154 
(D) health care purchasers and employers 
or groups representing purchasers or employers; 
and 
(E) organizations that develop health in-
formation technology standards and new health 
information technology. 
(3) OTHER
MEMBERSHIP
REQUIREMENTS.— 
The membership of the board of directors of the en-
tity shall be representative of individuals with expe-
rience with— 
(A) urban health care issues; 
(B) safety net health care issues; 
(C) rural or frontier health care issues; 
(D) quality and safety issues; 
(E) State or local health programs; 
(F) individuals or entities skilled in the 
conduct and interpretation of biomedical, health 
services, and health economics research and 
with expertise in outcomes and effectiveness re-
search and technology assessment; 
(G) individuals or entities involved in the 
development and establishment of standards 
and certification for health information tech-
nology systems and clinical data; and 
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(H) members of the medical and mental 
health professions with expertise in standards 
of professional ethics. 
(4) OPEN AND TRANSPARENT.—With respect to 
matters related to the arrangement with the Sec-
retary under subsection (a)(1), the organization 
shall conduct its business in an open and trans-
parent manner, and provide the opportunity for pub-
lic comment and ensure a balance among disparate 
stakeholders, so that no member organization unduly 
influences the work of the organization. 
(5) VOLUNTARY CONSENSUS STANDARDS SET-
TING ORGANIZATIONS.—The organization shall oper-
ate as a voluntary consensus standards setting orga-
nization as defined for purposes of section 12(d) of 
the National Technology Transfer and Advancement 
Act of 1995 (Public Law 104–113) and Office of 
Management and Budget Revised Circular A–119 
(published in the Federal Register on February 10, 
1998). 
(6) PARTICIPATION.—If the organization re-
quires a fee for membership, the organization shall 
ensure that such fee is not a substantial barrier to 
participation in the entity’s activities related to the 
arrangement with the Secretary. 
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(d) REQUIREMENTS FOR MEASURES.—The quality 
measures developed under this title shall comply with the 
following: 
(1) MEASURES.—The designated organization, 
in promoting the development of quality measures 
under this title, shall ensure that such measures— 
(A) are evidence-based, reliable, and valid; 
(B) include— 
(i) measures of clinical processes and 
outcomes, patient experience, efficiency, 
and equity; and 
(ii) measures to assess effectiveness, 
timeliness, patient self-management, pa-
tient centeredness, and safety; and 
(C) include measures of underuse and 
overuse. 
(2) PRIORITIES.—In carrying out its respon-
sibilities under this section, the designated organiza-
tion shall ensure that priority is given to— 
(A) measures that preserve access to qual-
ity health care by protecting the privacy and se-
curity of personal health information; 
(B) measures with the greatest potential 
impact for improving the performance and effi-
ciency of care; 
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(C) measures that may be rapidly imple-
mented by group health plans, health insurance 
issuers, physicians, hospitals, nursing homes, 
long-term care providers, and other providers; 
(D) measures which may inform health 
care decisions made by consumers and patients; 
(E) measures that apply to multiple serv-
ices furnished by different providers during an 
episode of care; 
(F) measures that can be integrated into 
certification process described in section 202; 
and 
(G) measures that may be integrated into 
the decision support function of qualified health 
information technology as defined by this title. 
(3) RISK ADJUSTMENT.—The designated orga-
nization, in consultation with performance measure 
developers and other stakeholders, shall establish 
procedures to ensure that quality measures take into 
account differences in patient health status, patient 
characteristics, and geographic location, as appro-
priate. 
(4) MAINTENANCE.—The designated organiza-
tion, in consultation with owners and developers of 
quality measures, shall require the owners or devel-
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opers of quality measures to update and enhance 
such measures, including the development of more 
accurate and precise specifications, and retire exist-
ing outdated measures. Such updating shall occur 
not more often than once during each 12-month pe-
riod, except in the case of emergency circumstances 
requiring a more immediate update to a measure. 
(e) GRANTS FOR PERFORMANCE MEASURE DEVEL-
OPMENT.—The Secretary, acting through the Agency for 
Healthcare Research and Quality, may award grants, in 
amounts not to exceed $50,000 each, to organizations to 
support the development and testing of quality measures 
that meet the standards established by the designated or-
ganization. 
SEC. 222. ADOPTION AND USE OF QUALITY MEASURES; RE-
PORTING. 
(a) IN GENERAL.—For purposes of carrying out ac-
tivities authorized or required by this title to ensure the 
use of quality measures and to foster uniformity between 
health care quality measures utilized by private entities, 
the Secretary shall— 
(1) select quality measures for adoption and 
use, from quality measures recommended by multi- 
stakeholder groups and endorsed by the designated 
organization; and 
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(2) ensure that standards adopted under sec-
tion 301 integrate the quality measures endorsed, 
adopted, and utilized under this section. 
(b) RELATIONSHIP WITH PROGRAMS UNDER THE 
SOCIAL SECURITY ACT.—The Secretary shall ensure that 
the quality measures adopted under this section— 
(1) complement quality measures developed by 
the Secretary under programs administered by the 
Secretary under the Social Security Act, including 
programs under titles XVIII, XIX, and XXI of such 
Act; and 
(2) do not conflict with the needs and priorities 
of the programs under titles XVIII, XIX, and XXI 
of such Act, as set forth by the Administrator of the 
Centers for Medicare & Medicaid Services. 
(c) REPORTING.—The Secretary shall implement pro-
cedures, consistent with generally accepted standards, to 
enable the Department of Health and Human Services to 
accept the electronic submission of data for purposes of 
performance measurement, including at the provider level, 
using the quality measures developed, endorsed, and 
adopted pursuant to this title. 
(d) DISSEMINATION OF INFORMATION.—In order to 
make comparative performance information available to 
health care consumers, health professionals, public health 
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officials, oversight organizations, researchers, and other 
appropriate individuals and entities, after consultation 
with multi-stakeholder groups, the Secretary shall promul-
gate regulations to provide for the dissemination, aggrega-
tion, and analysis of quality measures collected pursuant 
to this title. 
Subtitle D—Miscellaneous 
Provisions 
SEC. 231. HEALTH INFORMATION TECHNOLOGY RESOURCE 
CENTER. 
Section 914 of the Public Health Service Act (42 
U.S.C. 299b–3) is amended by adding at the end the fol-
lowing: 
‘‘(d) HEALTH
INFORMATION
TECHNOLOGY
RE-
SOURCE CENTER.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director, shall develop a Health Infor-
mation Technology Resource Center (referred to in 
this subsection as the ‘Center’) to provide technical 
assistance and develop best practices to support and 
accelerate efforts to adopt, implement, and effec-
tively use interoperable health information tech-
nology in compliance with sections 202 and 221 of 
the TRUST in Health Information Act of 2008. 
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‘‘(2) PURPOSES.—The purposes of the Center 
are to— 
‘‘(A) provide a forum for the exchange of 
knowledge and experience; 
‘‘(B) accelerate the transfer of lessons 
learned from existing public and private sector 
initiatives, including those currently receiving 
Federal financial support; 
‘‘(C) assemble, analyze, and widely dis-
seminate evidence and experience related to the 
adoption, implementation, and effective use of 
interoperable health information technology; 
‘‘(D) provide for the establishment of re-
gional and local health information networks to 
facilitate the development of interoperability 
across health care settings and improve the 
quality of health care; 
‘‘(E) provide for the development of solu-
tions to barriers to the exchange of electronic 
health information; and 
‘‘(F) conduct other activities identified by 
the States, local, or regional health information 
networks, or health care stakeholders as a focus 
for developing and sharing best practices. 
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‘‘(3) SUPPORT
FOR
ACTIVITIES.—To provide 
support for the activities of the Center, the Director 
shall modify the requirements, if necessary, that 
apply to the National Resource Center for Health 
Information Technology to provide the necessary in-
frastructure to support the duties and activities of 
the Center and facilitate information exchange 
across the public and private sectors. 
‘‘(4) RULE
OF
CONSTRUCTION.—Nothing in 
this subsection shall be construed to require the du-
plication of Federal efforts with respect to the estab-
lishment of the Center, regardless of whether such 
efforts were carried out prior to or after the enact-
ment of this subsection. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated, such sums as may be 
necessary for each of fiscal years 2009 and 2010 to carry 
out this section.’’. 
SEC. 232. FACILITATING THE PROVISION OF TELEHEALTH 
SERVICES ACROSS STATE LINES. 
Section 330L of the Public Health Service Act (42 
U.S.C. 254c–18) is amended to read as follows: 
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‘‘SEC. 330L. TELEMEDICINE; INCENTIVE GRANTS REGARD-
ING COORDINATION AMONG STATES. 
‘‘(a) FACILITATING
THE
PROVISION
OF
TELE-
HEALTH SERVICES ACROSS STATE LINES.—The Sec-
retary may make grants to States that have adopted re-
gional State reciprocity agreements for practitioner licen-
sure, in order to expedite the provision of telehealth serv-
ices across State lines. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out subsection (a), there are author-
ized to be appropriated such sums as may be necessary 
for each of the fiscal years 2009 and 2010.’’. 
Subtitle E—Definitions 
SEC. 241. DEFINITIONS. 
In this title, the following terms, defined in section 
171, have the meanings given such terms in such section: 
Breach , confidentiality, de-identified health information, 
disclose, Director of the Office of Health Information Pri-
vacy, employer, health care, health care provider, Office 
of Health Information Privacy, privacy, personal health 
information, Secretary, security, State, and use. 
TITLE III—ADDITIONAL 
PROVISIONS 
SEC. 301. FEDERAL PURCHASING AND DATA COLLECTION 
BY CMS AND OTHER FEDERAL AGENCIES. 
(a) COORDINATION OF FEDERAL SPENDING.— 
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(1) IN GENERAL.—Not later than 1 year after 
the adoption by the President of a recommendation 
under section 202(c)(6), the Administrator of the 
Center for Medicare & Medicaid Services and the 
head of any other Federal agency shall not expend 
Federal funds for the purchase of any new health in-
formation technology or health information tech-
nology system for clinical care or for the electronic 
retrieval, storage, or exchange of personal health in-
formation if such technology or system is not con-
sistent with applicable standards adopted by the 
Federal Government under section 202. 
(2) RULE
OF
CONSTRUCTION.—Nothing in 
paragraph (1) shall be construed to restrict the pur-
chase of minor (as determined by the Secretary) 
hardware or software components in order to mod-
ify, correct a deficiency in, or extend the life of exist-
ing hardware or software. 
(b) VOLUNTARY ADOPTION.— 
(1) IN GENERAL.—Any standards and imple-
mentation specifications adopted by the Federal 
Government under section 202(c) shall be voluntary 
with respect to private entities. 
(2) REQUIREMENT.—Private entities that enter 
into a contract with the Federal Government shall 
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