,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #ebie  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #d1 #bjai,mr4
 ,mead[s introduc$ ! foll[+ bill2 :i* 0 
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce  ,a ,,bill  ,to consolidate    
activities ( ! ,ag5cy = ,heal?c>e       
,rese>* & ,quality into ! ,national     
,in/itutes ( ,heal? z ! ,national       
,in/itute = ,rese>* on ,safety &        
,quality1 & = o!r purposes4  #a4 ,%ort  
title ,?is ,act may be cit$ z !         
,national ,in/itute = ,rese>* on ,safety
 & ,quality ,act4  #b4 ,consolidat+     
activities ( ,ag5cy = ,heal?c>e ,rese>* 
& ,quality into ,national ,in/itute =   
,rese>* on ,safety & ,quality  7a7      
,e/abli%m5t ( ,in/itute  7#a7 ,inclusion
 )9 ,,nih ,section #dja7;b7 ( ! ,public 
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bha7;b77 is am5d$--  7,a7 by r$esignat+
 p>agraph 7#be7 z p>agraph 7#bf72 &     
7,b7 by ins]t+ aft] p>agraph 7#bd7 !    
foll[+3  7#be7 ,national ,in/itute =    
,rese>* on ,safety & ,quality4  4  7#b7 

,increase ( cap on numb] ( in/itutes    
,section #dja7;d77#a7 ( ! ,public ,heal?
 ,s]vice ,act 7#db ,u4,s4,c4            
#bha7;d77#a77 is am5d$ by /rik+ #bg &   
ins]t+ #bh4  7#c7 ,e/abli%m5t ,"p ,c (  
title ,,iv ( ! ,public ,heal? ,s]vice   
,act 7#db ,u4,s4,c4 #bhe et seq47 is    
am5d$ by add+ at ! end ! foll[+3  #ba   
,national ,in/itute = ,rese>* on ,safety
 & ,quality  #dfd;aa-#a4 ,purpose (     
,in/itute ,! g5]al purpose ( ! ,national
 ,in/itute = ,rese>* on ,safety &       
,quality 7h]eaft] 9 ?is subp>t ref]r$ to
 z ! ,in/itute7 is to enhance ! quality1
 appropriat5ess1 & effectiv5ess ( heal? 
s]vices1 & access to su* s]vices1 ?r\gh 
! e/abli%m5t ( a broad base ( sci5tific 
rese>* & ?r\gh ! promotion ( improvem5ts
 9 cl9ical & heal? sy/em practices1     
includ+ ! prev5tion ( diseases & o!r    
heal? conditions4  #dfd;aa-#b4 ,promot+ 
heal? c>e quality improvem5t ,!         
,director ( ! ,in/itute %all promote    
heal? c>e quality improvem5t by conduct+
 & support+--  7#a7 rese>* t develops & 

pres5ts sci5tific evid5ce reg>d+ all    
aspects ( heal? c>e1 includ+--  7,a7 !  
developm5t & assessm5t ( me?ods =       
enhanc+ pati5t p>ticipation 9 _! own c>e
 & = facilitat+ %>$ pati5t-physician    
decision mak+2  7,b7 ! outcomes1        
effectiv5ess1 & co/-effectiv5ess ( heal?
 c>e practices1 includ+ prev5tive       
measures & long-t]m c>e2  7,c7 exi/+ &  
innovative te*nologies2  7,d7 ! co/s &  
utilization (1 & access to heal? c>e2   
7,e7 ! ways 9 :i* heal? c>e s]vices are 
organiz$1 deliv]$1 & f9anc$ & !         
int]action & impact ( ^! factors on !   
quality ( pati5t c>e2  7,f7 me?ods =    
measur+ quality & /rategies = improv+   
quality2 &  7,g7 ways 9 :i* pati5ts1    
consum]s1 pur*as]s1 & practition]s      
acquire new in=mation ab\t be/ practices
 & heal? b5efits1 ! det]m9ants & impact 
( _! use ( ?is in=mation2  7#b7 !       
syn!sis & dissem9ation ( available      
sci5tific evid5ce = use by pati5ts1     
consum]s1 practition]s1 provid]s1       
pur*as]s1 policy mak]s1 & educators2 &  

7#c7 initiatives to advance private &   
public ef=ts to improve heal? c>e       
quality4  #dfd;aa-#c4 ,requirem5ts )    
respect to rural & inn]-city areas &    
priority populations  7a7 ,rese>*1      
evaluations1 & demon/ration projects ,9 
c>ry+ out ?is subp>t1 ! ,director ( !   
,in/itute %all conduct & support rese>* 
& evaluations1 & support demon/ration   
projects1 ) respect to--  7#a7 ! deliv]y
 ( heal? c>e 9 inn]-city areas1 & 9     
rural areas 7includ+ fronti] areas72 &  
7#b7 heal? c>e = priority populations1  
:i* %all include--  7,a7 l[-income      
gr\ps2  7,b7 m9ority gr\ps2  7,c7 wom52 
7,d7 *ildr52  7,e7 ! eld]ly2 &  7,f7    
individuals ) special heal? c>e ne$s1   
includ+ individuals ) disabilities &    
individuals :o ne$ *ronic c>e or        
end-(-life heal? c>e4  7b7 ,process ,to 
ensure appropriate rese>* ,! ,director (
 ! ,in/itute %all e/abli% a process to  
ensure t ! requirem5ts ( subsection 7a7 
are reflect$ 9 ! ov]all portfolio (     
rese>* conduct$ & support$ by !         

,director ( ,national ,in/itutes (      
,heal?4  4  7b7 ,transf] ( au?ority     
7#a7 ,9 g5]al ,n lat] ,octob] #a1 #bjbj1
 ! ,secret>y ( ,heal? & ,human ,s]vices 
%all beg9 to transf] to ! ,national     
,in/itute = ,rese>* on ,safety &        
,quality ! au?orities 7includ+ all      
budget au?orities1 available            
appropriations1 & p]sonnel71 duties1    
obligations1 & relat$ legal &           
adm9i/rative functions prescrib$ by law 
or o!rwise grant$ to ! ,ag5cy =         
,heal?c>e ,rese>* & ,quality "u title   
,,ix ( ! ,public ,heal? ,s]vice ,act    
7#db ,u4,s4,c4 #bii et seq474 ,!        
,secret>y %all complete su* transf] n   
lat] ?an ,octob] #a1 #bjba4  7#b7       
,con=m+ repeal ,effective on ,octob] #a1
 #bjba1 title ,,ix ( ! ,public ,heal?   
,s]vice ,act 7#db ,u4,s4,c4 #bii et     
seq47 is repeal$4  7#c7 ,ref]5ces ,any  
ref]5ce to ! ,ag5cy = ,heal?c>e ,rese>* 
& ,quality 9 any law1 rule1 regulation1 
c]tificate1 directive1 in/ruction1 or   
o!r (ficial pap] 9 =ce on ! date (      

enactm5t ( ?is ,act %all be consid]$ to 
ref] & apply to ! ,national ,in/itute = 
,rese>* on ,safety & ,quality4  7#d7    
,au?orization ( appropriations ,( !     
am\nt au?oriz$ to be appropriat$ "u     
subp>agraph 7,f7 ( section              
#djb;,a7a77#a7 ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4             
#bhb7;a77#a77 = fiscal ye> #bjbj1 !     
,secret>y may use #bef1jjj1jjj to c>ry  
out ?is subsection4  7c7 ,effective date
 ,! am5dm5ts made by ?is section %all   
take effect on ,octob] #a1 #bjai4