,,ii  #aae? ,,congress  #b;d ,session   
,s4 #cdcd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #ab1 #bjah   
,ms4 ,smi? 7= h]self & ,mr4 ,cassidy7   
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 to provide = grants to     
enable ,/ates to c>ry out activities to 
r$uce adm9i/rative co/s & burd5s 9 heal?
 c>e4  #a4 ,%ort title  ,?is ,act may be
 cit$ z ! ,r$uc+ ,adm9i/rative ,co/s &  
,burd5s 9 ,heal? ,c>e ,act ( #bjah4  #b4
 ,r$uc+ adm9i/rative co/s & burd5s 9    
heal? c>e ,title ,,ii ( ! ,public ,heal?
 ,s]vice ,act 7#db ,u4,s4,c4 #bjb et    
seq47 is am5d$ by add+ at ! end !       
foll[+3  ,e ,r$uc+ adm9i/rative co/s &  
burd5s 9 heal? c>e  #bha4 ,elim9at+     
unnecess>y adm9i/rative burd5s & co/s   
7a7 ,r$uc+ adm9i/rative burd5s & co/s ,!
 ,secret>y1 9 consultation ) provid]s ( 
heal? s]vices1 heal? c>e suppli]s (     
s]vices1 heal? c>e pay]s1 heal?         

pr(essional societies1 heal? v5dors &   
develop]s1 heal? c>e quality            
organizations1 heal? c>e accr$itation   
organizations1 public heal? entities1   
,/ates1 pati5ts1 & o!r appropriate      
entities1 %all1 9 accordance )          
subsection 7b7--  7#a7 e/abli% a goal ( 
r$uc+ unnecess>y co/s & adm9i/rative    
burd5s across ! heal? c>e sy/em1 includ+
 ! ,m$ic>e program "u title ,,xviii ( ! 
,social ,security ,act1 ! ,m$icaid      
program "u title ,,xix ( su* ,act1 & !  
private heal? insurance m>ket1 by at    
lea/ half ov] a p]iod ( #aj ye>s f !    
date ( enactm5t ( ?is section2  7#b7    
develop /rategies & b5*m>ks = meet+ !   
goal e/abli%$ "u p>agraph 7#a72  7#c7   
develop recomm5dations = meet+ ! goal   
e/abli%$ "u p>agraph 7#a72 &  7#d7 take 
action to r$uce unnecess>y co/s &       
adm9i/rative burd5s bas$ on             
recomm5dations id5tifi$ 9 ?is           
subsection4  7b7 ,/rategies1            
recomm5dations1 & actions  7#a7 ,9 g5]al
 ,to a*ieve ! goal e/abli%$ "u          

subsection 7a77#a71 ! ,secret>y1 9      
consultation ) ! entities describ$ 9 su*
 subsection1 %all n lat] ?an #a ye> aft]
 ! date ( enactm5t ( ?is section1       
develop /rategies & recomm5dations &    
take actions to meet su* goal 9         
accordance ) ?is subsection4 ,no        
/rategies1 recomm5dation1 or action %all
 und]m9e ! quality ( pati5t c>e or      
pati5t heal? outcomes4  7#b7 ,/rategies 
,! /rategies develop$ "u p>agraph 7#a7  
%all address unnecess>y co/s &          
adm9i/rative burd5s4 ,su* /rategies %all
 include broad public comm5t & %all     
prioritize--  7,a7 recomm5dations       
id5tifi$ z a result ( ef=ts und]tak5 to 
implem5t section #cjja2  7,b7           
recomm5dations & be/ practices id5tifi$ 
z a results ( ef=ts und]tak5 "u ?is "p2 
7,c7 a review ( regulations1 rules1 &   
requirem5ts ( ! ,dep>tm5t ( ,heal? &    
,human ,s]vices t c\ld be modifi$ or    
elim9at$ to r$uce unnecess>y co/s &     
adm9i/rative burd5 impos$ on pati5ts1   
provid]s1 pay]s1 & o!r /akehold]s across

 ! heal? c>e sy/em2 &  7,d7 fe$back f   
/akehold]s 9 rural or fronti] areas on  
h[ to r$uce unnecess>y co/s &           
adm9i/rative burd5s on ! heal? c>e sy/em
 9 ^? areas4  7#c7 ,recomm5dations ,!   
recomm5dations develop$ "u p>agraph 7#a7
 %all include-- 7,a7 actions t improve !
 /&>dization & automation ( adm9i/rative
 transactions2  7,b7 actions t integrate
 cl9ical & adm9i/rative functions )9    
electronic heal? records2  7,c7 actions 
t improve pati5t c>e & r$uce unnecess>y 
co/s & adm9i/rative burd5s borne by     
pati5ts1 _! families1 & o!r c>etak]s2   
7,d7 actions t advance ! developm5t &   
adoption ( op5 application programm+    
int]faces to increase transp>5cy &      
int]op]ability1 emp[] pati5ts1 &        
facilitate bett] integration ( cl9ical &
 adm9i/rative functions2  7,e7 actions  
to be tak5 by ! ,secret>y & actions t   
ne$ to be tak5 by o!r entities2 &  7,f7 
o!r areas1 z ! ,secret>y det]m9es       
appropriate1 to r$uce unnecess>y co/s & 
adm9i/rative burd5s requir$ ( heal? c>e 

provid]s4  7#d7 ,actions ,! ,secret>y   
%all take action to a*ieve ! goal       
e/abli%$ "u section 7a77#a71 &1 n lat]  
?an  days aft] ! date ( enactm5t ( ?is  
section1 submit to ,congress & make     
publically available1 a report describ+ 
! actions tak5 by ! ,secret>y pursuant  
to goals1 /rategies1 & recomm5dations   
describ$ 9 ?is subsection4  7#e7 ,,faca 
,! ,f$]al ,advisory ,committee ,act 7#e 
,u4,s4,c4 ,app47 %all n apply to !      
developm5t ( ! goal1 /rategies1         
recomm5dations1 or actions describ$ 9   
?is section4  7#f7 ,rule ( con/ruction  
,no?+ 9 ?is subsection %all be con/ru$  
to au?orize1 or be us$ by1 ! ,f$]al     
,gov]nm5t to inhibit or o!rwise re/ra9  
ef=ts made to r$uce wa/e1 fraud1 & abuse
 across ! heal? c>e sy/em4  #bhb4       
,grants to ,/ates to develop            
recomm5dations  7a7 ,9 g5]al ,!         
,secret>y %all aw>d grants to at lea/   
#ae ,/ates to enable su* ,/ates to      
e/abli% & adm9i/] private-public        
multi-/akehold] commissions = ! purpose 

( r$uc+ heal? c>e adm9i/rative co/s &   
burd54 ,n less ?an #c ( su* grants %all 
be aw>d$ to ,/ates t are prim>ily rural1
 fronti]1 or a comb9ation !re(1 9       
nature4  7b7 ,application  7#a7 ,9 g5]al
 ,to be eligible to receive a grant "u  
subsection 7a7 a ,/ate %all submit to ! 
,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may reasonably require1       
includ+ ! in=mation describ$ 9 p>agraph 
7#b74  7#b7 ,requir$ in=mation ,9       
addition to any additional in=mation    
requir$ by ! ,secret>y "u ?is           
subsection1 an application %all include 
a description (--  7,a7 ! size &        
composition ( ! commission to be        
e/abli%$ "u ! grant1 includ+ !          
/akehold]s repres5t$ & ! degree to :i* !
 commission reflects important          
geographic & population *>act]i/ics ( ! 
,/ate2  7,b7 ! relation%ip ( !          
commission to ! ,/ate (ficial           
responsible = coord9at+ & implem5t+ !   
recomm5dations result+ f ! commission1 &

 ! role & responsibilities ( ! ,/ate )  
respect to ! commission1 includ+ any    
p>ticipation1 review1 ov]sight1         
implem5tation or o!r relat$ functions2  
7,c7 ! hi/ory & exp]i5ce ( ! ,/ate 9    
address+ heal? c>e adm9i/rative co/s1 & 
any exp]i5ce simil> to ! purpose ( !    
commission to improve heal? c>e         
adm9i/rative processes & ! ex*ange (    
heal? c>e adm9i/rative data2  7,d7 !    
res\rces & exp]tise t w be made         
available to ! commission by commission 
memb]s or o!r possible s\rces1 & h[     
,f$]al funds w be us$ to lev]age &      
complem5t ^! res\rces2  7,e7 ! gov]nance
 /ructure & proc$ures t ! commission w  
foll[ to make ! requir$ recomm5dations2 
7,f7 ! propos$ objectives relat+ to !   
simplification ( adm9i/rative           
transactions1 increas$ /&>dization1 & ! 
effici5cy & effectiv5ess ( !            
transmission ( heal? in=mation2  7,g7   
pot5tial co/ sav+s & o!r improvem5ts 9  
meet+ ! objectives describ$ 9           
subp>agraph 7,f72  7,h7 ! me?od or      

me?ods by :i* ! recomm5dations describ$ 
9 subsection 7c7 w be review$1 adopt$1  
implem5t$1 & updat$ z ne$$2 &  7,i7 !   
me?od or me?ods by :i* impacts &        
progress t[>d adm9i/rative              
simplification goals or objectives1     
includ+ adm9i/rative co/ sav+s & return 
on inve/m5t1 w be measur$ & report$4    
7c7 ,multi-,/akehold] commission  7#a7  
,9 g5]al ,n lat] ?an #ij days aft] !    
date on :i* a grant is aw>d$ to a ,/ate 
"u ?is section1 ! ,/ate (ficial describ$
 9 subsection 7b77#b77;,b71 insurance   
commission]1 or o!r appropriate ,/ate   
(ficial %all conv5e a multi-/akehold]   
commission1 9 accordance ) ?is          
subsection4  7#b7 ,memb]%ip ,!          
commission conv5$ "u p>agraph 7#a7 %all 
include repres5tatives f heal? plans1   
heal? c>e provid]s1 heal? v5dors1       
relevant ,/ate ag5cies1 heal? c>e /&>d  
developm5t organizations1 relevant      
pr(essional & trade associations1       
pati5ts1 & o!r entities det]m9$         
appropriate by ! ,/ate4  7#c7           

,recomm5dations ,n lat] ?an "o ye> aft] 
! date on :i* a grant is aw>d$ to a     
,/ate "u ?is section1 ! commission %all 
make recomm5dations & plans1 consi/5t ) 
! application submitt$ by ! ,/ate "u    
subsection 7b71 & int5d$ to meet !      
objectives def9$ 9 ! application4 ,su*  
recomm5dations %all comply )1 & build   
^u1 all relevant ,f$]al requirem5ts &   
regulations1 & may include--  7,a7      
common1 uni=m specifications1 be/       
practices1 & conv5tions1 = ! effici5t1  
effective ex*ange ( adm9i/rative        
transactions adopt$ pursuant to ! ,heal?
 ,insurance ,portability &              
,acc\ntability ,act ( #aiif 7,public    
,law #ajd-aia72  7,b7 ! developm5t (    
/reaml9$ bus9ess processes = ! ex*ange &
 use ( heal? c>e adm9i/rative data2 &   
7,c7 specifications1 inc5tives1         
requirem5ts1 tools1 me*anisms1 &        
res\rces to improve-- 7i7 ! access1     
ex*ange1 & use ( heal? c>e adm9i/rative 
in=mation ?r\gh electronic means2  7ii7 
! cr$5tial+ ( physicians1 hospitals1 or 

o!r heal? c>e provid]s or suppli]s )9 a 
heal? plan's network2  7iii7 !          
implem5tation ( utilization managem5t   
protocols2 &  7iv7 compliance ) ,f$]al &
 ,/ate laws4  7d7 ,additional use (     
funds ,a ,/ate may also use am\nts      
receiv$ "u a grant "u ?is section to    
support-- 7#a7 ! developm5t1            
implem5tation1 & be/ use ( %>$ data     
infra/ructure t supports ! electronic   
transmission ( adm9i/rative data2  7#b7 
! provision ( te*nical support &        
education to community /akehold]s to    
improve ! adoption & use ( key          
electronic heal? c>e transactions2  7#c7
 ! facilitation ( public & private      
initiatives aim$ at r$uc+ adm9i/rative  
co/s = ,/ate programs2 &  7#d7 ongo+    
ne$s assessm5ts & plann+ relat$ to !    
developm5t & implem5tation (            
adm9i/rative simplification initiatives4
  7e7 ,p]iod & am\nt ,a grant aw>d$ to a
 ,/ate "u ?is section %all be = a p]iod 
( #e ye>s & %all n exce$ #ej1jjj1jjj =  
su* #e-ye> p]iod4  7f7 ,reports  7#a7   

,/ates ,n lat] ?an #a ye> aft] ! end ( !
 #e-ye> grant p]iod1 a ,/ate receiv+ a  
grant "u ?is section %all submit to !   
,secret>y a report on ! outcomes1       
includ+ total sav+s1 a*iev$ by ! ,/ate 9
 implem5t+ ! recomm5dations describ$ 9  
subsection 7c77#c74  7#b7 ,secret>y ,n  
lat] ?an #f mon?s aft] ! ,/ate submits a
 report "u p>agraph 7#a71 ! ,secret>y1 9
 consultation ) ,national ,committee on 
,vital & ,heal? ,/ati/ics1 %all submit  
to ! ,committee on ,heal?1 ,education1  
,labor1 & ,p5sions ( ! ,s5ate & !       
,committee on ,en]gy & ,comm]ce ( !     
,h\se ( ,repres5tatives1 a report on !  
outcomes a*iev$ by ! ,/ates "u ! grants 
"u ?is section4  7#c7 ,,gao ,n lat] ?an 
#f mon?s aft] ! date on :i* ! ,secret>y 
submits ! report "u p>agraph 7#b71 !    
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all conduct a /udy1 & submit to !      
,committee on ,heal?1 ,education1       
,labor1 & ,p5sions ( ! ,s5ate & !       
,committee on ,en]gy & ,comm]ce ( !     
,h\se ( ,repres5tatives1 a report on !  

outcomes ( ! activities c>ri$ out "u !  
recomm5dations "u ?is section :i* %all  
conta9 a li/ ( be/ practices &          
recomm5dations to ,/ates conc]n+        
adm9i/rative simplification4  7g7       
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section1 #bjj1jjj1jjj = !           
#e-;fiscal-ye> p]iod beg9n+ ) fiscal ye>
 #bjbj4  #bhc4 ,grants to accel]ate     
,/ate innovation & adoption ( /&>ds to  
r$uce adm9i/rative co/s  7a7 ,9 g5]al ,!
 ,secret>y %all aw>d grants to ,/ates or
 ,/ate-designat$ entities1 includ+      
,/ates ) multi-/akehold] commissions "u 
section #bhb7;c71 z well z o!r          
multi-,/ate collaboratives1 to fund     
activities & improvem5ts t--  7#a7      
accel]ate ! e>ly adoption &             
implem5tation ( adm9i/rative            
transactions designat$ by ! ,secret>y & 
t h be5 adopt$ pursuant to ! ,heal?     
,insurance ,portability & ,acc\ntability
 ,act ( #aiif 7,public ,law #ajd-aia71  
includ+ transactions describ$ 9 section 

#aagc7;a77#b7 ( ! ,social ,security     
,act2  7#b7 accel]ate ! e>ly adoption & 
implem5tation ( additional adm9i/rative 
transactions & relat$ data ex*ange /&>ds
 t are be+ consid]$ = adoption "u !     
,heal? ,insurance ,portability &        
,acc\ntability ,act ( #aiif or are      
adopt$ pursuant to su* ,act1 or z       
designat$ by ! ,secret>y1 includ+ !     
electronic claim atta*m5t2 &  7#c7 to   
compile1 syn!size1 & dissem9ate lessons 
le>n$ to promote ! adoption ( !         
transactions describ$ 9 p>agraph 7#a7   
across ! heal? c>e sy/em4  7b7          
,eligibility ,to be eligible to receive 
a grant "u subsection 7a7 a ,/ate1 or   
,/ate designat$ entity 7includ+ a ,/ate 
) a commission e/abli%$ "u section      
#bhb7;c71 ,/ate ,m$icaid ag5cy1 or      
multi-,/ate collaborative1 z fur!r def9$
 by ! ,secret>y71 %all submit to !      
,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may reasonably require4  7c7  
,prioritization ,9 aw>d+ grants "u ?is  

section1 ! ,secret>y %all give priority 
to-- 7#a7 applications submitt$ by      
eligible entities locat$ 9 ,/ates1 or   
across multiple ,/ates1 t are compos$   
prim>ily ( rural or fronti] areas2  7#b7
 applications submitt$ by multi-,/ate   
collaboratives t1 z det]m9$ by !        
,secret>y1 may h ! greate/ *ance (      
successfully c>ry+ out ! activities     
describ$ 9 subsection 7a72 &  7#c7      
applications submitt$ by entities t     
propose to c>ry out a pilot program1 z  
describ$ 9 subsection 7d77#c74  7d7     
,activities ,a ,/ate %all use am\nts    
receiv$ "u a grant "u ?is section = "o  
or m ( ! foll[+3  7#a7 ,ne$s assessm5ts 
& plann+ ,grant funds may be us$ to     
det]m9e possible b>ri]s to ! adoption1  
implem5tation1 & effective use ( !      
transactions describ$ 9 subsection      
7a77#a7 9 section #a1 z well z to       
explore1 id5tify1 & plan options1       
approa*es1 & res\rces to address b>ri]s 
& make improvem5ts4  7#b7 ,education1   
tra9+1 & te*nical assi/ance ,grant funds

 may be us$ to develop & make available 
tra9+ & educational mat]ials1 =ums1 &   
activities z well z te*nical assi/ance  
to effectively implem5t1 use1 & b5efit f
 ! transactions describ$ 9 subsection   
7a77#a74  7#c7 ,pilot program ,grant    
funds may be us$ = pilot projects to te/
 approa*es to implem5t & use !          
transactions describ$ 9 subsection      
7a77#a7 9 practice "u a v>iety ( diff]5t
 sett+s4 ,) respect to ! electronic     
atta*m5t transaction1 priority %all be  
giv5 to pilot projects t te/ & evaluate 
me?ods & me*anisms to mo/ effectively   
incorporate pati5t heal? data f         
electronic heal? records & o!r          
electronic s\rces ) ! electronic        
atta*m5t transaction4 ,all su* pilot    
projects %all include plans to be       
evaluat$ = impacts & be/ practices & =  
report+ f9d+s = broad] ,/atewide &      
national use4  7#d7 ,adoption & use     
,grant funds may be us$ to accel]ate !  
adoption1 implem5tation1 & effective use
 ( ! transactions describ$ 9 subsection 

7a77#a7 across ,/ate programs4  7#e7    
,specifications1 inc5tives1 requirem5ts1
 tools1 me*anisms1 & res\rces ,grant    
funds may be us$ = develop+1 te/+1      
implem5t+1 & assess+ additional data    
ex*ange specifications1 inc5tives1      
requirem5ts1 tools1 me*anisms & res\rces
 to accel]ate ! adoption & effective use
 ( ! transactions describ$ 9 subsection 
7a77#a74  7e7 ,reports  7#a7 ,/ates ,n  
lat] ?an #a ye> aft] ! end ( ! #e-ye>   
grant p]iod1 an entity receiv+ a grant  
"u ?is section %all submit to !         
,secret>y a report on ! outcomes1       
includ+ total sav+s1 a*iev$ by ! ,/ate 9
 implem5t+ ! recomm5dations describ$ 9  
subsection 7d74  7#b7 ,secret>y ,n lat] 
?an #f mon?s aft] ! entity submits a    
report "u p>agraph 7#a71 ! ,secret>y1 9 
consultation ) ,national ,committee on  
,vital & ,heal? ,/ati/ics1 %all submit  
to ! ,committee on ,heal?1 ,education1  
,labor1 & ,p5sions ( ! ,s5ate & !       
,committee on ,en]gy & ,comm]ce ( !     
,h\se ( ,repres5tatives1 a report on !  

outcomes a*iev$ "u ! grants "u ?is      
section4  7#c7 ,,gao ,n lat] ?an #f     
mon?s aft] ! date on :i* ! ,secret>y    
submits ! report "u p>agraph 7#b71 !    
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all conduct a /udy1 & submit to !      
,committee on ,heal?1 ,education1       
,labor1 & ,p5sions ( ! ,s5ate & !       
,committee on ,en]gy & ,comm]ce ( !     
,h\se ( ,repres5tatives1 a report on !  
outcomes ( ! activities c>ri$ out "u !  
recomm5dations "u ?is section :i* %all  
conta9 a li/ ( be/ practices &          
recomm5dations to ,/ates conc]n+        
adm9i/rative simplification4  7f7       
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section1 #ej1jjj1jjj = !            
#e-;fiscal-ye> p]iod beg9n+ ) fiscal ye>
 #bjbj4  4