S.Amdt. 4530

1. Adds SEC. __. SMALL BUSINESS HEALTH INFORMATION TECHNOLOGY FINANCING PROGRAM wherever appropriate

   Adds a section

   Inserted: SEC. __. SMALL BUSINESS HEALTH INFORMATION TECHNOLOGY FINANCING PROGRAM.

   Inserted: The Small Business Act (15 U.S.C. 631 et seq.) is amended--

   Inserted: (1) by redesignating section 45 as section 46; and

   Inserted: (2) by inserting after section 44 the following:

   Inserted: "SEC. 45. LOAN GUARANTEES FOR HEALTH INFORMATION TECHNOLOGY.

   Inserted: "(a) Definitions.--In this section--

   Inserted: "(1) the term 'cost' has the meaning given that term in section 502 of the Federal Credit Reform Act of 1990 (2 U.S.C. 661a);

   Inserted: "(2) the term 'eligible professional' means--

   Inserted: "(A) a physician (as defined in section 1861(r) of the Social Security Act (42 U.S.C. 1395x(r)));

   Inserted: "(B) a practitioner described in section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 1395u(b)(18)(C));

   Inserted: "(C) a physical or occupational therapist;

   Inserted: "(D) a qualified speech-language pathologist (as defined in section 1861(ll)(4)(A) of the Social Security Act (42 U.S.C. 1395x(ll)(4)(A));

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   Inserted: "(E) a qualified audiologist (as defined in section 1861(ll)(4)(B) of the Social Security Act (42 U.S.C. 1395x(ll)(4)(B));

   Inserted: "(F) a qualified medical transcriptionist;

   Inserted: "(G) a State-licensed pharmacist;

   Inserted: "(H) a State-licensed supplier of durable medical equipment, prosthetics, orthotics, or supplies; and

   Inserted: "(I) a State-licensed, a State-certified, or a nationally accredited home health care provider;

   Inserted: "(3) the term 'health information technology'--

   Inserted: "(A) means computer hardware, software, and related technology that--

   Inserted: "(i) supports the requirements for being treated as a meaningful EHR user (as described in section 1848(o)(2)(A) of the Social Security Act (42 U.S.C. 1395w-4(o)(2)(A))) and is purchased by an eligible professional to aid in the provision of health care in a health care setting, including electronic medical records; and

   Inserted: "(ii) provides for--

   Inserted: "(I) enhancement of continuity of care for patients through electronic storage, transmission, and exchange of relevant personal health data and information, such as ensuring that this information is accessible at the times and places where clinical decisions will be or are likely to be made;

   Inserted: "(II) enhancement of communication between patients and health care providers;

   Inserted: "(III) improvement of quality measurement by eligible professionals enabling the eligible professionals to collect, store, measure, and report on the processes and outcomes of individual and population performance and quality of care;

   Inserted: "(IV) improvement of evidence-based decision support; or

   Inserted: "(V) enhancement of consumer and patient empowerment; and

   Inserted: "(B) does not include information technology the sole use of which is financial management, maintenance of inventory of basic supplies, or appointment scheduling;

   Inserted: "(4) the term 'qualified eligible professional' means an eligible professional whose office is a small business concern; and

   Inserted: "(5) the term 'qualified medical transcriptionist' means a specialist in medical language and the healthcare documentation process who--

   Inserted: "(A) interprets and transcribes dictation by physicians and other healthcare professionals to ensure accurate, complete, and consistent documentation of healthcare encounters; and

   Inserted: "(B) is certified by or registered with the Association for Healthcare Documentation Integrity, or a successor association thereto.

   Inserted: "(b) Loan Guarantees for Qualified Eligible Professionals.--

   Inserted: "(1) In general.--Subject to paragraph (2), the Administrator may guarantee not more than 90 percent of a loan made to a qualified eligible professional for the acquisition of health information technology for use in the medical practice of the qualified eligible professional and for the costs associated with the installation of the health information technology. Except as otherwise provided in this section, a loan guaranteed under this section shall be made on the same terms and conditions as a loan made under section 7(a).

   Inserted: "(2) Limitations on guarantee amounts.--The maximum amount of loan principal guaranteed under this subsection may not be more than--

   Inserted: "(A) $350,000 with respect to any 1 qualified eligible professional; and

   Inserted: "(B) $2,000,000 with respect to 1 group of affiliated qualified eligible professionals.

   Inserted: "(c) Fees.--

   Inserted: "(1) In general.--The Administrator may--

   Inserted: "(A) impose a guarantee fee on a qualified eligible professional for the purpose of reducing the cost of the guarantee to zero in an amount not to exceed 2 percent of the total guaranteed portion of any loan guaranteed under this section; and

   Inserted: "(B) impose an annual servicing fee on a lender making a loan guaranteed under this section of not more 0.5 percent of the outstanding balance of the guaranteed portion of loans by the lender guaranteed under this section.

   Inserted: "(2) No fees by lenders.--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 relating to a loan guaranteed under this section.

   Inserted: "(d) Deferral Period.--A loan guaranteed under this section shall carry a deferral period of not less than 1 year and not more than 3 years. The Administrator may subsidize interest during the period for which a loan guaranteed under this section is deferred.

   Inserted: "(e) Effective Date.--The Administrator may not guarantee a loan under this section until the meaningful EHR use requirements have been determined by the Secretary of Health and Human Services.

   Inserted: "(f) Sunset.--The Administrator may not guarantee a loan under this section after the date that is 7 years after meaningful EHR use requirements have been determined by the Secretary of Health and Human Services.

   Inserted: "(g) Authorization of Appropriations.--There are authorized to be appropriated such sums as are necessary for the cost of guaranteeing $10,000,000,000 in loans under this section. The Administrator shall determine the cost of guaranteeing loans under this section separately and distinctly from other programs operated by the Administrator.".

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   Original wording

   At the appropriate place, insert the following:

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As printed