‘‘(A) provide funding to such agencies 
through the Trust Fund under section 399OO; 
‘‘(B) establish a central registry of cer-
tified prevention health workers and prevention 
health entities; and 
‘‘(C) encourage such workers to access ad-
ditional training. 
‘‘SEC. 399OO. FUNDING FOR WELLNESS TRUST. 
‘‘(a) INITIAL FUNDING.—There is authorized to be 
appropriated and there is appropriated to the Trust Fund 
Board such sums as may be necessary to carry out sec-
tions 399MM and 399NN and other activities necessary 
for the implementation of this part. 
‘‘(b) 
ESTABLISHMENT
OF
WELLNESS
TRUST 
FUND.—Not later than January 1, 2011, there shall be 
established in the Treasury of the United States a trust 
fund to be known as the ‘Wellness Trust Fund’ (referred 
to in this section as the ‘Trust Fund’), consisting of such 
amounts as are appropriated or credited to the Fund as 
provided under this section. 
‘‘(c) APPROPRIATIONS TO THE FUND.— 
‘‘(1) FISCAL YEAR 2011.—There is hereby ap-
propriated to the Trust Fund for fiscal year 2011 an 
amount equal to the amount spent by all Federal 
health programs to pay for prevention services (as 
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defined by the Preventive Services Task Force con-
vened under section 915, except the definition of 
such services shall not be limited to those designated 
by the Task Force) in the most recent year for 
which complete data is available, as estimated by the 
Trustees. 
‘‘(2) FISCAL YEAR 2012.—There is hereby ap-
propriated to the Trust Fund for fiscal year 2012 
the amount appropriated to the Trust Fund for the 
previous fiscal year, increased by the annual percent-
age increase in the medical care component of the 
consumer price index (United States city average) 
for the 12-month period ending with April of the 
preceding fiscal year. 
‘‘(3) FISCAL
YEAR
2013
AND
SUBSEQUENT 
YEARS.—There is hereby appropriated to the Trust 
Fund for fiscal year 2013 and each subsequent fiscal 
year an amount equal to the sum of— 
‘‘(A) the amount appropriated to the Trust 
Fund for the previous fiscal year, increased by 
the annual percentage increase in the medical 
care component of the consumer price index 
(United States city average) for the 12-month 
period ending with April of the preceding fiscal 
year; 
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‘‘(B) the amount collected by the Secretary 
from health insurance issuers and applicable 
self-insured health plans under subsection (d) 
for the fiscal year; and 
‘‘(C) the amount associated with preven-
tion priorities for State and local spending, 
under-use, and the uninsured for the fiscal 
year, as estimated by the Trustees (which shall 
not exceed the amount equal to 10 percent of 
the amount otherwise appropriated to the Trust 
Fund for the fiscal year). 
‘‘(4) 
AVAILABILITY.—Amounts 
appropriated 
pursuant to this subsection shall remain available 
until expended. 
‘‘(d) ASSESSMENT OF HEALTH INSURANCE ISSUERS 
AND APPLICABLE SELF-INSURED HEALTH PLANS.— 
‘‘(1) IN
GENERAL.—Beginning in fiscal year 
2013 and on an annual basis thereafter, the Sec-
retary shall, subject to paragraph (2), assess and 
collect a fee from each health insurance issuer and 
each applicable self-insured health plan in an 
amount equal to the estimated amount spent by 
such health insurance issuer and self-insured health 
plan, respectively, for prevention services (as defined 
by the Trustees). 
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‘‘(2) COLLECTION
AMOUNT
ADJUSTMENT
BE-
GINNING IN FISCAL YEAR 2013.—The amount deter-
mined under paragraph (1) shall, on an annual 
basis, be increased by the annual percentage in-
crease in the medical care component of the con-
sumer price index (United States city average) for 
the 12-month period ending with April of the pre-
ceding fiscal year. 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) 
APPLICABLE
SELF-INSURED
HEALTH 
PLAN.—The term ‘applicable self-insured health 
plan’ means any plan for providing accident or 
health coverage if— 
‘‘(A) any portion of such coverage is pro-
vided other than through an insurance policy; 
and 
‘‘(B) such plan is established or main-
tained— 
‘‘(i) by 1 or more employers for the 
benefit of their employees or former em-
ployees; 
‘‘(ii) by 1 or more employee organiza-
tions for the benefit of their members or 
former members; 
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‘‘(iii) jointly by 1 or more employers 
and 1 or more employee organizations for 
the benefit of employees or former employ-
ees; 
‘‘(iv) by a voluntary employees’ bene-
ficiary association described in section 
501(c)(9) of the Internal Revenue Code of 
1986; 
‘‘(v) by any organization described in 
section 501(c)(6) of such Code; or 
‘‘(vi) in the case of a plan not de-
scribed in the preceding clauses, by a mul-
tiple employer welfare arrangement (as de-
fined in section 3(40) of the Employee Re-
tirement Income Security Act of 1974), a 
rural electric cooperative (as defined in 
section 3(40)(B)(iv) of such Act), or a 
rural telephone cooperative association (as 
defined in section 3(40)(B)(v) of such 
Act). 
‘‘(2) HEALTH INSURANCE ISSUER.—The term 
‘health insurance issuer’ means an insurance com-
pany, insurance service, or insurance organization 
(including a health maintenance organization, as de-
fined in paragraph (3)) which is licensed to engage 
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in the business of insurance in a State and which is 
subject to State law which regulates insurance (with-
in the meaning of section 514(b)(2) of the Employee 
Retirement Income Security Act of 1974). 
‘‘(3) HEALTH MAINTENANCE ORGANIZATION.— 
The 
term 
‘health 
maintenance 
organization’ 
means— 
‘‘(A) a Federally qualified health mainte-
nance organization (as defined in section 
1301(a)); 
‘‘(B) an organization recognized under 
State law as a health maintenance organization; 
or 
‘‘(C) a similar organization regulated 
under State law for solvency in the same man-
ner and to the same extent as such a health 
maintenance organization. 
‘‘SEC. 399PP. INSURING PREVENTION PRIORITIES. 
‘‘(a) WELLNESS TRUST AS PRIMARY PAYER FOR 
PREVENTION SERVICES.—The Trust shall enter into con-
tracts with certified prevention health workers and preven-
tion health entities to reimburse such workers and entities 
for the prevention services and community-based interven-
tions designated by the Trustees under section 399NN as 
prevention priorities. 
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‘‘(b) PRIORITIES.—The Trustees shall develop annual 
and 5-year budget targets for the designated prevention 
priorities under section 399NN, including clinical preven-
tive services and community-based interventions. The 
Trustees shall publish annually a list indicating which of 
these prevention priorities are eligible for funding through 
the Fund. 
‘‘(c) ELIGIBLE INDIVIDUALS AND ENTITIES.—Pursu-
ant to the contracts described under subsection (a), the 
Trust shall reimburse certified prevention health workers 
and prevention health entities for the prevention services 
and community-based interventions described under such 
subsection provided to all individuals who are United 
States citizens or legal immigrants, without regard to the 
insurance status of such individuals. 
‘‘(d) DEVELOPMENT, REFINEMENT, AND CHANGE OF 
PAYMENT SYSTEMS.—The Trustees shall determine pay-
ment methodologies for prevention priorities. Such pay-
ment methodologies shall correspond to the following tiers 
of activity: 
‘‘(1) COMPETITIVE
CONTRACTING
AUTHOR-
ITY.—The Trustees shall have a competitive con-
tracting authority for the national delivery system 
activities. 
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‘‘(2) DIRECT PAYMENT SYSTEMS.—The Trust-
ees shall develop different payment methodologies 
for the various designated prevention services and 
community-based interventions. These payment sys-
tems shall take into account existing rates, rates for 
similar services, and whether geographic adjustment 
is needed. Such systems shall link the priority of the 
service with payments. 
‘‘(3) USE OF STATE AND LOCAL GRANT SYS-
TEMS.—The Trustees shall utilize existing grant 
programs where feasible to distribute funds from the 
Trust Fund for prevention priorities. 
‘‘(4) REPORTS
FROM
FEDERAL
PROGRAMS.— 
Programs that receive funding for prevention prior-
ities through the Trust Fund shall report annually 
to Congress on the extent to which this funding dis-
places existing spending on prevention priorities. 
‘‘(e) PARTNERSHIP WITH MEDICARE AND OTHER IN-
SURERS.—The Trustees shall determine the most efficient 
way to transfer funds from the Trust Fund to certified 
prevention health workers and prevention health entities. 
In making such determination, the Trustees shall carry 
out the following: 
‘‘(1) COORDINATION
WITH
MEDICARE.—The 
Trustees shall examine the use of Medicare systems 
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for direct payments to certified prevention health 
workers and prevention health entities. Any addi-
tional administrative cost associated with the use of 
the payment systems, including those of a broader 
set of providers, shall come from the Trust Fund. 
‘‘(2) CONTRACT WITH OTHER INSURERS.—To 
the extent that the Medicare program, private insur-
ers, or States prove that such program, insurer, or 
State has the capacity to deliver prevention priorities 
in a cost effective manner, the Trustees may con-
tract with such entity for delivery of prevention serv-
ices covered under this Trust Fund.’’. 
SEC. 4. INTEGRATION OF PREVENTION HEALTH RECORD. 
Title XXX of the Public Health Service Act (42 
U.S.C. 300jj et seq.) is amended— 
(1) in section 3000(13)(B)— 
(A) in clause (iii), by striking ‘‘and’’ at the 
end; 
(B) in clause (iv), by striking the period at 
the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(v) to track the provision of preven-
tion health care over the course of the indi-
vidual’s lifetime and assist in evaluations 
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of the efficacy of prevention priorities des-
ignated under section 399NN.’’; 
(2) in section 3002(b)(2)(B), add at the end 
the following: 
‘‘(ix) The integration and inclusion of 
preventive and community-based health 
care services in any qualified electronic 
health record, in order to allow individuals 
and caregivers to track the provision of 
preventive health care services.’’; and 
(3) in section 3011(a), add at the end the fol-
lowing: 
‘‘(8) Integration of prevention health priorities, 
prevention data, and tracking of the provision of 
preventive care by means of qualified electronic 
health records.’’. 
Æ 
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