(III) promote quality, safety, and 
efficiency in health care; and 
(ii) the Commission’s governance pro-
cedures ensure effective representation of 
and accountability to affected stakeholder 
groups and transparent decision-making 
processes; 
(C) shall disapprove the Commission for 
purposes of this subsection if the Secretary de-
termines that the Commission’s certification 
processes or governance procedures do not sat-
isfy clause (i) or (ii), respectively, of subpara-
graph (B); and 
(D) if the Secretary disapproves the Com-
mission under this paragraph, shall provide spe-
cific recommendations to the Commission on 
changes that may be implemented by the Com-
mission in order to obtain approval under this 
paragraph. 
(4) INTEROPERABILITY
STANDARDS; ALTER-
NATIVE CERTIFICATION ENTITY.— 
(A) IN GENERAL.—For any period during 
which 
the 
Certification 
Commission 
for 
Healthcare Information Technology is not ac-
credited by the American National Standards
Institute and the Secretary disapproves such 
Commission under paragraph (3)(C), the Sec-
retary— 
(i) shall adopt interoperability stand-
ards and compliance criteria for health in-
formation technology products, including 
electronic medical records; or 
(ii) shall designate a private entity 
with certification and governance processes 
in accordance with paragraph (3)(B) to 
adopt such standards and criteria and to 
certify such products. 
(B) NINE-MONTH DEADLINE.—If the Cer-
tification Commission for Healthcare Informa-
tion Technology is accredited by the American 
National Standards Institute or approved by 
the Secretary under paragraph (3)(B) but fails 
to adopt interoperability standards and compli-
ance criteria for electronic medical records by 
the date that is 9 months after the date of the 
enactment of this Act, the Secretary may adopt 
such standards and criteria, or designate a pri-
vate entity with certification and governance 
processes in accordance with paragraph (3)(B)
to adopt such standards and criteria and to cer-
tify such products. 
(C) CONSULTATION.—In adopting stand-
ards and criteria under subparagraph (A)(i) or 
(B), the Secretary shall take into consideration 
the recommendations (if any) of the National 
Committee on Vital and Health Statistics. In 
making such recommendations, the National 
Committee on Vital and Health Statistics shall 
consult with all affected parties, including 
health care providers, patients, vendors, health 
plans, and regional health information organiza-
tions. 
(5) EFFECT OF FAILURE TO SEEK ACCREDITA-
TION BY ANSI.—In determining whether to approve 
the Certification Commission for Healthcare Infor-
mation Technology under paragraph (3)(B), the Sec-
retary shall not give any negative weight to a deci-
sion by the Commission to forgo seeking accredita-
tion by the American National Standards Institute. 
(b) TECHNICAL STANDARDS AND COMPLIANCE CRI-
TERIA.—The Secretary shall adopt such technical stand-
ards and compliance criteria for the organization and con-
tent of health information networks under section 3 as the 
Secretary deems appropriate to ensure that health infor-
mation data can be exchanged among such networks and 
between health information networks and Federal agen-
cies. The Secretary may delegate the authority to adopt 
such standards and criteria to a private entity, if— 
(1) the entity is accredited by the American 
National Standards Institute; or 
(2) the Secretary biannually certifies that the 
entity’s processes for adoption of standards and— 
(A) compliance criteria— 
(i) are open to input for all affected 
parties, including health care providers, 
patients, vendors, and health plans re-
gional health information organizations; 
(ii) reflect the prevailing opinion 
among the affected parties; and 
(iii) promote quality, safety, and effi-
ciency in health care; 
(B) governance procedures ensure effective 
representation of and accountability to affected 
stakeholder groups and transparent decision- 
making processes. 
SEC. 5. LOANS. 
(a) IN GENERAL.—The Secretary may make loans to 
any regional health information organization with a health 
information network that is accredited or provisionally ac-