[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1223 Introduced in Senate (IS)]
109th CONGRESS
1st Session
S. 1223
To amend the Public Health Service Act to improve the quality and
efficiency of health care delivery through improvements in health care
information technology, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 9, 2005
Mr. Dodd introduced the following bill; which was read twice and
referred to the Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to improve the quality and
efficiency of health care delivery through improvements in health care
information technology, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Information Technology for Health
Care Quality Act''.
SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.
The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by
adding at the end thereof the following:
``TITLE XXIX--HEALTH CARE INFORMATION TECHNOLOGY
``SEC. 2901. DEFINITIONS.
``In this title:
``(1) Coverage area.--The term `coverage area' means the
boundaries of a local health information infrastructure.
``(2) Director.--The term `Director' means the Director of
the Office of Health Information Technology.
``(3) Health care provider.--The term `health care
provider' means a hospital, skilled nursing facility, home
health entity, health care clinic, community health center,
group practice (as defined in section 1877(h)(4) of the Social
Security Act, including practices with only 1 physician), and
any other facility or clinician determined appropriate by the
Director.
``(4) Health information technology.--The term `health
information technology' means a computerized system that--
``(A) is consistent with the standards developed
pursuant to section 2903;
``(B) permits the secure electronic transmission of
information to other health care providers and public
health entities; and
``(C) includes--
``(i) an electronic health record (EHR)
that provides access in real-time to the
patient's complete medical record;
``(ii) a personal health record (PHR)
through which an individual (and anyone
authorized by such individual) can maintain and
manage their health information;
``(iii) computerized provider order entry
(CPOE) technology that permits the electronic
ordering of diagnostic and treatment services,
including prescription drugs;
``(iv) decision support to assist
physicians in making clinical decisions by
providing electronic alerts and reminders to
improve compliance with best practices, promote
regular screenings and other preventive
practices, and facilitate diagnoses and
treatments;
``(v) error notification procedures so that
a warning is generated if an order is entered
that is likely to lead to a significant adverse
outcome for the patient; and
``(vi) tools to allow for the collection,
analysis, and reporting of data on adverse
events, near misses, and the quality of care
provided to the patient.
``(5) Local health information infrastructures.--The term
`local health information infrastructure' means an independent
organization of health care entities established for the
purpose of linking health information systems to electronically
share information. A local health information infrastructure
may not be a single business entity.
``(6) Office.--The term `Office' means the Office of Health
Information Technology established under section 2902.
``SEC. 2902. OFFICE OF HEALTH INFORMATION TECHNOLOGY.
``(a) Establishment.--There is established within the executive
office of the President an Office of Health Information Technology. The
Office shall be headed by a Director to be appointed by the President.
The Director shall report directly to the President.
``(b) Purpose.--It shall be the purpose of the Office to--
``(1) improve the quality and increase the efficiency of
health care delivery through the use of health information
technology;
``(2) provide national leadership relating to, and
encourage the adoption of, health information technology;
``(3) direct all health information technology activities
within the Federal Government; and
``(4) facilitate the interaction between the Federal
Government and the private sector relating to health
information technology development and use.
``(c) Duties and Responsibilities.--The Office shall be responsible
for the following:
``(1) National strategy.--The Office shall develop a
national strategy for improving the quality and enhancing the
efficiency of health care through the improved use of health
information technology and the creation of a National Health
Information Infrastructure.
``(2) Federal leadership.--The Office shall--
``(A) serve as the principle advisor to the
President concerning health information technology;
``(B) direct all health information technology
activity within the Federal Government, including
approving or disapproving agency policies submitted
under paragraph (3);
``(C) work with public and private health
information technology stakeholders to implement the
national strategy described in paragraph (1); and
``(D) ensure that health information technology is
utilized as fully as practicable in carrying out health
surveillance efforts.
``(3) Agency policies.--
``(A) In general.--The Office shall, in accordance
with this paragraph, approve or disapprove the policies
of Federal departments or agencies with respect to any
policy proposed to be implemented by such agency or
department that would significantly affect that agency
or department's use of health information technology.
``(B) Submission of proposal.--The head of any
Federal Government agency or department that desires to
implement any policy with respect to such agency or
department that would significantly affect that agency
or department's use of health information technology
shall submit an implementation proposal to the Office
at least 60 days prior to the proposed date of the
implementation of such policy.
``(C) Approval or disapproval.--Not later than 60
days after the date on which a proposal is received
under subparagraph (B), the Office shall determine
whether to approve the implementation of such proposal.
In making such determination, the Office shall consider
whether the proposal is consistent with the national
strategy described in paragraph (1). If the Office
fails to make a determination within such 60-day
period, such proposal shall be deemed to be approved.
``(D) Failure to approve.--Except as otherwise
provided for by law, a proposal submitted under
subparagraph (B) may not be implemented unless such
proposal is approved or deemed to be approved under
subparagraph (C).
``(4) Coordination.--The Office shall--
``(A) encourage the development and adoption of
clinical, messaging, and decision support health
information data standards, pursuant to the
requirements of section 2903;
``(B) ensure the maintenance and implementation of
the data standards described in subparagraph (A);
``(C) oversee and coordinate the health information
technology efforts of the Federal Government;
``(D) ensure the compliance of the Federal
Government with federally adopted health information
technology data standards;
``(E) ensure that the Federal Government consults
and collaborates on decision making with respect to
health information technology with the private sector
and other interested parties; and
``(F) in consultation with private sector, adopt
certification and testing criteria to determine if
electronic health information systems interoperate.
``(5) Communication.--The Office shall--
``(A) act as the point of contact for the private
sector with respect to the use of health information
technology; and
``(B) work with the private sector to collect and
disseminate best health information technology
practices.
``(6) Evaluation and dissemination.--The Office shall
coordinate with the Agency for Health Research and Quality and
other Federal agencies to--
``(A) evaluate and disseminate information relating
to evidence of the costs and benefits of health
information technology and to whom those costs and
benefits accrue;
``(B) evaluate and disseminate information on the
impact of health information technology on the quality
and efficiency of patient care; and
``(C) review Federal payment structures and
differentials for health care providers that utilize
health information technology systems.
``(7) Technical assistance.--The Office shall utilize
existing private sector quality improvement organizations to--
``(A) promote the adoption of health information
technology among healthcare providers; and
``(B) provide technical assistance concerning the
implementation of health information technology to
healthcare providers.
``(8) Federal reimbursement.--
``(A) In general.--Not later than 6 months after
the date of enactment of this title, the Office shall
make recommendations to the President and the Secretary
of Health and Human Service on changes to Federal
reimbursement and payment structures that would
encourage the adoption of information technology (IT)
to improve health care quality and safety.
``(B) Plan.--Not later than 90 days after receiving
recommendations under subparagraph (A), the Secretary
shall provide to the relevant Committees of Congress a
report that provides, with respect to each
recommendation, a plan for the implementation, or an
explanation as to why implementation is inadvisable, of
such recommendations. The Office shall continue to
monitor federally funded and supported information
technology and quality initiatives (including the initiatives
authorized in this title), and periodically update recommendations to
the President and the Secretary.
``(d) Resources.--The President shall make available to the Office,
the resources, both financial and otherwise, necessary to enable the
Director to carry out the purposes of, and perform the duties and
responsibilities of the Office under, this section.
``(e) Detail of Federal Employees.--Upon the request of the
Director, the head of any Federal agency is authorized to detail,
without reimbursement from the Office, any of the personnel of such
agency to the Office to assist it in carrying out its duties under this
section. Any such detail shall not interrupt or otherwise affect the
civil service status or privileges of the Federal employee.
``SEC. 2903. PROMOTING THE INTEROPERABILITY OF HEALTH CARE INFORMATION
TECHNOLOGY SYSTEMS.
``(a) Development, and Federal Government Adoption, of Standards.--
``(1) Adoption.--
``(A) In general.--Not later than 2 years after the
date of the enactment of this title, the Director, in
collaboration with the Consolidated Health Informatics
Initiative (or a successor organization to such
Initiative), shall provide for the adoption by the
Federal Government of national data and communication
health information technology standards that promote
the efficient exchange of data between varieties of
provider health information technology systems. In
carrying out the preceding sentence, the Director may
adopt existing standards. Except as otherwise provided
for in this title, standards adopted under this section
shall be voluntary for private sector entities.
``(B) Grants or contracts.--The Director may
utilize grants or contracts to provide for the private
sector development of standards for adoption by the
Federal Government under subparagraph (A).
``(C) Definition.--In this paragraph, the term
`provide for' means that the Director shall promulgate,
and each Federal agency or department shall adopt,
regulations to ensure that each such agency or
department complies with the requirements of subsection
(b).
``(2) Requirements.--The standards developed and adopted
under paragraph (1) shall be designed to--
``(A) enable health information technology to be
used for the collection and use of clinically specific
data;
``(B) promote the interoperability of health care
information across health care settings;
``(C) facilitate clinical decision support through
the use of health information technology; and
``(D) ensure the privacy and confidentiality of
medical records.
``(3) Public private partnership.--Consistent with
activities being carried out on the date of enactment of this
title, including the Consolidated Health Informatics Initiative
(or a successor organization to such Initiative), health
information technology standards shall be adopted by the
Director under paragraph (1) at the conclusion of a
collaborative process that includes consultation between the
Federal Government and private sector health care and
information technology stakeholders.
``(4) Privacy and security.--The regulations promulgated by
the Secretary under part C of title XI of the Social Security
Act (42 U.S.C. 1320d et seq.) and sections 261, 262, 263, and
264 of the Health Insurance Portability and Accountability Act
of 1996 (42 U.S.C. 1320d-2 note) with respect to the privacy,
confidentiality, and security of health information shall apply
to the implementation of programs and activities under this
title.
``(5) Pilot tests.--To the extent practical, the Director
shall pilot test the health information technology data
standards developed under paragraph (1) prior to their
implementation under this section.
``(6) Dissemination.--
``(A) In general.--The Director shall ensure that
the standards adopted under paragraph (1) are widely
disseminated to interested stakeholders.
``(B) Licensing.--To facilitate the dissemination
and implementation of the standards developed and
adopted under paragraph (1), the Director may license
such standards, or utilize other means, to ensure the
widespread use of such standards.
``(b) Implementation of Standards.--
``(1) Purchase of systems by the secretary.--Effective
beginning on the date that is 1 year after the adoption of the
technology standards pursuant to subsection (a), the Secretary
shall not purchase any health care information technology
system unless such system is in compliance with the standards
adopted under subsection (a), nor shall the Director approve
any proposal pursuant to section 2902(c)(3) unless such
proposal utilizes systems that are in compliance with the
standards adopted under subsection (a).
``(2) Recipients of federal funds.--Effective on the date
described in paragraph (1), no appropriated funds may be used
to purchase a health care information technology system unless
such system is in compliance with applicable standards adopted
under subsection (a).
``(c) Modification of Standards.--The Director shall provide for
ongoing oversight of the health information technology standards
developed under subsection (a) to--
``(1) identify gaps or other shortcomings in such
standards; and
``(2) modify such standards when determined appropriate or
develop additional standards, in collaboration with standard
setting organizations.
``SEC. 2904. LOAN GUARANTEES FOR THE ADOPTION OF HEALTH INFORMATION
TECHNOLOGY.
``(a) In General.--The Director shall guarantee payment of the
principal of and the interest on loans made to eligible entities to
enable such entities--
``(1) to implement local health information infrastructures
to facilitate the development of interoperability across health
care settings to improve quality and efficiency; or
``(2) to facilitate the purchase and adoption of health
information technology to improve quality and efficiency.
``(b) Eligibility.--To be eligible to receive a loan guarantee
under subsection (a) an entity shall--
``(1) with respect to an entity desiring a loan guarantee--
``(A) under subsection (a)(1), be a coalition of
entities that represent an independent consortium of
health care stakeholders within a community that--
``(i) includes--
``(I) physicians (as defined in
section 1881(r)(1) of the Social
Security Act);
``(II) hospitals; and
``(III) group health plans or other
health insurance issuers (as such terms
are defined in section 2791); and
``(ii) may include any other health care
providers; or
``(B) under subsection (a)(2) be a health care
provider;
``(2) to the extent practicable, adopt the national health
information technology standards adopted under section 2903;
``(3) provide assurances that the entity shall submit to
the Director regular reports on the activities carried out
under the loan guarantee, including--
``(A) a description of the financial costs and
benefits of the project involved and of the entities to
which such costs and benefits accrue;
``(B) a description of the impact of the project on
health care quality and safety; and
``(C) a description of any reduction in duplicative
or unnecessary care as a result of the project
involved;
``(4) provide assurances that not later than 30 days after
the development of the standard quality measures pursuant to
section 2906, the entity shall submit to the Director regular
reports on such measures, including provider level data and
analysis of the impact of information technology on such
measures; and
``(5) prepare and submit to the Director an application at
such time, in such manner, and containing such information as
the Director may require.
``(c) Use of Funds.--Amounts received under a loan guarantee under
subsection (a) shall be used--
``(1) with respect to a loan guarantee described in
subsection (a)(1)--
``(A) to develop a plan for the implementation of a
local health information infrastructure under this
section;
``(B) to establish systems for the sharing of data
in accordance with the national health information
technology standards developed under section 2903;
``(C) to purchase directly related integrated
hardware and software to establish an interoperable
health information technology system that is capable of
linking to a local health care information
infrastructure; and
``(D) to train staff, maintain health information
technology systems, and maintain adequate security and
privacy protocols;
``(2) with respect to a loan guarantee described in
subsection (a)(2)--
``(A) to develop a plan for the purchase and
installation of health information technology;
``(B) to purchase directly related integrated
hardware and software to establish an interoperable
health information technology system that is capable of
linking to a national or local health care information
infrastructure; and
``(C) to train staff, maintain health information
technology systems, and maintain adequate security and
privacy protocols; and
``(3) to carry out any other activities determined
appropriate by the Director.
``(d) Special Considerations for Certain Entities.--In awarding
loan guarantees under this section, the Director shall give special
consideration to eligible entities that--
``(1) provide service to low-income and underserved
populations; and
``(2) agree to electronically submit the information
described in paragraphs (3) and (4) of subsection (b) on a
daily basis.
``(e) Special Considerations for Local Health Information
Infrastructures.--In awarding loan guarantees under this section to
local health information infrastructures, the Director shall give
special consideration to eligible entities that--
``(1) include at least 50 percent of the patients living in
the designated coverage area;
``(2) incorporate public health surveillance and reporting
into the overall architecture of the proposed infrastructure;
and
``(3) link local health information infrastructures.
``(f) Areas of Specific Interest.--In awarding loan guarantees
under this section, the Director shall include--
``(1) entities with a coverage area that includes an entire
State; and
``(2) entities with a multi-state coverage area.
``(g) Administrative Provisions.--
``(1) Aggregate amount.--
``(A) In general.--Except as provided in
subparagraph (B), the aggregate amount of principal of
loans guaranteed under subsection (a) with respect to
an eligible entity may not exceed $5,000,000. In any
12-month period the amount disbursed to an eligible
entity under this section (by a lender under a
guaranteed loan) may not exceed $5,000,000.
``(B) Exception.--The cumulative total of the
principal of the loans outstanding at any time to which
guarantees have been issued under subsection (a) may
not exceed such limitations as may be specified in
appropriation Acts.
``(2) Protection of federal government.--
``(A) In general.--The Director may not approve an
application for a loan guarantee under this section
unless the Director determines that--
``(i) the terms, conditions, security (if
any), and schedule and amount of repayments
with respect to the loan are sufficient to
protect the financial interests of the United
States and are otherwise reasonable, including
a determination that the rate of interest does
not exceed such percent per annum on the
principal obligation outstanding as the
Director determines to be reasonable, taking
into account the range of interest rates
prevailing in the private market for loans with
similar maturities, terms, conditions, and
security and the risks assumed by the United
States; and
``(ii) the loan would not be available on
reasonable terms and conditions without the
enactment of this section.
``(B) Recovery.--
``(i) In general.--The United States shall
be entitled to recover from the applicant for a
loan guarantee under this section the amount of
any payment made pursuant to such loan
guarantee, unless the Director for good cause
waives such right of recovery, and, upon making
any such payment, the United States shall be
subrogated to all of the rights of the
recipient of the payments with respect to which
the loan was made.
``(ii) Modification of terms.--Any terms
and conditions applicable to a loan guarantee
under this section may be modified by the
Director to the extent the Director determines
it to be consistent with the financial interest
of the United States.
``(3) Defaults.--The Director may take such action as the
Director deems appropriate to protect the interest of the
United States in the event of a default on a loan guaranteed
under this section, including taking possession of, holding,
and using real property pledged as security for such a loan
guarantee.
``(h) Authorization of Appropriations.--
``(1) In general.--There is authorized to be appropriated
to carry out this section, $250,000,000 for each of fiscal
years 2006 through 2011.
``(2) Availability.--Amounts appropriated under
subparagraph (A) shall remain available for obligation until
expended.
``SEC. 2905. GRANTS FOR THE PURCHASE OF HEALTH INFORMATION TECHNOLOGY.
``(a) In General.--The Director may award competitive grants to
eligible entities--
``(1) to implement local health information infrastructures
to facilitate the development of interoperability across health
care settings; or
``(2) to facilitate the purchase and adoption of health
information technology.
``(b) Eligibility.--To be eligible to receive a grant under section
(a) an entity shall--
``(1) demonstrate financial need to the Director;
``(2) with respect to an entity desiring a grant--
``(A) under subsection (a)(1), represent an
independent consortium of health care stakeholders
within a community that--
``(i) includes--
``(I) physicians (as defined in
section 1881(r)(1) of the Social
Security Act);
``(II) hospitals; and
``(III) group health plans or other
health insurance issuers (as such terms
are defined in section 2791); and
``(ii) may include any other health care
providers; or
``(B) under subsection (a)(2) be a health care
provider that provides health care services to low-
income and underserved populations;
``(3) adopt the national health information technology
standards developed under section 2903;
``(4) provide assurances that the entity shall submit to
the Director regular reports on the activities carried out
under the loan guarantee, including--
``(A) a description of the financial costs and
benefits of the project involved and of the entities to
which such costs and benefits accrue;
``(B) a description of the impact of the project on
health care quality and safety; and
``(C) a description of any reduction in duplicative
or unnecessary care as a result of the project
involved;
``(5) provide assurances that not later than 30 days after
the development of the standard quality measures pursuant to
section 2906, the entity shall submit to the Director regular
reports on such measures, including provider level data and
analysis of the impact of information technology on such
measures;
``(6) prepare and submit to the Director an application at
such time, in such manner, and containing such information as
the Director may require; and
``(7) agree to provide matching funds in accordance with
subsection (g).
``(c) Use of Funds.--Amounts received under a grant under
subsection (a) shall be used to--
``(1) with respect to a grant described in subsection
(a)(1)--
``(A) to develop a plan for the implementation of a
local health information infrastructure under this
section;
``(B) to establish systems for the sharing of data
in accordance with the national health information
technology standards developed under section 2903;
``(C) to implement, enhance, or upgrade a
comprehensive, electronic health information technology
system; and
``(D) to maintain adequate security and privacy
protocols;
``(2) with respect to a grant described in subsection
(a)(2)--
``(A) to develop a plan for the purchase and
installation of health information technology;
``(B) to purchase directly related integrated
hardware and software to establish an interoperable
health information technology system that is capable of
linking to a national or local health care information
infrastructure; and
``(C) to train staff, maintain health information
technology systems, and maintain adequate security and
privacy protocols;
``(3) maintain adequate security and privacy protocols; and
``(4) to carry out any other activities determined
appropriate by the Director.
``(d) Special Considerations for Certain Entities.--In awarding
grants under this section, the Director shall give special
consideration to eligible entities that--
``(1) provide service to low-income and underserved
populations; and
``(2) agree to electronically submit the information
described in paragraphs (4) and (5) of subsection (b).
``(e) Special Considerations for Local Health Information
Infrastructures.--In awarding grants under this section to local health
information infrastructures, the Director shall give special
consideration to eligible entities that--
``(1) include at least 50 percent of the patients living in
the designated coverage area;
``(2) incorporate public health surveillance and reporting
into the overall architecture of the proposed infrastructure;
and
``(3) link local health information infrastructures;
``(f) Areas of Specific Interest.--In awarding grants under this
section, the Director shall include--
``(1) entities with a coverage area that includes an entire
State; and
``(2) entities with a multi-state coverage area.
``(g) Matching Requirement.--
``(1) In general.--The Director may not make a grant under
this section to an entity unless the entity agrees that, with
respect to the costs to be incurred by the entity in carrying
out the infrastructure program for which the grant was awarded,
the entity will make available (directly or through donations
from public or private entities) non-Federal contributions
toward such costs in an amount equal to not less than 20
percent of such costs ($1 for each $5 of Federal funds provided
under the grant).
``(2) Determination of amount contributed.--Non-Federal
contributions required under paragraph (1) may be in cash or in
kind, fairly evaluated, including equipment, technology, or
services. Amounts provided by the Federal Government, or
services assisted or subsidized to any significant extent by
the Federal Government, may not be included in determining the
amount of such non-Federal contributions.
``(h) Authorization of Appropriations.--
``(1) In general.--There is authorized to be appropriated
to carry out this section, $250,000,000 for each of fiscal
years 2006 through 2011.
``(2) Availability.--Amounts appropriated under paragraph
(1) shall remain available for obligation until expended.''.
SEC. 3. STANDARDIZED MEASURES OF QUALITY HEALTH CARE AND DATA
COLLECTION.
Title XXIX of the Public Health Service Act, as added by section 2,
is amended by adding at the end the following:
``SEC. 2906. STANDARDIZED MEASURES OF QUALITY HEALTH CARE.
``(a) In General.--
``(1) Collaboration.--The Secretary of Health and Human
Services, the Secretary of Defense, and the Secretary of
Veterans Affairs (referred to in this section as the
`Secretaries'), in consultation with the Quality Interagency
Coordination Taskforce (as established by Executive Order on
March 13, 1998), the Institute of Medicine, the Joint
Commission on Accreditation of Healthcare Organizations, the
National Committee for Quality Assurance, the American Health
Quality Association, the National Quality Forum, the Medicare
Payment Advisory Committee, and other individuals and
organizations determined appropriate by the Secretaries, shall
establish uniform health care quality measures to assess the
effectiveness, timeliness, patient-centeredness, efficiency,
equity, and safety of care delivered across all federally
supported health delivery programs.
``(2) Development of measures.--Not later than 18 months
after the date of enactment of this title, the Secretaries
shall develop standardized sets of quality measures for each of
the 20 priority areas for improvement in health care quality as
identified by the Institute of Medicine in their report
entitled `Priority Areas for National Action' in 2003, or other
such areas as identified by the Secretaries in order to assist
beneficiaries in making informed choices about health plans or
care delivery systems. The selection of appropriate quality
indicators under this subsection shall include the evaluation
criteria formulated by clinical professionals, consumers, and
data collection experts.
``(3) Pilot testing.--Each federally supported health
delivery program may conduct a pilot test of the quality
measures developed under paragraph (2) that shall include a
collection of patient-level data and a public release of
comparative performance reports.
``(b) Public Reporting Requirements.--The Secretaries, working
collaboratively, shall establish public reporting requirements for
clinicians, institutional providers, and health plans in each of the
federally supported health delivery program described in subsection
(a). Such requirements shall provide that the entities described in the
preceding sentence shall report to the appropriate Secretary on the
measures developed under subsection (a).
``(c) Full Implementation.--The Secretaries, working
collaboratively, shall implement all sets of quality measures and
reporting systems developed under subsections (a) and (b) by not later
than the date that is 1 year after the date on which the measures are
developed under subsection (a)(2).
``(d) Reports.--Not later than 1 year after the date of enactment
of this title, and annually thereafter, the Secretary shall--
``(1) submit to Congress a report that details the
collaborative efforts carried out under subsection (a), the
progress made on standardizing quality indicators throughout
the Federal Government, and the state of quality measurement
for priority areas that links data to the report submitted
under paragraph (2) for the year involved; and
``(2) submit to Congress a report that details areas of
clinical care requiring further research necessary to establish
effective clinical treatments that will serve as a basis for
additional quality indicators.
``(e) Comparative Quality Reports.--Beginning not later than 3
years after the date of enactment of this title, in order to make
comparative quality information available to health care consumers,
including members of health disparity populations, health
professionals, public health officials, researchers, and other
appropriate individuals and entities, the Secretaries shall provide for
the pooling, analysis, and dissemination of quality measures collected
under this section. Nothing in this section shall be construed as
modifying the privacy standards under the Health Insurance Portability
and Accountability Act of 1996 (Public Law 104-191).
``(f) Ongoing Evaluation of Use.--The Secretary of Health and Human
Services shall ensure the ongoing evaluation of the use of the health
care quality measures established under this section.
``(g) Evaluation and Regulations.--
``(1) Evaluation.--
``(A) In general.--The Secretary shall, directly or
indirectly through a contract with another entity,
conduct an evaluation of the collaborative efforts of
the Secretaries to establish uniform health care
quality measures and reporting requirements for
federally supported health care delivery programs as
required under this section.
``(B) Report.--Not later than 1 year after the date
of enactment of this title, the Secretary of Health and
Human Services shall submit a report to the appropriate
committees of Congress concerning the results of the
evaluation under subparagraph (A).
``(2) Regulations.--
``(A) Proposed.--Not later than 6 months after the
date on which the report is submitted under paragraph
(1)(B), the Secretary shall publish proposed
regulations regarding the application of the uniform
health care quality measures and reporting requirements
described in this section to federally supported health
delivery programs.
``(B) Final regulations.--Not later than 1 year
after the date on which the report is submitted under
paragraph (1)(B), the Secretary shall publish final
regulations regarding the uniform health care quality
measures and reporting requirements described in this
section.
``(h) Definitions.--In this section, the term `federally supported
health delivery program' means a program that is funded by the Federal
Government under which health care items or services are delivered
directly to patients.''.
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