submit to the Secretary an annual report 
evaluating the effectiveness of activities funded with grants 
awarded under such subsection. Such report shall, at a min-
imum, include the impact of the activities funded on patient 
safety and on the availability and price of medical liability 
insurance. 
‘‘(2) BY SECRETARY.—The Secretary shall submit to Con-
gress an annual compendium of the reports submitted under 
paragraph (1) and an analysis of the activities funded under 
subsection (a) that examines any differences that result from 
such activities in terms of the quality of care, number and 
nature of medical errors, medical resources used, length of