,i #aacth ,,congress #ast ,session ,h4 ,r4 #bcfc ,,in ,,the ,,house ,,of ,,representatives ,june #ac1 #bjac ,mr4 ,honda introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committees on ,ways and ,means and ,small ,business1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to foster further innovation and entrepreneurship in the health information technology sector4 #a4 ,short title ,this ,act may be cited as the ,health ,care ,innovation and ,marketplace ,technologies ,act of #bjac4 #b4 ,health information technology placed in service by medical care provider 7a7 ,in general ,part ,,vi of subchapter ,b of chapter #a of the ,internal ,revenue ,code of #aihf is amended by adding at the end the following3 #bjj4 ,health ,,it placed in service by medical care provider 7a7 ,in general ,in the case of a medical care provider1 there shall be allowed as a deduction an amount equal to the amount paid or incurred by the medical care provider for qualified health information technology placed in service by the provider during the taxable year4 7b7 ,limitation ,the amount allowed as a deduction to a medical care provider by subsection 7a7 for a taxable year shall not exceed #bej1jjj4 7c7 ,definitions ,for purposes of this section-- 7#a7 ,medical care provider ,the term medical care provider means-- 7,a7 a provider of services 7as defined in section #ahfa7u7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7u771 7,b7 a provider of medical or health services 7as defined in section #ahfa7s7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7s771 and 7,c7 any other person who furnishes1 bills1 or is paid for health care in the normal course of business4 7#b7 ,qualified health information technology ,the term qualified health information technology means the application of information processing involving both computer hardware and software that deals with the storage1 retrieval1 sharing1 and use of health care information1 data1 and knowledge for communication and decisionmaking4 ,such term does not include certified ,,ehr technology4 7d7 ,special rules 7#a7 ,pass-thru entities ,in the case of a partnership or ,s corporation1 this section shall be applied at the entity level and at the partner or similar level4 7#b7 ,coordination with other deductions ,any amount taken into account under subsection 7a7 shall not be allowed as a deduction under any other section of this chapter4 7e7 ,termination ,this section shall not apply to amounts paid or incurred after ,december #ca1 #bjah4 4 7b7 ,clerical amendment ,the table of sections for part ,,vi of subchapter ,b of chapter #a of such ,code is amended by adding at the end the following new item3 ,sec4 #bjj4 ,health ,,it placed in service by medical care provider4 4 7c7 ,effective date ,the amendments made by this section shall apply to taxable years beginning after ,december #ca1 #bjac4 #c4 ,small business health information technology financing program ,the ,small ,business ,act 7#ae ,u4,s4,c4 #fca et seq47 is amended by redesignating sections #de1 #df1 and #dg as sections #df1 #dg1 and #dh1 respectively1 and by inserting the following new section after section #dd3 #de4 ,loan guarantees for health information technology 7a7 ,definitions ,as used in this section3 7#a7 ,the term health information technology means computer hardware1 software1 services1 and related technology that is purchased by an eligible professional to aid in the provision of health care in a health care setting and that provides for-- 7,a7 enhancement of continuity of care for patients through electronic storage1 transmission1 and exchange of relevant personal health data and information1 such that this information is accessible at the times and places where clinical decisions will be or are likely to be made2 7,b7 enhancement of communication between patients and health care providers2 7,c7 improvement of quality measurement by eligible professionals enabling them to collect1 store1 measure1 and report on the processes and outcomes of individual and population performance and quality of care2 7,d7 improvement of evidence-based decision support2 7,e7 enhancement of consumer and patient empowerment2 or 7,f7 services that assist with workflow redesign1 training1 system configuration1 human change management and other similar services focused on getting the best value from existing technology that has already been purchased4 ,such term shall not include information technology whose sole use is financial management1 maintenance of inventory of basic supplies1 or appointment scheduling4 7#b7 ,the term eligible professional means any of the following3 7,a7 ,a physician 7as defined in section #ahfa7r7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7r7774 7,b7 ,a practitioner described in section #ahdb7;b77#ah77;,c7 of that ,act4 7,c7 ,a physical or occupational therapist or a qualified speech-language pathologist4 7,d7 ,a qualified audiologist 7as defined in section #ahfa7ll77#c77;,b77 of that ,act4 7,e7 ,a ,state-licensed pharmacist4 7,f7 ,a ,state-licensed1 a ,state-certified1 or a nationally accredited home health care provider4 7#c7 ,the term qualified eligible professional means an eligible professional whose office can be classified as a small business concern by the ,administrator for purposes of this ,act under size standards established under section #c of this ,act4 7b7 ,loan guarantees for qualified eligible professionals 7#a7 ,in general ,subject to paragraph 7#b71 the ,administrator may guarantee up to #ij percent of the amount of a loan made to a qualified eligible professional to be used for the acquisition of health information technology for use in such eligible professional's medical practice and for the costs associated with the installation of such technology4 ,except as otherwise provided in this section1 the terms and conditions that apply to loans made under section #g7;a7 of this ,act shall apply to loan guarantees made under this section4 7#b7 ,limitations on guarantee amounts ,the maximum amount of loan principal guaranteed under this subsection may not exceed-- 7,a7 #bej1jjj with respect to any single qualified eligible professional2 and 7,b7 #ejj1jjj with respect to a single group of affiliated qualified eligible professionals4 7c7 ,fees 7#a7 ,the ,administrator may impose a guarantee fee on the borrower for the purpose of reducing the cost 7as defined in section #ejb7e7 of the ,federal ,credit ,reform ,act of #aiij7 of the guarantee to zero in an amount not to exceed #b percent of the total guaranteed portion of any loan guaranteed under this section4 ,the ,administrator may also impose annual servicing fees on lenders not to exceed #j4e percent of the outstanding balance of the guarantees on lenders' books4 7#b7 ,no service fees1 processing fees1 origination fees1 application fees1 points1 brokerage fees1 bonus points1 or other fees may be charged to a loan applicant or recipient by a lender in the case of a loan guaranteed under this section4 7d7 ,deferral period ,loans guaranteed under this section shall carry a deferral period of not less than #a year and not more than #c years4 ,the ,administrator shall have the authority to subsidize interest during the deferral period4 7e7 ,effective date ,no loan may be guaranteed under this section after the date that is #f months after the date of enactment of this section4 7f7 ,sunset ,no loan may be guaranteed under this section after the date that is #aj years after the date that is #f months after the date of enactment of this section4 7g7 ,authorization of appropriations ,there are authorized to be appropriated such sums as are necessary for the cost 7as defined in section #ejb7e7 of the ,federal ,credit ,reform ,act of #aiij7 of guaranteeing #be1jjj1jjj in loans under this section4 ,the ,administrator shall determine such program cost separately and distinctly from other programs operated by the ,administrator4 4 #d4 ,challenge grant program2 ,disruptive technologies prize program 7a7 ,in general ,subtitle ,b of title ,,xxx of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;jj-#ca et4 seq47 is amended-- 7#a7 by redesignating sections #cjag and #cjah as sections #cjai and #cjbj1 respectively2 and 7#b7 by inserting after section #cjaf the following new sections3 #cjag4 ,challenge grant program 7a7 ,in general ,subject to the availability of appropriations1 the ,secretary1 acting through the ,national ,coordinator1 shall award competitive grants to eligible entities to carry out the activities described in subsection 7d74 7b7 ,eligible entity defined ,in this section1 the term eligible entity means any individual or entity1 except for an entity that-- 7#a7 has #ejj or more employees2 and 7#b7 has an annual revenue of #g1jjj1jjj or more4 7c7 ,application ,an eligible entity seeking a grant under this section shall submit an application to the ,national ,coordinator at such time1 in such manner1 and containing such information as the ,national ,coordinator may require1 including a description of the product1 process1 or structure described in subsection 7d7 for which the entity intends to use the grant4 7d7 ,uses of funds ,an eligible entity that receives a grant under this section shall use such funds to develop an effective product1 process1 or structure that enhances the use1 particularly by patients1 of health information technology1 by-- 7#a7 integrating more than one aspect of health information2 7#b7 performing a medical consultation using technology2 7#c7 providing health information to physicians or patients2 7#d7 allowing better coordination during the delivery and follow-up after the delivery of health care2 or 7#e7 addressing any of the three areas that the ,commission established under section #cjah7;e77#a7 has identified pursuant to its duties under section #cjah7;e77#b77;,a74 7e7 ,prohibited use of funds ,an eligible entity that receives a grant under this section may not use such grant to develop a product1 process1 or structure that meets only the requirements that are necessary to be a certified ,,ehr technology4 7f7 ,grant amount ,a grant awarded under this section may not be greater than #ge1jjj4 7g7 ,report ,not later than one year after the date of receipt of a grant under this section1 an eligible entity shall submit to the ,national ,coordinator and the ,administrator of the ,centers for ,medicare ,medicaid ,services a report that describes-- 7#a7 the progress that the entity has made on the product1 process1 or structure funded by the grant2 and 7#b7 how patients1 health care providers1 and other individuals and entities involved in the delivery of healthcare1 including the ,centers for ,medicare ,medicaid ,services1 could use the product1 process1 or structure funded by the grant to enhance the delivery of and reduce the cost of health care4 7h7 ,authorization of ,appropriations ,there is authorized to be appropriated to carry out this section #e1jjj1jjj for each of fiscal years #bjae through #bjag4 #cjah4 ,disruptive technologies prize program 7a7 ,prize program authorized ,for purposes of rewarding innovation in health information technology1 the ,secretary1 acting through the ,national ,coordinator1 shall carry out a program to award one prize competitively in each of the three areas identified by the ,commission under subsection 7e77#b77;,a7 using the benchmarks developed under subsection 7e77#b77;,b7 to select the prize recipient in each category4 7b7 ,administration of ,program ,in carrying out the program under subsection 7a71 the following shall apply3 7#a7 ,advertising ,the ,national ,coordinator shall widely advertise the prize competition to encourage broad participation4 7#b7 ,requirements and ,registration ,the ,national ,coordinator shall publish a notice in the ,federal ,register announcing-- 7,a7 the rules for being eligible to participate in the competition2 7,b7 the process for participants to register for the competition2 7,c7 the areas of health information technology that the ,commission develops under subsection 7e77#b77;,a7 for each prize2 and 7,d7 the benchmarks that the ,commission develops under subsection 7e77#b77;,b7 based on which a winner will be selected in each such area4 7c7 ,eligibility ,to be eligible to win a prize under this section1 an individual or entity-- 7#a7 shall register to participate in the competition in accordance with any rules promulgated by the ,national ,coordinator under subsection 7b77#b72 7#b7 in the case of an entity1 shall be incorporated in and maintain a primary place of business in the ,united ,states1 and in the case of an individual1 whether participating singly or in a group1 shall be a citizen or permanent resident of the ,united ,states2 and 7#c7 may not be a ,federal entity or ,federal employee acting within the scope of their employment2 and 7#d7 shall submit an application that includes an explanation of the anticipated market viability of the technology that such individual or entity would develop with funds received under the prize program4 7d7 ,prize amount 7#a7 ,in general ,subject to paragraph 7#b71 a prize awarded under this section shall be in the amount of #aj1jjj1jjj4 7#b7 ,alternative rule ,in the case that the amount made available for prize awards under this section is less than #cc1jjj1jjj1 the ,national ,coordinator may reserve not more than #aj percent for the administrative costs of carrying out this section1 and shall divide the remaining amount equally for the three prizes awarded under this section4 7e7 ,commission 7#a7 ,in general ,there is established a commission to carry out the activities described in paragraph 7#b7 7referred to in this section as the ,commission74 7#b7 ,duties 7,a7 ,areas of health information technology ,for the purposes of the prize program under subsection 7a71 the ,commission shall identify three areas within the field of health information technology that are not adequately addressed by certified ,,ehr technologies and the use of such technologies4 ,each area identified shall be an area that will promote the development of technologies that would be widely useful1 would help decrease the cost of health care1 and would improve the quality of health care1 particularly for patients4 7,b7 ,benchmarks ,the ,commission shall develop the benchmarks that the ,national ,coordinator shall use to determine the prize recipient in each area identified under subparagraph 7,a74 ,the ,commission shall identify such benchmarks with the goals of-- 7i7 attracting participants from outside the health information technology field that will take new approaches to addressing the areas identified by the ,commission under subparagraph 7,a72 7ii7 solving such challenges2 and 7iii7 promoting the development of technologies that will be widely adopted1 particularly by patients4 7,c7 ,restriction of prize award ,the ,commission shall determine how to restrict the prize recipients' use of the funds awarded as a prize under this section1 with respect to the development of health information technology1 in order to ensure that the prize recipients use such funds to further develop the technologies for which such prize was awarded4 7#c7 ,members 7,a7 ,number and appointment ,the ,commission shall be composed of #aj members appointed by the ,national ,coordinator not later than #ij days after the date of the enactment of this ,act4 7,b7 ,composition ,each member of the ,commission shall be appointed to represent one of the following four categories3 7i7 ,the varied disciplines within the health information technology field4 7ii7 ,the varied disciplines within the medical field that are not described in clause 7i74 7iii7 ,individuals who-- 7,i7 represent a patient-led1 patient-centered organization with a patient constituency2 7,,ii7 have experience with health information technology and privacy2 and 7,,iii7 are trained1 knowledgeable1 and prepared to participate in the decisionmaking process regarding health information technology4 7iv7 ,officers or employees of the ,federal ,government4 7,c7 ,representation of membership categories ,at least two members of the ,commission shall represent each of the categories described in subparagraph 7,b74 7,d7 ,travel expenses ,each member shall receive travel expenses1 including per diem in lieu of subsistence1 in accordance with applicable provisions under subchapter ,i of chapter #eg of title #e1 ,united ,states ,code4 7,e7 ,first meeting ,the ,commission shall hold its first meeting not later than #ahj days after the date of the enactment of this ,act4 7#d7 ,report to the ,national ,coordinator ,not later than one year after the date of enactment of this ,act1 the ,commission shall submit to the ,national ,coordinator a report containing the areas1 benchmarks1 and restrictions on the uses of prize awards that the ,commission identifies for the prize program under paragraph 7#b74 7#e7 ,termination ,the ,commission shall terminate upon submitting its report to the ,national ,coordinator under paragraph 7#d74 7f7 ,authorization of ,appropriations ,in addition to sums authorized to be appropriated to carry out this subtitle under section #cjbj1 there is authorized to be appropriated to carry out this section #cc1jjj1jjj for fiscal year #bjae4 4 7b7 ,conforming ,amendments 7#a7 ,section #cjaa of such ,act 7#db ,u4,s4,c4 #cjj;jj-#ca7 is amended-- 7,a7 in subsection 7a71 by striking section #cjah and inserting section #cjbj2 and 7,b7 in subsection 7c71 by striking section #cjah and inserting section #cjbj4 7#b7 ,section #cjbj of such ,act 7as so redesignated7 is amended by inserting except for section #cjah1 after ,for purposes of carrying out this subtitle14 #e4 ,establishment of the ,office of ,wireless ,health ,technology ,chapter ,x of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cia et seq47 is amended by adding at the end the following new section3 #ajac4 ,office of ,wireless ,health ,technology 7a7 ,establishment ,there is established within the ,office of the ,commissioner an office to be known as the ,office of ,wireless ,health ,technology 7referred to in this section as the ,office71 which shall be headed by a director4 7b7 ,appointment of first ,director ,the first ,director of the ,office shall be appointed by the ,commissioner not later than #ij days after the date of enactment of this section4 7c7 ,duties ,the ,director of the ,office shall-- 7#a7 through public meetings and other forms of communication with individuals and entities that design1 produce1 disseminate1 or have a prevailing interest in wireless health technology1 receive and analyze recommendations with respect to ways that existing regulations regarding wireless health technology might be made more reasonable and predictable1 including ways that such regulations could be clarified and simplified2 7#b7 coordinate with ,federal agencies1 offices1 institutes1 and centers involved in the regulation of wireless health technology1 including the ,federal ,communications ,commission1 the ,office of the ,national ,coordinator for ,health ,information ,technology1 the ,centers for ,medicare ,medicaid ,services1 the ,agency for ,healthcare ,research and ,quality1 the ,national ,institute of ,standards and ,technology1 the ,health ,resources and ,services ,administration1 and the ,national ,institutes of ,health1 regarding activities of such agencies1 offices1 institutes1 and centers that can be improved so as to make such regulation more robust1 predictable1 and easily understood and navigated by individuals and entities that design1 produce1 disseminate1 or have a prevailing interest in wireless health technology2 7#c7 provide information to individuals and entities that design1 produce1 disseminate1 or have a prevailing interest in wireless health technology on how to design1 produce1 or disseminate wireless health technology in accordance with existing law2 and 7#d7 publish and make available on the public ,internet ,web site of the ,food and ,drug ,administration in a searchable format an annual report that-- 7,a7 explains how the ,food and ,drug ,administration implemented regulations regarding wireless health technology during the prior year2 7,b7 analyzes the effectiveness of-- 7i7 such regulations2 and 7ii7 other wireless health-related efforts by the ,food and ,drug ,administration2 and 7,c7 provides specific recommendations on how the ,food and ,drug ,administration should improve its practices with regard to wireless health technology 7in a manner that ensures consistency within the ,food and ,drug ,administration regarding the application of its regulatory approach without compromising patient safety or privacy7 in order to-- 7i7 remove barriers to innovations in such technology2 and 7ii7 align such practices with the practices of other ,federal agencies4 7d7 ,consultation with working groups and commissions ,in carrying out the duties specified in subsection 7c71 the ,director of the ,office may consult with any working groups or commissions1 including any working group or commission convened for a purpose related to the regulation of wireless health technology4 7e7 ,definition of wireless health technology ,for purposes of this section1 the term wireless health technology has such meaning as specified by the ,commissioner pursuant to regulation1 but in no case shall include technology this is not regulated under the provisions of this ,act 7other than this section74 7f7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #a1jjj1jjj for each of fiscal years #bjae through #bjai4 4 #f4 ,mobile health software application technology responsibilities of the ,health ,information ,technology ,research ,center ,section #cjab of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;jj-#cb7 is amended-- 7#a7 in subsection 7b71 by adding at the end the following new paragraph3 7#d7 ,encouragement of design1 production1 and dissemination of mobile health software application technology 7,a7 ,in general ,in addition to the purposes under paragraph 7#c71 the ,center shall-- 7i7 establish an educational ,web site repository and a response mechanism 7such as a national telephone number7 to provide timely responses to questions in order to make information available and provide direct support to individuals and entities that design1 produce1 disseminate1 or have a prevailing interest in mobile health software application technology regarding the actions such individuals and entities must take in order to ensure that such technology is designed1 produced1 and disseminated in accordance with ,federal law2 and 7ii7 publish and make available on the public ,internet ,web site of the ,department in a searchable format an annual report that-- 7,i7 highlights and explains the laws and regulations that commonly impede efforts by individuals and entities to design1 produce1 or disseminate mobile health software application technology2 and 7,,ii7 discusses the work the ,center has completed in the past year with regard to mobile health software application technology1 including accomplishments by the ,center and challenges that may require more work or outside support in order for the ,center to accomplish the objectives outlined in this subparagraph4 7,b7 ,definition of mobile health software application technology ,for purposes of subparagraph 7,a71 the term mobile health software application technology means a software program that-- 7i7 offers health-related services and runs on a mobile device2 or 7ii7 enables health-related services through other portals associated with the use of a mobile device4 7,c7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this paragraph #ejj1jjj for each of fiscal years #bjae through #bjai4 2 and 7#b7 in subsection 7c77#h71 by deleting paragraph 7#c7 and inserting paragraphs 7#c7 and 7#d74 #g4 ,workforce ,retraining ,grants 7a7 ,in ,general ,the ,national ,coordinator for ,health ,information ,technology may award to eligible entities grants to be used for training health care workers in health information technology 7in this section referred to as ,,hit74 7b7 ,period of ,grant ,the period of a grant under this section shall be #bd months4 7c7 ,eligible ,entities ,in this section1 eligible entities means entities that provide clinical health care services to individuals within the ,united ,states4 7d7 ,job ,transition ,as a condition on receipt of a grant under this section1 a grantee shall ensure that each employee whose ,,hit training is funded by that grant assumes expanded duties with the grantee1 either in the form of a new employment position or revised duties within such employee's existing employment position1 that requires the use of ,,hit1 not more than #a year after the employee completes the training4 7e7 ,reporting ,each grantee shall submit a report not later than #bd months after receipt of a grant to the ,national ,coordinator for ,health ,information ,technology including the following3 7#a7 ,the number of employees who received training pursuant to the grant4 7#b7 ,the ,,hit skills covered during such training or trainings4 7#c7 ,documentation that each trained employee commenced or will commence work in a new position that satisfies the condition set forth in subsection 7d74 7f7 ,authorization of ,appropriations ,there are authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjae through #bjai4