,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #abfj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #a1 #bjai ,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$uc+ ,adm9i/rative ,co/s &   
,burd5s 9 ,heal? ,c>e ,act ( #bjai4  #b4
 ,r$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 /&>d developm5t    
organizations & op]at+ rule entities1   
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 result ( 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     
functions2  7,c7 actions t improve      
pati5t c>e & r$uce unnecess>y co/s &    
adm9i/rative burd5s borne by pati5ts1 _!
 families1 & o!r c>etak]s2  7,d7 actions
 t advance ! developm5t & adoption ( op5
 application programm+ int]faces & o!r  
em]g+ te*nologies to increase transp>5cy
 & int]op]ability1 emp[] pati5ts1 &     
facilitate bett] integration ( cl9ical &
 adm9i/rative functions2  7,e7 actions  
to be tak5 by ! ,secret>y & actions t   
ne$ 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 ,consi/5cy ,any         
improvem5ts 9 electronic processes      
propos$ by ! ,secret>y "u ?is section   
%\ld lev]age exi/+ in=mation te*nology  
def9itions "u ,f$]al ,law4              
,specifically1 any electronic processes 
%\ld n be con/ru$ to include a          
facsimile1 a propriet>y pay] portal t   
does n meet /&>ds specifi$ by !         
,secret>y1 or an electronic =m image4   
7#e7 ,actions ,! ,secret>y %all take    
action to a*ieve ! goal e/abli%$ "u     
subsection 7a77#a71 &1 n lat] ?an #a ye>
 aft] ! date ( enactm5t ( ?is section1 &
 bi5nially !reaft]1 submit to ,congress 
& make publically available1 a report   
describ+ ! actions tak5 by ! ,secret>y  
pursuant to goals1 /rategies1 &         
recomm5dations describ$ 9 ?is           
subsection4  7#f7 ,,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#g7   

,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 & implem5t            
recomm5dations to accel]ate ,/ate       
innovation to r$uce heal? c>e           
adm9i/rative co/s  7a7 ,grants  7#a7 ,9 
g5]al ,n lat] ?an #f mon?s aft] ! date (
 enactm5t ( ?is section1 ! ,secret>y    
%all aw>d grants to at lea/ #ae ,/ates1 
& "o coord9at+ entity designat$ z       
provid$ = "u subsection 7e71 to enable  
su* ,/ates to e/abli% & adm9i/]         
private-public multi-/akehold]          
commissions = ! purpose ( r$uc+ heal?   
c>e adm9i/rative co/s & burd5 )9 &      
across ,/ates4 ,n less ?an #c ( su*     
grants %all be aw>d$ to ,/ates t are    
prim>ily rural1 fronti]1 or a comb9ation
 !re(1 9 nature4  7#b7 ,entities ,=     
purposes ( ?is section1 ! t]m ,/ate     
means a ,/ate1 a ,/ate designat$ entity1

 or a multi-,/ate collaborative 7z def9$
 by ! ,secret>y74  7#c7 ,priority ,9    
aw>d+ grants "u ?is section1 ! ,secret>y
 %all give priority to applications     
submitt$ by ,/ates t propose to c>ry out
 a pilot program or support ! adoption (
 electronic heal? c>e transactions &    
op]at+ rules4  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 9  
su* a mann] & 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$ures t ! commission w  
foll[ to make1 implem5t1 & pilot        
recomm5dations2  7,f7 ! propos$         
objectives relat+ to ! simplification ( 
adm9i/rative transactions & op]at+      
rules1 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 te/$1    
adopt$1 implem5t$1 & updat$ z ne$$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 ! ,/ate        
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 & op]at+ rule 
entities1 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 
! implem5tation ( utilization managem5t 
protocols2 &  7iii7 compliance ) ,f$]al 

& ,/ate laws4  7d7 ,use ( funds =       
implem5tation ,a ,/ate may use am\nts   
receiv$ "u a grant "u ?is section = "o  
or m ( ! foll[+3 7#a7 ,! developm5t1    
implem5tation1 & be/ use ( %>$ data     
infra/ructure t supports ! electronic   
transmission ( adm9i/rative data4  7#b7 
,! developm5t & provision ( tra9+ &     
educational mat]ials1 =ums1 & activities
 z well z te*nical assi/ance to         
effectively implem5t1 use1 & b5efit f   
electronic heal? c>e transactions &     
op]at+ rules4  7#c7 ,to accel]ate ! e>ly
 adoption & implem5tation ( adm9i/rative
 transactions & op]at+ rules designat$  
by ! ,secret>y & t h be5 adopt$ pursuant
 to ! ,heal? ,insurance ,portability &  
,acc\ntability ,act ( #aiif 7,public    
,law #ajd-aia71 includ+ transactions &  
op]at+ rules describ$ 9 section         
#aagc7;a77#b7 ( ! ,social ,security     
,act4  7#d7 ,to accel]ate ! e>ly        
adoption & implem5tation ( additional or
 updat$ adm9i/rative transactions1      
op]at+ rules1 & 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*m5t4  7#e7 ,to    
conduct pilot projects to te/ approa*es 
to implem5t & use ! electronic heal? c>e
 transactions & op]at+ rules 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  7#f7 ,to assess  
b>ri]s to ! adoption1 implem5tation1 &  
effective use ( electronic heal? c>e    
transactions & op]at+ rules1 z well z to
 explore1 id5tify1 & plan options1      
approa*es1 & res\rces to address b>ri]s 
& make improvem5ts4  7#g7 ,!            
facilitation ( public & private         
initiatives to r$uce adm9i/rative co/s &

 accel]ate ! adoption1 implem5tation1 & 
effective use ( electronic heal? c>e    
transactions & op]at+ rules = ,/ate     
programs4  7#h7 ,develop+1 te/+1        
implem5t+1 & assess+ additional data    
ex*ange specifications1 op]at+ rules1   
inc5tives1 requirem5ts1 tools1          
me*anisms1 & res\rces to accel]ate !    
adoption & effective use ( !            
transactions & op]at+ rules4  7#i7      
,ongo+ ne$s assessm5ts & plann+ relat$  
to ! developm5t & implem5tation (       
adm9i/rative simplification initiatives4
  7e7 ,coord9at+ entity  7#a7 ,functions
 ,n lat] ?an #f mon?s aft] ! date (     
enactm5t ( ?is section1 ! ,secret>y %all
 designate a coord9at+ entity "u ?is    
subsection = ! purpose (-- 7,a7 provid+ 
te*nical assi/ance to ,/ates relat+ to !
 simplification ( adm9i/rative          
transactions & op]at+ rules1 increas$   
/&>dization1 & ! effici5cy &            
effectiv5ess ( ! transmission ( heal?   
c>e in=mation2  7,b7 evaluat+ pilot     
projects & o!r ef=ts conduct$ "u ?is    

section = impact & be/ practices to in=m
 broad] national use2  7,c7 us+ consi/5t
 evaluation me?odologies to comp>e      
return on inve/m5t across ef=ts conduct$
 "u ?is section2  7,d7 compil+1         
syn!siz+1 dissem9at+1 & adopt+ lessons  
le>n$ to promote ! adoption ( electronic
 heal? c>e transactions & op]at+ rules  
across ! heal? c>e sy/em2 &  7,e7 mak+  
recomm5dations to ! ,secret>y & !       
,national ,committee on ,vital & ,heal? 
,/ati/ics reg>d+ ! national adoption (  
ef=ts conduct$ "u ?is section4  7#b7    
,eligibility ,! entity designat$ "u     
p>agraph 7#a7 %all be a qualifi$        
nonpr(it entity t-- 7,a7 focuses its    
mission on adm9i/rative simplification2 
7,b7 has demon/rat$ exp]i5ce us+ a      
multi-/akehold] & cons5sus-bas$ process 
= ! developm5t ( common1 uni=m          
specifications1 op]at+ rules1 be/       
practices1 & conv5tions1 = ! effici5t1  
effective ex*ange ( adm9i/rative        
transactions t includes repres5tation by
 or p>ticipation f heal? plans1 heal?   

c>e provid]s1 v5dors1 ,/ates1 relevant  
,f$]al ag5cies1 & o!r heal? c>e /&>d    
developm5t organizations2  7,c7 has     
demon/rat$ exp]i5ce provid+ te*nical    
assi/ance to heal? plans1 heal? c>e     
provid]s1 v5dors1 & ,/ates relat+ to !  
simplification ( adm9i/rative           
transactions & op]at+ rules1 increas$   
/&>dization1 & ! effici5cy &            
effectiv5ess ( ! transmission ( heal?   
c>e in=mation2  7,d7 has demon/rat$     
exp]i5ce evaluat+ & measur+ ! adoption &
 return on inve/m5t ( adm9i/rative      
transactions & op]at+ rules2  7,e7 has  
demon/rat$ exp]i5ce ga!r+1 syn!siz+1 &  
adopt+ common1 uni=m specifications1    
op]at+ rules1 be/ practices1 &          
conv5tions = national use bas$ on       
lessons le>n$ to promote ! adoption (   
electronic heal? c>e transactions &     
op]at+ rules across ! heal? c>e sy/em2  
7,f7 has a public set ( guid+ pr9ciples 
t ensure processes are op5 & transp>5t1 
& supports nondiscrim9ation & conflict (
 int]e/ policies t demon/rate a         

commitm5t to op51 fair1 &               
nondiscrim9atory practices2  7,g7 builds
 on ! transaction /&>ds issu$ "u ,heal? 
,insurance ,portability & ,acc\ntability
 ,act ( #aiif2 &  7,h7 all[s = public   
review & updates ( common1 uni=m        
specifications1 op]at+ rules1 be/       
practices1 & conv5tions to support      
adm9i/rative simplification4  7f7 ,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 ,a grant aw>d$ to ! coord9at+    
entity designat$ by ! ,secret>y "u      
subsection 7e7 %all be = a p]iod ( #e   
ye>s & %all n exce$ #ae1jjj1jjj = su*   
#e-ye> p]iod4  7g7 ,reports  7#a7 ,/ates
 ,n lat] ?an #a ye> aft] receiv+ a grant
 "u ?is section1 & bi5nially !reaft]1 a 
,/ate %all submit to ! ,secret>y a      
report on ! outcomes exp]i5c$ by ! ,/ate
 "u ! grant4  7#b7 ,coord9at+ entity ,n 
lat] ?an #a ye> aft] receiv+ a grant "u 
?is section1 & at lea/ bi5nially        
!reaft]1 ! coord9at+ entity %all submit 

to ! ,secret>y & ! ,national ,committee 
on ,vital & ,heal? ,/ati/ics a report ( 
evaluations conduct$ "u ! grant "u ?is  
section & recomm5dations reg>d+ !       
national adoption ( ef=ts conduct$ "u   
?is section4  7#c7 ,secret>y ,n lat] ?an
 #f mon?s aft] ! date on :i* ! ,/ates & 
coord9at+ entity submit ! report requir$
 "u p>agraphs 7#a7 & 7#b71 ! ,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#d7 ,,gao ,n lat] ?an #f     
mon?s aft] ! date on :i* ! ,secret>y    
submits ! f9al report "u p>agraph 7#c71 
! ,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 ?is
 section :i* %all conta9 a li/ ( be/    
practices & recomm5dations to ,/ates    
conc]n+ adm9i/rative simplification4    
7h7 ,au?orization ( appropriations ,!re 
is au?oriz$ to be appropriat$ to c>ry   
out ?is section1 #bej1jjj1jjj = !       
#e-;fiscal-ye> p]iod beg9n+ ) fiscal ye>
 #bjbj4  4