(b) RESOURCES.—The President shall make available 
to the Office of the National Coordinator for Health Infor-
mation Technology the resources, both financial and oth-
erwise, necessary to enable the National Coordinator to 
carry out the purposes of, and perform the duties and re-
sponsibilities of, the Office. 
SEC. 4. BUILDING THE NATIONAL HEALTH INFORMATION 
INFRASTRUCTURE. 
Title XI of the Social Security Act (42 U.S.C. 1301 
et seq.) is amended by adding at the end the following 
part: 
‘‘PART D—BUILDING THE NATIONAL HEALTH 
INFORMATION INFRASTRUCTURE 
‘‘FINANCIAL INCENTIVE TO SMALL MEDICAL CARE PRO-
VIDERS AND ENTITIES TO IMPLEMENT A NATIONAL 
HEALTH INFORMATION INFRASTRUCTURE 
‘‘SEC. 1181. (a) IN GENERAL.—The Secretary shall 
include additional Medicare payment incentives to assure 
small medical care providers have the capability to move 
toward a national health care information infrastructure 
by acquiring electronic health record systems and other 
health information technologies. 
‘‘(b) CONDITIONS FOR QUALIFICATION.—As a condi-
tion of qualifying for financial incentives described in this 
section, the Secretary shall grant the use of financial in-
VerDate Aug 31 2005 
23:42 Apr 20, 2007
Jkt 059200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H1952.IH
H1952
pwalker on PROD1PC71 with BILLS
centives to assure that such technologies are consistent 
with the goals of creation of a national health information 
infrastructure, such as— 
‘‘(1) voluntary participation in studies or dem-
onstration projects to evaluate the use of such sys-
tems to measure and report quality data based on 
accepted clinical performance measures; 
‘‘(2) voluntary participation in studies to dem-
onstrate the impact of such technologies on improv-
ing patient care, reducing costs and increasing effi-
ciencies; and 
‘‘(3) voluntary participation in studies and dem-
onstration projects on providing patient-centered 
care coordinated by a patient’s personal physician 
(as defined by the Institute of Medicine), using elec-
tronic systems that enable and facilitate care coordi-
nation and sharing of information among the physi-
cian and other treating health care professionals, 
family caregivers, and the patient. 
‘‘(c) ADDITIONAL MEDICARE PAYMENT TO SMALL 
MEDICAL CARE PROVIDERS AND ENTITIES FOR EXPEND-
ITURES RELATING TO THE IMPLEMENTATION OF PRAC-
TICE-BASED ELECTRONIC SYSTEMS THAT WILL SERVE 
AS THE FOUNDATION FOR A NATIONAL HEALTH INFOR-
MATION INFRASTRUCTURE.— 
VerDate Aug 31 2005 
23:42 Apr 20, 2007
Jkt 059200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H1952.IH
H1952
pwalker on PROD1PC71 with BILLS
‘‘(1) IN GENERAL.—The Secretary shall provide 
for additional payment to medical care providers in 
small practice settings, including physicians and oth-
ers in clinical practice, for the purpose of assisting 
such entities to acquire and adopt patient registries, 
evidence-based clinical decision support tools at the 
point of care, electronic health records, secure email, 
and other health information technologies defined by 
the Secretary as a key component of a national 
health care information infrastructure. 
‘‘(2) 
TYPES
OF
REIMBURSEMENT
INCEN-
TIVES.—In developing the reimbursement incentives 
described in paragraph (1), the Secretary shall con-
sider inclusion of one or more of the following types 
of incentives: 
‘‘(A) Adds-ons to payments for evaluation 
and management services. 
‘‘(B) Care management fees that include 
an allowance for the costs associated with ac-
quiring the electronic systems associated with 
providing coordinated and patient-centered care 
to beneficiaries, especially those with multiple 
chronic illnesses, as determined by the Sec-
retary and that is included in the top 5 percent 
of claims (determined on the basis of cost). 
VerDate Aug 31 2005 
23:42 Apr 20, 2007
Jkt 059200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H1952.IH
H1952
pwalker on PROD1PC71 with BILLS
‘‘(C) Payments for structured e-mail 
consults and other technologies that will facili-
tate care coordination that are separately iden-
tifiable medical services from other evaluation 
and management services. 
‘‘(D) Any other method deemed appro-
priate by the Secretary to encourage participa-
tion. 
‘‘(3) 
AMOUNT
OF
REIMBURSEMENT.—The 
amount of reimbursement made to small medical 
care providers and entities to implement a national 
health care information infrastructure shall be in a 
manner determined by the Secretary that takes into 
account the costs of implementation, training, and 
complying with applicable standards. Such reim-
bursement amounts shall be calculated on a sliding 
scale, in a manner determined by the Secretary, to 
reward qualifying practices using more functional 
and comprehensive health information systems that 
meet the certification guidelines under paragraph 
(4) based on the following weighted-structure: 
‘‘(A) BASIC.—The maintenance of patient 
registries for the purpose of identifying and fol-
lowing up with at-risk patients and for the pro-
vision of educational resources to patients. 
VerDate Aug 31 2005 
23:42 Apr 20, 2007
Jkt 059200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H1952.IH
H1952
pwalker on PROD1PC71 with BILLS