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ment: Provided further, That funds under this heading must 
be awarded by State housing finance agencies within 120 
days of enactment of the Act and obligated by the developer 
of the low-income housing tax credit project within one year 
of the date of enactment of this Act, shall expend 75 percent 
of the funds within two years of the date on which the funds 
become available, and shall expend 100 percent of the funds 
within 3 years of such date: Provided further, That failure 
by a developer to expend funds within the parameters re-
quired within the previous proviso shall result in a redis-
tribution of these funds by a State housing finance agency 
or by the Secretary if there is a more deserving project in 
another jurisdiction: Provided further, That projects award-
ed tax credits within 3 years prior to the date of enactment 
of this Act shall be eligible for funding under this heading: 
Provided further, That as part of the review, the Secretary 
shall ensure equitable distribution of funds and an appro-
priate balance in addressing the needs of urban and rural 
communities with a special priority on areas that have suf-
fered from excessive job loss and foreclosures: Provided fur-
ther, That State housing finance agencies shall give priority 
to projects that require an additional share of Federal funds 
in order to complete an overall funding package, and to 
projects that are expected to be completed within 3 years 
of enactment: Provided further, That any assistance pro-
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vided to an eligible low-income housing tax credit project 
under this heading shall be made in the same manner and 
be subject to the same limitations (including rent, income, 
and use restrictions) as an allocation of the housing credit 
amount allocated by the State housing finance agency 
under section 42 of the I.R.C. of 1986, except that such as-
sistance shall not be limited by, or otherwise affect (except 
as provided in subsection (h)(3)(J) of such section), the 
State housing finance agency applicable to such agency: 
Provided further, That the State housing finance agency 
shall perform asset management functions to ensure compli-
ance with section 42 of the I.R.C. of 1986, and the long 
term viability of buildings funded by assistance under this 
heading: Provided further, That the term basis (as such 
term is defined in such section 42) of a qualified low-income 
housing tax credit building receiving assistance under this 
heading shall not be reduced by the amount of any grant 
described under this heading: Provided further, That the 
Secretary shall collect all information related to the award 
of Federal funds from state housing finance agencies and 
establish an internet site that shall identify all projects se-
lected for an award, including the amount of the award 
as well as the process and all information that was used 
to make the award decision. 
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HOMELESSNESS PREVENTION FUND 
For homelessness prevention activities, $1,500,000,000, 
to remain available until September 30, 2011: Provided, 
That funds provided under this heading shall be used for 
the provision of short-term or medium-term rental assist-
ance; housing relocation and stabilization services includ-
ing housing search, mediation or outreach to property own-
ers, credit repair, security or utility deposits, utility pay-
ments, rental assistance for a final month at a location, 
and moving cost assistance; or other appropriate homeless-
ness prevention activities: Provided further, That grantees 
receiving such assistance shall collect data on the use of the 
funds awarded and persons served with this assistance in 
the Homeless Management Information System (HMIS) or 
other comparable database: Provided further, That grantees 
may use up to 5 percent of any grant for administrative 
costs: Provided further, That funding made available under 
this heading shall be allocated to eligible grantees (as de-
fined and designated in sections 411 and 412 of subtitle 
B of title IV of the McKinney-Vento Homeless Assistance 
Act, (the ‘‘Act’’)) pursuant to the formula authorized by sec-
tion 413 of the Act: Provided further, That the Secretary 
may establish a minimum grant size: Provided further, 
That grantees shall expend at least 75 percent of funds with-
in 2 years of the date that funds became available to them 
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for obligation, and 100 percent of funds within 3 years of 
such date, and the Secretary may recapture unexpended 
funds in violation of the 2-year expenditure requirement 
and reallocate such funds to grantees in compliance with 
that requirement: Provided further, That the Secretary may 
waive statutory or regulatory provisions (except provisions 
for fair housing, nondiscrimination, labor standards, and 
the environment) necessary to facilitate the timely expendi-
ture of funds: Provided further, That the Secretary shall 
publish a notice to establish such requirements as may be 
necessary to carry out the provisions of this section within 
30 days of enactment of the Act and that this notice shall 
take effect upon issuance: Provided further, That of the 
funds provided under this heading, up to 1.5 percent shall 
be available for staffing, training, technical assistance, tech-
nology, monitoring, research and evaluation activities: Pro-
vided further, That any funds made available under this 
heading used by the Secretary for personnel expense shall 
be transferred to and merged with funding provided to 
‘‘Community Planning and Development Personnel Com-
pensation and Benefits’’: Provided further, That any funds 
made available under this heading used by the Secretary 
for training or other administrative expenses shall be trans-
ferred to and merged with funding provided to ‘‘Adminis-
tration, Operations, and Management’’ for non-personnel 
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expenses of the Department of Housing and Urban Develop-
ment: Provided further, That any funding made available 
under this heading used by the Secretary for technology 
shall be transferred to and merged with the funding pro-
vided to ‘‘Working Capital Fund.’’ 
ASSISTED HOUSING STABILITY AND ENERGY AND GREEN 
RETROFIT INVESTMENTS 
For assistance to owners of properties receiving 
project-based assistance pursuant to section 202 of the 
Housing Act of 1959 (12 U.S.C. 17012), section 811 of the 
Cranston-Gonzalez National Affordable Housing Act (42 
U.S.C. 8013), or section 8 of the United States Housing 
Act of 1937 as amended (42 U.S.C. 1437f), $2,250,000,000, 
of which $2,132,000,000 shall be for an additional amount 
for paragraph (1) under the heading ‘‘Project-Based Rental 
Assistance’’ in Public Law 110–161 for payments to owners 
for 12-month periods, and of which $118,000,000 shall be 
for grants or loans for energy retrofit and green investments 
in such assisted housing: Provided, That projects funded 
with grants or loans provided under this heading must com-
ply with the requirements of subchapter IV of chapter 31 
of title 40, United States Code: Provided further, That such 
grants or loans shall be provided through the existing poli-
cies, procedures, contracts, and transactional infrastructure 
of the authorized programs administered by the Office of 
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Affordable Housing Preservation of the Department of 
Housing and Urban Development, on such terms and condi-
tions as the Secretary of Housing and Urban Development 
deems appropriate to ensure the maintenance and preserva-
tion of the property, the continued operation and mainte-
nance of energy efficiency technologies, and the timely ex-
penditure of funds: Provided further, That the Secretary 
may provide incentives to owners to undertake energy or 
green retrofits as a part of such grant or loan terms, includ-
ing, but not limited to, investment fees to cover oversight 
and implementation costs incurred by said owner, or to en-
courage job creation for low-income or very low-income in-
dividuals: Provided further, That the grants or loans shall 
include a financial assessment and physical inspection of 
such property: Provided further, That eligible owners must 
have at least a satisfactory management review rating, be 
in substantial compliance with applicable performance 
standards and legal requirements, and commit to an addi-
tional period of affordability determined by the Secretary, 
but of not fewer than 15 years: Provided further, That the 
Secretary shall undertake appropriate underwriting and 
oversight with respect to grant and loan transactions and 
may set aside up to 5 percent of the funds made available 
under this heading for grants or loans for such purpose: 
Provided further, That the Secretary shall take steps nec-
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essary to ensure that owners receiving funding for energy 
and green retrofit investments under this heading shall ex-
pend such funding within 2 years of the date they received 
the funding: Provided further, That the Secretary may 
waive or modify statutory or regulatory requirements with 
respect to any existing grant, loan, or insurance mechanism 
authorized to be used by the Secretary to enable or facilitate 
the accomplishment of investments supported with funds 
made available under this heading for grants or loans: Pro-
vided further, That of the funds provided under this head-
ing, up to 1.5 percent shall be available for staffing, train-
ing, technical assistance, technology, monitoring, research 
and evaluation activities: Provided further, That funding 
made available under this heading and used by the Sec-
retary for personnel expenses shall be transferred to and 
merged with funding provided to ‘‘Housing Compensation 
and Benefits’’: Provided further, That any funding made 
available under this heading used by the Secretary for 
training and other administrative expenses shall be trans-
ferred to and merged with funding provided to ‘‘Adminis-
tration, Operations and Management’’ for non-personnel 
expenses of the Department of Housing and Urban Develop-
ment: Provided further, That any funding made available 
under this heading used by the Secretary for technology 
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shall be transferred to and merged with funding provided 
to ‘‘Working Capital Fund.’’ 
OFFICE OF HEALTHY HOMES AND LEAD HAZARD 
CONTROL 
For an additional amount for the ‘‘Lead Hazard Re-
duction’’, as authorized by section 1011 of the Residential 
Lead-Based Paint Hazard Reduction Act of 1992, 
$100,000,000, to remain available until September 30, 
2011: Provided, That funds shall be awarded first to appli-
cant jurisdictions which had applied under the Lead-Based 
Paint Hazard Control Grant Program Notice of Funding 
Availability for fiscal year 2008, and were found in the 
application review to be qualified for award, but were not 
awarded because of funding limitations, and that any funds 
which remain after reservation of funds for such grants 
shall be added to the amount of funds to be awarded under 
the Lead-Based Paint Hazard Control Grant Program No-
tice of Funding Availability for fiscal year 2009: Provided 
further, That each applicant jurisdiction for the Lead- 
Based Paint Hazard control Grant Program Notice of 
Funding Availability for fiscal year 2009 shall submit a 
detailed plan and strategy that demonstrates adequate ca-
pacity that is acceptable to the Secretary to carry out the 
proposed use of funds: Provided further, That recipients of 
funds under this heading shall obligate 100 percent of such 
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funds within 1 year of the date of enactment of this Act, 
expend at least 75 percent of such funds within 2 years 
of the date on which funds become available to such jurisdic-
tions for obligation, and expend 100 percent of such funds 
within 3 years of such date: Provided further, That if a 
recipient fails to comply with either the 1-year obligation 
requirement or the 2-year expenditure requirement, the Sec-
retary shall recapture all remaining funds awarded to the 
recipient and reallocate such funds to recipients that are 
in compliance with those requirements: Provided further, 
That if a recipient fails to comply with the 3-year expendi-
ture requirement, the Secretary shall recapture the balance 
of the funds awarded to the recipient: Provided further, 
That in administering funds provided in this heading, the 
Secretary may waive any provision of any statute or regu-
lation that the Secretary administers in connection with 
the obligation by the Secretary or the use by the recipient 
of these funds except for requirements imposed by this head-
ing and requirements related to fair housing, non-
discrimination, labor standards, and the environment, 
upon a finding that such waiver is required to facilitate 
the timely use of such funds and would not be inconsistent 
with the overall purpose of the statute or regulation: Pro-
vided further, That, of the funds made available under this 
heading, up to 1 percent shall be available for staffing, 
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training, technical assistance, technology, monitoring, re-
search and evaluation activities: Provided further, That 
any funds made available under this heading used by the 
Secretary for personnel expenses shall be transferred to and 
merged with funding provided to ‘‘Personnel Compensation 
and Benefits, Office of Healthy Homes and Lead Hazard 
Control’’: Provided further, That any funds made available 
under this heading used by the Secretary for training or 
other administrative expenses shall be transferred to and 
merged with funding provided to ‘‘Administration, Oper-
ations, and Management’’, for non-personnel expenses of the 
Department of Housing and Urban Development: Provided 
further, That any funds made available under this heading 
used by the Secretary for technology shall be transferred to 
and merged with the funding provided to ‘‘Working Capital 
Fund’’. 
OFFICE OF INSPECTOR GENERAL 
For an additional amount for the necessary salaries 
and expenses of the Office of Inspector General in carrying 
out the Inspector General Act of 1978, as amended, 
$2,750,000, to remain available until September 30, 2011, 
and an additional $12,250,000 for such purposes, to remain 
available until September 30, 2012: Provided, That the In-
spector General shall have independent authority over all 
personnel issues within this office. 
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TITLE XIII—HEALTH 
INFORMATION TECHNOLOGY 
SEC. 1301. SHORT TITLE. 
This title may be cited as the ‘‘Health Information 
Technology for Economic and Clinical Health Act’’ or the 
‘‘HITECH Act’’. 
Subtitle A—Promotion of Health 
Information Technology 
PART I—IMPROVING HEALTH CARE QUALITY, 
SAFETY, AND EFFICIENCY 
SEC. 13101. ONCHIT; STANDARDS DEVELOPMENT AND 
ADOPTION. 
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. 3000. DEFINITIONS. 
‘‘In this title: 
‘‘(1) CERTIFIED EHR TECHNOLOGY.—The term 
‘certified EHR technology’ means a qualified elec-
tronic health record and that is certified pursuant to 
section 3001(c)(5) as meeting standards adopted 
under section 3004 that are applicable to the type of 
record involved (as determined by the Secretary, such 
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as an ambulatory electronic health record for office- 
based physicians or an inpatient hospital electronic 
health record for hospitals). 
‘‘(2) ENTERPRISE INTEGRATION.—The term ‘en-
terprise integration’ means the electronic linkage of 
health care providers, health plans, the government, 
and other interested parties, to enable the electronic 
exchange and use of health information among all the 
components in the health care infrastructure in ac-
cordance with applicable law, and such term includes 
related application protocols and other related stand-
ards. 
‘‘(3) 
HEALTH
CARE
PROVIDER.—The 
term 
‘health care provider’ means a hospital, skilled nurs-
ing facility, nursing facility, home health entity, or 
other long-term care facility, health care clinic, com-
munity mental health center (as defined in section 
1913(b)), renal dialysis facility, blood center, ambula-
tory surgical center described in section 1833(i) of the 
Social Security Act, emergency medical services pro-
vider, Federally qualified health center, group prac-
tice (as defined in section 1877(h)(4) of the Social Se-
curity Act), a pharmacist, a pharmacy, a laboratory, 
a physician (as defined in section 1861(r) of the So-
cial Security Act), a practitioner (as described in sec-
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‘‘(A) includes patient demographic and 
clinical health information, such as medical his-
tory and problem lists; and 
‘‘(B) has the capacity— 
‘‘(i) to provide clinical decision sup-
port; 
‘‘(ii) to support physician order entry; 
‘‘(iii) to capture and query informa-
tion relevant to health care quality; and 
‘‘(iv) to exchange electronic health in-
formation with, and integrate such infor-
mation from other sources. 
‘‘(14) 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. 
‘‘Subtitle A—Promotion of Health 
Information Technology 
‘‘SEC. 3001. OFFICE OF THE NATIONAL COORDINATOR FOR 
HEALTH INFORMATION TECHNOLOGY. 
‘‘(a) ESTABLISHMENT.—There is established within 
the Department of Health and Human Services an Office 
of the National Coordinator for Health Information Tech-
nology (referred to in this section as the ‘Office’). The Office 
shall be headed by a National Coordinator who shall be ap-
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pointed by the Secretary and shall report directly to the 
Secretary. 
‘‘(b) PURPOSE.—The National Coordinator shall per-
form the duties under subsection (c) in a manner consistent 
with the development of a nationwide health information 
technology infrastructure that allows for the electronic use 
and exchange of information and that— 
‘‘(1) ensures that each patient’s health informa-
tion is secure and protected, in accordance with ap-
plicable law; 
‘‘(2) improves health care quality, reduces med-
ical errors, and advances the delivery of patient-cen-
tered medical care; 
‘‘(3) reduces health care costs resulting from inef-
ficiency, medical errors, inappropriate care, duplica-
tive care, and incomplete information; 
‘‘(4) provides appropriate information to help 
guide medical decisions at the time and place of care; 
‘‘(5) ensures the inclusion of meaningful public 
input in such development of such infrastructure; 
‘‘(6) improves the coordination of care and infor-
mation among hospitals, laboratories, physician of-
fices, and other entities through an effective infra-
structure for the secure and authorized exchange of 
health care information; 
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‘‘(7) improves public health activities and facili-
tates the early identification and rapid response to 
public health threats and emergencies, including bio-
terror events and infectious disease outbreaks; 
‘‘(8) facilitates health and clinical research and 
health care quality; 
‘‘(9) promotes early detection, prevention, and 
management of chronic diseases; 
‘‘(10) promotes a more effective marketplace, 
greater competition, greater systems analysis, in-
creased consumer choice, and improved outcomes in 
health care services; and 
‘‘(11) improves efforts to reduce health dispari-
ties. 
‘‘(c) DUTIES OF THE NATIONAL COORDINATOR.— 
‘‘(1) STANDARDS.—The National Coordinator 
shall— 
‘‘(A) review and determine whether to en-
dorse each standard, implementation specifica-
tion, and certification criterion for the electronic 
exchange and use of health information that is 
recommended by the HIT Standards Committee 
under section 3003 for purposes of adoption 
under section 3004; 
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‘‘(B) make such determinations under sub-
paragraph (A), and report to the Secretary such 
determinations, not later than 45 days after the 
date the recommendation is received by the Coor-
dinator; 
‘‘(C) review Federal health information 
technology investments to ensure that Federal 
health information technology programs are 
meeting the objectives of the strategic plan pub-
lished under paragraph (3); and 
‘‘(D) provide comments and advice regard-
ing specific Federal health information tech-
nology programs, at the request of the Office of 
Management and Budget. 
‘‘(2) HIT POLICY COORDINATION.— 
‘‘(A) IN GENERAL.—The National Coordi-
nator shall coordinate health information tech-
nology policy and programs of the Department 
with those of other relevant executive branch 
agencies with a goal of avoiding duplication of 
efforts and of helping to ensure that each agency 
undertakes health information technology activi-
ties primarily within the areas of its greatest ex-
pertise and technical capability and in a man-
ner towards a coordinated national goal. 
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‘‘(B) HIT POLICY AND STANDARDS COMMIT-
TEES.—The National Coordinator shall be a 
leading member in the establishment and oper-
ations of the HIT Policy Committee and the 
HIT Standards Committee and shall serve as a 
liaison among those two Committees and the 
Federal Government. 
‘‘(3) STRATEGIC PLAN.— 
‘‘(A) IN GENERAL.—The National Coordi-
nator shall, in consultation with other appro-
priate Federal agencies (including the National 
Institute of Standards and Technology), update 
the Federal Health IT Strategic Plan (developed 
as of June 3, 2008) to include specific objectives, 
milestones, and metrics with respect to the fol-
lowing: 
‘‘(i) The electronic exchange and use of 
health information and the enterprise inte-
gration of such information. 
‘‘(ii) The utilization of an electronic 
health record for each person in the United 
States by 2014. 
‘‘(iii) The incorporation of privacy 
and security protections for the electronic 
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exchange of an individual’s individually 
identifiable health information. 
‘‘(iv) Ensuring security methods to en-
sure appropriate authorization and elec-
tronic authentication of health information 
and specifying technologies or methodologies 
for rendering health information unusable, 
unreadable, or indecipherable. 
‘‘(v) Specifying a framework for co-
ordination and flow of recommendations 
and policies under this subtitle among the 
Secretary, the National Coordinator, the 
HIT Policy Committee, the HIT Standards 
Committee, and other health information 
exchanges and other relevant entities. 
‘‘(vi) Methods to foster the public un-
derstanding of health information tech-
nology. 
‘‘(vii) Strategies to enhance the use of 
health information technology in improving 
the quality of health care, reducing medical 
errors, reducing health disparities, improv-
ing public health, increasing prevention and 
coordination with community resources, 
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and improving the continuity of care 
among health care settings. 
‘‘(viii) Specific plans for ensuring that 
populations with unique needs, such as chil-
dren, are appropriately addressed in the 
technology design, as appropriate, which 
may include technology that automates en-
rollment and retention for eligible individ-
uals. 
‘‘(B) COLLABORATION.—The strategic plan 
shall be updated through collaboration of public 
and private entities. 
‘‘(C) MEASURABLE OUTCOME GOALS.—The 
strategic plan update shall include measurable 
outcome goals. 
‘‘(D) PUBLICATION.—The National Coordi-
nator shall republish the strategic plan, includ-
ing all updates. 
‘‘(4) WEBSITE.—The National Coordinator shall 
maintain and frequently update an Internet website 
on which there is posted information on the work, 
schedules, reports, recommendations, and other infor-
mation to ensure transparency in promotion of a na-
tionwide health information technology infrastruc-
ture. 
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‘‘(5) HARMONIZATION.—The Secretary may rec-
ognize an entity or entities for the purpose of harmo-
nizing or updating standards and implementation 
specifications in order to achieve uniform and con-
sistent implementation of the standards and imple-
mentation specifications. 
‘‘(6) CERTIFICATION.— 
‘‘(A) IN GENERAL.—The National Coordi-
nator, in consultation with the Director of the 
National Institute of Standards and Technology, 
shall recognize a program or programs for the 
voluntary certification of health information 
technology as being in compliance with applica-
ble certification criteria adopted under this sub-
title. Such program shall include, as appro-
priate, testing of the technology in accordance 
with section 14201(b) of the Health Information 
Technology for Economic and Clinical Health 
Act. 
‘‘(B) 
CERTIFICATION
CRITERIA
DE-
SCRIBED.—In this title, the term ‘certification 
criteria’ means, with respect to standards and 
implementation specifications for health infor-
mation technology, criteria to establish that the 
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technology meets such standards and implemen-
tation specifications. 
‘‘(6) REPORTS AND PUBLICATIONS.— 
‘‘(A) REPORT ON ADDITIONAL FUNDING OR 
AUTHORITY NEEDED.—Not later than 12 months 
after the date of the enactment of this title, the 
National Coordinator shall submit to the appro-
priate committees of jurisdiction of the House of 
Representatives and the Senate a report on any 
additional funding or authority the Coordinator 
or the HIT Policy Committee or HIT Standards 
Committee requires to evaluate and develop 
standards, implementation specifications, and 
certification criteria, or to achieve full participa-
tion of stakeholders in the adoption of a nation-
wide health information technology infrastruc-
ture that allows for the electronic use and ex-
change of health information. 
‘‘(B) IMPLEMENTATION REPORT.—The Na-
tional Coordinator shall prepare a report that 
identifies lessons learned from major public and 
private health care systems in their implementa-
tion of health information technology, including 
information on whether the technologies and 
practices developed by such systems may be ap-
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plicable to and usable in whole or in part by 
other health care providers. 
‘‘(C) ASSESSMENT OF IMPACT OF HIT ON 
COMMUNITIES WITH HEALTH DISPARITIES AND 
UNINSURED, UNDERINSURED, AND
MEDICALLY 
UNDERSERVED
AREAS.—The National Coordi-
nator shall assess and publish the impact of 
health information technology in communities 
with health disparities and in areas with a high 
proportion of individuals who are uninsured, 
underinsured, and medically underserved indi-
viduals (including urban and rural areas) and 
identify practices to increase the adoption of 
such technology by health care providers in such 
communities, and the use of health information 
technology to reduce and better manage chronic 
diseases. 
‘‘(D) EVALUATION OF BENEFITS AND COSTS 
OF THE ELECTRONIC USE AND EXCHANGE OF 
HEALTH
INFORMATION.—The National Coordi-
nator shall evaluate and publish evidence on the 
benefits and costs of the electronic use and ex-
change of health information and assess to whom 
these benefits and costs accrue. 
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(E) RESOURCE REQUIREMENTS.—The Na-
tional Coordinator shall estimate and publish re-
sources required annually to reach the goal of 
utilization of an electronic health record for each 
person in the United States by 2014, includ-
ing— 
(i) the required level of Federal fund-
ing; 
(ii) expectations for regional, State, 
and private investment; 
(iii) the expected contributions by vol-
unteers to activities for the utilization of 
such records; and 
(iv) the resources needed to establish or 
expand education programs in medical and 
health informatics and health information 
management to train health care and infor-
mation technology students and provide a 
health information technology workforce suf-
ficient to ensure the rapid and effective de-
ployment and utilization of health informa-
tion technologies. 
‘‘(7) ASSISTANCE.—The National Coordinator 
may provide financial assistance to consumer advo-
cacy groups and not-for-profit entities that work in 
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the public interest for purposes of defraying the cost 
to such groups and entities to participate under, 
whether in whole or in part, the National Technology 
Transfer Act of 1995 (15 U.S.C. 272 note). 
‘‘(8) GOVERNANCE FOR NATIONWIDE HEALTH IN-
FORMATION
NETWORK.—The National Coordinator 
shall establish a governance mechanism for the na-
tionwide health information network. 
‘‘(d) DETAIL OF FEDERAL EMPLOYEES.— 
‘‘(1) IN GENERAL.—Upon the request of the Na-
tional Coordinator, the head of any Federal agency is 
authorized to detail, with or without reimbursement 
from the Office, any of the personnel of such agency 
to the Office to assist it in carrying out its duties 
under this section. 
‘‘(2) EFFECT OF DETAIL.—Any detail of per-
sonnel under paragraph (1) shall— 
‘‘(A) not interrupt or otherwise affect the 
civil service status or privileges of the Federal 
employee; and 
‘‘(B) be in addition to any other staff of the 
Department employed by the National Coordi-
nator. 
‘‘(3) ACCEPTANCE
OF
DETAILEES.—Notwith-
standing any other provision of law, the Office may 
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accept detailed personnel from other Federal agencies 
without regard to whether the agency described under 
paragraph (1) is reimbursed. 
‘‘(e) CHIEF PRIVACY OFFICER OF THE OFFICE OF THE 
NATIONAL COORDINATOR.—Not later than 12 months after 
the date of the enactment of this title, the Secretary shall 
appoint a Chief Privacy Officer of the Office of the National 
Coordinator, whose duty it shall be to advise the National 
Coordinator on privacy, security, and data stewardship of 
electronic health information and to coordinate with other 
Federal agencies (and similar privacy officers in such agen-
cies), with State and regional efforts, and with foreign 
countries with regard to the privacy, security, and data 
stewardship of electronic individually identifiable health 
information. 
‘‘SEC. 3002. HIT POLICY COMMITTEE. 
‘‘(a) ESTABLISHMENT.—There is established a HIT 
Policy Committee to make policy recommendations to the 
National Coordinator relating to the implementation of a 
nationwide health information technology infrastructure, 
including implementation of the strategic plan described in 
section 3001(c)(3). 
‘‘(b) DUTIES.— 
‘‘(1) RECOMMENDATIONS ON HEALTH INFORMA-
TION TECHNOLOGY INFRASTRUCTURE.—The HIT Pol-
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icy Committee shall recommend a policy framework 
for the development and adoption of a nationwide 
health information technology infrastructure that per-
mits the electronic exchange and use of health infor-
mation as is consistent with the strategic plan under 
section 3001(c)(3) and that includes the recommenda-
tions under paragraph (2). The Committee shall up-
date such recommendations and make new rec-
ommendations as appropriate. 
‘‘(2) SPECIFIC AREAS OF STANDARD DEVELOP-
MENT.— 
‘‘(A) IN GENERAL.—The HIT Policy Com-
mittee shall recommend the areas in which 
standards, implementation specifications, and 
certification criteria are needed for the electronic 
exchange and use of health information for pur-
poses of adoption under section 3004 and shall 
recommend an order of priority for the develop-
ment, harmonization, and recognition of such 
standards, specifications, and certification cri-
teria among the areas so recommended. Such 
standards and implementation specifications 
shall include named standards, architectures, 
and software schemes for the authentication and 
security of individually identifiable health infor-
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mation and other information as needed to en-
sure the reproducible development of common so-
lutions across disparate entities. 
‘‘(B) AREAS
REQUIRED
FOR
CONSIDER-
ATION.—For purposes of subparagraph (A), the 
HIT Policy Committee shall make recommenda-
tions for at least the following areas: 
‘‘(i) Technologies that protect the pri-
vacy of health information and promote se-
curity in a qualified electronic health 
record, including for the segmentation and 
protection from disclosure of specific and 
sensitive individually identifiable health in-
formation with the goal of minimizing the 
reluctance of patients to seek care (or dis-
close information about a condition) be-
cause of privacy concerns, in accordance 
with applicable law, and for the use and 
disclosure of limited data sets of such infor-
mation. 
‘‘(ii) A nationwide health information 
technology infrastructure that allows for the 
electronic use and accurate exchange of 
health information. 
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‘‘(iii) The utilization of a certified elec-
tronic health record for each person in the 
United States by 2014. 
‘‘(iv) Technologies that as a part of a 
qualified electronic health record allow for 
an accounting of disclosures made by a cov-
ered entity (as defined for purposes of regu-
lations promulgated under section 264(c) of 
the Health Insurance Portability and Ac-
countability Act of 1996) for purposes of 
treatment, payment, and health care oper-
ations (as such terms are defined for pur-
poses of such regulations). 
‘‘(v) The use of certified electronic 
health records to improve the quality of 
health care, such as by promoting the co-
ordination of health care and improving 
continuity of health care among health care 
providers, by reducing medical errors, by 
improving 
population 
health, 
reducing 
chronic disease, and by advancing research 
and education. 
‘‘(vi) The use of electronic systems to 
ensure the comprehensive collection of pa-
tient demographic data, including, at a 
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minimum, race, ethnicity, primary lan-
guage, and gender information. 
‘‘(vii) Technologies and design features 
that address the needs of children and other 
vulnerable populations. 
‘‘(C) OTHER AREAS FOR CONSIDERATION.— 
In making recommendations under subpara-
graph (A), the HIT Policy Committee may con-
sider the following additional areas: 
‘‘(i) The appropriate uses of a nation-
wide health information infrastructure, in-
cluding for purposes of— 
‘‘(I) the collection of quality data 
and public reporting; 
‘‘(II) biosurveillance and public 
health; 
‘‘(III) medical and clinical re-
search; and 
‘‘(IV) drug safety. 
‘‘(ii) Self-service technologies that fa-
cilitate the use and exchange of patient in-
formation and reduce wait times. 
‘‘(iii) Telemedicine technologies, in 
order to reduce travel requirements for pa-
tients in remote areas. 
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improve the quality and efficiency of health 
care. 
‘‘(3) FORUM.—The HIT Policy Committee shall 
serve as a forum for broad stakeholder input with spe-
cific expertise in policies relating to the matters de-
scribed in paragraphs (1) and (2). 
‘‘(4) CONSISTENCY
WITH
EVALUATION
CON-
DUCTED UNDER MIPPA.— 
‘‘(A) REQUIREMENT
FOR
CONSISTENCY.— 
The HIT Policy Committee shall ensure that rec-
ommendations made under paragraph (2)(B)(vi) 
are consistent with the evaluation conducted 
under section 1809(a) of the Social Security Act. 
‘‘(B) SCOPE.—Nothing in subparagraph (A) 
shall be construed to limit the recommendations 
under paragraph (2)(B)(vi) to the elements de-
scribed in section 1809(a)(3) of the Social Secu-
rity Act. 
‘‘(C) TIMING.—The requirement under sub-
paragraph (A) shall be applicable to the extent 
that evaluations have been conducted under sec-
tion 1809(a) of the Social Security Act, regard-
less of whether the report described in subsection 
(b) of such section has been submitted. 
‘‘(c) MEMBERSHIP AND OPERATIONS.— 
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‘‘(1) IN
GENERAL.—The National Coordinator 
shall provide leadership in the establishment and op-
erations of the HIT Policy Committee. 
‘‘(2) MEMBERSHIP.—The HIT Policy Committee 
shall be composed of members to be appointed as fol-
lows: 
‘‘(A) One member shall be appointed by the 
Secretary. 
‘‘(B) One member shall be appointed by the 
Secretary of Veterans Affairs who shall represent 
the Department of Veterans Affairs. 
‘‘(C) One member shall be appointed by the 
Secretary of Defense who shall represent the De-
partment of Defense. 
‘‘(D) One member shall be appointed by the 
Majority Leader of the Senate. 
‘‘(E) One member shall be appointed by the 
Minority Leader of the Senate. 
‘‘(F) One member shall be appointed by the 
Speaker of the House of Representatives. 
‘‘(G) One member shall be appointed by the 
Minority Leader of the House of Representatives. 
‘‘(H) Eleven members shall be appointed by 
the Comptroller General of the United States, of 
whom— 
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‘‘(i) three members shall represent pa-
tients or consumers; 
‘‘(ii) one member shall represent health 
care providers; 
‘‘(iii) one member shall be from a labor 
organization representing health care work-
ers; 
‘‘(iv) one member shall have expertise 
in privacy and security; 
‘‘(v) one member shall have expertise 
in improving the health of vulnerable popu-
lations; 
‘‘(vi) one member shall represent health 
plans or other third party payers; 
‘‘(vii) one member shall represent in-
formation technology vendors; 
‘‘(viii) one member shall represent pur-
chasers or employers; and 
‘‘(ix) one member shall have expertise 
in health care quality measurement and re-
porting. 
‘‘(3) CHAIRPERSON AND VICE CHAIRPERSON.— 
The HIT Policy Committee shall designate one mem-
ber to serve as the chairperson and one member to 
serve as the vice chairperson of the Policy Committee. 
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‘‘(4) NATIONAL
COORDINATOR.—The National 
Coordinator shall serve as a member of the HIT Pol-
icy Committee and act as a liaison among the HIT 
Policy Committee, the HIT Standards Committee, 
and the Federal Government. 
‘‘(5) PARTICIPATION.—The members of the HIT 
Policy Committee appointed under paragraph (2) 
shall represent a balance among various sectors of the 
health care system so that no single sector unduly in-
fluences the recommendations of the Policy Com-
mittee. 
‘‘(6) TERMS.— 
‘‘(A) IN GENERAL.—The terms of the mem-
bers of the HIT Policy Committee shall be for 3 
years, except that the Comptroller General shall 
designate staggered terms for the members first 
appointed. 
‘‘(B) VACANCIES.—Any member appointed 
to fill a vacancy in the membership of the HIT 
Policy Committee that occurs prior to the expi-
ration of the term for which the member’s prede-
cessor 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 
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HIT Policy Committee shall be filled in the 
manner in which the original appointment was 
made. 
‘‘(7) OUTSIDE INVOLVEMENT.—The HIT Policy 
Committee shall ensure an adequate opportunity for 
the participation of outside advisors, including indi-
viduals with expertise in— 
‘‘(A) health information privacy and secu-
rity; 
‘‘(B) improving the health of vulnerable 
populations; 
‘‘(C) health care quality and patient safety, 
including individuals with expertise in the meas-
urement and use of health information tech-
nology to capture data to improve health care 
quality and patient safety; 
‘‘(D) long-term care and aging services; 
‘‘(E) medical and clinical research; and 
‘‘(F) data exchange and developing health 
information technology standards and new 
health information technology. 
‘‘(8) QUORUM.—Ten members of the HIT Policy 
Committee shall constitute a quorum for purposes of 
voting, but a lesser number of members may meet and 
hold hearings. 
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‘‘(9) FAILURE OF INITIAL APPOINTMENT.—If, on 
the date that is 45 days after the date of enactment 
of this title, an official authorized under paragraph 
(2) to appoint one or more members of the HIT Pol-
icy Committee has not appointed the full number of 
members that such paragraph authorizes such official 
to appoint— 
‘‘(A) the number of members that such offi-
cial is authorized to appoint shall be reduced to 
the number that such official has appointed as of 
that date; and 
‘‘(B) the number prescribed in paragraph 
(8) as the quorum shall be reduced to the small-
est whole number that is greater than one-half of 
the total number of members who have been ap-
pointed as of that date. 
‘‘(10) CONSIDERATION.—The National Coordi-
nator shall ensure that the relevant recommendations 
and comments from the National Committee on Vital 
and Health Statistics are considered in the develop-
ment of policies. 
‘‘(d) APPLICATION OF FACA.—The Federal Advisory 
Committee Act (5 U.S.C. App.), other than section 14 of 
such Act, shall apply to the HIT Policy Committee. 
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‘‘(e) PUBLICATION.—The Secretary shall provide for 
publication in the Federal Register and the posting on the 
Internet website of the Office of the National Coordinator 
for Health Information Technology of all policy rec-
ommendations made by the HIT Policy Committee under 
this section. 
‘‘SEC. 3003. HIT STANDARDS COMMITTEE. 
‘‘(a) ESTABLISHMENT.—There is established a com-
mittee to be known as the HIT Standards Committee to 
recommend to the National Coordinator standards, imple-
mentation specifications, and certification criteria for the 
electronic exchange and use of health information for pur-
poses of adoption under section 3004, consistent with the 
implementation of the strategic plan described in section 
3001(c)(3) and beginning with the areas listed in section 
3002(b)(2)(B) in accordance with policies developed by the 
HIT Policy Committee. 
‘‘(b) DUTIES.— 
‘‘(1) STANDARD DEVELOPMENT.— 
‘‘(A) IN
GENERAL.—The HIT Standards 
Committee shall recommend to the National Co-
ordinator standards, implementation specifica-
tions, and certification criteria described in sub-
section (a) that have been developed, harmonized, 
or recognized by the HIT Standards Committee. 
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range of stakeholders to provide input on the develop-
ment, harmonization, and recognition of standards, 
implementation specifications, and certification cri-
teria necessary for the development and adoption of 
a nationwide health information technology infra-
structure that allows for the electronic use and ex-
change of health information. 
‘‘(3) SCHEDULE.—Not later than 90 days after 
the date of the enactment of this title, the HIT Stand-
ards Committee shall develop a schedule for the assess-
ment of policy recommendations developed by the 
HIT Policy Committee under section 3002. The HIT 
Standards Committee shall update such schedule an-
nually. The Secretary shall publish such schedule in 
the Federal Register. 
‘‘(4) PUBLIC INPUT.—The HIT Standards Com-
mittee shall conduct open public meetings and develop 
a process to allow for public comment on the schedule 
described in paragraph (3) and recommendations de-
scribed in this subsection. Under such process com-
ments shall be submitted in a timely manner after the 
date of publication of a recommendation under this 
subsection. 
‘‘(5) CONSIDERATION.—The National Coordi-
nator shall ensure that the relevant recommendations 
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and comments from the National Committee on Vital 
and Health Statistics are considered in the develop-
ment of standards. 
‘‘(c) MEMBERSHIP AND OPERATIONS.— 
‘‘(1) IN
GENERAL.—The National Coordinator 
shall provide leadership in the establishment and op-
erations of the HIT Standards Committee. 
‘‘(2) MEMBERSHIP.—The membership of the HIT 
Standards Committee shall at least reflect providers, 
ancillary healthcare workers, consumers, purchasers, 
health plans, technology vendors, researchers, relevant 
Federal agencies, and individuals with technical ex-
pertise on health care quality, privacy and security, 
and on the electronic exchange and use of health in-
formation. 
‘‘(3) BROAD
PARTICIPATION.—There is broad 
participation in the HIT Standards Committee by a 
variety of public and private stakeholders, either 
through membership in the Committee or through an-
other means. 
‘‘(4) CHAIRPERSON; VICE
CHAIRPERSON.—The 
HIT Standards Committee may designate one mem-
ber to serve as the chairperson and one member to 
serve as the vice chairperson. 
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‘‘(5) 
DEPARTMENT
MEMBERSHIP.—The 
Sec-
retary shall be a member of the HIT Standards Com-
mittee. The National Coordinator shall act as a liai-
son among the HIT Standards Committee, the HIT 
Policy Committee, and the Federal Government. 
‘‘(6) BALANCE AMONG SECTORS.—In developing 
the procedures for conducting the activities of the HIT 
Standards Committee, the HIT Standards Committee 
shall act to ensure a balance among various sectors of 
the health care system so that no single sector unduly 
influences the actions of the HIT Standards Com-
mittee. 
‘‘(7) ASSISTANCE.—For the purposes of carrying 
out this section, the Secretary may provide or ensure 
that financial assistance is provided by the HIT 
Standards Committee to defray in whole or in part 
any membership fees or dues charged by such Com-
mittee to those consumer advocacy groups and not for 
profit entities that work in the public interest as a 
part of their mission. 
‘‘(d) OPEN AND PUBLIC PROCESS.—In providing for 
the establishment of the HIT Standards Committee pursu-
ant to subsection (a), the Secretary shall ensure the fol-
lowing: 
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‘‘(1) CONSENSUS APPROACH; OPEN PROCESS.— 
The HIT Standards Committee shall use a consensus 
approach and a fair and open process to support the 
development, harmonization, and recognition of 
standards described in subsection (a)(1). 
‘‘(2) PARTICIPATION
OF
OUTSIDE
ADVISERS.— 
The HIT Standards Committee shall ensure an ade-
quate opportunity for the participation of outside ad-
visors, including individuals 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 
healthcare quality and patient safety; 
‘‘(D) long-term care and aging services; and 
‘‘(E) data exchange and developing health 
information technology standards and new 
health information technology. 
‘‘(3) OPEN MEETINGS.—Plenary and other regu-
larly scheduled formal meetings of the HIT Standards 
Committee (or established subgroups thereof) shall be 
open to the public. 
‘‘(4) PUBLICATION
OF
MEETING
NOTICES
AND 
MATERIALS PRIOR TO MEETINGS.—The HIT Stand-
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ards Committee shall develop and maintain an Inter-
net website on which it publishes, prior to each meet-
ing, a meeting notice, a meeting agenda, and meeting 
materials. 
‘‘(5) OPPORTUNITY FOR PUBLIC COMMENT.—The 
HIT Standards Committee shall develop a process 
that allows for public comment during the process by 
which the Entity develops, harmonizes, or recognizes 
standards and implementation specifications. 
‘‘(e) VOLUNTARY CONSENSUS STANDARD BODY.—The 
provisions of section 12(d) of the National Technology 
Transfer and Advancement Act of 1995 (15 U.S.C. 272 
note) and the Office of Management and Budget circular 
119 shall apply to the HIT Standards Committee. 
‘‘(f) PUBLICATION.—The Secretary shall provide for 
publication in the Federal Register and the posting on the 
Internet website of the Office of the National Coordinator 
for Health Information Technology of all recommendations 
made by the HIT Standards Committee under this section. 
‘‘SEC. 3004. PROCESS FOR ADOPTION OF ENDORSED REC-
OMMENDATIONS; ADOPTION OF INITIAL SET 
OF STANDARDS, IMPLEMENTATION SPECI-
FICATIONS, AND CERTIFICATION CRITERIA. 
‘‘(a) PROCESS FOR ADOPTION OF ENDORSED REC-
OMMENDATIONS.— 
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‘‘(1) REVIEW OF ENDORSED STANDARDS, IMPLE-
MENTATION SPECIFICATIONS, AND CERTIFICATION CRI-
TERIA.—Not later than 90 days after the date of re-
ceipt of standards, implementation specifications, or 
certification criteria endorsed under section 3001(c), 
the Secretary, in consultation with representatives of 
other relevant Federal agencies, shall jointly review 
such standards, implementation specifications, or cer-
tification criteria and shall determine whether or not 
to propose adoption of such standards, implementa-
tion specifications, or certification criteria. 
‘‘(2) DETERMINATION TO ADOPT STANDARDS, IM-
PLEMENTATION SPECIFICATIONS, AND CERTIFICATION 
CRITERIA.—If the Secretary determines— 
‘‘(A) to propose adoption of any grouping of 
such standards, implementation specifications, 
or certification criteria, the Secretary shall, by 
regulation, determine whether or not to adopt 
such grouping of standards, implementation 
specifications, or certification criteria; or 
‘‘(B) not to propose adoption of any group-
ing of standards, implementation specifications, 
or certification criteria, the Secretary shall no-
tify the National Coordinator and the HIT 
Standards Committee in writing of such deter-
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mination and the reasons for not proposing the 
adoption of such recommendation. 
‘‘(3) PUBLICATION.—The Secretary shall provide 
for publication in the Federal Register of all deter-
minations made by the Secretary under paragraph 
(1). 
‘‘(b) ADOPTION
OF STANDARDS, IMPLEMENTATION 
SPECIFICATIONS, AND CERTIFICATION CRITERIA.— 
‘‘(1) IN GENERAL.—Not later than December 31, 
2009, the Secretary shall, through the rulemaking 
process described in section 3003, adopt an initial set 
of standards, implementation specifications, and cer-
tification criteria for the areas required for consider-
ation under section 3002(b)(2)(B). 
‘‘(2) APPLICATION OF CURRENT STANDARDS, IM-
PLEMENTATION SPECIFICATIONS, AND CERTIFICATION 
CRITERIA.—The standards, implementation specifica-
tions, and certification criteria adopted before the 
date of the enactment of this title through the process 
existing through the Office of the National Coordi-
nator for Health Information Technology may be ap-
plied towards meeting the requirement of paragraph 
(1). 
‘‘(3) SUBSEQUENT
STANDARDS
ACTIVITY.—The 
Secretary shall adopt additional standards, imple-
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mentation specifications, and certification criteria as 
necessary and consistent with the schedule published 
under section 3003(b)(2). 
‘‘SEC. 3005. APPLICATION AND USE OF ADOPTED STAND-
ARDS 
AND 
IMPLEMENTATION 
SPECIFICA-
TIONS BY FEDERAL AGENCIES. 
‘‘For requirements relating to the application and use 
by Federal agencies of the standards and implementation 
specifications adopted under section 3004, see section 13111 
of the Health Information Technology for Economic and 
Clinical Health Act. 
‘‘SEC. 3006. VOLUNTARY APPLICATION AND USE OF ADOPT-
ED STANDARDS AND IMPLEMENTATION SPEC-
IFICATIONS BY PRIVATE ENTITIES. 
‘‘(a) IN GENERAL.—Except as provided under section 
13112 of the Health Information Technology for Economic 
and Clinical Health Act, any standard or implementation 
specification adopted under section 3004 shall be voluntary 
with respect to private entities. 
‘‘(b) RULE OF CONSTRUCTION.—Nothing in this sub-
title shall be construed to require that a private entity that 
enters into a contract with the Federal Government apply 
or use the standards and implementation specifications 
adopted under section 3004 with respect to activities not 
related to the contract. 
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‘‘SEC. 3007. FEDERAL HEALTH INFORMATION TECHNOLOGY. 
‘‘(a) IN GENERAL.—The National Coordinator shall 
support the development and routine updating of qualified 
electronic health record technology (as defined in section 
3000) consistent with subsections (b) and (c) and make 
available such qualified electronic health record technology 
unless the Secretary and the HIT Policy Committee deter-
mine through an assessment that the needs and demands 
of providers are being substantially and adequately met 
through the marketplace. 
‘‘(b) CERTIFICATION.—In making such EHR tech-
nology publicly available, the National Coordinator shall 
ensure that the qualified EHR technology described in sub-
section (a) is certified under the program developed under 
section 3001(c)(3) to be in compliance with applicable 
standards adopted under section 3003(a). 
‘‘(c) AUTHORIZATION TO CHARGE A NOMINAL FEE.— 
The National Coordinator may impose a nominal fee for 
the adoption by a health care provider of the health infor-
mation technology system developed or approved under sub-
section (a) and (b). Such fee shall take into account the 
financial circumstances of smaller providers, low income 
providers, and providers located in rural or other medically 
underserved areas. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require that a private or govern-
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ment entity adopt or use the technology provided under this 
section. 
SEC. 3008. TRANSITIONS. 
‘‘(a) ONCHIT.—Nothing in section 3001 shall be con-
strued as requiring the creation of a new entity to the extent 
that the Office of the National Coordinator for Health Infor-
mation Technology established pursuant to Executive Order 
13335 is consistent with the provisions of section 3001. 
‘‘(b) NATIONAL EHEALTH COLLABORATIVE.—Nothing 
in sections 3002 or 3003 or this subsection shall be con-
strued as prohibiting the National eHealth Collaborative 
from modifying its charter, duties, membership, and any 
other structure or function required to be consistent with 
the requirements of a voluntary consensus standards body 
so as to allow the Secretary to recognize the National 
eHealth Collaborative as the HIT Standards Committee. 
‘‘(c) CONSISTENCY OF RECOMMENDATIONS.—In car-
rying out section 3003(b)(1)(A), until recommendations are 
made by the HIT Policy Committee, recommendations of 
the HIT Standards Committee shall be consistent with the 
most recent recommendations made by such AHIC Suc-
cessor, Inc. 
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‘‘SEC. 3009. RELATION TO HIPAA PRIVACY AND SECURITY 
LAW. 
‘‘(a) IN GENERAL.—With respect to the relation of this 
title to HIPAA privacy and security law: 
‘‘(1) This title may not be construed as having 
any effect on the authorities of the Secretary under 
HIPAA privacy and security law. 
‘‘(2) The purposes of this title include ensuring 
that the health information technology standards and 
implementation specifications adopted under section 
3004 take into account the requirements of HIPAA 
privacy and security law. 
‘‘(b) DEFINITION.—For purposes of this section, the 
term ‘HIPAA privacy and security law’ means— 
‘‘(1) the provisions of part C of title XI of the 
Social Security Act, section 264 of the Health Insur-
ance Portability and Accountability Act of 1996, and 
subtitle D of the Health Information Technology for 
Economic and Clinical Health Act; and 
‘‘(2) regulations under such provisions.’’. 
SEC. 13102. TECHNICAL AMENDMENT. 
Section 1171(5) of the Social Security Act (42 U.S.C. 
1320d) is amended by striking ‘‘or C’’ and inserting ‘‘C, 
or D’’. 
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PART II—APPLICATION AND USE OF ADOPTED 
HEALTH 
INFORMATION 
TECHNOLOGY 
STANDARDS; REPORTS 
SEC. 13111. COORDINATION OF FEDERAL ACTIVITIES WITH 
ADOPTED 
STANDARDS 
AND 
IMPLEMENTA-
TION SPECIFICATIONS. 
(a) SPENDING
ON
HEALTH
INFORMATION
TECH-
NOLOGY SYSTEMS.—As each agency (as defined in the Exec-
utive Order issued on August 22, 2006, relating to pro-
moting quality and efficient health care in Federal govern-
ment administered or sponsored health care programs) im-
plements, acquires, or upgrades health information tech-
nology systems used for the direct exchange of individually 
identifiable health information between agencies and with 
non-Federal entities, it shall utilize, where available, health 
information technology systems and products that meet 
standards and implementation specifications adopted under 
section 3004(b) of the Public Health Service Act, as added 
by section 13101. 
(b) FEDERAL
INFORMATION
COLLECTION
ACTIVI-
TIES.—With respect to a standard or implementation speci-
fication adopted under section 3004(b) of the Public Health 
Service Act, as added by section 13101, the President shall 
take measures to ensure that Federal activities involving 
the broad collection and submission of health information 
are consistent with such standard or implementation speci-
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