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A bill to promote a better health information system PDF

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CilSLi').:!)•> C2-07-13 7500Secu'i!-YBlvd. Saltimo*-';. M.ar/f^rci 21244 raCONGRESS T-|- -pj DPfOOOOCDf 2DSession |-|^ j^^ Topromoteabetterhealthinformationsystem. IN THE HOUSE OF REPRESENTATIVES April24,2008 Mr. Burgessintroducedthefollowingbill;whichwasreferredtotheCom- mitteeonEnergy-andCommerce, andinadditiontotheCommitteeon Ways and Means, for a period to be subsequentlydetermined bythe Speaker,ineachcaseforconsiderationofsuchprovisionsasfallwithin thejurisdictionofthecommitteeconcerned A BILL Topromoteabetterhealthinformationsystem. 1 BeitenactedhytheSenateandHouseofRepresenta- 2 tivesoftheUnitedStatesofAmericainCongressassembled, 3 SECTION1.SHORTTITLEANDTABLEOFCONTENTS. — 4 (a) Short Title. This Act may be cited as the 5 "HealthInformationTechnologyPromotionActof2008". — 6 (b) Table ofContents. Thetableofcontentsof 7 thisActisasfollows: See. 1. Shorttitleandtableofcontents. Sec.2.Preservingprivacyandsecuritylaws. TITLEI—PROMOTINGTHEUSEOFHEALTHINFORMATION TECHNOLOGYTOBETTERCOORDINATEHEALTHCARE 2 Sec. 101. Safeharborstoantikickbackcivilpenaltiesandcriminalpenaltiesfor provisionofHealthInformationTechnologyandtrainingserv- ices. Sec. 102.Exceptiontolimitationoncertainphysicianreferrals(underStark) forprovisionofHealthInformationTechnologyandtraining servicestohealthcareprofessionals. Sec. 103.Rulesofconstructionregardinguseofconsortia. TITLEn—ADDITIONALPROVISIONS See. 201.Promotionoftelehealthservices. Sec. 202. Studyandreportonexpansionofhomehealth-relatedtelehealthserv- ices. Sec. 203. Studyandreportonstoreandforwardtechnologyfortelehealth. Sec. 204.Ensuringhealth care providers participating in PHSA programs, Medicaid,SCHIP,ortheMCHprogrammaymaintainhealth informationinelectronicform. See.205.EnsuringhealthcareprovidersparticipatingintheMedicareprogram maymaintainhealthinformationinelectronicform. Sec. 206. StudyandreportonState,regional,andcommunityhetdthinforma- tionexchanges. Sec. 207. PromotingHealthInformationTechnologyasatoolforchronicdis- easemanagement. 1 SEC.2.PRESERVINGPRIVACYANDSECURITYLAWS. 2 NothinginthisAct(ortheamendmentsmadebythis 3 Act) shallbe construedto affectthe scope, substance, or 4 apphcabihty of section 264(c) of the Health Insurance 5 PortabihtyandAccountabihtyActof1996andanyregu- 6 lationissuedpursuanttosuchsection. m •HR5885 3 TITLE I—PROMOTING THE USE 1 OF HEALTH INFORMATION 2 TECHNOLOGY TO BETTER CO- 3 ORDINATE HEALTH CARE 4 5 SEC. 101. SAFE HARBORS TO ANTIKICKBACK CIVIL PEN- 6 ALTIESANDCRIMINALPENALTIESFORPRO- 7 VISION OF HEALTH INFORMATION TECH- 8 NOLOGYANDTRAININGSERVICES. — 9 (a) For Civil Penalties. Section 1128A of the 10 Social SecurityAct (42 U.S.C. 1320a-7a) is amended— 11 (1) in subsection (b), byaddingatthe endthe 12 followingnewparagraph: 13 "(4)Forpurposesofthissubsection,inducementsto 14 reduce or hmit services described in paragraph (1) shall 15 not include the practical or other advantages resulting 16 fromhealthinformationtechnologyorrelatedinstallation, 17 maintenance,support,ortrainingservices.";and 18 (2) in subsection (i), byadding at the endthe 19 followingnewparagraph: 20 "(8) The term 'health information technology' 21 meanshardware, soft^\'are, license, right, intellectual 22 property, equipment, or other information tech- 23 nology (including new versions, upgrades, and 24 connectivity) designed or pro\ided primarilyfor the 25 electronic creation, maintenance, or exchange of m •HR5885 — 4 1 health information to better coordinate care or im- 2 provehealthcarequahty,efficiency,orresearch.". — 3 (b) For Criminal Penalties. Section 1128B of 4 suchAct(42U.S.C.1320a-7b)isamended— 5 (1)insubsection(b)(3) 6 (A) in subparagraph (G), by striking 7 "and"attheend; 8 (B)inthesubparagraph (H) addedbysec- 9 tion 237(d) ofthe MedicarePrescriptionDrug, 10 Improvement, and Modernization Act of 2003 11 (PubhcLaw108-173; 117Stat. 2213)— 12 (i) by moving such subparagraph 2 13 emstotheleft;and 14 (ii) by striking the period at the end 15 andinsertingasemicolon; 16 (C)inthesubparagraph (H) addedbysec- 17 tion431(a)ofsuchAct(117 Stat. 2287)— 18 (i) by redesignating such subpara- 19 graphassubparagraph(I); 20 (ii) by moving such subparagraph 2 21 emstotheleft;and 22 (iii) by strikingthe period at the end 23 andinserting";and";and 24 (D)byaddingattheendthefollowingnew 25 subparagraph: m •HR5885 — 5 1 "(J) any nonmonetary remuneration (in the 2 form ofhealthinformationtechnology, asdefinedin 3 section 1128A(i)(8), or related installation, mainte- 4 nance, support, ortrainingservices) made to aper- 5 son by a specified entity (as defined in subsection 6 (g))if— 7 "(i) the provision ofsuch remuneration is 8 -without an agreement between the parties or 9 legalconditionthat 10 "(I) limits or restricts the use ofthe 11 health information technology'' to services 12 providedbythephysiciantoindividualsre- 13 ceivingservicesatthespecifiedentity; 14 "(II) hmits or restrictstheuse ofthe 15 health information technology^ in conjune- 16 tion with other health information tech- 17 nology;or 18 "(III) conditionstheprovisionofsuch 19 remunerationonthereferralofpatientsor 20 businesstothespecifiedentity; 21 "(ii) such remuneration is arranged forin 22 awritten agreement that is signedbythepar- 23 ties involved (ortheirrepresentatives) and that 24 specifies the remuneration soUcited or received 25 (or offered or paid) and states that the provi- •HR5885IH 1 sion ofsuch remuneration is made forthe pri- 2 marypurpose ofbetter coordination ofcare or 3 improvementofhealthquality, efficiency, orre- 4 search;and 5 "(iii) the specified entityprovidingthe re- 6 muneration (or a representative ofsuch entity) 7 has not taken any action to disable any basic 8 feature ofanyhardwareorsoftwarecomponent 9 of such remuneration that would permit inter- 10 operabihty.";and 11 (2) byaddingattheendthefollowingnewsub- 12 section: — 13 "(g) SpecifiedEntityDefined. Forpurposesof 14 subsection (b)(3)(J), theterm 'specifiedentity' meansan 15 entitythatisahospital, grouppractice,prescriptiondrug 16 plan sponsor, aMedicareAdvantageorganization, orany 17 other such entity specified bythe Secretary, considering 18 thegoalsandobjectivesofthissection,aswellasthegoals 19 tobettercoordinatethedehveryofhealthcareandtopro- 20 mote the adoption and use of health information tech- 21 nology.". 22 (c) Effective Date and Effect on State — 23 Laws. — 24 (1) Effective date. The amendmentsmade 25 by subsections (a) and (b) shall take effect on the m •HR5885 7 1 date that is 120 days after the date of the enact- 2 mentofthisAct. — 3 (2) Preemption of state laws. No State 4 (asdefinedin section 1101(a) ofthe Social Security 5 Act (42 U.S.C. 1301(a)) forpurposes oftitleXI of 6 such Act) shall have in effect a State law that im- 7 posesacriminalorcivilpenaltyforatransactionde- 8 scribed in section 1128A(b)(4) or section 9 1128B(b)(3)(J)ofsuchAct,asaddedbysubsections 10 (a)(1) and (b), respectively, if the conditions de- ll scribed in the respective provision, with respect to 12 suchtransaction,aremet. 13 (d) Study and Report To Assess Effect of — 14 SafeHarborsonHealthSystem. — 15 (1)Ingeneral. TheSecretaryofHealthand 16 Human Services shall conduct a studyto determine 17 the impact ofeach ofthe safe harbors described in 18 paragraph(3).Inparticular,thestudyshallexamine 19 thefollowing: 20 (A) The effectiveness ofeach safe harbor 21 inincreasingtheadoptionofhealthinformation 22 technology. 23 (B) The types ofhealth information tech- 24 nologyprovidedundereachsafeharbor. m •HR5885 — 8 1 (C) The extent to which the financial or 2 other business relationsliips between pro\aders 3 under each safe harbor have changed as a re- 4 suit ofthe safe harborin awaythat adversely 5 affects or benefits the health care system or 6 choicesavailabletoconsumers. 7 (D) The impact ofthe adoption ofhealth 8 information technology on health care quahty, 9 cost,andaccessundereachsafeharbor. — 10 (2) Report. Not laterthan three years after 11 the effective date describedin subsection (c)(1), the 12 SecretaryofHealth and Human Services shall sub- 13 mit to Congress a report on the study under para- 14 graph(1). — 15 (3) Safe harbors described. Forpurposes 16 of paragraphs (1) and (2), the safe harbors de- 17 scribedinthisparagraphare 18 (A) the safe harbor under section 19 1128A(b)(4) of such Act (42 U.S.C. 1320a- 20 7a(b)(4)),asaddedbysubsection(a)(1);and 21 (B) the safe harbor under section 22 1128B(b)(3)(J) ofsuchAct (42 U.S.C. 1320a- 23 7b(b)(3)(J)),asaddedbysubsection(b). m •HR5885 — — — 9 1 SEC.102.EXCEPTIONTOLIMITATIONONCERTAINPHYSI- 2 CIANREFERRALS(UNDERSTARK)FORPRO- 3 VISION OF HEALTH INFORMATION TECH- 4 NOLOGY AND TRAINING SERVICES TO 5 HEALTHCAREPROFESSIONALS. — 6 (a) InGeneral. Section 1877(b) oftheSocialSe- 7 curityAct (42 U.S.C. 1395nii(b)) is amendedbyadding 8 attheendthefollowingnewparagraph: 9 "(6) Information technology and train- 10 ingservices. — 11 "(A) In GENERAL. ^Any nonmonetary re- 12 muneration (in the form ofhealth information 13 technologyor related installation, maintenance, 14 support or training services) made by a speci- 15 fiedentitytoaphysicianif 16 "(i) the provision of such remunera- 17 tion is without an agreement between the 18 partiesorlegalconditionthat 19 "(I) hmits or restricts theuse of 20 the health information technology to 21 services pro\ided by the physician to 22 individuals receiving services at the 23 specifiedentity; 24 "(II) hmitsorrestrictstheuseof 25 the health information technology^ in •HR5885IH 10 1 conjunctionwithotherhealthinforma- 2 tiontechnology;or 3 "(HI) conditions the provision of 4 such remuneration on the referral of 5 patients or business to the specified 6 entity; 7 "(ii) such remuneration is arranged 8 for in a written agreement that is signed 9 bytheparties involved (ortheirrepresent- 10 atives) andthatspecifiestheremuneration 11 madeandstatesthattheprovisionofsuch 12 remunerationismadefortheprimarypur- 13 pose ofbetter coordination ofcare or im- 14 provement of health quahty, efficiency, or 15 research;and 16 "(iii) the specified entity (or a rep- 17 resentative of such entity) has not taken 18 any action to disable anybasic feature of 19 any hardware or software component of 20 such remuneration that would permit 21 interoperabihty. 22 "(B) Health information technology — 23 DEFINED. Forpurposesofthisparagraph,the 24 term 'health information technology' means 25 hardware, software, license, right, intellectual •HR5885m

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