S.Amdt. 386

SA 386. Mr. ENZI submitted an amendment intended to be proposed to
amendment SA 98 proposed by Mr. Inouye (for himself and Mr. Baucus) to
the bill H.R. 1, making supplemental appropriations for job
preservation and creation, infrastructure investment, energy efficiency
and science, assistance to the unemployed, and State and local fiscal
stabilization, for fiscal year ending September 30, 2009, and for other
purposes; which was ordered to lie on the table; as follows:

Beginning on page 292, strike line 4 and all that follows
through line 6 on page 293, and insert the following:

``SEC. 3007. FEDERAL HEALTH INFORMATION TECHNOLOGY.

``(a) In General.--The National Coordinator, in
consultation with other appropriate Federal agencies, shall
support the development and routine updating of qualified
electronic health record technology (as defined in section
3000) for any Federal agency that is engaged in such
activities on the date

[[Page S1714]]

of enactment of this title, and shall also provide qualified
electronic health record technologies, consistent with
subsections (b) and (c), but only if such qualified
electronic health record technology uses open standards and
the Secretary and the HIT Policy Committee first determine
that the needs and demands of providers are not being
substantially and adequately met through the marketplace.
``(b) Certification.--In making qualified electronic health
record technology publicly available under subsection (a),
the National Coordinator shall ensure that the qualified
electronic health record technology described in such
subsection is certified under the program developed under
section 3001(c)(5) to be in compliance with applicable
standards adopted under section 3004.
``(c) Authorization to Charge a Nominal Fee.--The National
Coordinator may impose a nominal fee for the adoption by a
health care provider of the qualified electronic health
record technology system provided for under subsection (a).
Such fee shall take into account the financial circumstances
of smaller providers, low income providers, and providers
located in rural or other medically underserved areas.
``(d) Rule of Construction.--Nothing in this section shall
be construed to require that a private or government entity
adopt or use the technology provided for under this section.
``(e) Definition.--In this section, the term `not being
substantially and adequately met through the marketplace'
means that the Secretary and the HIT Policy Committee have
determined, through a comprehensive market survey or other
assessment as the Secretary determines appropriate, that
certified technologies are either not available or are not in
widespread use in the marketplace. In order to ensure that
providers of qualified electronic health record technologies
have adequate opportunity to comply with applicable standards
adopted under section 3003(a), the Secretary shall undertake
such market survey or assessment not earlier than 12 months
after the date on which such standards are adopted and
promulgated.''.
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