HR 4157 PCS 
mental health clinics or other publicly funded mental 
health facilities for the purpose of payment under 
such section for the provision of telehealth services 
at such clinics or facilities. 
(b) SPECIFICS OF STUDY.—Such study shall dem-
onstrate whether the changes described in paragraphs (1) 
and (2) of subsection (a) will result in the following: 
(1) Enhanced health outcomes for individuals 
with one or more chronic conditions. 
(2) Health outcomes for individuals furnished 
telehealth services or home health-related telehealth 
services that are at least comparable to the health 
outcomes for individuals furnished similar items and 
services by a health care provider at the same loca-
tion of the individual or at the home of the indi-
vidual, respectively. 
(3) Facilitation of communication of more accu-
rate clinical information between health care pro-
viders. 
(4) Closer monitoring of individuals by health 
care providers. 
(5) Overall reduction in expenditures for health 
care items and services. 
(6) Improved access to health care. 
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(c) HOME HEALTH-RELATED TELEHEALTH SERV-
ICES DEFINED.—For purposes of this section, the term 
‘‘home health-related telehealth services’’ means tech-
nology-based professional consultations, patient moni-
toring, patient training services, clinical observation, pa-
tient assessment, and any other health services that utilize 
telecommunications technologies. Such term does not in-
clude a telecommunication that consists solely of a tele-
phone audio conversation, facsimile, electronic text mail, 
or consultation between two health care providers. 
(d) REPORT.—Not later than 18 months after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services shall submit to Congress a report 
on the study conducted under subsection (a) and shall in-
clude in such report such recommendations for legislation 
or administration action as the Secretary determines ap-
propriate. 
SEC. 403. STUDY AND REPORT ON STORE AND FORWARD 
TECHNOLOGY FOR TELEHEALTH. 
(a) STUDY.—The Secretary of Health and Human 
Services, acting through the Director of the Office for the 
Advancement of Telehealth, shall conduct a study on the 
use of store and forward technologies (that provide for the 
asynchronous transmission of health care information in 
single or multimedia formats) in the provision of tele-
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health services. Such study shall include an assessment of 
the feasibility, advisability, and the costs of expanding the 
use of such technologies for use in the diagnosis and treat-
ment of certain conditions. 
(b) REPORT.—Not later than 18 months after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services shall submit to Congress a report 
on the study conducted under subsection (a) and shall in-
clude in such report such recommendations for legislation 
or administration action as the Secretary determines ap-
propriate. 
SEC. 404. ENSURING HEALTH CARE PROVIDERS PARTICI-
PATING 
IN 
PHSA 
PROGRAMS, 
MEDICAID, 
SCHIP, OR THE MCH PROGRAM MAY MAIN-
TAIN HEALTH INFORMATION IN ELECTRONIC 
FORM. 
Part D of title II of the Public Health Service Act, 
as added by section 101(a) and amended by sections 103 
and 105, is further amended by adding at the end the 
following new section: 
‘‘SEC. 274. ENSURING HEALTH CARE PROVIDERS MAY MAIN-
TAIN HEALTH INFORMATION IN ELECTRONIC 
FORM. 
‘‘(a) IN GENERAL.—Any health care provider that 
participates in a health care program that receives Federal 
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funds under this Act, or under title V, XIX, or XXI of 
the Social Security Act, shall be deemed as meeting any 
requirement for the maintenance of data in paper form 
under such program (whether or not for purposes of man-
agement, billing, reporting, reimbursement, or otherwise) 
if the required data is maintained in an electronic form. 
‘‘(b) RELATION TO STATE LAWS.—Beginning on the 
date that is one year after the date of the enactment of 
this section, subsection (a) shall supersede any contrary 
provision of State law. 
‘‘(c) CONSTRUCTION.—Nothing in this section shall 
be construed as— 
‘‘(1) requiring health care providers to maintain 
or submit data in electronic form; 
‘‘(2) preventing a State from permitting health 
care providers to maintain or submit data in paper 
form; or 
‘‘(3) preventing a State from requiring health 
care providers to maintain or submit data in elec-
tronic form.’’. 
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SEC. 405. ENSURING HEALTH CARE PROVIDERS PARTICI-
PATING IN THE MEDICARE PROGRAM MAY 
MAINTAIN HEALTH INFORMATION IN ELEC-
TRONIC FORM. 
Section 1871 of the Social Security Act (42 U.S.C. 
1395hh) is amended by adding at the end the following 
new subsection: 
‘‘(g)(1) Any provider of services or supplier shall be 
deemed as meeting any requirement for the maintenance 
of data in paper form under this title (whether or not for 
purposes of management, billing, reporting, reimburse-
ment, or otherwise) if the required data is maintained in 
an electronic form. 
‘‘(2) Nothing in this subsection shall be construed as 
requiring health care providers to maintain or submit data 
in electronic form.’’. 
SEC. 406. STUDY AND REPORT ON STATE, REGIONAL, AND 
COMMUNITY 
HEALTH 
INFORMATION 
EX-
CHANGES. 
(a) STUDY.—The Secretary of Health and Human 
Services shall conduct a study on issues related to the de-
velopment, operation, and implementation of State, re-
gional, and community health information exchanges. 
Such study shall include the following, with respect to 
such health information exchanges: 
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(1) Profiles detailing the current stages of such 
health information exchanges with respect to the 
progression of the development, operation, imple-
mentation, organization, and governance of such ex-
changes. 
(2) The impact of such exchanges on healthcare 
quality, safety, and efficiency, including— 
(A) any impact on the coordination of 
health 
information 
and 
services 
across 
healthcare providers and other organizations 
relevant to health care; 
(B) any impact on the availability of health 
information at the point-of-care to make timely 
medical decisions; 
(C) any benefits with respect to the pro-
motion of wellness, disease prevention, and 
chronic disease management; 
(D) any improvement with respect to pub-
lic health preparedness and response; 
(E) any impact on the widespread adoption 
of interoperable health information technology, 
including electronic health records; 
(F) any contributions to achieving an 
Internet-based national health information net-
work; 
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(G) any contribution of health information 
exchanges to consumer access and to con-
sumers’ use of their health information; and 
(H) any impact on the operation of— 
(i) the Medicaid and Medicare pro-
grams; 
(ii) the State Children’s Health Insur-
ance Program (SCHIP); 
(iii) disproportionate share hospitals 
described in section 1923 of the Social Se-
curity Act; 
(iv) Federally-qualified health centers; 
or 
(v) managed care plans, if a signifi-
cant number of the plan’s enrollees are 
beneficiaries in the Medicaid program or 
SCHIP. 
(3) 
Best 
practice 
models 
for 
financing, 
incentivizing, and sustaining such health information 
exchanges. 
(4) Information identifying the common prin-
ciples, policies, tools, and standards used (or pro-
posed) in the public and private sectors to support 
the development, operation, and implementation of 
such health information exchanges. 
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(5) A description of any areas in which Federal 
government leadership is needed to support growth 
and sustainability of such health information ex-
changes. 
(b) REPORT.—Not later than one year after the date 
of enactment of this Act, the Secretary of Health and 
Human Services shall submit to Congress a report on the 
study described in subsection (a), including such rec-
ommendations as the Secretary determines appropriate to 
facilitate the development, operation, and implementation 
of health information exchanges. 
SEC. 
407. 
PROMOTING 
HEALTH 
INFORMATION 
TECH-
NOLOGY AS A TOOL FOR CHRONIC DISEASE 
MANAGEMENT. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a two-year project to dem-
onstrate the impact of health information technology on 
disease management for individuals entitled to medical as-
sistance under a State plan under title XIX of the Social 
Security Act. 
(b) STRUCTURE OF PROJECT.—The project under 
subsection (a) shall— 
(1) create a web-based virtual case management 
tool that provides access to best practices for man-
aging chronic disease; and 
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(2) provide chronic disease patients and care-
givers access to their own medical records and to a 
single source of information on chronic disease. 
(c) COMPETITION.—Not later than the date that is 
90 days after the date of the enactment of this Act, the 
Secretary of Health and Human Services shall seek pro-
posals from States to carry out the project under sub-
section (a). The Secretary shall select not less than four 
of such proposals submitted, and at least one proposal se-
lected shall include a regional approach that features ac-
cess to an integrated hospital information system in at 
least two adjoining States and that permits the measure-
ment of health outcomes. 
(d) REPORT.—Not later than the date that is 90 days 
after the last day of the project under subsection (a), the 
Secretary of Health and Human Services shall submit to 
Congress a report on such project and shall include in 
such report the amount of any cost-savings resulting from 
the project and such recommendations for legislation or 
administrative action as the Secretary determines appro-
priate. 
Passed the House of Representatives July 27, 2006. 
Attest: 
KAREN L. HAAS, 
Clerk. 
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Calendar No. 587 
109TH CONGRESS 
2D SESSION 
H. R. 4157 
AN ACT 
To promote a better health information system. 
SEPTEMBER 5, 2006 
Read the second time and placed on the calendar 
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