and XXI of the Social Security Act shall be carried out
consistent with section 1142 of such Act.
‘‘(e) DISCLAIMER.—The Agency shall not mandate na-
tional standards of clinical practice or quality health care
standards. Recommendations resulting from projects funded
and published by the Agency shall include a corresponding
disclaimer.
‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to imply that the Agency’s role is
to mandate a national standard or specific approach to
quality measurement and reporting. In research and qual-
ity improvement activities, the Agency shall consider a wide
range of choices, providers, health care delivery systems,
and individual preferences.
‘‘PART B—HEALTH CARE IMPROVEMENT
RESEARCH
‘‘SEC. 911. HEALTH CARE OUTCOME IMPROVEMENT RE-
SEARCH.
‘‘(a) EVIDENCE RATING SYSTEMS.—In collaboration
with experts from the public and private sector, the Agency
shall identify and disseminate methods or systems that it
uses to assess health care research results, particularly
methods or systems that it uses to rate the strength of the
scientific evidence behind health care practice, recommenda-
tions in the research literature, and technology assessments.
The Agency shall make methods or systems for evidence rat-
ing widely available. Agency publications containing health
care recommendations shall indicate the level of substantiat-
ing evidence using such methods or systems.
‘‘(b) HEALTH CARE IMPROVEMENT RESEARCH CEN-
TERS AND PROVIDER-BASED RESEARCH NETWORKS.—
‘‘(1) IN GENERAL.—In order to address the full
continuum of care and outcomes research, to link re-
search to practice improvement, and to speed the dis-
semination of research findings to community prac-
tice settings, the Agency shall employ research strate-
gies and mechanisms that will link research directly
with clinical practice in geographically diverse loca-
tions throughout the United States, including—
‘‘(A) Health Care Improvement Research
Centers that combine demonstrated multidisci-
plinary expertise in outcomes or quality im-
provement research with linkages to relevant
sites of care;
‘‘(B) Provider-based Research Networks, in-
cluding plan, facility, or delivery system sites of
care (especially primary care), that can evaluate
outcomes and promote quality improvement; and
‘‘(C) other innovative mechanisms or strate-
gies to link research with clinical practice.
‘‘(2) REQUIREMENTS.—The Director is author-
ized to establish the requirements for entities applying
for grants under this subsection.
‘‘SEC. 912. PRIVATE-PUBLIC PARTNERSHIPS TO IMPROVE
ORGANIZATION AND DELIVERY.
‘‘(a) SUPPORT FOR EFFORTS TO DEVELOP INFORMA-
TION ON QUALITY.—
‘‘(1) SCIENTIFIC AND TECHNICAL SUPPORT.—In
its role as the principal agency for health research
and quality, the Agency may provide scientific and
technical support for private and public efforts to im-
prove health care quality, including the activities of
accrediting organizations.
‘‘(2) ROLE OF THE AGENCY.—With respect to
paragraph (1), the role of the Agency shall include—
‘‘(A) the identification and assessment of
methods for the evaluation of the health of—
‘‘(i) enrollees in health plans by type of
plan, provider, and provider arrangements;
and
‘‘(ii) other populations, including those
receiving long-term care services;
‘‘(B) the ongoing development, testing, and
dissemination of quality measures, including
measures of health and functional outcomes;
‘‘(C) the compilation and dissemination of
health care quality measures developed in the
private and public sector;
‘‘(D) assistance in the development of im-
proved health care information systems;
‘‘(E) the development of survey tools for the
purpose of measuring participant and bene-
ficiary assessments of their health care; and
‘‘(F) identifying and disseminating infor-
mation on mechanisms for the integration of in-
formation on quality into purchaser and con-
sumer decision-making processes.
‘‘(b) CENTERS FOR EDUCATION AND RESEARCH ON
THERAPEUTICS.—
‘‘(1) 
IN
GENERAL.—The 
Secretary, 
acting
through the Director and in consultation with the
Commissioner of Food and Drugs, shall establish a
program for the purpose of making one or more
grants for the establishment and operation of one or
more centers to carry out the activities specified in
paragraph (2).
‘‘(2) REQUIRED ACTIVITIES.—The activities re-
ferred to in this paragraph are the following:
‘‘(A) The conduct of state-of-the-art research
for the following purposes:
‘‘(i) To increase awareness of—
‘‘(I) new uses of drugs, biological
products, and devices;
‘‘(II) ways to improve the effective
use of drugs, biological products, and
devices; and
‘‘(III) risks of new uses and risks
of combinations of drugs and biological
products.
‘‘(ii) To provide objective clinical in-
formation to the following individuals and
entities:
‘‘(I) Health care practitioners and
other providers of health care goods or
services.
‘‘(II) Pharmacists, pharmacy ben-
efit managers and purchasers.
‘‘(III) Health maintenance orga-
nizations and other managed health
care organizations.
‘‘(IV) Health care insurers and
governmental agencies.
‘‘(V) Patients and consumers.
‘‘(iii) To improve the quality of health
care while reducing the cost of health care
through—
‘‘(I) an increase in the appro-
priate use of drugs, biological products,
or devices; and
‘‘(II) the prevention of adverse ef-
fects of drugs, biological products, and
devices and the consequences of such ef-
fects, such as unnecessary hospitaliza-
tions.
‘‘(B) The conduct of research on the com-
parative effectiveness, cost-effectiveness, and safe-
ty of drugs, biological products, and devices.
‘‘(C) Such other activities as the Secretary
determines to be appropriate, except that a grant
may not be expended to assist the Secretary in
the review of new drugs.
‘‘(c) REDUCING ERRORS IN MEDICINE.—The Director
shall conduct and support research and build private-public
partnerships to—
‘‘(1) identify the causes of preventable health
care errors and patient injury in health care delivery;
‘‘(2) develop, demonstrate, and evaluate strate-
gies for reducing errors and improving patient safety;
and
‘‘(3) promote the implementation of effective
strategies throughout the health care industry.
‘‘SEC. 913. INFORMATION ON QUALITY AND COST OF CARE.
‘‘(a) IN GENERAL.—In carrying out 902(a), the
Director shall—
‘‘(1) conduct a survey to collect data on a
nationally representative sample of the population on
the cost, use and, for fiscal year 2001 and subsequent
fiscal years, quality of health care, including the
types of health care services Americans use, their ac-
cess to health care services, frequency of use, how
much is paid for the services used, the source of those
payments, the types and costs of private health insur-
ance, access, satisfaction, and quality of care for the
general population and also for populations identified
in section 901(c); and
‘‘(2) develop databases and tools that provide in-
formation to States on the quality, access, and use of
health care services provided to their residents.
‘‘(b) QUALITY AND OUTCOMES INFORMATION.—
‘‘(1) IN
GENERAL.—Beginning in fiscal year
2001, the Director shall ensure that the survey con-
ducted under subsection (a)(1) will—
‘‘(A) identify determinants of health out-
comes and functional status, the needs of special
populations in such variables as well as an un-
derstanding of changes over time, relationships
to health care access and use, and monitor the
overall national impact of Federal and State
policy changes on health care;
‘‘(B) provide information on the quality of
care and patient outcomes for frequently occur-
ring clinical conditions for a nationally rep-
resentative sample of the population; and
‘‘(C) provide reliable national estimates for
children and persons with special health care
needs through the use of supplements or periodic
expansions of the survey.
In expanding the Medical Expenditure Panel Survey,
as in existence on the date of enactment of this title
in fiscal year 2001 to collect information on the qual-
ity of care, the Director shall take into account any
outcomes measurements generally collected by private
sector accreditation organizations.
‘‘(2) ANNUAL REPORT.—Beginning in fiscal year
2003, the Secretary, acting through the Director, shall
submit to Congress an annual report on national
trends in the quality of health care provided to the
American people.
‘‘SEC. 914. INFORMATION SYSTEMS FOR HEALTH CARE IM-
PROVEMENT.
‘‘(a) IN GENERAL.—In order to foster a range of inno-
vative approaches to the management and communication
of health information, the Agency shall support research,
evaluations and initiatives to advance—
‘‘(1) the use of information systems for the study
of health care quality and outcomes, including the
generation of both individual provider and plan-level
comparative performance data;
‘‘(2) training for health care practitioners and
researchers in the use of information systems;
‘‘(3) the creation of effective linkages between
various sources of health information, including the
development of information networks;
‘‘(4) the delivery and coordination of evidence-
based health care services, including the use of real-
time health care decision-support programs;
‘‘(5) the structure, content, definition, and cod-
ing of health information data and medical vocabu-
laries in consultation with appropriate Federal enti-
ties and shall seek input from appropriate private en-
tities;
‘‘(6) the use of computer-based health records in
outpatient and inpatient settings as a personal health
record for individual health assessment and mainte-
nance, and for monitoring public health and outcomes
of care within populations; and
‘‘(7) the protection of individually identifiable
information in health services research and health
care quality improvement.
‘‘(b) DEMONSTRATION.—The Agency shall support
demonstrations into the use of new information tools aimed
at improving shared decision-making between patients and
their care-givers.
‘‘SEC. 915. RESEARCH SUPPORTING PRIMARY CARE AND AC-
CESS IN UNDERSERVED AREAS.
‘‘(a) PREVENTIVE SERVICES TASK FORCE.—
‘‘(1) PURPOSE.—The Agency shall provide ongo-
ing administrative, research, and technical support
for the operation of the Preventive Services Task
Force. The Agency shall coordinate and support the
dissemination of the Preventive Services Task Force
recommendations.
‘‘(2) OPERATION.—The Preventive Services Task
Force shall review the scientific evidence related to the
effectiveness, appropriateness, and cost-effectiveness of
clinical preventive services for the purpose of develop-
ing recommendations for the health care community,
and updating previous recommendations, regarding
their usefulness in daily clinical practice. In carrying
out its responsibilities under paragraph (1), the Task
Force shall not be subject to the provisions of Appen-
dix 2 of title 5, United States Code.
‘‘(b) PRIMARY CARE RESEARCH.—
‘‘(1) IN GENERAL.—There is established within
the Agency a Center for Primary Care Research (re-
ferred to in this subsection as the ‘Center’) that shall
serve as the principal source of funding for primary
care practice research in the Department of Health
and Human Services. For purposes of this paragraph,
primary care research focuses on the first contact
when illness or health concerns arise, the diagnosis,
treatment or referral to specialty care, preventive
care, and the relationship between the clinician and
the patient in the context of the family and commu-
nity.
‘‘(2) RESEARCH.—In carrying out this section,
the Center shall conduct and support research
concerning—
‘‘(A) the nature and characteristics of pri-
mary care practice;
‘‘(B) the management of commonly occur-
ring clinical problems;
‘‘(C) the management of undifferentiated
clinical problems; and
‘‘(D) the continuity and coordination of
health services.
‘‘SEC. 916. CLINICAL PRACTICE AND TECHNOLOGY INNOVA-
TION.
‘‘(a) IN GENERAL.—The Director shall promote inno-
vation in evidence-based clinical practice and health care
technologies by—
‘‘(1) conducting and supporting research on the
development, diffusion, and use of health care tech-
nology;
‘‘(2) developing, evaluating, and disseminating
methodologies for assessments of health care practices
and health care technologies;
‘‘(3) conducting intramural and supporting ex-
tramural assessments of existing and new health care
practices and technologies;
‘‘(4) promoting education, training, and provid-
ing technical assistance in the use of health care prac-
tice and health care technology assessment methodolo-
gies and results; and
‘‘(5) working with the National Library of Medi-
cine and the public and private sector to develop an
electronic clearinghouse of currently available assess-
ments and those in progress.
‘‘(b) SPECIFICATION OF PROCESS.—
‘‘(1) IN GENERAL.—Not later than December 31,
2000, the Director shall develop and publish a de-
scription of the methods used by the Agency and its
contractors for practice and technology assessment.
‘‘(2) CONSULTATIONS.—In carrying out this sub-
section, the Director shall cooperate and consult with
the Assistant Secretary for Health, the Administrator
of the Health Care Financing Administration, the Di-
rector of the National Institutes of Health, the Com-
missioner of Food and Drugs, and the heads of any
other interested Federal department or agency, and
shall seek input, where appropriate, from professional
societies and other private and public entities.
‘‘(3) METHODOLOGY.—The Director shall, in de-
veloping the methods used under paragraph (1),
consider—
‘‘(A) safety, efficacy, and effectiveness;
‘‘(B) legal, social, and ethical implications;
‘‘(C) costs, benefits, and cost-effectiveness;
‘‘(D) comparisons to alternate technologies
and practices; and
‘‘(E) requirements of Food and Drug Ad-
ministration approval to avoid duplication.
‘‘(c) SPECIFIC ASSESSMENTS.—
‘‘(1) IN GENERAL.—The Director shall conduct
or support specific assessments of health care tech-
nologies and practices.
‘‘(2) REQUESTS FOR ASSESSMENTS.—The Direc-
tor is authorized to conduct or support assessments,
on a reimbursable basis, for the Health Care Financ-
ing Administration, the Department of Defense, the
Department of Veterans Affairs, the Office of Person-
nel Management, and other public or private entities.
‘‘(3) GRANTS AND CONTRACTS.—In addition to
conducting assessments, the Director may make
grants to, or enter into cooperative agreements or con-
tracts with, entities described in paragraph (4) for
the purpose of conducting assessments of experi-
mental, emerging, existing, or potentially outmoded
health care technologies, and for related activities.
‘‘(4) ELIGIBLE ENTITIES.—An entity described
in this paragraph is an entity that is determined to
be appropriate by the Director, including academic
medical centers, research institutions and organiza-
tions, professional organizations, third party payers,
governmental agencies, and consortia of appropriate
research entities established for the purpose of con-
ducting technology assessments.
‘‘SEC. 917. COORDINATION OF FEDERAL GOVERNMENT
QUALITY IMPROVEMENT EFFORTS.
‘‘(a) REQUIREMENT.—
‘‘(1) IN GENERAL.—To avoid duplication and
ensure that Federal resources are used efficiently and
effectively, the Secretary, acting through the Director,
shall coordinate all research, evaluations, and dem-
onstrations related to health services research, quality
measurement and quality improvement activities un-
dertaken and supported by the Federal Government.
‘‘(2) SPECIFIC ACTIVITIES.—The Director, in col-
laboration with the appropriate Federal officials rep-
resenting all concerned executive agencies and depart-
ments, shall develop and manage a process to—
‘‘(A) improve interagency coordination, pri-
ority setting, and the use and sharing of research
findings and data pertaining to Federal quality
improvement programs, technology assessment,
and health services research;
‘‘(B) strengthen the research information
infrastructure, including databases, pertaining
to Federal health services research and health
care quality improvement initiatives;
‘‘(C) set specific goals for participating
agencies and departments to further health serv-
ices research and health care quality improve-
ment; and
‘‘(D) strengthen the management of Federal
health care quality improvement programs.
‘‘(b) STUDY BY THE INSTITUTE OF MEDICINE.—
‘‘(1) IN GENERAL.—To provide Congress, the De-
partment of Health and Human Services, and other
relevant departments with an independent, external
review of their quality oversight, quality improvement
and quality research programs, the Secretary shall
enter into a contract with the Institute of Medicine—
‘‘(A) to describe and evaluate current qual-
ity improvement, quality research and quality
monitoring processes through—
‘‘(i) an overview of pertinent health
services research activities and quality im-
provement efforts conducted by all Federal
programs, with particular attention paid to
those under titles XVIII, XIX, and XXI of
the Social Security Act; and
‘‘(ii) a summary of the partnerships
that the Department of Health and Human
Services has pursued with private accredi-
tation, quality measurement and improve-
ment organizations; and
‘‘(B) to identify options and make rec-
ommendations to improve the efficiency and ef-
fectiveness of quality improvement programs
through—
‘‘(i) the improved coordination of ac-
tivities across the medicare, medicaid and
child health insurance programs under titles
XVIII, XIX and XXI of the Social Security
Act and health services research programs;
‘‘(ii) the strengthening of patient choice
and participation by incorporating state-of-
the-art quality monitoring tools and mak-
ing information on quality available; and
‘‘(iii) the enhancement of the most ef-
fective programs, consolidation as appro-
priate, and elimination of duplicative ac-
tivities within various federal agencies.
‘‘(2) REQUIREMENTS.—
‘‘(A) IN
GENERAL.—The Secretary shall
enter into a contract with the Institute of Medi-
cine for the preparation—
‘‘(i) not later than 12 months after the
date of enactment of this title, of a report
providing an overview of the quality im-
provement programs of the Department of
Health and Human Services for the medi-
care, medicaid, and CHIP programs under
titles XVIII, XIX, and XXI of the Social Se-
curity Act; and
‘‘(ii) not later than 24 months after the
date of enactment of this title, of a final re-
port containing recommendations.
‘‘(B) REPORTS.—The Secretary shall sub-
mit the reports described in subparagraph (A) to
the Committee on Finance and the Committee on
Health, Education, Labor, and Pensions of the
Senate and the Committee on Ways and Means
and the Committee on Commerce of the House of
Representatives.
‘‘PART C—GENERAL PROVISIONS
‘‘SEC. 921. ADVISORY COUNCIL FOR HEALTH CARE RE-
SEARCH AND QUALITY.
‘‘(a) ESTABLISHMENT.—There is established an advi-
sory council to be known as the Advisory Council for Health
Care Research and Quality.
‘‘(b) DUTIES.—
‘‘(1) IN GENERAL.—The Advisory Council shall
advise the Secretary and the Director with respect to
activities proposed or undertaken to carry out the
purpose of the Agency under section 901(b).
‘‘(2) CERTAIN RECOMMENDATIONS.—Activities of
the Advisory Council under paragraph (1) shall in-
clude making recommendations to the Director
regarding—
‘‘(A) priorities regarding health care re-
search, especially studies related to quality, out-
comes, cost and the utilization of, and access to,
health care services;
‘‘(B) the field of health care research and re-
lated disciplines, especially issues related to
training needs, and dissemination of informa-
tion pertaining to health care quality; and
‘‘(C) the appropriate role of the Agency in
each of these areas in light of private sector ac-
tivity and identification of opportunities for
public-private sector partnerships.
‘‘(c) MEMBERSHIP.—
‘‘(1) IN GENERAL.—The Advisory Council shall,
in accordance with this subsection, be composed of ap-
pointed members and ex officio members. All members
of the Advisory Council shall be voting members other
than the individuals designated under paragraph
(3)(B) as ex officio members.
‘‘(2) APPOINTED MEMBERS.—The Secretary shall
appoint to the Advisory Council 18 appropriately
qualified individuals. At least 14 members of the Ad-
visory Council shall be representatives of the public
who are not officers or employees of the United States.
The Secretary shall ensure that the appointed mem-
bers of the Council, as a group, are representative of
professions and entities concerned with, or affected by,
activities under this title and under section 1142 of
the Social Security Act. Of such members—
‘‘(A) 3 shall be individuals distinguished in
the conduct of research, demonstration projects,
and evaluations with respect to health care;
‘‘(B) 3 shall be individuals distinguished in
the practice of medicine of which at least 1 shall
be a primary care practitioner;
‘‘(C) 3 shall be individuals distinguished in
the other health professions;
‘‘(D) 3 shall be individuals either represent-
ing the private health care sector, including
health plans, providers, and purchasers or indi-
viduals distinguished as administrators of health
care delivery systems;
‘‘(E) 3 shall be individuals distinguished in
the fields of health care quality improvement, ec-
onomics, information systems, law, ethics, busi-
ness, or public policy; and
‘‘(F) 3 shall be individuals representing the
interests of patients and consumers of health
care.
‘‘(3) EX OFFICIO MEMBERS.—The Secretary shall
designate as ex officio members of the Advisory
Council—
‘‘(A) the Assistant Secretary for Health, the
Director of the National Institutes of Health, the
Director of the Centers for Disease Control and
Prevention, the Administrator of the Health Care
Financing Administration, the Assistant Sec-
retary of Defense (Health Affairs), and the
Under Secretary for Health of the Department of
Veterans Affairs; and
‘‘(B) such other Federal officials as the Sec-
retary may consider appropriate.
‘‘(d) TERMS.—Members of the Advisory Council ap-
pointed under subsection (c)(2) shall serve for a term of 3
years. A member of the Council appointed under such sub-
section may continue to serve after the expiration of the
term of the members until a successor is appointed.
‘‘(e) VACANCIES.—If a member of the Advisory Council
appointed under subsection (c)(2) does not serve the full
term applicable under subsection (d), the individual ap-
pointed to fill the resulting vacancy shall be appointed for
the remainder of the term of the predecessor of the individ-
ual.
‘‘(f) CHAIR.—The Director shall, from among the
members of the Advisory Council appointed under sub-
section (c)(2), designate an individual to serve as the chair
of the Advisory Council.
‘‘(g) MEETINGS.—The Advisory Council shall meet not
less than once during each discrete 4-month period and
shall otherwise meet at the call of the Director or the chair.
‘‘(h) 
COMPENSATION
AND
REIMBURSEMENT
OF
EXPENSES.—
‘‘(1) APPOINTED MEMBERS.—Members of the Ad-
visory Council appointed under subsection (c)(2) shall
receive compensation for each day (including travel
time) engaged in carrying out the duties of the Advi-
sory Council unless declined by the member. Such
compensation may not be in an amount in excess of
the maximum rate of basic pay payable for GS–18
of the General Schedule.
‘‘(2) EX
OFFICIO
MEMBERS.—Officials des-
ignated under subsection (c)(3) as ex officio members
of the Advisory Council may not receive compensation
for service on the Advisory Council in addition to the
compensation otherwise received for duties carried out
as officers of the United States.
‘‘(i) STAFF.—The Director shall provide to the Advi-
sory Council such staff, information, and other assistance
as may be necessary to carry out the duties of the Council.
‘‘SEC. 922. PEER REVIEW WITH RESPECT TO GRANTS AND
CONTRACTS.
‘‘(a) REQUIREMENT OF REVIEW.—
‘‘(1) IN GENERAL.—Appropriate technical and
scientific peer review shall be conducted with respect
to each application for a grant, cooperative agree-
ment, or contract under this title.
‘‘(2) REPORTS TO DIRECTOR.—Each peer review
group to which an application is submitted pursuant
to paragraph (1) shall report its finding and rec-
ommendations respecting the application to the Direc-
tor in such form and in such manner as the Director
shall require.
‘‘(b) APPROVAL AS PRECONDITION OF AWARDS.—The
Director may not approve an application described in sub-
section (a)(1) unless the application is recommended for ap-
proval by a peer review group established under subsection
(c).
‘‘(c) ESTABLISHMENT OF PEER REVIEW GROUPS.—
‘‘(1) IN GENERAL.—The Director shall establish
such technical and scientific peer review groups as
may be necessary to carry out this section. Such
groups shall be established without regard to the pro-
visions of title 5, United States Code, that govern ap-
pointments in the competitive service, and without re-
gard to the provisions of chapter 51, and subchapter
III of chapter 53, of such title that relate to classifica-
tion and pay rates under the General Schedule.
‘‘(2) MEMBERSHIP.—The members of any peer
review group established under this section shall be
appointed from among individuals who by virtue of
their training or experience are eminently qualified
to carry out the duties of such peer review group. Of-
ficers and employees of the United States may not
constitute more than 25 percent of the membership of
any such group. Such officers and employees may not
receive compensation for service on such groups in ad-
dition to the compensation otherwise received for these
duties carried out as such officers and employees.
‘‘(3) DURATION.—Notwithstanding section 14(a)
of the Federal Advisory Committee Act, peer review
groups established under this section may continue in
existence until otherwise provided by law.
‘‘(4) QUALIFICATIONS.—Members of any peer-re-
view group shall, at a minimum, meet the following
requirements:
‘‘(A) Such members shall agree in writing
to treat information received, pursuant to their
work for the group, as confidential information,
except that this subparagraph shall not apply to
public records and public information.
‘‘(B) Such members shall agree in writing
to recuse themselves from participation in the
peer-review of specific applications which present
a potential personal conflict of interest or ap-
pearance of such conflict, including employment
in a directly affected organization, stock owner-
ship, or any financial or other arrangement that
might introduce bias in the process of peer-re-
view.
‘‘(d) AUTHORITY FOR PROCEDURAL ADJUSTMENTS IN
CERTAIN CASES.—In the case of applications for financial
assistance whose direct costs will not exceed $100,000, the
Director may make appropriate adjustments in the proce-
dures otherwise established by the Director for the conduct
of peer review under this section. Such adjustments may
be made for the purpose of encouraging the entry of individ-
uals into the field of research, for the purpose of encourag-
ing clinical practice-oriented or provider-based research,
and for such other purposes as the Director may determine
to be appropriate.
‘‘(e) REGULATIONS.—The Director shall issue regula-
tions for the conduct of peer review under this section.
‘‘SEC. 923. CERTAIN PROVISIONS WITH RESPECT TO DEVEL-
OPMENT, COLLECTION, AND DISSEMINATION
OF DATA.
‘‘(a) STANDARDS WITH RESPECT
TO UTILITY
OF
DATA.—
‘‘(1) IN GENERAL.—To ensure the utility, accu-
racy, and sufficiency of data collected by or for the
Agency for the purpose described in section 901(b),
the Director shall establish standard methods for de-
veloping and collecting such data, taking into
consideration—
‘‘(A) other Federal health data collection
standards; and
‘‘(B) the differences between types of health
care plans, delivery systems, health care provid-
ers, and provider arrangements.
‘‘(2) RELATIONSHIP WITH OTHER DEPARTMENT
PROGRAMS.—In any case where standards under
paragraph (1) may affect the administration of other
programs carried out by the Department of Health
and Human Services, including the programs under
title XVIII, XIX or XXI of the Social Security Act,
or may affect health information that is subject to a
standard developed under part C of title XI of the So-
cial Security Act, they shall be in the form of rec-
ommendations to the Secretary for such program.
‘‘(b) STATISTICS
AND
ANALYSES.—The Director
shall—
‘‘(1) take appropriate action to ensure that sta-
tistics and analyses developed under this title are of
high quality, timely, and duly comprehensive, and
that the statistics are specific, standardized, and ade-
quately analyzed and indexed; and
‘‘(2) publish, make available, and disseminate
such statistics and analyses on as wide a basis as is
practicable.
‘‘(c) AUTHORITY REGARDING CERTAIN REQUESTS.—
Upon request of a public or private entity, the Director may
conduct or support research or analyses otherwise author-
ized by this title pursuant to arrangements under which
such entity will pay the cost of the services provided.
Amounts received by the Director under such arrangements
shall be available to the Director for obligation until ex-
pended.
‘‘SEC. 924. DISSEMINATION OF INFORMATION.
‘‘(a) IN GENERAL.—The Director shall—
‘‘(1) without regard to section 501 of title 44,
United States Code, promptly publish, make avail-
able, and otherwise disseminate, in a form under-
standable and on as broad a basis as practicable so
as to maximize its use, the results of research, dem-
onstration projects, and evaluations conducted or sup-
ported under this title;
‘‘(2) ensure that information disseminated by the
Agency is science-based and objective and undertakes
consultation as necessary to assess the appropriate-
ness and usefulness of the presentation of information
that is targeted to specific audiences;
‘‘(3) promptly make available to the public data
developed in such research, demonstration projects,
and evaluations;
‘‘(4) provide, in collaboration with the National
Library of Medicine where appropriate, indexing, ab-
stracting, translating, publishing, and other services
leading to a more effective and timely dissemination
of information on research, demonstration projects,
and evaluations with respect to health care to public
and private entities and individuals engaged in the
improvement of health care delivery and the general
public, and undertake programs to develop new or
improved methods for making such information avail-
able; and
‘‘(5) as appropriate, provide technical assistance
to State and local government and health agencies
and conduct liaison activities to such agencies to fos-
ter dissemination.
‘‘(b) PROHIBITION AGAINST RESTRICTIONS.—Except
as provided in subsection (c), the Director may not restrict
the publication or dissemination of data from, or the results
of, projects conducted or supported under this title.
‘‘(c) LIMITATION
ON USE
OF CERTAIN INFORMA-
TION.—No information, if an establishment or person sup-
plying the information or described in it is identifiable, ob-
tained in the course of activities undertaken or supported
under this title may be used for any purpose other than
the purpose for which it was supplied unless such establish-
ment or person has consented (as determined under regula-
tions of the Director) to its use for such other purpose. Such
information may not be published or released in other form
if the person who supplied the information or who is de-
scribed in it is identifiable unless such person has consented
(as determined under regulations of the Director) to its pub-
lication or release in other form.
‘‘(d) PENALTY.—Any person who violates subsection
(c) shall be subject to a civil monetary penalty of not more
than $10,000 for each such violation involved. Such penalty
shall be imposed and collected in the same manner as civil
money penalties under subsection (a) of section 1128A of
the Social Security Act are imposed and collected.
‘‘SEC. 925. ADDITIONAL PROVISIONS WITH RESPECT TO
GRANTS AND CONTRACTS.
‘‘(a) FINANCIAL CONFLICTS OF INTEREST.—With re-
spect to projects for which awards of grants, cooperative
agreements, or contracts are authorized to be made under
this title, the Director shall by regulation define—
‘‘(1) the specific circumstances that constitute fi-
nancial interests in such projects that will, or may be
reasonably expected to, create a bias in favor of ob-
taining results in the projects that are consistent with
such interests; and
‘‘(2) the actions that will be taken by the Direc-
tor in response to any such interests identified by the
Director.
‘‘(b) REQUIREMENT OF APPLICATION.—The Director
may not, with respect to any program under this title au-
thorizing the provision of grants, cooperative agreements,
or contracts, provide any such financial assistance unless
an application for the assistance is submitted to the Sec-
retary and the application is in such form, is made in such
manner, and contains such agreements, assurances, and in-
formation as the Director determines to be necessary to
carry out the program involved.
‘‘(c) PROVISION OF SUPPLIES AND SERVICES IN LIEU
OF FUNDS.—
‘‘(1) IN GENERAL.—Upon the request of an en-
tity receiving a grant, cooperative agreement, or con-
tract under this title, the Secretary may, subject to
paragraph (2), provide supplies, equipment, and serv-
ices for the purpose of aiding the entity in carrying
out the project involved and, for such purpose, may
detail to the entity any officer or employee of the De-
partment of Health and Human Services.
‘‘(2) CORRESPONDING REDUCTION IN FUNDS.—
With respect to a request described in paragraph (1),
the Secretary shall reduce the amount of the financial
assistance involved by an amount equal to the costs
of detailing personnel and the fair market value of
any supplies, equipment, or services provided by the
Director. The Secretary shall, for the payment of ex-
penses incurred in complying with such request, ex-
pend the amounts withheld.
‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS WITH
RESPECT TO CONTRACTS.—Contracts may be entered into
under this part without regard to sections 3648 and 3709
of the Revised Statutes (31 U.S.C. 529; 41 U.S.C. 5).
‘‘SEC. 926. CERTAIN ADMINISTRATIVE AUTHORITIES.
‘‘(a) DEPUTY DIRECTOR AND OTHER OFFICERS AND
EMPLOYEES.—
‘‘(1) DEPUTY DIRECTOR.—The Director may ap-
point a deputy director for the Agency.
‘‘(2) OTHER
OFFICERS
AND
EMPLOYEES.—The
Director may appoint and fix the compensation of
such officers and employees as may be necessary to
carry out this title. Except as otherwise provided by
law, such officers and employees shall be appointed in
accordance with the civil service laws and their com-
pensation fixed in accordance with title 5, United
States Code.
‘‘(b) FACILITIES.—The Secretary, in carrying out this
title—
‘‘(1) may acquire, without regard to the Act of
March 3, 1877 (40 U.S.C. 34), by lease or otherwise
through the Director of General Services, buildings or
portions of buildings in the District of Columbia or
communities located adjacent to the District of Co-
lumbia for use for a period not to exceed 10 years;
and
‘‘(2) may acquire, construct, improve, repair, op-
erate, and maintain laboratory, research, and other
necessary facilities and equipment, and such other
real or personal property (including patents) as the
Secretary deems necessary.
‘‘(c) PROVISION OF FINANCIAL ASSISTANCE.—The Di-
rector, in carrying out this title, may make grants to public
and nonprofit entities and individuals, and may enter into
cooperative agreements or contracts with public and private
entities and individuals.
‘‘(d) UTILIZATION OF CERTAIN PERSONNEL AND RE-
SOURCES.—
‘‘(1) DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES.—The Director, in carrying out this title,
may utilize personnel and equipment, facilities, and
other physical resources of the Department of Health
and Human Services, permit appropriate (as deter-
mined by the Secretary) entities and individuals to
utilize the physical resources of such Department, and
provide technical assistance and advice.
‘‘(2) OTHER AGENCIES.—The Director, in carry-
ing out this title, may use, with their consent, the
services, equipment, personnel, information, and fa-
cilities of other Federal, State, or local public agen-
cies, or of any foreign government, with or without
reimbursement of such agencies.
‘‘(e) CONSULTANTS.—The Secretary, in carrying out
this title, may secure, from time to time and for such peri-
ods as the Director deems advisable but in accordance with
section 3109 of title 5, United States Code, the assistance
and advice of consultants from the United States or abroad.
‘‘(f) EXPERTS.—
‘‘(1) IN GENERAL.—The Secretary may, in car-
rying out this title, obtain the services of not more
than 50 experts or consultants who have appropriate
scientific or professional qualifications. Such experts
or consultants shall be obtained in accordance with
section 3109 of title 5, United States Code, except that
the limitation in such section on the duration of serv-
ice shall not apply.
‘‘(2) TRAVEL EXPENSES.—
‘‘(A) IN
GENERAL.—Experts and consult-
ants whose services are obtained under para-
graph (1) shall be paid or reimbursed for their
expenses associated with traveling to and from
their assignment location in accordance with sec-
tions 5724, 5724a(a), 5724a(c), and 5726(C) of
title 5, United States Code.
‘‘(B) LIMITATION.—Expenses specified in
subparagraph (A) may not be allowed in connec-
tion with the assignment of an expert or consult-
ant whose services are obtained under paragraph
(1) unless and until the expert agrees in writing
to complete the entire period of assignment, or 1
year, whichever is shorter, unless separated or re-
assigned for reasons that are beyond the control
of the expert or consultant and that are accept-
able to the Secretary. If the expert or consultant
violates the agreement, the money spent by the
United States for the expenses specified in sub-
paragraph (A) is recoverable from the expert or
consultant as a statutory obligation owed to the
United States. The Secretary may waive in
whole or in part a right of recovery under this
subparagraph.
‘‘(g) VOLUNTARY AND UNCOMPENSATED SERVICES.—
The Director, in carrying out this title, may accept vol-
untary and uncompensated services.
‘‘SEC. 927. FUNDING.
‘‘(a) INTENT.—To ensure that the United States in-
vestment in biomedical research is rapidly translated into
improvements in the quality of patient care, there must be
a corresponding investment in research on the most effective
clinical and organizational strategies for use of these find-
ings in daily practice. The authorization levels in sub-
sections (b) and (c) provide for a proportionate increase
in health care research as the United States investment in
biomedical research increases.
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this title, there are authorized to
be appropriated $250,000,000 for fiscal year 2000, and such
sums as may be necessary for each of the fiscal years 2001
through 2004.
‘‘(c) EVALUATIONS.—In addition to amounts available
pursuant to subsection (b) for carrying out this title, there
shall be made available for such purpose, from the amounts
made available pursuant to section 241 (relating to evalua-
tions), an amount equal to 40 percent of the maximum
amount authorized in such section 241 to be made available
for a fiscal year.
‘‘SEC. 928. DEFINITIONS.
‘‘In this title:
‘‘(1) ADVISORY
COUNCIL.—The term ‘Advisory
Council’ means the Advisory Council on Health Care
Research and Quality established under section 921.
‘‘(2) AGENCY.—The term ‘Agency’ means the
Agency for Health Research and Quality.
‘‘(3) DIRECTOR.—The term ‘Director’ means the
Director of the Agency for Health Research and Qual-
ity.’’.
(b) RULES OF CONSTRUCTION.—
(1) IN GENERAL.—Section 901(a) of the Public
Health Service Act (as added by subsection (a) of this
section) applies as a redesignation of the agency that
carried out title IX of such Act on the day before the
date of enactment of this Act, and not as the termi-
nation of such agency and the establishment of a dif-
ferent agency. The amendment made by subsection (a)
of this section does not affect appointments of the per-
sonnel of such agency who were employed at the agen-
cy on the day before such date.
(2) REFERENCES.—Any reference in law to the
Agency for Health Care Policy and Research is
deemed to be a reference to the Agency for Health Re-
search and Quality, and any reference in law to the
Administrator for Health Care Policy and Research
is deemed to be a reference to the Director of the
Agency for Health Research and Quality.
SEC. 3. GRANTS REGARDING UTILIZATION OF PREVENTIVE
HEALTH SERVICES.
Subpart I of part D of title III of the Public Health
Service Act (42 U.S.C. 254b et seq.) is amended by adding
at the end the following section:
‘‘SEC. 330D. CENTERS FOR STRATEGIES ON FACILITATING
UTILIZATION OF PREVENTIVE HEALTH SERV-
ICES AMONG VARIOUS POPULATIONS.
‘‘(a) IN GENERAL.—The Secretary, acting through the
appropriate agencies of the Public Health Service, shall
make grants to public or nonprofit private entities for the
establishment and operation of regional centers whose pur-
pose is to identify particular populations of patients and
facilitate the appropriate utilization of preventive health
services by patients in the populations through developing
and disseminating strategies to improve the methods used
by public and private health care programs and providers
in interacting with such patients.
‘‘(b) RESEARCH AND TRAINING.—The activities car-
ried out by a center under subsection (a) may include estab-
lishing programs of research and training with respect to
the purpose described in such subsection, including the de-
velopment of curricula for training individuals in imple-
menting the strategies developed under such subsection.
‘‘(c) QUALITY MANAGEMENT.—A condition for the re-
ceipt of a grant under subsection (a) is that the applicant
involved agree that, in order to ensure that the strategies
developed under such subsection take into account prin-
ciples of quality management with respect to consumer sat-
isfaction, the applicant will make arrangements with one
or more private entities that have experience in applying
such principles.
‘‘(d) PRIORITY
REGARDING
INFANTS
AND
CHIL-
DREN.—In carrying out the purpose described in subsection
(a), the Secretary shall give priority to various populations
of infants, young children, and their mothers.
‘‘(e) EVALUATIONS.—The Secretary, acting through the
appropriate agencies of the Public Health Service, shall (di-
rectly or through grants or contracts) provide for the eval-
uation of strategies under subsection (a) in order to deter-
mine the extent to which the strategies have been effective
in facilitating the appropriate utilization of preventive
health services in the populations with respect to which the
strategies were developed.
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated such sums as may be necessary for each
of the fiscal years 2000 through 2004.’’.