I 
109TH CONGRESS 
1ST SESSION 
H. R. 747
To amend title XI of the Social Security Act to achieve a national health 
information infrastructure, and to amend the Internal Revenue Code 
of 1986 to establish a refundable credit for expenditures of health care 
providers implementing such infrastructure. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 10, 2005
Mr. GONZALEZ (for himself, Mr. MCHUGH, Ms. JACKSON-LEE of Texas, Mr. 
TOWNS, 
Mr. 
LIPINSKI, 
Mr. 
HINOJOSA, 
Mr. 
CROWLEY, 
Mrs. 
CHRISTENSEN, Mr. MOORE of Kansas, and Mr. MILLER of North Caro-
lina) introduced the following bill; which was referred to the Committee 
on Energy and Commerce, and in addition to the Committee on Ways 
and Means, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned 
A BILL 
To amend title XI of the Social Security Act to achieve 
a national health information infrastructure, and to 
amend the Internal Revenue Code of 1986 to establish 
a refundable credit for expenditures of health care pro-
viders implementing such infrastructure.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE. 
This Act may be cited as ‘‘National Health Informa-
tion Incentive Act of 2005’’. 
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.—The Congress finds as follows: 
(1) A March 2001 Institute of Medicine 
(‘‘IOM’’) study concludes that in order to improve 
quality, the nation must have a national commit-
ment to building an information infrastructure to 
support healthcare delivery, consumer health, quality 
measurement and improvement, public account-
ability, clinical and health services research, and 
clinical education. 
(2) A November 2001 National Committee on 
Vital Health Statistics study lauds the importance of 
a national health information infrastructure to im-
prove patient safety, improve healthcare quality, im-
prove bioterrorism detection, better inform and em-
power healthcare consumers regarding their own 
personal health information, and to better under-
stand healthcare costs. 
(3) An October 2002 IOM report calls on the 
federal government to take steps to encourage and 
facilitate development in the information technology 
infrastructure that is critical to healthcare quality 
and safety enhancement.
(4) A General Accounting Office October 2003 
report found that the benefits of an electronic 
healthcare information system included improved 
quality of care, reduced costs associated with medi-
cation errors, more accurate and complete medical 
documentation, more accurate capture of codes and 
charges, and improved communication among pro-
viders enabling them to respond more quickly to pa-
tients’ needs. 
(5) Other studies and surveys show that culti-
vating a national healthcare information infrastruc-
ture and improving patient care will depend crucially 
on adoption of uniform medical data standards and 
interoperability. 
(6) Acquisition costs, physician and staff time 
required to transition from paper-based offices to 
electronic health systems, and the lack of industry 
standards on interoperability are the principle bar-
riers to creating a national health information infra-
structure. 
(7) The success of a national health informa-
tion infrastructure depends on the widespread use 
and acceptance of electronic health records in physi-
cian offices.
(b) PURPOSES.—The purposes of this Act are as fol-
lows: 
(1) To facilitate the development of standards 
and to create incentives that encourage physicians 
and other health professionals to adopt interoperable 
electronic health records, electronic prescribing sys-
tems, evidence-based clinical support tools, patient 
registries, and other health information technology 
as a key component of a national health care infor-
mation infrastructure in the United States to ensure 
the rapid flow of secure, private and digitized infor-
mation relevant to all facets of patient care. 
(2) To do so in a voluntary manner that does 
not become an unfunded mandate on small physician 
practices. 
(3) To do so in a manner that does not com-
promise the health care provider’s ability to make 
patient care decisions based solely on his or her clin-
ical expertise and experience, and what the provider 
concludes is the best for a particular patient based 
upon scientific evidence and knowledge of the pa-
tient’s medical history.
SEC. 3. OFFICE OF THE NATIONAL COORDINATOR FOR 
HEALTH INFORMATION TECHNOLOGY. 
(a) ESTABLISHMENT.—There is established within 
the executive office of the President an Office of the Na-
tional Coordinator for Health Information Technology (re-
ferred to in this section as the ‘‘Office’’). The Office shall 
be headed by a Director appointed by the President. The 
Director of the Office shall report directly to the Presi-
dent. 
(b) RESOURCES.—The President shall make available 
to the Office the resources, both financial and otherwise, 
necessary to enable the Director of the Office to carry out 
the purposes of, and perform the duties and responsibil-
ities of, the Office. 
SEC. 4. STANDARDS FOR 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—STANDARDS FOR BUILDING THE NA-
TIONAL 
HEALTH 
INFORMATION 
INFRA-
STRUCTURE 
‘‘SEC. 1181. STANDARDS FOR BUILDING THE NATIONAL 
HEALTH INFORMATION INFRASTRUCTURE. 
‘‘(a) STANDARDS.—
‘‘(1) DEVELOPMENT AND ADOPTION.—
‘‘(A) 
IN
GENERAL.—The 
Secretary, 
through the Office of the National Coordinator 
for Health Information Technology and in col-
laboration with the Committee on Systematic 
Interoperability, shall develop or adopt stand-
ards for transactions and data elements for 
such transactions (in this section referred to as 
‘standards’) to enable the creation of a national 
health care information infrastructure. 
‘‘(B) ROLE OF STANDARD SETTING ORGA-
NIZATIONS.—
‘‘(i) IN
GENERAL.—Except as pro-
vided in clause (ii), any standard adopted 
under this section shall be a standard that 
has been developed, adopted, or modified 
by a standard setting organization. 
‘‘(ii) STANDARD SETTING ORGANIZA-
TION.—For purposes of this section, the 
term ‘standard setting organization’ means 
an organization accredited by the Amer-
ican National Standards Institute that de-
velops standards for information trans-
actions, data elements, or any other stand-
ard that is necessary to, or will facilitate, 
the implementation of this part.