A bill to promote a better health information system

2008·0.99 MB·English

by  United States. Congress. House

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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".
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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.
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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
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1 health information to better coordinate care or im-
2 provehealthcarequahty,efficiency,orresearch.".
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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:
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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-
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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:
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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.
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24 (1) Effective date. The amendmentsmade
25 by subsections (a) and (b) shall take effect on the
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1 date that is 120 days after the date of the enact-
2 mentofthisAct.
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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
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14 SafeHarborsonHealthSystem.
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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.
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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.
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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).
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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).
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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.
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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
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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
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23 DEFINED. Forpurposesofthisparagraph,the
24 term 'health information technology' means
25 hardware, software, license, right, intellectual
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