,,ii  #aad? ,,congress  #a/ ,session    
,s4 #bada  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,octob] #f1 #bjae ,mr4 
,cassidy 7= himself & ,mr4 ,:iteh\se7   
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d ! ,public ,heal?    
,s]vice ,act ) respect to heal?         
in=mation te*nology4  #a4 ,%ort title   
,?is ,act may be cit$ z ! ,transp>5t    
,rat+s on ,usability & ,security to     
,trans=m ,in=mation ,te*nology ,act (   
#bjae or ! ,,tru/ ,,x ,act4  #b4        
,def9itions ,section #cjjj ( ! ,public  
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;jj7 is am5d$-- 7#a7 by r$esignat+  
p>agraphs 7#aj7 ?r\gh 7#ad7 z p>agraphs 
7#ab7 ?r\gh 7#af71 respectively2 &  7#b7
 by ins]t+ aft] p>agraph 7#i7 ! foll[+3 
7#aj7 ,in=mation block+ ,! t]m in=mation
 block+ means1 ) respect to !           
developm5t1 configuration1              
implem5tation1 & use ( qualifi$         
electronic heal? records & o!r heal?    

in=mation te*nology1 bus9ess1 te*nical1 
& organizational practices t--  7,a7    
except z requir$ by law1 prev5t or      
mat]ially disc\rage ! access1 ex*ange1  
or use ( electronic heal? in=mation2 &  
7,b7 ! p]son kn[s or %\ld "k 7z def9$ 9 
section #aabh;,a7i77#g7 ( ! ,social     
,security ,act7 are likely to int]f]e ) 
! access1 ex*ange1 or use ( electronic  
heal? in=mation4  7#aa7 ,int]op]ability 
,! t]m int]op]ability means ! ability ( 
#b or m heal? in=mation sy/ems or       
compon5ts to ex*ange cl9ical & o!r      
in=mation & to use ! in=mation t has be5
 ex*ang$ us+ common /&>ds to provide    
access to longitud9al or reque/$        
in=mation to heal? c>e provid]s1        
pati5ts1 & o!r au?oriz$ us]s :5 su*     
p]sons ne$ su* in=mation 9 ord] to      
facilitate coord9at$ c>e & improv$      
pati5t outcomes4  4  #c4 ,enhancem5ts to
 te/+ & c]tification  ,section          
#cjja7;c77#e7 ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj;jj-#aa7 is    
am5d$-- 7#a7 9 subp>agraph 7,a7--  7,a7 

by /rik+ ,! ,national ,coord9ator &     
ins]t+ ! foll[+3  7i7 ,volunt>y         
c]tification program ,! ,national       
,coord9ator  2 &  7,b7 by add+ at ! end 
! foll[+3  7ii7 ,transp>5cy ( program   
7,i7 ,9 g5]al ,to enhance transp>5cy 9 !
 compliance ( heal? in=mation te*nology 
) c]tification crit]ia adopt$ "u ?is    
subtitle1 ! ,national ,coord9ator1 9    
coord9ation ) au?oriz$ c]tification     
bodies1 may make in=mation demon/rat+ h[
 heal? in=mation te*nology meets su*    
c]tification crit]ia publicly available4
 ,su* in=mation may include summ>ies1   
scre5%ots1 video demon/rations1 or any  
o!r in=mation ! ,national ,coord9ator   
det]m9es appropriate4  7,,ii7           
,protection ( propriet>y in=mation ,no?+
 9 ?is p>agraph %all be con/ru$ to      
require ! release ( trade secrets or any
 o!r protect$ intellectual prop]ty4  2  
7#b7 9 subp>agraph 7,b71 by add+ at !   
end ! foll[+3 ,beg9n+ #ah mon?s aft]    
report+ crit]ia are f9aliz$ "u section  
#cjji;,a1 c]tification crit]ia %all     

include1 9 addition to crit]ia to       
e/abli% t ! te*nology meets su* /&>ds & 
implem5tation specifications1 crit]ia   
consi/5t ) section #cjji;,a7b7 to       
e/abli% t te*nology meets applicable    
security requirem5ts1 incorporates      
us]-c5t]$ design1 & a*ieves             
int]op]ability42 &  7#c7 by add+ at !   
end ! foll[+3  7,c7 ,conditions (       
c]tification ,beg9n+ #a ye> aft] ! date 
( enactm5t ( ! ,,tru/ ,,x ,act1 !       
,secret>y %all require t ea* v5dor (    
heal? in=mation te*nology & entity seek+
 c]tification ( heal? in=mation         
te*nology1 z a condition ( c]tification 
& ma9t5ance ( c]tification ( su*        
te*nology1 provide to ! ,secret>y an    
atte/ation t--  7i7 ! v5dor or entity1  
unless = a legitimate purpose specifi$  
by ! ,secret>y1 has n tak5 & w n take   
any action t con/itutes in=mation block+
 ) respect to heal? in=mation te*nology2
  7ii7 ! v5dor or entity w n engage 9   
bus9ess practices or impose b9d+ bus9ess
 relation%ip obligations t seek to      

int5tionally limit communication betwe5 
heal? in=mation te*nology us]s & an     
au?oriz$ c]tification body reg>d+ !     
usability1 int]op]ability1 security1    
bus9ess practices1 or o!r relevant      
in=mation ab\t ! heal? in=mation        
te*nology or us]s' exp]i5ce ) ! heal?   
in=mation te*nology2 &  7iii7 heal?     
in=mation f su* te*nology may be        
ex*ang$1 access$1 & us$ ?r\gh ! use (   
application programm+ int]faces & o!r   
/&>ds )\t special ef=t1 z au?oriz$ "u   
applicable law4  7,d7 ,inspector g5]al  
au?ority  7i7 ,9 g5]al ,! ,inspector    
,g5]al ( ! ,dep>tm5t ( ,heal? & ,human  
,s]vices may inve/igate any claim t--   
7,i7 a v5dor (1 or o!r entity (f]+1     
c]tifi$ heal? in=mation te*nology-- 7aa7
 violat$ an atte/ation made "u          
subp>agraph 7,c72 or  7bb7 engag$ 9     
in=mation block+ ) respect to ! use (   
su* heal? in=mation te*nology by a heal?
 c>e provid]1 unless = a legitimate     
purpose specifi$ by ! ,secret>y2  7,,ii7
 a heal? c>e provid] engag$ 9 in=mation 

block+ ) respect to ! use ( c]tifi$     
heal? in=mation te*nology1 unless = a   
legitimate purpose specifi$ by !        
,secret>y2  7,,iii7 a heal? in=mation   
sy/em provid] engag$ 9 in=mation block+ 
) respect to ! use ( su* c]tifi$ heal?  
in=mation te*nology1 unless = a         
legitimate purpose specifi$ by !        
,secret>y4  7ii7 ,p5alty ,any p]son or  
entity det]m9$ by ! ,inspector ,g5]al to
 h committ$ an act describ$ 9 subclause 
7,i71 7,,ii71 or 7,,iii7 ( clause 7i7   
%all be subject to a civil monet>y      
p5alty ( n m ?an #aj1jjj = ea* su* act4 
,! provisions ( section #aabh;,a ( !    
,social ,security ,act 7o!r ?an         
subsections 7a7 & 7b77 %all apply to a  
civil money p5alty appli$ "u ?is        
subsection 9 ! same mann] z su*         
provisions apply to a civil money p5alty
 or proce$+ "u section #aabh;,a7a74  4  
#d4 ,heal? in=mation te*nology rat+     
program ,subtitle ,a ( title ,,xxx ( !  
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjj;jj-#aa et seq47 is am5d$ 

by add+ at ! end ! foll[+3  #cjji;,a4   
,heal? in=mation te*nology rat+ program 
7a7 ,e/abli%m5t ,n lat] ?an #ahj days   
aft] ! date ( enactm5t ( ! ,,tru/ ,,x   
,act1 ! ,secret>y %all recognize a      
developm5t c\ncil made up ( "o          
repres5tative f ea* ( ! accr$it$ c]tify+
 bodies accr$it$ by ! ,(fice & ! te/+   
laboratories accr$it$ "u section        
#acbja7;b7 ( ! ,heal? ,in=mation        
,te*nology = ,economic & ,cl9ical ,heal?
 ,act 7#db ,u4,s4,c4 #agiaa7;b771 & "o  
repres5tative f ! ,(fice ( ! ,national  
,coord9ator1 = ! purpose ( e/abli%+ a   
heal? in=mation te*nology rat+ program  
to evaluate1 bas$ on ! me?odology       
e/abli%$ "u subsection 7d71 ! field     
p]=mance ( c]tifi$ heal? in=mation      
te*nology ) reg>d to int]op]ability1    
usability1 & security1 9 accordance ) ! 
foll[+3  7#a7 #a /> rat+ ,c]tifi$ heal? 
in=mation te*nology %all receive a #a />
 rat+ if an au?oriz$ c]tification body  
det]m9es t ! heal? in=mation te*nology  
is less ?an satisfactory4  7#b7 #b />   

rat+ ,c]tifi$ heal? in=mation te*nology 
%all receive a #b /> rat+ if ! au?oriz$ 
c]tification body det]m9es t ! heal?    
in=mation te*nology is satisfactory4    
7#c7 #c /> rat+ ,c]tifi$ heal? in=mation
 te*nology %all receive a #c /> rat+ if 
! au?oriz$ c]tification body det]m9es t 
! heal? in=mation te*nology is excell5t4
  7b7 ,report+ crit]ia  7#a7 ,n lat] ?an
 #a ye> aft] ! date ( enactm5t ( !      
,,tru/ ,,x ,act1 ! ,secret>y1 9         
consultation ) ! developm5t c\ncil      
describ$ 9 subsection 7a71 %all conv5e  
/akehold]s z describ$ 9 p>agraph 7#b7 = 
! purpose ( develop+ ! report+ crit]ia 9
 accordance ) p>agraph 7#c74  7#b7      
,developm5t ( report+ crit]ia ,! report+
 crit]ia "u ?is subsection %all be      
develop$ ?r\gh a public1 transp>5t      
process t reflects input f relevant     
/akehold]s1 includ+--  7,a7 prim>y c>e &
 specialty c>e heal? c>e pr(essionals2  
7,b7 hospitals2  7,c7 heal? in=mation   
te*nology v5dors2  7,d7 advocates =     
pati5ts or consum]s2  7,e7 data %>+     

networks1 su* z heal? in=mation         
ex*anges2  7,f7 au?oriz$ c]tification   
bodies & te/+ laboratories2  7,g7       
security exp]ts2 &  7,h7 o!r entities or
 p]sons1 z ! ,secret>y1 9 consultation )
 ! developm5t c\ncil1 det]m9es          
appropriate4  7#c7 ,consid]ations =     
report+ crit]ia ,! report+ crit]ia      
develop$ "u ?is subsection-- 7,a7 may   
include measures t reflect categories   
includ+1 ) respect to ! te*nology--  7i7
 security2  7ii7 usability & us]-c5t]$  
design2  7iii7 int]op]ability2  7iv7    
con=mance to c]tification te/+2 &  7v7  
o!r categories z appropriate to measure 
! p]=mance ( heal? in=mation te*nology2 
7,b7 may include measures su* z--  7i7  
enabl+ ! us] to ord] & view ! results ( 
laboratory te/s1 imag+ te/s1 & o!r      
diagno/ic te/s2  7ii7 submitt+1 edit+1 &
 retriev+ data f regi/ries = quality (  
c>e1 su* z physician regi/ries2  7iii7  
access+ & ex*ang+ in=mation & data f    
m$ical devices2  7iv7 access+ & ex*ang+ 
in=mation & data held by ,f$]al1 ,/ate1 

& local ag5cies & o!r applicable        
entities useful to a heal? c>e provid]  
or o!r applicable us] 9 ! fur!rance (   
pati5t c>e2  7v7 access+ & ex*ang+      
in=mation f o!r heal? c>e provid]s or   
applicable us]s2  7vi7 access+ & ex*ang+
 pati5t g5]at$ in=mation2  7vii7 provid+
 ! pati5t ) a complete copy ( _!        
electronic record 9 a computable =mat2 &
  7viii7 o!r appropriate                
functionalities2 &  7,c7 %all be design$
 to ensure t small & />t up v5dors (    
heal? in=mation te*nology are n unduly  
disadvantag$ by ! report+ crit]ia or    
rat+ scale me?odology4  7#d7 ,public    
comm5t ,! ,secret>y %all conduct a      
#fj-;day public comm5t p]iod dur+ :i*   
any memb] ( ! public may provide comm5ts
 on ! propos$ report+ crit]ia & !       
me?odology = au?oriz$ c]tification      
bodies to use 9 det]m9+ ! /> rat+s4 ,!  
,secret>y %all provide timely responses 
to su* comm5ts be=e issu+ a f9al rule4  
7#e7 ,modifications ,aft] ! report+     
crit]ia h be5 e/abli%$1 ! ,secret>y1 9  

consultation ) ! developm5t c\ncil1 may 
conv5e /akehold]s & conduct a public    
report+ p]iod = ! purpose ( modify+ !   
report+ crit]ia develop$ 9 ?is          
subsection & me?odology = det]m9+ ! />  
rat+s propos$ "u subsection 7d74  7#f7  
,consid]ation ( developm5t c\ncil       
recomm5dations ,9 promulgat+ f9al rules 
"u ?is subsection1 includ+ modifications
 to su* rules "u p>agraph 7#e71 !       
,secret>y may accept or reject !        
recomm5dations ( ! developm5t c\ncil1 b 
may n promulgate a rule t does n        
repres5t a complete recomm5dation ( su* 
c\ncil4  7c7 ,collection ( fe$back ,!   
,secret>y1 9 consultation ) ! developm5t
 c\ncil1 %all e/abli% a process =       
au?oriz$ c]tification bodies to collect 
& v]ify confid5tial fe$back f--  7#a7   
heal? c>e provid]s1 pati5ts1 & o!r us]s 
( heal? in=mation te*nology on !        
usability1 security1 & int]op]ability ( 
heal? in=mation te*nology products2 &   
7#b7 v5dors or o!r entities (f]+ heal?  
in=mation te*nology on practices ( heal?

 in=mation te*nology us]s t may inhibit 
int]op]ability4  7d7 ,me?odology ,!     
,secret>y1 9 consultation ) ! developm5t
 c\ncil1 %all develop a me?odology =    
au?oriz$ c]tification bodies to use to  
calculate ! /> rat+s = c]tifi$ heal?    
in=mation te*nology describ$ 9          
subsection 7a74 ,! me?odology %all use !
 report+ crit]ia develop$ 9 subsection  
7b7 & confid5tial fe$back collect$ "u   
subsection 7c74  7e7 ,p>ticipation ,ea* 
v5dor (1 or entity (f]+1 heal? in=mation
 te*nology t is c]tifi$ "u section      
#cjja7;c77#e7 ( ! ,public ,heal? ,s]vice
 ,act aft] ! date ( enactm5t ( ! ,,tru/ 
,,x ,act %all report on ! crit]ia       
develop$ "u subsection 7b7 on ! date t  
is #b ye>s aft] su* c]tification & e #b 
ye>s !reaft]4  7f7 ,"o /> rat+ ,ea*     
v5dor (1 or entity (f]+1 heal? in=mation
 te*nology t receives a #a /> rat+ %all 
take action1 ?r\gh a corrective action  
plan develop$ ) ! au?oriz$ c]tification 
body & approv$ by ! ,secret>y1 to       
improve ! heal? in=mation te*nology rat+

 )9 a timeframe t ! ,secret>y det]m9es  
appropriate4  7g7 ,en=cem5t au?orities  
7#a7 ,9 g5]al ,! ,secret>y may assess   
f9es on any v5dor (1 or entity (f]+1    
c]tifi$ heal? in=mation te*nology &     
dec]tify heal? in=mation te*nology 9    
accordance ) p>agraphs 7#b7 & 7#c74     
7#b7 ,f9es  7,a7 ,9 g5]al ,! ,secret>y  
may assess f9es aga9/ su* a v5dor or    
entity if ! v5dor or entity-- 7i7 does n
 meet ! requirem5ts ( ! corrective      
action plan describ$ 9 subsection 7f72  
7ii7 does n improve f a "o /> rat+ 9    
accordance ) subsection 7f72 or  7iii7  
does n report on crit]ia 9 accordance ) 
subsection 7e74  7,b7 ,f9e am\nts ,n    
lat] ?an #a ye> aft] ! date ( enactm5t (
 ! ,,tru/ ,,x ,act1 ! ,secret>y %all    
e/abli% f9e am\nts = violations (       
clauses 7i71 7ii71 & 7iii7 ( subp>agraph
 7,a74 ,9 sett+ su* am\nts1 ! ,secret>y 
%all consid] ! am\nts necess>y to       
reimburse1 9 "p or 9 full1 ! us]s (     
dec]tifi$ heal? in=mation te*nology = ! 
am\nts inve/$ 9 pur*as+ new c]tifi$     

heal? in=mation te*nology1 z applicable4
  7#c7 ,dec]tification ,! ,secret>y may 
dec]tify heal? in=mation te*nology if-- 
7,a7 ! heal? in=mation te*nology does n 
improve f a "o /> rat+ )9 ! timeframe   
e/abli%$ "u subsection 7f72  7,b7 does n
 report on crit]ia 9 accordance )       
subsection 7b72 or  7,c7 9 o!r          
circum/ances1 z ! ,secret>y det]m9es    
appropriate4  7h7 ,,gao reports ,!      
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all submit to ,congress a report e #d  
ye>s on ! rat+ scale me?odology develop$
 pursuant to subsection 7b71 provid+    
obs]vations on ! appropriat5ess ( !     
curr5t me?odology & recomm5dations =    
*anges to ! me?odology4  7i7 ,int]net   
,website ,! ,secret>y %all publi% ! />  
rat+ = ea* c]tifi$ heal? in=mation      
te*nology & me?odology to det]m9e ! />  
rat+ on ! ,int]net website ( ! ,(fice ( 
! ,national ,coord9ator4 ,foll[+ !      
biannual report+ describ$ 9 subsection  
7e71 au?oriz$ c]tifi$ bodies %all h #cj 
days to calculate & submit updat$ rat+s 

to ! ,secret>y1 & updat$ rat+s %all be  
publi%$ on su* ,int]net website n lat]  
?an #cj days foll[+ su* submission4  7j7
 ,us] comp5sation fund ,! ,secret>y %all
 e/abli% a revolv+ us] comp5sation fund 
9 :i* am\nts collect$ "u subsection     
7g77#b7 %all be direct$ & us$ to assi/  
us]s ( heal? in=mation te*nology t are  
dec]tifi$ "u subsection 7g77#c7 to      
reimburse us]s = ! co/s ( pur*as+ new   
c]tifi$ heal? in=mation te*nology       
products4  7k7 ,h>d%ip exemption ,!     
,secret>y %all1 on a case-by-case basis1
 exempt an eligible pr(essional1        
eligible hospital1 or critical access   
hospital f ! application ( ! paym5t     
adju/m5t "u ! ,mean+ful ,use ( ,c]tifi$ 
,,ehr ,te*nology program "u sections    
#ahdh7;a77#g77;,a71                     
#ahhf7;b77#c77;,b77ix77,i71 &           
#ahad7l77#d71 respectively1 ( ! ,social 
,security ,act = #a ye> if ! eligible   
pr(essional1 eligible hospital1 or      
critical access hospital uses heal?     
in=mation te*nology t becomes dec]tifi$ 

"u subsection 7g77#c71 to help su*      
eligible pr(essional1 eligible hospital1
 or critical access hospital transition 
to a new c]tifi$ electronic heal? record
 te*nology4  7l7 ,appeals ,! ,secret>y  
%all e/abli% a process :]eby any v5dor  
(1 or entity (f]+1 heal? in=mation      
te*nology c appeal--  7#a7 ! heal?      
in=mation te*nology product's /> rat+2  
or  7#b7 ! ,secret>y's decision to      
dec]tify a product1 z applicable4  4    
#e4 ,updat+ in=mation on access+ p]sonal
 heal? in=mation ,subtitle ,a ( title   
,,xxx ( ! ,public ,heal? ,s]vice ,act   
7#db ,u4,s4,c4 #cjj;jj-#aa et seq471 z  
am5d$ by section #d1 is fur!r am5d$ by  
add+ at ! end ! foll[+3  #cjji;,b4      
,updat+ in=mation on access+ p]sonal    
heal? in=mation ,! ,national            
,coord9ator1 9 consultation ) !         
,director ( ! ,(fice ( ,civil ,rights1  
%all1 z appropriate1 update ! ,int]net  
website ( ! ,(fice ) in=mation to assi/ 
individuals 9 und]/&+ _! rights to      
access & protect _! p]sonal heal?       

in=mation "u ! ,heal? ,insurance        
,portability & ,acc\ntability ,act (    
#aiif 7,public ,law #ajd-aia71 includ+  
be/ practices = reque/+ _! p]sonal heal?
 in=mation 9 a computable =mat & us+    
pati5t portals1 among o!r in=mation4  4