I 113th CONGRESS 1st Session H. R. 28 IN THE HOUSE OF REPRESENTATIVES January 3, 2013 Ms. Velázquez introduced the following bill; which was referred to the Committee on Small Business A BILL To amend the Small Business Act to provide loan guarantees for the acquisition of health information technology by eligible professionals in solo and small group practices, and for other purposes.

1. Short title This Act may be cited as the Working Families’ Access to Health Innovations Act of 2013 . 2. Amendment of small business act The Small Business Act is amended by redesignating section 45 as section 46 and by inserting after section 44 the following: 45. Loan guarantees for health information technology (a) Definitions As used in this section: (1) The term health information technology means computer hardware, software, and related technology (including electronic medical record technology) that— (A) supports the compliance with the meaningful EHR use requirements set forth in section 1848(o)(2)(A) of the Social Security Act ( 42 U.S.C. 1395w–4(o)(2)(A) ); (B) is purchased by an eligible professional to aid in the provision of health care in a health care setting; and (C) provides for— (i) enhancement of continuity of care for patients through electronic storage, transmission, and exchange of relevant personal health data and information, such that this information is accessible at the times and places where clinical decisions will be or are likely to be made; (ii) enhancement of communication between patients and health care providers; (iii) improvement of quality measurement by eligible professionals enabling them to collect, store, measure, and report on the processes and outcomes of individual and population performance and quality of care; (iv) improvement of evidence-based decision support; or (v) enhancement of consumer and patient empowerment. Such term does not include information technology the sole use of which is financial management, maintenance of inventory of basic supplies, or appointment scheduling. (2) The term eligible professional means any of the following: (A) A physician (as defined in section 1861(r) of the Social Security Act (42 U.S.C. 1395x(r))). (B) A practitioner described in section 1842(b)(18)(C) of such Act (42 U.S.C. 1395u(b)(18)(C)). (C) A physical or occupational therapist or a qualified speech-language pathologist. (D) A qualified audiologist (as defined in section 1861(ll)(4)(B) of such Act (42 U.S.C. 1395x(ll)(4)(B))). (E) A State-licensed pharmacist. (F) A State-licensed supplier of durable medical equipment, prosthetics, orthotics, or supplies. (G) A State-licensed, a State-certified, or a nationally accredited home health care provider. (3) The term qualified eligible professional means an eligible professional whose practice— (A) is a small business concern; and (B) (i) is in a medically underserved community (as defined in section 799B(6) of the Public Health Service Act ( 42 U.S.C. 295p(6) )); (ii) serves individuals at least 50 percent of whom are entitled to benefits or enrolled under title XVIII of the Social Security Act; or (iii) serves an area that consists predominantly of low-income families (as defined in section 3 of the United States Housing Act of 1937 ( 42 U.S.C. 1437a )). (b) Loan guarantees for qualified eligible professionals (1) Guarantee percentage Subject to paragraph (2), the Administrator may guarantee up to 90 percent of the amount of the loan made to a qualified eligible professional for the acquisition of health information technology for use in such eligible professional’s medical practice and for the costs associated with the installation of such technology. (2) Limitations on guarantee amounts The maximum amount of loan principal guaranteed under this subsection may not exceed— (A) $350,000 with respect to any single qualified eligible professional; and (B) $2,000,000 with respect to a single group of affiliated qualified eligible professionals. (c) Fees (1) The Administrator may impose a guarantee fee on the borrower in an amount not to exceed 2 percent of the total guaranteed portion of any loan guaranteed under this section. The Administrator may also impose annual servicing fees on lenders not to exceed 0.5 percent of the outstanding balance of the guarantees on lenders’ books. (2) No service fees, processing fees, origination fees, application fees, points, brokerage fees, bonus points, or other fees may be charged to a loan applicant or recipient by a lender in the case of a loan guaranteed under this section. (d) Interest rates The interest rate charged on a loan guaranteed under this section shall not be greater than 25 basis points below the rate provided for a loan under the program under section 7(a). (e) Deferral period Loans guaranteed under this section shall carry a deferral period of not more than 3 years. (f) Terms and conditions for loan guarantees The loans guaranteed under this section shall be subject to the terms and conditions that apply to the program under section 7(a) or other such terms and conditions as are prescribed by the Administrator. . 3. Small business development center duties Section 21(c)(3) of the Small Business Act ( 15 U.S.C. 648(c)(3) ) is amended— (1) by striking and at the end of subparagraph (S); (2) by striking the period at the end of subparagraph (T) and inserting a semicolon; and (3) by adding at the end the following: (U) facilitating the training of medical professionals in health information technology systems; and (V) establishing and providing a network of small health information technology companies available to medical professionals in low-income and underserved areas, as defined by the Secretary of Health and Human Services, for the purpose of aiding medical professionals in such areas to purchase, utilize, and maintain such technology. .