I 
109TH CONGRESS 
2D SESSION 
H. R. 4859 
To amend chapter 89 of title 5, United States Code, to provide for the 
implementation of a system of electronic health records under the Federal 
Employees Health Benefits Program. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 2, 2006 
Mr. PORTER (for himself and Mr. CLAY) introduced the following bill; which 
was referred to the Committee on Government Reform 
A BILL 
To amend chapter 89 of title 5, United States Code, to 
provide for the implementation of a system of electronic 
health records under the Federal Employees Health Ben-
efits Program. 
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 the ‘‘Federal Family Health 
Information Technology Act of 2006’’. 
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SEC. 2. ELECTRONIC HEALTH RECORDS. 
(a) IN GENERAL.—Chapter 89 of title 5, United 
States Code, is amended by inserting after section 8902a 
the following: 
‘‘§ 8902b. Electronic health records 
‘‘(a) This section provides for the establishment, in 
connection with the program established under this chap-
ter, of electronic health records for each covered indi-
vidual, including— 
‘‘(1) requiring the establishment of a carrier 
electronic health record under subsection (b); 
‘‘(2) requiring the offering by carriers to cov-
ered individuals of a personal electronic health 
record under subsection (c); and 
‘‘(3) providing carrier-based incentives for es-
tablishing provider-based electronic health records 
under subsection (d). 
‘‘(b)(1) Each contract under this chapter shall re-
quire that the carrier establish, maintain, and make avail-
able, in accordance with standards adopted by the Office 
of Personnel Management under this section, a carrier 
electronic health record for each covered individual who 
is enrolled under this chapter in a health benefits plan 
offered by the carrier. 
‘‘(2)(A) A carrier electronic health record for a cov-
ered individual under this subsection shall consist of a car-
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rier’s health information on the individual’s health care 
claims, health care services data, or both, such as informa-
tion describing the individual’s inpatient facility admis-
sions, emergency room visits, and claims for prescription 
drugs. Such a record shall include, to the maximum extent 
practicable, such information as it relates to claims or 
services for another carrier in which the covered individual 
was previously enrolled under this title. 
‘‘(B) The information under subparagraph (A) shall 
cover the period beginning on the later of January 1, 
2008, or the date of the covered individual’s enrollment 
with the carrier under this title. Such period is not re-
quired to be longer than the period specified in standards 
adopted by the Office of Personnel Management under 
this section. 
‘‘(C) In the case of a covered individual who changes 
enrollment under this title after the effective date specified 
in paragraph (4) from one carrier to another carrier, the 
first carrier shall transfer information from the carrier 
electronic health record under this subsection to the sec-
ond carrier to the extent specified by the Office of Per-
sonnel Management by not later than 90 days after the 
date the first carrier receives notice of the change in en-
rollment. 
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‘‘(3) Information from a carrier electronic health 
record for a covered individual shall be made available to 
the individual and shall be made available (in accordance 
with the regulations promulgated pursuant to section 
264(c) of the Health Insurance Portability and Account-
ability Act of 1996) to a health care provider treating the 
individual. A carrier shall make such information avail-
able, in accordance with standards adopted under this sec-
tion— 
‘‘(A) promptly; 
‘‘(B) over a secure internet or other electronic- 
based connection; 
‘‘(C) in a format useful for diagnosis and treat-
ment; and 
‘‘(D) in a format that permits its importation 
into a personal electronic health record under sub-
section (c). 
‘‘(4) The previous provisions of this subsection shall 
apply with respect to contracts for contract years begin-
ning with— 
‘‘(A) the 3rd contract year (or 4th contract 
year, if the Office of Personnel Management deter-
mines that carriers are not prepared to implement 
the previous provisions of this subsection by such 
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3rd contract year) beginning after the date of the 
enactment of this section; or 
‘‘(B) such earlier contract year as the Office of 
Personnel Management may determine. 
‘‘(c)(1) Each contract under this chapter shall re-
quire the carrier in accordance with standards adopted 
under this section— 
‘‘(A) to provide, upon the request of a covered 
individual, for the establishment and maintenance of 
a personal electronic health record for the individual; 
‘‘(B) to establish a method for the individual to 
access the individual’s personal electronic health 
record through a mechanism that is integrated with 
access to the carrier electronic health record for the 
individual under subsection (b); and 
‘‘(C) to establish a method for the individual to 
transfer the individual’s personal electronic health 
record to the individual (or to a carrier or other en-
tity designated by the individual) upon the request 
of the individual at any time, including at the time 
of disenrollment of the individual. 
‘‘(2) A personal electronic health record for a covered 
individual shall consist of such personal health informa-
tion, such as family health history, symptoms, use of over- 
the-counter medication, diet, exercise, and other relevant 
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health information and activities, as the individual may 
provide. Such record may also include information from 
a provider-based electronic health record referred to in 
subsection (d) as well as from a carrier electronic health 
record. 
‘‘(3) Each contract under this chapter shall require 
the carrier to enable health information to be imported 
in standard electronic format into a personal electronic 
health record from a provider-based electronic health 
record and from a carrier electronic health record con-
sistent with standards adopted by the Office. 
‘‘(4) Nothing in this subsection shall be construed as 
authorizing the carrier or another person, other than a 
covered individual, to access a personal electronic health 
record of the individual without the authorization of the 
individual. 
‘‘(5) The previous provisions of this subsection shall 
apply with respect to contracts for contract years begin-
ning with the contract year beginning after the first con-
tract year with respect to which the requirements of sub-
section (b) are in effect under subsection (b)(4). 
‘‘(d)(1) Each contract under this chapter shall re-
quire the carrier to provide, in accordance with standards 
adopted by the Office under this section, incentives (sub-
ject to the availability of amounts from the Federal Fam-
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ily Health Information Technology Trust Fund, as estab-
lished by section 4 of the Federal Family Health Informa-
tion Technology Act of 2006) for providers to implement 
a comprehensive system of provider-based electronic 
health records for all patients covered by the contract. 
‘‘(2) The previous provisions of this subsection shall 
be effective with respect to contract years beginning with 
such contract year as the Office of Personnel Management 
shall determine. 
‘‘(e) Beginning with the contract year beginning after 
the first contract year with respect to which the require-
ments of subsection (b) are in effect, each carrier shall 
report to the Office of Personnel Management its progress 
and plan for enabling each covered individual, upon re-
quest, to store and access, through a portable, electronic 
medium, the individual’s personal electronic health record 
established under subsection (c), as well as the carrier 
electronic health record for the individual (established 
under subsection (b)) and provider-based electronic health 
records relating to the individual referred to in subsection 
(d). Such plan shall provide a means for such storage and 
access through such a portable medium beginning with the 
5th contract year after the first contract year with respect 
to which the requirements of subsection (b) are in effect. 
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‘‘(f)(1) Standards adopted under this section regard-
ing carrier, personal, and provider-based electronic health 
records shall be consistent with any standards for inter-
operability of electronic health records developed by 
ONCHIT. 
‘‘(2) In addition to paragraph (1), the Office of Per-
sonnel Management shall consult with ONCHIT in the im-
plementation of this section, including the establishment 
of effective dates under subsections (b)(4)(B) and (d)(2). 
‘‘(3) For purposes of this subsection, the term 
‘ONCHIT’ means the Office of the National Coordinator 
for Health Information Technology in the Department of 
Health and Human Services, and includes any successor 
to the functions performed by such Office. 
‘‘(g)(1) The Office of Personnel Management may 
waive any or all of the requirements of this section for 
a carrier described in paragraph (2) insofar as the carrier 
has established an electronic health record system that 
substantially meets the purpose of each such requirement 
that is waived. 
‘‘(2) A carrier described in this paragraph is a carrier 
that— 
‘‘(A) is an integrated health care system that 
combines the functions of a health plan, hospitals, 
pharmacy, laboratories, and clinicians; and 
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‘‘(B) has developed and is implementing, as of 
the date of the enactment of this section, a provider- 
based comprehensive electronic medical record for 
each member of the health plan. 
‘‘(h) For purposes of this section, the term ‘covered 
individual’ has the meaning given such term by section 
8902a(a)(1)(B).’’. 
(b) CONFORMING AMENDMENTS.—(1) Section 8902 
of title 5, United States Code, is amended by adding at 
the end the following: 
‘‘(p) A contract may not be made which is not in con-
formance with the requirements of section 8902b, except 
that the Office of Personnel Management may phase in 
or waive conformance with some or all of such require-
ments during the first two contract years in which a car-
rier has a contract under this title.’’. 
(2) The table of sections for chapter 89 of such title 
is amended by inserting after the item relating to section 
8902a the following: 
‘‘8902b. Electronic health records.’’. 
SEC. 3. PROVISION REGARDING RATES. 
During the period ending with the contract year fol-
lowing the first contract year with respect to which the 
requirements of subsection (b) of section 8902b of title 
5, United States Code, as inserted by section 2(a), are 
in effect, in determining rates under section 8902(i) of 
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such title, the Office of Personnel Management shall not 
take into account any carrier administrative costs, mone-
tary savings, or return on investment resulting from im-
plementation of carrier and personal electronic health 
records required under subsections (b) and (c) of such sec-
tion 8902b, except that the Office shall have access to the 
unused portion of contributions set aside in the Employees 
Health Benefits Fund under section 8909(b)(1) of such 
title without fiscal year limitation for such use as the Of-
fice considers necessary to assist carriers in complying 
with such subsections. 
SEC. 4. FEDERAL FAMILY HEALTH INFORMATION TECH-
NOLOGY TRUST FUND. 
(a) IN GENERAL.—The Office of Personnel Manage-
ment shall establish the Federal Family Health Informa-
tion Technology Trust Fund (in this section referred to 
as the ‘‘Trust Fund’’) for the purpose of receiving dona-
tions to be used to award grants to carriers who meet cer-
tain requirements as set forth by the Office. 
(b) ACCEPTANCE
OF DONATIONS.—In accordance 
with the section, the Office may accept donations made 
to the Trust Fund. Donations made to the Trust Fund, 
and grants awarded from such Fund to carriers, shall not 
be considered to be the solicitation or payment of remu-
neration of any kind, nor shall receipt of such grants be 
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considered an inducement to refer, purchase, order, or 
lease any good, facility, item, or service. 
(c) DEPOSIT OF AMOUNTS RECEIVED.—Funds re-
ceived by the Office under this section shall be transmitted 
by the Office to the Trust Fund. 
(d) FUNDS TO BE USED FOR CARRIER GRANTS.— 
The Office shall award grants from the Trust Fund to 
carriers under chapter 89 of title 5, United States Code, 
to be distributed under section 8902b(d) of such title as 
incentives to their contracting health care providers for 
implementing provider-based electronic health records 
based on requirements and qualifications set forth by the 
Office and standards adopted under section 8902b(f) of 
such title. 
SEC. 5. IMPLEMENTATION. 
The Office of Personnel Management shall provide 
for the implementation of this Act through appropriate ad-
ministrative guidance, which may be by regulation, by car-
rier letter, or otherwise. 
SEC. 6. HIPAA COMPLIANCE. 
Nothing in this Act shall be construed as affecting 
the application or compliance with regulations promul-
gated pursuant to section 264(c) of the Health Insurance 
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Portability and Accountability Act of 1996 (relating to ac-
cess to and disclosure of health information). 
Æ 
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