H. R. 3590—849 
to the extent practicable, other payers, to the extent such 
information would provide a more accurate portrayal of physi-
cian performance; 
(5) processes to ensure appropriate attribution of care when 
multiple physicians and other providers are involved in the 
care of a patient; 
(6) processes to ensure timely statistical performance feed-
back is provided to physicians concerning the data reported 
under any program subject to public reporting under this sec-
tion; and 
(7) implementation of computer and data systems of the 
Centers for Medicare & Medicaid Services that support valid, 
reliable, and accurate public reporting activities authorized 
under this section. 
(c) ENSURING PATIENT PRIVACY.—The Secretary shall ensure 
that information on physician performance and patient experience 
is not disclosed under this section in a manner that violates sections 
552 or 552a of title 5, United States Code, with regard to the 
privacy of individually identifiable health information. 
(d) FEEDBACK FROM MULTI-STAKEHOLDER GROUPS.—The Sec-
retary shall take into consideration input provided by multi-stake-
holder groups, consistent with sections 1890(b)(7) and 1890A of 
the Social Security Act, as added by section 3014 of this Act, 
in selecting quality measures for use under this section. 
(e) CONSIDERATION
OF
TRANSITION
TO
VALUE-BASED
PUR-
CHASING.—In developing the plan under this subsection (a)(2), the 
Secretary shall, as the Secretary determines appropriate, consider 
the plan to transition to a value-based purchasing program for 
physicians and other practitioners developed under section 131 
of the Medicare Improvements for Patients and Providers Act of 
2008 (Public Law 110–275). 
(f) REPORT TO CONGRESS.—Not later than January 1, 2015, 
the Secretary shall submit to Congress a report on the Physician 
Compare Internet website developed under subsection (a)(1). Such 
report shall include information on the efforts of and plans made 
by the Secretary to collect and publish data on physician quality 
and efficiency and on patient experience of care in support of 
value-based purchasing and consumer choice, together with rec-
ommendations for such legislation and administrative action as 
the Secretary determines appropriate. 
(g) EXPANSION.—At any time before the date on which the 
report is submitted under subsection (f), the Secretary may expand 
(including expansion to other providers of services and suppliers 
under title XVIII of the Social Security Act) the information made 
available on such website. 
(h) FINANCIAL INCENTIVES TO ENCOURAGE CONSUMERS TO 
CHOOSE HIGH QUALITY PROVIDERS.—The Secretary may establish 
a demonstration program, not later than January 1, 2019, to provide 
financial incentives to Medicare beneficiaries who are furnished 
services by high quality physicians, as determined by the Secretary 
based on factors in subparagraphs (A) through (G) of subsection 
(a)(2). In no case may Medicare beneficiaries be required to pay 
increased premiums or cost sharing or be subject to a reduction 
in benefits under title XVIII of the Social Security Act as a result 
of such demonstration program. The Secretary shall ensure that
H. R. 3590—850 
any such demonstration program does not disadvantage those bene-
ficiaries without reasonable access to high performing physicians 
or create financial inequities under such title. 
(i) DEFINITIONS.—In this section: 
(1) ELIGIBLE
PROFESSIONAL.—The term ‘‘eligible profes-
sional’’ has the meaning given that term for purposes of the 
Physician Quality Reporting Initiative under section 1848 of 
the Social Security Act (42 U.S.C. 1395w–4). 
(2) PHYSICIAN.—The term ‘‘physician’’ has the meaning 
given that term in section 1861(r) of such Act (42 U.S.C. 
1395x(r)). 
(3) PHYSICIAN COMPARE.—The term ‘‘Physician Compare’’ 
means the Internet website developed under subsection (a)(1). 
(4) SECRETARY.—The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
SEC. 10332. AVAILABILITY OF MEDICARE DATA FOR PERFORMANCE 
MEASUREMENT. 
(a) IN GENERAL.—Section 1874 of the Social Security Act (42 
U.S.C. 1395kk) is amended by adding at the end the following 
new subsection: 
‘‘(e) AVAILABILITY OF MEDICARE DATA.— 
‘‘(1) IN GENERAL.—Subject to paragraph (4), the Secretary 
shall make available to qualified entities (as defined in para-
graph (2)) data described in paragraph (3) for the evaluation 
of the performance of providers of services and suppliers. 
‘‘(2) QUALIFIED ENTITIES.—For purposes of this subsection, 
the term ‘qualified entity’ means a public or private entity 
that— 
‘‘(A) is qualified (as determined by the Secretary) to 
use claims data to evaluate the performance of providers 
of services and suppliers on measures of quality, efficiency, 
effectiveness, and resource use; and 
‘‘(B) agrees to meet the requirements described in para-
graph (4) and meets such other requirements as the Sec-
retary may specify, such as ensuring security of data. 
‘‘(3) DATA DESCRIBED.—The data described in this para-
graph are standardized extracts (as determined by the Sec-
retary) of claims data under parts A, B, and D for items 
and services furnished under such parts for one or more speci-
fied geographic areas and time periods requested by a qualified 
entity. The Secretary shall take such actions as the Secretary 
deems necessary to protect the identity of individuals entitled 
to or enrolled for benefits under such parts. 
‘‘(4) REQUIREMENTS.— 
‘‘(A) FEE.—Data described in paragraph (3) shall be 
made available to a qualified entity under this subsection 
at a fee equal to the cost of making such data available. 
Any fee collected pursuant to the preceding sentence shall 
be deposited into the Federal Supplementary Medical 
Insurance Trust Fund under section 1841. 
‘‘(B) SPECIFICATION OF USES AND METHODOLOGIES.— 
A qualified entity requesting data under this subsection 
shall— 
‘‘(i) submit to the Secretary a description of the 
methodologies that such qualified entity will use to
H. R. 3590—851 
evaluate the performance of providers of services and 
suppliers using such data; 
‘‘(ii)(I) except as provided in subclause (II), if avail-
able, use standard measures, such as measures 
endorsed by the entity with a contract under section 
1890(a) and measures developed pursuant to section 
931 of the Public Health Service Act; or 
‘‘(II) use alternative measures if the Secretary, 
in consultation with appropriate stakeholders, deter-
mines that use of such alternative measures would 
be more valid, reliable, responsive to consumer pref-
erences, cost-effective, or relevant to dimensions of 
quality and resource use not addressed by such 
standard measures; 
‘‘(iii) include data made available under this sub-
section with claims data from sources other than claims 
data under this title in the evaluation of performance 
of providers of services and suppliers; 
‘‘(iv) only include information on the evaluation 
of performance of providers and suppliers in reports 
described in subparagraph (C); 
‘‘(v) make available to providers of services and 
suppliers, upon their request, data made available 
under this subsection; and 
‘‘(vi) prior to their release, submit to the Secretary 
the format of reports under subparagraph (C). 
‘‘(C) REPORTS.—Any report by a qualified entity evalu-
ating the performance of providers of services and suppliers 
using data made available under this subsection shall— 
‘‘(i) include an understandable description of the 
measures, which shall include quality measures and 
the rationale for use of other measures described in 
subparagraph (B)(ii)(II), risk adjustment methods, 
physician 
attribution 
methods, 
other 
applicable 
methods, data specifications and limitations, and the 
sponsors, so that consumers, providers of services and 
suppliers, health plans, researchers, and other stake-
holders can assess such reports; 
‘‘(ii) be made available confidentially, to any pro-
vider of services or supplier to be identified in such 
report, prior to the public release of such report, and 
provide an opportunity to appeal and correct errors; 
‘‘(iii) only include information on a provider of 
services or supplier in an aggregate form as determined 
appropriate by the Secretary; and 
‘‘(iv) except as described in clause (ii), be made 
available to the public. 
‘‘(D) APPROVAL
AND
LIMITATION
OF
USES.—The Sec-
retary shall not make data described in paragraph (3) 
available to a qualified entity unless the qualified entity 
agrees to release the information on the evaluation of 
performance of providers of services and suppliers. Such 
entity shall only use such data, and information derived 
from such evaluation, for the reports under subparagraph 
(C). Data released to a qualified entity under this sub-
section shall not be subject to discovery or admission as
H. R. 3590—852 
evidence in judicial or administrative proceedings without 
consent of the applicable provider of services or supplier.’’. 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 
shall take effect on January 1, 2012. 
SEC. 10333. COMMUNITY-BASED COLLABORATIVE CARE NETWORKS. 
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 new 
subpart: 
‘‘Subpart XI—Community-Based Collaborative 
Care Network Program 
‘‘SEC. 340H. COMMUNITY-BASED COLLABORATIVE CARE NETWORK 
PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary may award grants to eligible 
entities to support community-based collaborative care networks 
that meet the requirements of subsection (b). 
‘‘(b) COMMUNITY-BASED COLLABORATIVE CARE NETWORKS.— 
‘‘(1) DESCRIPTION.—A community-based collaborative care 
network (referred to in this section as a ‘network’) shall be 
a consortium of health care providers with a joint governance 
structure (including providers within a single entity) that pro-
vides comprehensive coordinated and integrated health care 
services (as defined by the Secretary) for low-income popu-
lations. 
‘‘(2) REQUIRED INCLUSION.—A network shall include the 
following providers (unless such provider does not exist within 
the community, declines or refuses to participate, or places 
unreasonable conditions on their participation): 
‘‘(A) A hospital that meets the criteria in section 
1923(b)(1) of the Social Security Act; and 
‘‘(B) All Federally qualified health centers (as defined 
in section 1861(aa) of the Social Security Act located in 
the community. 
‘‘(3) PRIORITY.—In awarding grants, the Secretary shall 
give priority to networks that include— 
‘‘(A) the capability to provide the broadest range of 
services to low-income individuals; 
‘‘(B) the broadest range of providers that currently 
serve a high volume of low-income individuals; and 
‘‘(C) a county or municipal department of health. 
‘‘(c) APPLICATION.— 
‘‘(1) APPLICATION.—A network described in subsection (b) 
shall submit an application to the Secretary. 
‘‘(2) RENEWAL.—In subsequent years, based on the perform-
ance of grantees, the Secretary may provide renewal grants 
to prior year grant recipients. 
‘‘(d) USE OF FUNDS.— 
‘‘(1) USE BY GRANTEES.—Grant funds may be used for the 
following activities: 
‘‘(A) Assist low-income individuals to— 
‘‘(i) access and appropriately use health services; 
‘‘(ii) enroll in health coverage programs; and 
‘‘(iii) obtain a regular primary care provider or 
a medical home. 
‘‘(B) Provide case management and care management.
H. R. 3590—853 
‘‘(C) Perform health outreach using neighborhood 
health workers or through other means. 
‘‘(D) Provide transportation. 
‘‘(E) Expand capacity, including through telehealth, 
after-hours services or urgent care. 
‘‘(F) Provide direct patient care services. 
‘‘(2) GRANT FUNDS TO HRSA GRANTEES.—The Secretary may 
limit the percent of grant funding that may be spent on direct 
care services provided by grantees of programs administered 
by the Health Resources and Services Administration or impose 
other requirements on such grantees deemed necessary. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There are authorized 
to be appropriated to carry out this section such sums as may 
be necessary for each of fiscal years 2011 through 2015.’’. 
SEC. 10334. MINORITY HEALTH. 
(a) OFFICE OF MINORITY HEALTH.— 
(1) IN GENERAL.—Section 1707 of the Public Health Service 
Act (42 U.S.C. 300u–6) is amended— 
(A) in subsection (a), by striking ‘‘within the Office 
of Public Health and Science’’ and all that follows through 
the end and inserting ‘‘. The Office of Minority Health 
as existing on the date of enactment of the Patient Protec-
tion and Affordable Care Act shall be transferred to the 
Office of the Secretary in such manner that there is estab-
lished in the Office of the Secretary, the Office of Minority 
Health, which shall be headed by the Deputy Assistant 
Secretary for Minority Health who shall report directly 
to the Secretary, and shall retain and strengthen authori-
ties (as in existence on such date of enactment) for the 
purpose of improving minority health and the quality of 
health care minorities receive, and eliminating racial and 
ethnic disparities. In carrying out this subsection, the Sec-
retary, acting through the Deputy Assistant Secretary, 
shall award grants, contracts, enter into memoranda of 
understanding, cooperative, interagency, intra-agency and 
other agreements with public and nonprofit private entities, 
agencies, as well as Departmental and Cabinet agencies 
and organizations, and with organizations that are indige-
nous human resource providers in communities of color 
to assure improved health status of racial and ethnic 
minorities, and shall develop measures to evaluate the 
effectiveness of activities aimed at reducing health dispari-
ties and supporting the local community. Such measures 
shall evaluate community outreach activities, language 
services, workforce cultural competence, and other areas 
as determined by the Secretary.’’; and 
(B) by striking subsection (h) and inserting the fol-
lowing: 
‘‘(h) 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 fiscal years 2011 through 
2016.’’. 
(2) TRANSFER OF FUNCTIONS.—There are transferred to the 
Office of Minority Health in the office of the Secretary of 
Health and Human Services, all duties, responsibilities, 
authorities, accountabilities, functions, staff, funds, award
H. R. 3590—854 
mechanisms, and other entities under the authority of the 
Office of Minority Health of the Public Health Service as in 
effect on the date before the date of enactment of this Act, 
which shall continue in effect according to the terms in effect 
on the date before such date of enactment, until modified, 
terminated, superseded, set aside, or revoked in accordance 
with law by the President, the Secretary, a court of competent 
jurisdiction, or by operation of law. 
(3) REPORTS.—Not later than 1 year after the date of enact-
ment of this section, and biennially thereafter, the Secretary 
of Health and Human Services shall prepare and submit to 
the appropriate committees of Congress a report describing 
the activities carried out under section 1707 of the Public 
Health Service Act (as amended by this subsection) during 
the period for which the report is being prepared. Not later 
than 1 year after the date of enactment of this section, and 
biennially thereafter, the heads of each of the agencies of the 
Department of Health and Human Services shall submit to 
the Deputy Assistant Secretary for Minority Health a report 
summarizing the minority health activities of each of the 
respective agencies. 
(b) ESTABLISHMENT
OF
INDIVIDUAL
OFFICES
OF
MINORITY 
HEALTH WITHIN THE DEPARTMENT OF HEALTH AND HUMAN SERV-
ICES.— 
(1) IN GENERAL.—Title XVII of the Public Health Service 
Act (42 U.S.C. 300u et seq.) is amended by inserting after 
section 1707 the following section: 
‘‘SEC. 1707A. INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN THE 
DEPARTMENT. 
‘‘(a) IN GENERAL.—The head of each agency specified in sub-
section (b)(1) shall establish within the agency an office to be 
known as the Office of Minority Health. The head of each such 
Office shall be appointed by the head of the agency within which 
the Office is established, and shall report directly to the head 
of the agency. The head of such agency shall carry out this section 
(as this section relates to the agency) acting through such Director. 
‘‘(b) SPECIFIED AGENCIES.—The agencies referred to in sub-
section (a) are the Centers for Disease Control and Prevention, 
the Health Resources and Services Administration, the Substance 
Abuse and Mental Health Services Administration, the Agency for 
Healthcare Research and Quality, the Food and Drug Administra-
tion, and the Centers for Medicare & Medicaid Services. 
‘‘(c) DIRECTOR; APPOINTMENT.—Each Office of Minority Health 
established in an agency listed in subsection (a) shall be headed 
by a director, with documented experience and expertise in minority 
health services research and health disparities elimination. 
‘‘(d) REFERENCES.—Except as otherwise specified, any reference 
in Federal law to an Office of Minority Health (in the Department 
of Health and Human Services) is deemed to be a reference to 
the Office of Minority Health in the Office of the Secretary. 
‘‘(e) FUNDING.— 
‘‘(1) ALLOCATIONS.—Of the amounts appropriated for a 
specified agency for a fiscal year, the Secretary must designate 
an appropriate amount of funds for the purpose of carrying 
out activities under this section through the minority health 
office of the agency. In reserving an amount under the preceding
H. R. 3590—855 
sentence for a minority health office for a fiscal year, the 
Secretary shall reduce, by substantially the same percentage, 
the amount that otherwise would be available for each of the 
programs of the designated agency involved. 
‘‘(2) AVAILABILITY OF FUNDS FOR STAFFING.—The purposes 
for which amounts made available under paragraph may be 
expended by a minority health office include the costs of 
employing staff for such office.’’. 
(2) NO NEW REGULATORY AUTHORITY.—Nothing in this sub-
section and the amendments made by this subsection may 
be construed as establishing regulatory authority or modifying 
any existing regulatory authority. 
(3) LIMITATION
ON
TERMINATION.—Notwithstanding any 
other provision of law, a Federal office of minority health or 
Federal appointive position with primary responsibility over 
minority health issues that is in existence in an office of agency 
of the Department of Health and Human Services on the date 
of enactment of this section shall not be terminated, reorga-
nized, or have any of its power or duties transferred unless 
such termination, reorganization, or transfer is approved by 
an Act of Congress. 
(c) REDESIGNATION OF NATIONAL CENTER ON MINORITY HEALTH 
AND HEALTH DISPARITIES.— 
(1) REDESIGNATION.—Title IV of the Public Health Service 
Act (42 U.S.C. 281 et seq.) is amended— 
(A) by redesignating subpart 6 of part E as subpart 
20; 
(B) by transferring subpart 20, as so redesignated, 
to part C of such title IV; 
(C) by inserting subpart 20, as so redesignated, after 
subpart 19 of such part C; and 
(D) in subpart 20, as so redesignated— 
(i) by redesignating sections 485E through 485H 
as sections 464z–3 through 464z–6, respectively; 
(ii) by striking ‘‘National Center on Minority 
Health and Health Disparities’’ each place such term 
appears and inserting ‘‘National Institute on Minority 
Health and Health Disparities’’; and 
(iii) by striking ‘‘Center’’ each place such term 
appears and inserting ‘‘Institute’’. 
(2) PURPOSE OF INSTITUTE; DUTIES.—Section 464z–3 of the 
Public Health Service Act, as so redesignated, is amended— 
(A) in subsection (h)(1), by striking ‘‘research endow-
ments at centers of excellence under section 736.’’ and 
inserting the following: ‘‘research endowments— 
‘‘(1) at centers of excellence under section 736; and 
‘‘(2) at centers of excellence under section 464z–4.’’; 
(B) in subsection (h)(2)(A), by striking ‘‘average’’ and 
inserting ‘‘median’’; and 
(C) by adding at the end the following: 
‘‘(h) 
INTERAGENCY
COORDINATION.—The 
Director 
of 
the 
Institute, as the primary Federal officials with responsibility for 
coordinating all research and activities conducted or supported by 
the National Institutes of Health on minority health and health 
disparities, shall plan, coordinate, review and evaluate research 
and other activities conducted or supported by the Institutes and 
Centers of the National Institutes of Health.’’.
H. R. 3590—856 
(3) TECHNICAL AND CONFORMING AMENDMENTS.— 
(A) Section 401(b)(24) of the Public Health Service 
Act (42 U.S.C. 281(b)(24)) is amended by striking ‘‘Center’’ 
and inserting ‘‘Institute’’. 
(B) Subsection (d)(1) of section 903 of the Public Health 
Service Act (42 U.S.C. 299a–1(d)(1)) is amended by striking 
‘‘section 485E’’ and inserting ‘‘section 464z–3’’. 
SEC. 10335. TECHNICAL CORRECTION TO THE HOSPITAL VALUE-BASED 
PURCHASING PROGRAM. 
Section 1886(o)(2)A) of the Social Security Act, as added by 
section 3001, is amended, in the first sentence, by inserting ‘‘, 
other than measures of readmissions,’’ after ‘‘shall select measures’’. 
SEC. 10336. GAO STUDY AND REPORT ON MEDICARE BENEFICIARY 
ACCESS TO HIGH-QUALITY DIALYSIS SERVICES. 
(a) STUDY.— 
(1) IN GENERAL.—The Comptroller General of the United 
States shall conduct a study on the impact on Medicare bene-
ficiary access to high-quality dialysis services of including speci-
fied oral drugs that are furnished to such beneficiaries for 
the treatment of end stage renal disease in the bundled prospec-
tive payment system under section 1881(b)(14) of the Social 
Security Act (42 U.S.C. 1395rr(b)(14)) (pursuant to the proposed 
rule published by the Secretary of Health and Human Services 
in the Federal Register on September 29, 2009 (74 Fed. Reg. 
49922 et seq.)). Such study shall include an analysis of— 
(A) the ability of providers of services and renal dialysis 
facilities to furnish specified oral drugs or arrange for 
the provision of such drugs; 
(B) the ability of providers of services and renal dialysis 
facilities to comply, if necessary, with applicable State laws 
(such as State pharmacy licensure requirements) in order 
to furnish specified oral drugs; 
(C) whether appropriate quality measures exist to safe-
guard care for Medicare beneficiaries being furnished speci-
fied oral drugs by providers of services and renal dialysis 
facilities; and 
(D) other areas determined appropriate by the Comp-
troller General. 
(2) SPECIFIED ORAL DRUG DEFINED.—For purposes of para-
graph (1), the term ‘‘specified oral drug’’ means a drug or 
biological for which there is no injectable equivalent (or other 
non-oral form of administration). 
(b) REPORT.—Not later than 1 year after the date of the enact-
ment of this Act, the Comptroller General of the United States 
shall submit to Congress a report containing the results of the 
study conducted under subsection (a), together with recommenda-
tions for such legislation and administrative action as the Comp-
troller General determines appropriate. 
Subtitle D—Provisions Relating to Title IV 
SEC. 10401. AMENDMENTS TO SUBTITLE A. 
(a) Section 4001(h)(4) and (5) of this Act is amended by striking 
‘‘2010’’ each place such appears and inserting ‘‘2020’’. 
(b) Section 4002(c) of this Act is amended—
H. R. 3590—857 
(1) by striking ‘‘research and health screenings’’ and 
inserting ‘‘research, health screenings, and initiatives’’; and 
(2) by striking ‘‘for Preventive’’ and inserting ‘‘Regarding 
Preventive’’. 
(c) Section 4004(a)(4) of this Act is amended by striking ‘‘a 
Gateway’’ and inserting ‘‘an Exchange’’. 
SEC. 10402. AMENDMENTS TO SUBTITLE B. 
(a) Section 399Z–1(a)(1(A) of the Public Health Service Act, 
as added by section 4101(b) of this Act, is amended by inserting 
‘‘and vision’’ after ‘‘oral’’. 
(b) Section 1861(hhh)(4)(G) of the Social Security Act, as added 
by section 4103(b), is amended to read as follows: 
‘‘(G) A beneficiary shall be eligible to receive only an 
initial preventive physical examination (as defined under 
subsection (ww)(1)) during the 12-month period after the 
date that the beneficiary’s coverage begins under part B 
and shall be eligible to receive personalized prevention 
plan services under this subsection each year thereafter 
provided that the beneficiary has not received either an 
initial preventive physical examination or personalized 
prevention plan services within the preceding 12-month 
period.’’. 
SEC. 10403. AMENDMENTS TO SUBTITLE C. 
Section 4201 of this Act is amended— 
(1) in subsection (a), by adding before the period the fol-
lowing: ‘‘, with not less than 20 percent of such grants being 
awarded to rural and frontier areas’’; 
(2) in subsection (c)(2)(B)(vii), by striking ‘‘both urban and 
rural areas’’ and inserting ‘‘urban, rural, and frontier areas’’; 
and 
(3) in subsection (f), by striking ‘‘each fiscal years’’ and 
inserting ‘‘each of fiscal year’’. 
SEC. 10404. AMENDMENTS TO SUBTITLE D. 
Section 399MM(2) of the Public Health Service Act, as added 
by section 4303 of this Act, is amended by striking ‘‘by ensuring’’ 
and inserting ‘‘and ensuring’’. 
SEC. 10405. AMENDMENTS TO SUBTITLE E. 
Subtitle E of title IV of this Act is amended by striking section 
4401. 
SEC. 10406. AMENDMENT RELATING TO WAIVING COINSURANCE FOR 
PREVENTIVE SERVICES. 
Section 4104(b) of this Act is amended to read as follows: 
‘‘(b) PAYMENT AND ELIMINATION OF COINSURANCE IN ALL SET-
TINGS.—Section 1833(a)(1) of the Social Security Act (42 U.S.C. 
1395l(a)(1)), as amended by section 4103(c)(1), is amended— 
‘‘(1) in subparagraph (T), by inserting ‘(or 100 percent 
if such services are recommended with a grade of A or B 
by the United States Preventive Services Task Force for any 
indication or population and are appropriate for the individual)’ 
after ‘80 percent’; 
‘‘(2) in subparagraph (W)—
H. R. 3590—858 
‘‘(A) in clause (i), by inserting ‘(if such subparagraph 
were applied, by substituting ‘‘100 percent’’ for ‘‘80 per-
cent’’)’ after ‘subparagraph (D)’; and 
‘‘(B) in clause (ii), by striking ‘80 percent’ and inserting 
‘100 percent’; 
‘‘(3) by striking ‘and’ before ‘(X)’; and 
‘‘(4) by inserting before the semicolon at the end the fol-
lowing: ‘, and (Y) with respect to preventive services described 
in subparagraphs (A) and (B) of section 1861(ddd)(3) that are 
appropriate for the individual and, in the case of such services 
described in subparagraph (A), are recommended with a grade 
of A or B by the United States Preventive Services Task Force 
for any indication or population, the amount paid shall be 
100 percent of (i) except as provided in clause (ii), the lesser 
of the actual charge for the services or the amount determined 
under the fee schedule that applies to such services under 
this part, and (ii) in the case of such services that are covered 
OPD services (as defined in subsection (t)(1)(B)), the amount 
determined under subsection (t)’.’’. 
SEC. 10407. BETTER DIABETES CARE. 
(a) SHORT TITLE.—This section may be cited as the ‘‘Catalyst 
to Better Diabetes Care Act of 2009’’. 
(b) NATIONAL DIABETES REPORT CARD.— 
(1) IN GENERAL.—The Secretary, in collaboration with the 
Director of the Centers for Disease Control and Prevention 
(referred to in this section as the ‘‘Director’’), shall prepare 
on a biennial basis a national diabetes report card (referred 
to in this section as a ‘‘Report Card’’) and, to the extent possible, 
for each State. 
(2) CONTENTS.— 
(A) IN
GENERAL.—Each Report Card shall include 
aggregate health outcomes related to individuals diagnosed 
with diabetes and prediabetes including— 
(i) preventative care practices and quality of care; 
(ii) risk factors; and 
(iii) outcomes. 
(B) UPDATED REPORTS.—Each Report Card that is pre-
pared after the initial Report Card shall include trend 
analysis for the Nation and, to the extent possible, for 
each State, for the purpose of— 
(i) tracking progress in meeting established 
national goals and objectives for improving diabetes 
care, costs, and prevalence (including Healthy People 
2010); and 
(ii) informing policy and program development. 
(3) AVAILABILITY.—The Secretary, in collaboration with the 
Director, shall make each Report Card publicly available, 
including by posting the Report Card on the Internet. 
(c) IMPROVEMENT OF VITAL STATISTICS COLLECTION.— 
(1) IN
GENERAL.—The Secretary, acting through the 
Director of the Centers for Disease Control and Prevention 
and in collaboration with appropriate agencies and States, 
shall— 
(A) promote the education and training of physicians 
on the importance of birth and death certificate data and 
how to properly complete these documents, including the
H. R. 3590—859 
collection of such data for diabetes and other chronic dis-
eases; 
(B) encourage State adoption of the latest standard 
revisions of birth and death certificates; and 
(C) work with States to re-engineer their vital statistics 
systems in order to provide cost-effective, timely, and 
accurate vital systems data. 
(2) DEATH
CERTIFICATE
ADDITIONAL
LANGUAGE.—In car-
rying out this subsection, the Secretary may promote improve-
ments to the collection of diabetes mortality data, including 
the addition of a question for the individual certifying the 
cause of death regarding whether the deceased had diabetes. 
(d) STUDY ON APPROPRIATE LEVEL OF DIABETES MEDICAL EDU-
CATION.— 
(1) IN GENERAL.—The Secretary shall, in collaboration with 
the Institute of Medicine and appropriate associations and coun-
cils, conduct a study of the impact of diabetes on the practice 
of medicine in the United States and the appropriateness of 
the level of diabetes medical education that should be required 
prior to licensure, board certification, and board recertification. 
(2) REPORT.—Not later than 2 years after the date of the 
enactment of this Act, the Secretary shall submit a report 
on the study under paragraph (1) to the Committees on Ways 
and Means and Energy and Commerce of the House of Rep-
resentatives and the Committees on Finance and Health, Edu-
cation, Labor, and Pensions of the Senate. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There are authorized 
to be appropriated to carry out this section such sums as may 
be necessary. 
SEC. 10408. GRANTS FOR SMALL BUSINESSES TO PROVIDE COM-
PREHENSIVE WORKPLACE WELLNESS PROGRAMS. 
(a) ESTABLISHMENT.—The Secretary shall award grants to 
eligible employers to provide their employees with access to com-
prehensive workplace wellness programs (as described under sub-
section (c)). 
(b) SCOPE.— 
(1) DURATION.—The grant program established under this 
section shall be conducted for a 5-year period. 
(2) ELIGIBLE
EMPLOYER.—The term ‘‘eligible employer’’ 
means an employer (including a non-profit employer) that— 
(A) employs less than 100 employees who work 25 
hours or greater per week; and 
(B) does not provide a workplace wellness program 
as of the date of enactment of this Act. 
(c) COMPREHENSIVE WORKPLACE WELLNESS PROGRAMS.— 
(1) CRITERIA.—The Secretary shall develop program criteria 
for comprehensive workplace wellness programs under this sec-
tion that are based on and consistent with evidence-based 
research and best practices, including research and practices 
as provided in the Guide to Community Preventive Services, 
the Guide to Clinical Preventive Services, and the National 
Registry for Effective Programs. 
(2) REQUIREMENTS.—A comprehensive workplace wellness 
program shall be made available by an eligible employer to 
all employees and include the following components:
H. R. 3590—860 
(A) Health awareness initiatives (including health edu-
cation, preventive screenings, and health risk assessments). 
(B) 
Efforts 
to 
maximize 
employee 
engagement 
(including mechanisms to encourage employee participa-
tion). 
(C) Initiatives to change unhealthy behaviors and life-
style choices (including counseling, seminars, online pro-
grams, and self-help materials). 
(D) Supportive environment efforts (including work-
place policies to encourage healthy lifestyles, healthy 
eating, increased physical activity, and improved mental 
health). 
(d) APPLICATION.—An eligible employer desiring to participate 
in the grant program under this section shall submit an application 
to the Secretary, in such manner and containing such information 
as the Secretary may require, which shall include a proposal for 
a comprehensive workplace wellness program that meet the criteria 
and requirements described under subsection (c). 
(e) AUTHORIZATION OF APPROPRIATION.—For purposes of car-
rying out the grant program under this section, there is authorized 
to be appropriated $200,000,000 for the period of fiscal years 2011 
through 2015. Amounts appropriated pursuant to this subsection 
shall remain available until expended. 
SEC. 10409. CURES ACCELERATION NETWORK. 
(a) SHORT TITLE.—This section may be cited as the ‘‘Cures 
Acceleration Network Act of 2009’’. 
(b) REQUIREMENT FOR THE DIRECTOR OF NIH TO ESTABLISH 
A CURES ACCELERATION NETWORK.—Section 402(b) of the Public 
Health Service Act (42 U.S.C. 282(b)) is amended— 
(1) in paragraph (22), by striking ‘‘and’’ at the end; 
(2) in paragraph (23), by striking the period and inserting 
‘‘; and’’; and 
(3) by inserting after paragraph (23), the following: 
‘‘(24) implement the Cures Acceleration Network described 
in section 402C.’’. 
(c) ACCEPTING GIFTS TO SUPPORT THE CURES ACCELERATION 
NETWORK.—Section 499(c)(1) of the Public Health Service Act (42 
U.S.C. 290b(c)(1)) is amended by adding at the end the following: 
‘‘(E) The Cures Acceleration Network described in sec-
tion 402C.’’. 
(d) ESTABLISHMENT OF THE CURES ACCELERATION NETWORK.— 
Part A of title IV of the Public Health Service Act is amended 
by inserting after section 402B (42 U.S.C. 282b) the following: 
‘‘SEC. 402C. CURES ACCELERATION NETWORK. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) BIOLOGICAL PRODUCT.—The term ‘biological product’ 
has the meaning given such term in section 351 of the Public 
Health Service Act. 
‘‘(2) DRUG; DEVICE.—The terms ‘drug’ and ‘device’ have 
the meanings given such terms in section 201 of the Federal 
Food, Drug, and Cosmetic Act. 
‘‘(3) HIGH NEED CURE.—The term ‘high need cure’ means 
a drug (as that term is defined by section 201(g)(1) of the 
Federal Food, Drug, and Cosmetic Act, biological product (as 
that term is defined by section 262(i)), or device (as that term 
is defined by section 201(h) of the Federal Food, Drug, and
H. R. 3590—861 
Cosmetic Act) that, in the determination of the Director of 
NIH— 
‘‘(A) is a priority to diagnose, mitigate, prevent, or 
treat harm from any disease or condition; and 
‘‘(B) for which the incentives of the commercial market 
are unlikely to result in its adequate or timely development. 
‘‘(4) MEDICAL PRODUCT.—The term ‘medical product’ means 
a drug, device, biological product, or product that is a combina-
tion of drugs, devices, and biological products. 
‘‘(b) ESTABLISHMENT OF THE CURES ACCELERATION NETWORK.— 
Subject to the appropriation of funds as described in subsection 
(g), there is established within the Office of the Director of NIH 
a program to be known as the Cures Acceleration Network (referred 
to in this section as ‘CAN’), which shall— 
‘‘(1) be under the direction of the Director of NIH, taking 
into account the recommendations of a CAN Review Board 
(referred to in this section as the ‘Board’), described in sub-
section (d); and 
‘‘(2) award grants and contracts to eligible entities, as 
described in subsection (e), to accelerate the development of 
high need cures, including through the development of medical 
products and behavioral therapies. 
‘‘(c) FUNCTIONS.—The functions of the CAN are to— 
‘‘(1) conduct and support revolutionary advances in basic 
research, translating scientific discoveries from bench to bed-
side; 
‘‘(2) award grants and contracts to eligible entities to accel-
erate the development of high need cures; 
‘‘(3) provide the resources necessary for government agen-
cies, independent investigators, research organizations, bio-
technology companies, academic research institutions, and other 
entities to develop high need cures; 
‘‘(4) reduce the barriers between laboratory discoveries and 
clinical trials for new therapies; and 
‘‘(5) facilitate review in the Food and Drug Administration 
for the high need cures funded by the CAN, through activities 
that may include— 
‘‘(A) the facilitation of regular and ongoing communica-
tion with the Food and Drug Administration regarding 
the status of activities conducted under this section; 
‘‘(B) ensuring that such activities are coordinated with 
the approval requirements of the Food and Drug Adminis-
tration, with the goal of expediting the development and 
approval of countermeasures and products; and 
‘‘(C) connecting interested persons with additional tech-
nical assistance made available under section 565 of the 
Federal Food, Drug, and Cosmetic Act. 
‘‘(d) CAN BOARD.— 
‘‘(1) ESTABLISHMENT.—There is established a Cures Accel-
eration Network Review Board (referred to in this section as 
the ‘Board’), which shall advise the Director of NIH on the 
conduct of the activities of the Cures Acceleration Network. 
‘‘(2) MEMBERSHIP.— 
‘‘(A) IN GENERAL.— 
‘‘(i) APPOINTMENT.—The Board shall be comprised 
of 24 members who are appointed by the Secretary 
and who serve at the pleasure of the Secretary.
H. R. 3590—862 
‘‘(ii) CHAIRPERSON
AND
VICE
CHAIRPERSON.—The 
Secretary shall designate, from among the 24 members 
appointed under clause (i), one Chairperson of the 
Board (referred to in this section as the ‘Chairperson’) 
and one Vice Chairperson. 
‘‘(B) TERMS.— 
‘‘(i) IN GENERAL.—Each member shall be appointed 
to serve a 4-year term, except that any member 
appointed to fill a vacancy occurring prior to the expira-
tion of the term for which the member’s predecessor 
was appointed shall be appointed for the remainder 
of such term. 
‘‘(ii) 
CONSECUTIVE
APPOINTMENTS; 
MAXIMUM 
TERMS.—A member may be appointed to serve not 
more than 3 terms on the Board, and may not serve 
more than 2 such terms consecutively. 
‘‘(C) QUALIFICATIONS.— 
‘‘(i) IN
GENERAL.—The Secretary shall appoint 
individuals to the Board based solely upon the individ-
ual’s established record of distinguished service in one 
of the areas of expertise described in clause (ii). Each 
individual appointed to the Board shall be of distin-
guished achievement and have a broad range of dis-
ciplinary interests. 
‘‘(ii) 
EXPERTISE.—The 
Secretary 
shall 
select 
individuals based upon the following requirements: 
‘‘(I) For each of the fields of— 
‘‘(aa) basic research; 
‘‘(bb) medicine; 
‘‘(cc) biopharmaceuticals; 
‘‘(dd) discovery and delivery of medical 
products; 
‘‘(ee) bioinformatics and gene therapy; 
‘‘(ff) medical instrumentation; and 
‘‘(gg) regulatory review and approval of 
medical products, 
the Secretary shall select at least 1 individual 
who is eminent in such fields. 
‘‘(II) At least 4 individuals shall be recognized 
leaders in professional venture capital or private 
equity organizations and have demonstrated 
experience in private equity investing. 
‘‘(III) At least 8 individuals shall represent 
disease advocacy organizations. 
‘‘(3) EX-OFFICIO MEMBERS.— 
‘‘(A) APPOINTMENT.—In addition to the 24 Board mem-
bers described in paragraph (2), the Secretary shall appoint 
as ex-officio members of the Board— 
‘‘(i) a representative of the National Institutes of 
Health, recommended by the Secretary of the Depart-
ment of Health and Human Services; 
‘‘(ii) a representative of the Office of the Assistant 
Secretary of Defense for Health Affairs, recommended 
by the Secretary of Defense;
H. R. 3590—863 
‘‘(iii) a representative of the Office of the Under 
Secretary for Health for the Veterans Health Adminis-
tration, recommended by the Secretary of Veterans 
Affairs; 
‘‘(iv) a representative of the National Science 
Foundation, recommended by the Chair of the National 
Science Board; and 
‘‘(v) a representative of the Food and Drug 
Administration, recommended by the Commissioner of 
Food and Drugs. 
‘‘(B) TERMS.—Each ex-officio member shall serve a 3- 
year term on the Board, except that the Chairperson may 
adjust the terms of the initial ex-officio members in order 
to provide for a staggered term of appointment for all 
such members. 
‘‘(4) RESPONSIBILITIES OF THE BOARD AND THE DIRECTOR 
OF NIH.— 
‘‘(A) RESPONSIBILITIES OF THE BOARD.— 
‘‘(i) IN GENERAL.—The Board shall advise, and pro-
vide recommendations to, the Director of NIH with 
respect to— 
‘‘(I) policies, programs, and procedures for car-
rying out the duties of the Director of NIH under 
this section; and 
‘‘(II) significant barriers to successful trans-
lation of basic science into clinical application 
(including issues under the purview of other agen-
cies and departments). 
‘‘(ii) REPORT.—In the case that the Board identifies 
a significant barrier, as described in clause (i)(II), the 
Board shall submit to the Secretary a report regarding 
such barrier. 
‘‘(B) RESPONSIBILITIES OF THE DIRECTOR OF NIH.—With 
respect to each recommendation provided by the Board 
under subparagraph (A)(i), the Director of NIH shall 
respond in writing to the Board, indicating whether such 
Director will implement such recommendation. In the case 
that the Director of NIH indicates a recommendation of 
the Board will not be implemented, such Director shall 
provide an explanation of the reasons for not implementing 
such recommendation. 
‘‘(5) MEETINGS.— 
‘‘(A) IN GENERAL.—The Board shall meet 4 times per 
calendar year, at the call of the Chairperson. 
‘‘(B) QUORUM; REQUIREMENTS; LIMITATIONS.— 
‘‘(i) QUORUM.—A quorum shall consist of a total 
of 13 members of the Board, excluding ex-officio mem-
bers, with diverse representation as described in clause 
(iii). 
‘‘(ii) CHAIRPERSON
OR
VICE
CHAIRPERSON.—Each 
meeting of the Board shall be attended by either the 
Chairperson or the Vice Chairperson. 
‘‘(iii) DIVERSE REPRESENTATION.—At each meeting 
of the Board, there shall be not less than one scientist, 
one representative of a disease advocacy organization, 
and one representative of a professional venture capital 
or private equity organization.
H. R. 3590—864 
‘‘(6) COMPENSATION AND TRAVEL EXPENSES.— 
‘‘(A) COMPENSATION.—Members shall receive com-
pensation at a rate to be fixed by the Chairperson but 
not to exceed a rate equal to the daily equivalent of the 
annual rate of basic pay prescribed for level IV of the 
Executive Schedule under section 5315 of title 5, United 
States Code, for each day (including travel time) during 
which the member is engaged in the performance of the 
duties of the Board. All members of the Board who are 
officers or employees of the United States shall serve with-
out compensation in addition to that received for their 
services as officers or employees of the United States. 
‘‘(B) TRAVEL EXPENSES.—Members of the Board shall 
be allowed travel expenses, including per diem in lieu 
of subsistence, at rates authorized for persons employed 
intermittently by the Federal Government under section 
5703(b) of title 5, United States Code, while away from 
their homes or regular places of business in the perform-
ance of services for the Board. 
‘‘(e) GRANT PROGRAM.— 
‘‘(1) SUPPORTING INNOVATION.—To carry out the purposes 
described in this section, the Director of NIH shall award 
contracts, grants, or cooperative agreements to the entities 
described in paragraph (2), to— 
‘‘(A) promote innovation in technologies supporting the 
advanced research and development and production of high 
need cures, including through the development of medical 
products and behavioral therapies. 
‘‘(B) accelerate the development of high need cures, 
including through the development of medical products, 
behavioral therapies, and biomarkers that demonstrate the 
safety or effectiveness of medical products; or 
‘‘(C) help the award recipient establish protocols that 
comply with Food and Drug Administration standards and 
otherwise permit the recipient to meet regulatory require-
ments at all stages of development, manufacturing, review, 
approval, and safety surveillance of a medical product. 
‘‘(2) ELIGIBLE ENTITIES.—To receive assistance under para-
graph (1), an entity shall— 
‘‘(A) be a public or private entity, which may include 
a private or public research institution, an institution of 
higher education, a medical center, a biotechnology com-
pany, a pharmaceutical company, a disease advocacy 
organization, a patient advocacy organization, or an aca-
demic research institution; 
‘‘(B) submit an application containing— 
‘‘(i) a detailed description of the project for which 
the entity seeks such grant or contract; 
‘‘(ii) a timetable for such project; 
‘‘(iii) an assurance that the entity will submit— 
‘‘(I) interim reports describing the entity’s— 
‘‘(aa) progress in carrying out the project; 
and 
‘‘(bb) compliance with all provisions of this 
section and conditions of receipt of such grant 
or contract; and
H. R. 3590—865 
‘‘(II) a final report at the conclusion of the 
grant period, describing the outcomes of the 
project; and 
‘‘(iv) a description of the protocols the entity will 
follow to comply with Food and Drug Administration 
standards and regulatory requirements at all stages 
of development, manufacturing, review, approval, and 
safety surveillance of a medical product; and 
‘‘(C) provide such additional information as the Director 
of NIH may require. 
‘‘(3) AWARDS.— 
‘‘(A) THE CURES ACCELERATION PARTNERSHIP AWARDS.— 
‘‘(i) INITIAL AWARD AMOUNT.—Each award under 
this subparagraph shall be not more than $15,000,000 
per project for the first fiscal year for which the project 
is funded, which shall be payable in one payment. 
‘‘(ii) FUNDING IN SUBSEQUENT FISCAL YEARS.—An 
eligible entity receiving an award under clause (i) may 
apply for additional funding for such project by submit-
ting to the Director of NIH the information required 
under subparagraphs (B) and (C) of paragraph (2). 
The Director may fund a project of such eligible entity 
in an amount not to exceed $15,000,000 for a fiscal 
year subsequent to the initial award under clause (i). 
‘‘(iii) MATCHING
FUNDS.—As a condition for 
receiving an award under this subsection, an eligible 
entity shall contribute to the project non-Federal funds 
in the amount of $1 for every $3 awarded under clauses 
(i) and (ii), except that the Director of NIH may waive 
or modify such matching requirement in any case 
where the Director determines that the goals and objec-
tives of this section cannot adequately be carried out 
unless such requirement is waived. 
‘‘(B) THE CURES ACCELERATION GRANT AWARDS.— 
‘‘(i) INITIAL AWARD AMOUNT.—Each award under 
this subparagraph shall be not more than $15,000,000 
per project for the first fiscal year for which the project 
is funded, which shall be payable in one payment. 
‘‘(ii) FUNDING IN SUBSEQUENT FISCAL YEARS.—An 
eligible entity receiving an award under clause (i) may 
apply for additional funding for such project by submit-
ting to the Board the information required under sub-
paragraphs (B) and (C) of paragraph (2). The Director 
of NIH may fund a project of such eligible entity in 
an amount not to exceed $15,000,000 for a fiscal year 
subsequent to the initial award under clause (i). 
‘‘(C) THE
CURES
ACCELERATION
FLEXIBLE
RESEARCH 
AWARDS.—If the Director of NIH determines that the goals 
and objectives of this section cannot adequately be carried 
out through a contract, grant, or cooperative agreement, 
the Director of NIH shall have flexible research authority 
to use other transactions to fund projects in accordance 
with the terms and conditions of this section. Awards made 
under such flexible research authority for a fiscal year 
shall not exceed 20 percent of the total funds appropriated 
under subsection (g)(1) for such fiscal year.
H. R. 3590—866 
‘‘(4) SUSPENSION OF AWARDS FOR DEFAULTS, NONCOMPLI-
ANCE WITH PROVISIONS AND PLANS, AND DIVERSION OF FUNDS; 
REPAYMENT OF FUNDS.—The Director of NIH may suspend the 
award to any entity upon noncompliance by such entity with 
provisions and plans under this section or diversion of funds. 
‘‘(5) AUDITS.—The Director of NIH may enter into agree-
ments with other entities to conduct periodic audits of the 
projects funded by grants or contracts awarded under this 
subsection. 
‘‘(6) CLOSEOUT
PROCEDURES.—At the end of a grant or 
contract period, a recipient shall follow the closeout procedures 
under section 74.71 of title 45, Code of Federal Regulations 
(or any successor regulation). 
‘‘(7) REVIEW.—A determination by the Director of NIH as 
to whether a drug, device, or biological product is a high need 
cure (for purposes of subsection (a)(3)) shall not be subject 
to judicial review. 
‘‘(f) COMPETITIVE BASIS OF AWARDS.—Any grant, cooperative 
agreement, or contract awarded under this section shall be awarded 
on a competitive basis. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—For purposes of carrying out this section, 
there are authorized to be appropriated $500,000,000 for fiscal 
year 2010, and such sums as may be necessary for subsequent 
fiscal years. Funds appropriated under this section shall be 
available until expended. 
‘‘(2) LIMITATION
ON
USE
OF
FUNDS
OTHERWISE
APPRO-
PRIATED.—No funds appropriated under this Act, other than 
funds appropriated under paragraph (1), may be allocated to 
the Cures Acceleration Network.’’. 
SEC. 10410. CENTERS OF EXCELLENCE FOR DEPRESSION. 
(a) SHORT TITLE.—This section may be cited as the ‘‘Estab-
lishing a Network of Health-Advancing National Centers of Excel-
lence for Depression Act of 2009’’ or the ‘‘ENHANCED Act of 2009’’. 
(b) CENTERS OF EXCELLENCE FOR DEPRESSION.—Subpart 3 of 
part B of title V of the Public Health Service Act (42 U.S.C. 
290bb et seq.) is amended by inserting after section 520A the 
following: 
‘‘SEC. 520B. NATIONAL CENTERS OF EXCELLENCE FOR DEPRESSION. 
‘‘(a) DEPRESSIVE DISORDER DEFINED.—In this section, the term 
‘depressive disorder’ means a mental or brain disorder relating 
to depression, including major depression, bipolar disorder, and 
related mood disorders. 
‘‘(b) GRANT PROGRAM.— 
‘‘(1) IN
GENERAL.—The Secretary, acting through the 
Administrator, shall award grants on a competitive basis to 
eligible entities to establish national centers of excellence for 
depression (referred to in this section as ‘Centers’), which shall 
engage in activities related to the treatment of depressive dis-
orders. 
‘‘(2) ALLOCATION
OF
AWARDS.—If the funds authorized 
under subsection (f) are appropriated in the amounts provided 
for under such subsection, the Secretary shall allocate such 
amounts so that—
H. R. 3590—867 
‘‘(A) not later than 1 year after the date of enactment 
of the ENHANCED Act of 2009, not more than 20 Centers 
may be established; and 
‘‘(B) not later than September 30, 2016, not more than 
30 Centers may be established. 
‘‘(3) GRANT PERIOD.— 
‘‘(A) IN GENERAL.—A grant awarded under this section 
shall be for a period of 5 years. 
‘‘(B) RENEWAL.—A grant awarded under subparagraph 
(A) may be renewed, on a competitive basis, for 1 additional 
5-year period, at the discretion of the Secretary. In deter-
mining whether to renew a grant, the Secretary shall con-
sider the report cards issued under subsection (e)(2). 
‘‘(4) USE OF FUNDS.—Grant funds awarded under this sub-
section shall be used for the establishment and ongoing activi-
ties of the recipient of such funds. 
‘‘(5) ELIGIBLE ENTITIES.— 
‘‘(A) REQUIREMENTS.—To be eligible to receive a grant 
under this section, an entity shall— 
‘‘(i) be an institution of higher education or a public 
or private nonprofit research institution; and 
‘‘(ii) submit an application to the Secretary at such 
time and in such manner as the Secretary may require, 
as described in subparagraph (B). 
‘‘(B) 
APPLICATION.—An 
application 
described 
in 
subparagraph (A)(ii) shall include— 
‘‘(i) evidence that such entity— 
‘‘(I) provides, or is capable of coordinating with 
other entities to provide, comprehensive health 
services with a focus on mental health services 
and subspecialty expertise for depressive disorders; 
‘‘(II) collaborates with other mental health pro-
viders, as necessary, to address co-occurring 
mental illnesses; 
‘‘(III) is capable of training health profes-
sionals about mental health; and 
‘‘(ii) such other information, as the Secretary may 
require. 
‘‘(C) PRIORITIES.—In awarding grants under this sec-
tion, the Secretary shall give priority to eligible entities 
that meet 1 or more of the following criteria: 
‘‘(i) Demonstrated capacity and expertise to serve 
the targeted population. 
‘‘(ii) Existing infrastructure or expertise to provide 
appropriate, evidence-based and culturally and linguis-
tically competent services. 
‘‘(iii) A location in a geographic area with dis-
proportionate numbers of underserved and at-risk 
populations in medically underserved areas and health 
professional shortage areas. 
‘‘(iv) Proposed innovative approaches for outreach 
to initiate or expand services. 
‘‘(v) Use of the most up-to-date science, practices, 
and interventions available. 
‘‘(vi) Demonstrated capacity to establish coopera-
tive and collaborative agreements with community 
mental health centers and other community entities
H. R. 3590—868 
to provide mental health, social, and human services 
to individuals with depressive disorders. 
‘‘(6) NATIONAL COORDINATING CENTER.— 
‘‘(A) IN GENERAL.—The Secretary, acting through the 
Administrator, shall designate 1 recipient of a grant under 
this section to be the coordinating center of excellence 
for depression (referred to in this section as the ‘coordi-
nating center’). The Secretary shall select such coordinating 
center on a competitive basis, based upon the demonstrated 
capacity of such center to perform the duties described 
in subparagraph (C). 
‘‘(B) APPLICATION.—A Center that has been awarded 
a grant under paragraph (1) may apply for designation 
as the coordinating center by submitting an application 
to the Secretary at such time, in such manner, and con-
taining such information as the Secretary may require. 
‘‘(C) DUTIES.—The coordinating center shall— 
‘‘(i) develop, administer, and coordinate the net-
work of Centers under this section; 
‘‘(ii) oversee and coordinate the national database 
described in subsection (d); 
‘‘(iii) lead a strategy to disseminate the findings 
and activities of the Centers through such database; 
and 
‘‘(iv) serve as a liaison with the Administration, 
the National Registry of Evidence-based Programs and 
Practices of the Administration, and any Federal inter-
agency or interagency forum on mental health. 
‘‘(7) MATCHING FUNDS.—The Secretary may not award a 
grant or contract under this section to an entity unless the 
entity agrees that it will make available (directly or through 
contributions from other public or private entities) non-Federal 
contributions toward the activities to be carried out under 
the grant or contract in an amount equal to $1 for each $5 
of Federal funds provided under the grant or contract. Such 
non-Federal matching funds may be provided directly or 
through donations from public or private entities and may 
be in cash or in-kind, fairly evaluated, including plant, equip-
ment, or services. 
‘‘(c) ACTIVITIES OF THE CENTERS.—Each Center shall carry out 
the following activities: 
‘‘(1) GENERAL ACTIVITIES.—Each Center shall— 
‘‘(A) integrate basic, clinical, or health services inter-
disciplinary research and practice in the development, 
implementation, and dissemination of evidence-based inter-
ventions; 
‘‘(B) involve a broad cross-section of stakeholders, such 
as researchers, clinicians, consumers, families of con-
sumers, and voluntary health organizations, to develop a 
research agenda and disseminate findings, and to provide 
support in the implementation of evidence-based practices; 
‘‘(C) provide training and technical assistance to mental 
health professionals, and engage in and disseminate 
translational research with a focus on meeting the needs 
of individuals with depressive disorders; and
H. R. 3590—869 
‘‘(D) educate policy makers, employers, community 
leaders, and the public about depressive disorders to reduce 
stigma and raise awareness of treatments. 
‘‘(2) IMPROVED
TREATMENT
STANDARDS, CLINICAL
GUIDE-
LINES, DIAGNOSTIC PROTOCOLS, AND CARE COORDINATION PRAC-
TICE.—Each Center shall collaborate with other Centers in 
the network to— 
‘‘(A) develop and implement treatment standards, clin-
ical guidelines, and protocols that emphasize primary 
prevention, early intervention, treatment for, and recovery 
from, depressive disorders; 
‘‘(B) 
foster 
communication 
with 
other 
providers 
attending to co-occurring physical health conditions such 
as cardiovascular, diabetes, cancer, and substance abuse 
disorders; 
‘‘(C) leverage available community resources, develop 
and implement improved self-management programs, and, 
when appropriate, involve family and other providers of 
social support in the development and implementation of 
care plans; and 
‘‘(D) use electronic health records and telehealth tech-
nology to better coordinate and manage, and improve access 
to, care, as determined by the coordinating center. 
‘‘(3) TRANSLATIONAL
RESEARCH
THROUGH
COLLABORATION 
OF
CENTERS
AND
COMMUNITY-BASED
ORGANIZATIONS.—Each 
Center shall— 
‘‘(A) demonstrate effective use of a public-private part-
nership to foster collaborations among members of the net-
work and community-based organizations such as commu-
nity mental health centers and other social and human 
services providers; 
‘‘(B) 
expand 
interdisciplinary, 
translational, 
and 
patient-oriented research and treatment; and 
‘‘(C) coordinate with accredited academic programs to 
provide ongoing opportunities for the professional and con-
tinuing education of mental health providers. 
‘‘(d) NATIONAL DATABASE.— 
‘‘(1) IN GENERAL.—The coordinating center shall establish 
and maintain a national, publicly available database to improve 
prevention programs, evidence-based interventions, and disease 
management programs for depressive disorders, using data col-
lected from the Centers, as described in paragraph (2). 
‘‘(2) DATA
COLLECTION.—Each Center shall submit data 
gathered at such center, as appropriate, to the coordinating 
center regarding— 
‘‘(A) the prevalence and incidence of depressive dis-
orders; 
‘‘(B) the health and social outcomes of individuals with 
depressive disorders; 
‘‘(C) the effectiveness of interventions designed, tested, 
and evaluated; 
‘‘(D) other information, as the Secretary may require. 
‘‘(3) SUBMISSION
OF
DATA
TO
THE
ADMINISTRATOR.—The 
coordinating center shall submit to the Administrator the data 
and financial information gathered under paragraph (2). 
‘‘(4) PUBLICATION
USING
DATA
FROM
THE
DATABASE.—A 
Center, or an individual affiliated with a Center, may publish
H. R. 3590—870 
findings using the data described in paragraph (2) only if such 
center submits such data to the coordinating center, as required 
under such paragraph. 
‘‘(e) ESTABLISHMENT OF STANDARDS; REPORT CARDS AND REC-
OMMENDATIONS; THIRD PARTY REVIEW.— 
‘‘(1) ESTABLISHMENT OF STANDARDS.—The Secretary, acting 
through the Administrator, shall establish performance stand-
ards for— 
‘‘(A) each Center; and 
‘‘(B) the network of Centers as a whole. 
‘‘(2) REPORT
CARDS.—The Secretary, acting through the 
Administrator, shall— 
‘‘(A) for each Center, not later than 3 years after the 
date on which such center of excellence is established and 
annually thereafter, issue a report card to the coordinating 
center to rate the performance of such Center; and 
‘‘(B) not later than 3 years after the date on which 
the first grant is awarded under subsection (b)(1) and 
annually thereafter, issue a report card to Congress to 
rate the performance of the network of centers of excellence 
as a whole. 
‘‘(3) RECOMMENDATIONS.—Based upon the report cards 
described in paragraph (2), the Secretary shall, not later than 
September 30, 2015— 
‘‘(A) make recommendations to the Centers regarding 
improvements such centers shall make; and 
‘‘(B) make recommendations to Congress for expanding 
the Centers to serve individuals with other types of mental 
disorders. 
‘‘(4) THIRD PARTY REVIEW.—Not later than 3 years after 
the date on which the first grant is awarded under subsection 
(b)(1) and annually thereafter, the Secretary shall arrange for 
an independent third party to conduct an evaluation of the 
network of Centers to ensure that such centers are meeting 
the goals of this section. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN
GENERAL.—To carry out this section, there are 
authorized to be appropriated— 
‘‘(A) $100,000,000 for each of the fiscal years 2011 
through 2015; and 
‘‘(B) $150,000,000 for each of the fiscal years 2016 
through 2020. 
‘‘(2) ALLOCATION OF FUNDS AUTHORIZED.—Of the amount 
appropriated under paragraph (1) for a fiscal year, the Secretary 
shall determine the allocation of each Center receiving a grant 
under this section, but in no case may the allocation be more 
than $5,000,000, except that the Secretary may allocate not 
more than $10,000,000 to the coordinating center.’’. 
SEC. 10411. PROGRAMS RELATING TO CONGENITAL HEART DISEASE. 
(a) SHORT TITLE.—This subtitle may be cited as the ‘‘Congenital 
Heart Futures Act’’. 
(b) PROGRAMS RELATING
TO CONGENITAL HEART DISEASE.— 
(1) NATIONAL CONGENITAL HEART DISEASE SURVEILLANCE 
SYSTEM.—Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.), as amended by section 5405, is further 
amended by adding at the end the following:
H. R. 3590—871 
‘‘SEC. 399V–2. NATIONAL CONGENITAL HEART DISEASE SURVEILLANCE 
SYSTEM. 
‘‘(a) IN GENERAL.—The Secretary, acting through the Director 
of the Centers for Disease Control and Prevention, may— 
‘‘(1) enhance and expand infrastructure to track the epide-
miology of congenital heart disease and to organize such 
information into a nationally-representative, population-based 
surveillance system that compiles data concerning actual occur-
rences of congenital heart disease, to be known as the ‘National 
Congenital Heart Disease Surveillance System’; or 
‘‘(2) award a grant to one eligible entity to undertake 
the activities described in paragraph (1). 
‘‘(b) PURPOSE.—The purpose of the Congenital Heart Disease 
Surveillance System shall be to facilitate further research into 
the types of health services patients use and to identify possible 
areas for educational outreach and prevention in accordance with 
standard practices of the Centers for Disease Control and Preven-
tion. 
‘‘(c) CONTENT.—The Congenital Heart Disease Surveillance 
System— 
‘‘(1) may include information concerning the incidence and 
prevalence of congenital heart disease in the United States; 
‘‘(2) may be used to collect and store data on congenital 
heart disease, including data concerning— 
‘‘(A) demographic factors associated with congenital 
heart disease, such as age, race, ethnicity, sex, and family 
history of individuals who are diagnosed with the disease; 
‘‘(B) risk factors associated with the disease; 
‘‘(C) causation of the disease; 
‘‘(D) treatment approaches; and 
‘‘(E) outcome measures, such that analysis of the out-
come measures will allow derivation of evidence-based best 
practices and guidelines for congenital heart disease 
patients; and 
‘‘(3) may ensure the collection and analysis of longitudinal 
data related to individuals of all ages with congenital heart 
disease, including infants, young children, adolescents, and 
adults of all ages. 
‘‘(d) PUBLIC ACCESS.—The Congenital Heart Disease Surveil-
lance System shall be made available to the public, as appropriate, 
including congenital heart disease researchers. 
‘‘(e) PATIENT PRIVACY.—The Secretary shall ensure that the 
Congenital Heart Disease Surveillance System is maintained in 
a manner that complies with the regulations promulgated under 
section 264 of the Health Insurance Portability and Accountability 
Act of 1996. 
‘‘(f) ELIGIBILITY FOR GRANT.—To be eligible to receive a grant 
under subsection (a)(2), an entity shall— 
‘‘(1) be a public or private nonprofit entity with specialized 
experience in congenital heart disease; and 
‘‘(2) submit to the Secretary an application at such time, 
in such manner, and containing such information as the Sec-
retary may require.’’. 
(2) CONGENITAL HEART DISEASE RESEARCH.—Subpart 2 of 
part C of title IV of the Public Health Service Act (42 U.S.C. 
285b et seq.) is amended by adding at the end the following:
H. R. 3590—872 
‘‘SEC. 425. CONGENITAL HEART DISEASE. 
‘‘(a) IN GENERAL.—The Director of the Institute may expand, 
intensify, and coordinate research and related activities of the 
Institute with respect to congenital heart disease, which may 
include congenital heart disease research with respect to— 
‘‘(1) causation of congenital heart disease, including genetic 
causes; 
‘‘(2) long-term outcomes in individuals with congenital 
heart disease, including infants, children, teenagers, adults, 
and elderly individuals; 
‘‘(3) diagnosis, treatment, and prevention; 
‘‘(4) studies using longitudinal data and retrospective anal-
ysis to identify effective treatments and outcomes for individ-
uals with congenital heart disease; and 
‘‘(5) identifying barriers to life-long care for individuals 
with congenital heart disease. 
‘‘(b) COORDINATION OF RESEARCH ACTIVITIES.—The Director of 
the Institute may coordinate research efforts related to congenital 
heart disease among multiple research institutions and may develop 
research networks. 
‘‘(c) MINORITY AND MEDICALLY UNDERSERVED COMMUNITIES.— 
In carrying out the activities described in this section, the Director 
of the Institute shall consider the application of such research 
and other activities to minority and medically underserved commu-
nities.’’. 
(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized 
to be appropriated to carry out the amendments made by this 
section such sums as may be necessary for each of fiscal years 
2011 through 2015. 
SEC. 10412. AUTOMATED DEFIBRILLATION IN ADAM’S MEMORY ACT. 
Section 312 of the Public Health Service Act (42 U.S.C. 244) 
is amended— 
(1) in subsection (c)(6), after ‘‘clearinghouse’’ insert ‘‘, that 
shall be administered by an organization that has substantial 
expertise in pediatric education, pediatric medicine, and 
electrophysiology and sudden death,’’; and 
(2) in the first sentence of subsection (e), by striking ‘‘fiscal 
year 2003’’ and all that follows through ‘‘2006’’ and inserting 
‘‘for each of fiscal years 2003 through 2014’’. 
SEC. 10413. YOUNG WOMEN’S BREAST HEALTH AWARENESS AND SUP-
PORT OF YOUNG WOMEN DIAGNOSED WITH BREAST 
CANCER. 
(a) SHORT TITLE.—This section may be cited as the ‘‘Young 
Women’s Breast Health Education and Awareness Requires 
Learning Young Act of 2009’’ or the ‘‘EARLY Act’’. 
(b) AMENDMENT.—Title III of the Public Health Service Act 
(42 U.S.C. 241 et seq.), as amended by this Act, is further amended 
by adding at the end the following: