HR 1021 IHCommentsClose CommentsPermalink

To improve research, diagnosis, and treatment of musculoskeletal diseases, conditions, and injuries, to conduct a longitudinal study on aging, and for other purposes.CommentsClose CommentsPermalink

February 12, 2009CommentsClose CommentsPermalink

Mr. GENE GREEN of Texas (for himself and Mr. BURGESS) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Science and Technology, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concernedCommentsClose CommentsPermalink

To improve research, diagnosis, and treatment of musculoskeletal diseases, conditions, and injuries, to conduct a longitudinal study on aging, and for other purposes.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE.

(a) Short Title- This Act may be cited as the ‘Access to America’s Orthopaedic Services Act of 2009’.CommentsClose CommentsPermalink

SEC. 2. TABLE OF CONTENTS; DEFINITION.

(a) Table of Contents- The table of contents for this Act is as follows:CommentsClose CommentsPermalink





Sec. 1. Short title.CommentsClose CommentsPermalink





Sec. 2. Table of contents; definition.CommentsClose CommentsPermalink

TITLE I--MUSCULOSKELETAL HEALTH

Sec. 101. Findings.CommentsClose CommentsPermalink





Sec. 102. Musculoskeletal research.CommentsClose CommentsPermalink





Sec. 103. Musculoskeletal trauma research and care.CommentsClose CommentsPermalink





Sec. 104. Transplants, tissues, and replacement joints.CommentsClose CommentsPermalink





Sec. 105. Traffic and workplace safety.CommentsClose CommentsPermalink





Sec. 106. Public education campaign.CommentsClose CommentsPermalink





Sec. 107. Orthopaedic physician workforce training study.CommentsClose CommentsPermalink





Sec. 108. Bone density under the Medicare Program.CommentsClose CommentsPermalink





Sec. 109. Access to orthopaedic services for beneficiaries of Medicaid and SCHIP.CommentsClose CommentsPermalink





Sec. 110. Age-related programs.CommentsClose CommentsPermalink





Sec. 111. Minority health disparities.CommentsClose CommentsPermalink

TITLE II--THIRD LONGITUDINAL STUDY ON AGING

Sec. 201. Third longitudinal study on aging.CommentsClose CommentsPermalink





(b) Secretary Defined- For purposes of the Act, the term ‘Secretary’ means the Secretary of Health and Human Services, except as otherwise provided.CommentsClose CommentsPermalink

TITLE I--MUSCULOSKELETAL HEALTHCommentsClose CommentsPermalink

SEC. 101. FINDINGS.

Congress makes the following findings:CommentsClose CommentsPermalink





(1) Musculoskeletal diseases and conditions are the leading cause of disability in the United States.CommentsClose CommentsPermalink





(2) Musculoskeletal diseases account for more than one-half of all chronic conditions in people over 50 years of age in developed countries.CommentsClose CommentsPermalink





(3) More than one in four individuals in the United States has a musculoskeletal condition requiring medical attention.CommentsClose CommentsPermalink





(4) Direct and indirect costs for bone and joint health are $849,000,000,000 per year in the United States.CommentsClose CommentsPermalink





(5) Musculoskeletal conditions are the greatest cause of total lost workdays and medical bed days in the United States.CommentsClose CommentsPermalink





(6) The 2004 Surgeon General Report on Bone Health and Osteoporosis concluded that there is a lack of awareness of bone disease among the public and health care professionals.CommentsClose CommentsPermalink





(7) Research demonstrates that there is need among ethnic and racial minorities to improve knowledge of and treatment for musculoskeletal diseases and conditions.CommentsClose CommentsPermalink

SEC. 102. MUSCULOSKELETAL RESEARCH.

(a) Regulations Concerning Reporting Criteria for Percent of Effort-CommentsClose CommentsPermalink





(1) IN GENERAL- The Secretary, in consultation with the Director of the National Institutes of Health, shall establish, by regulation, criteria for accounting and reporting the percent of effort expended by researchers, with respect to research that is--CommentsClose CommentsPermalink





(A) conducted during each fiscal year beginning after the last day of the second fiscal year following the date of enactment of this Act; andCommentsClose CommentsPermalink





(B) funded through research grants on musculoskeletal health awarded by either the Director of the National Institutes of Health or the Director of the Agency for Healthcare Research and Quality.CommentsClose CommentsPermalink





(2) DEADLINE FOR REGULATIONS- Not later than the last day of the 2-year period beginning on the date of enactment of this Act, the Secretary shall issue and implement the regulations required by paragraph (1).CommentsClose CommentsPermalink





(b) New Investigators in Musculoskeletal Research-CommentsClose CommentsPermalink





(1) REPORT- Not later than 90 days after the last day of each fiscal year that begins more than one year following the date of enactment of this Act, the Secretary, in consultation with the Director of the National Institutes of Health, shall prepare and submit to Congress a report on the following:CommentsClose CommentsPermalink





(A) The number of new investigators who are awarded grants for musculoskeletal health research by the National Institutes of Health during the fiscal year.CommentsClose CommentsPermalink





(B) The total amount of funds awarded to those investigators under such grants during the fiscal year.CommentsClose CommentsPermalink





(C) The percentage of the National Institutes of Health’s budget for musculoskeletal health research that was awarded to such investigators through such grants during the fiscal year.CommentsClose CommentsPermalink





(D) The race and ethnicity of the new investigators who are awarded such grants during the fiscal year.CommentsClose CommentsPermalink





(E) A description of the efforts made by the Director of the National Institutes of Health to encourage individuals from underrepresented minority groups (as defined by the Secretary) to apply for grants for musculoskeletal health research awarded by the National Institutes of Health during the fiscal year.CommentsClose CommentsPermalink





(2) RECOMMENDATIONS- The first report submitted under paragraph (1) shall include, and subsequent reports may include, recommendations concerning additional resources that the National Institutes of Health or other entities could use--CommentsClose CommentsPermalink





(A) to increase the number of new investigators awarded grants referred to in paragraph (1)(A); andCommentsClose CommentsPermalink





(B) to increase the number of new investigators awarded such grants who are members of underrepresented minority groups.CommentsClose CommentsPermalink





(3) DEFINITIONS- For purposes of this section, the following definitions apply:CommentsClose CommentsPermalink





(A) NEW INVESTIGATOR- The term ‘new investigator’ has the meaning given the term ‘new investigator’ by the Secretary for purposes of administering title III of the Public Health Service Act (42 U.S.C. 241 et seq.), but only with respect to musculoskeletal health research.CommentsClose CommentsPermalink





(B) RACE; ETHNICITY- The terms ‘race’ and ‘ethnicity’ have the meaning given such terms by the Office of Management and Budget for purposes of Federal statistics and administrative reporting.CommentsClose CommentsPermalink

SEC. 103. MUSCULOSKELETAL TRAUMA RESEARCH AND CARE.

(a) Musculoskeletal Trauma Research-CommentsClose CommentsPermalink





(1) REPORT- Not later than 2 years after the date of enactment of this Act, the Secretary shall prepare and submit to Congress a report on all programs and activities relating to musculoskeletal trauma care that are being conducted by the Federal Government or supported by funding made available by Federal Government.CommentsClose CommentsPermalink





(2) CONTENTS OF REPORT- Such report shall include, at a minimum, the following:CommentsClose CommentsPermalink





(A) Information on the status of each Federal program and activity referred to in paragraph (1), including specific information on any research program and activity.CommentsClose CommentsPermalink





(B) Information on the methods being used to coordinate research being conducted under such Federal programs and activities and the effectiveness of such methods.CommentsClose CommentsPermalink





(3) CONSULTATION- In preparing and submitting the report under paragraph (1), the Secretary shall consult with--CommentsClose CommentsPermalink





(A) the Secretary of Defense; andCommentsClose CommentsPermalink





(B) the heads of other Federal departments and agencies that administer programs and activities that are relevant to musculoskeletal trauma care, as determined by the Secretary.CommentsClose CommentsPermalink





(b) Orthopaedic Treatment Through Trauma Systems-CommentsClose CommentsPermalink





(1) STUDY- The Secretary shall conduct a study on the impact of trauma care systems that connect hospitals with other providers of health care services (including orthopedists) on musculoskeletal health.CommentsClose CommentsPermalink





(2) PURPOSES OF STUDY- The purposes of the study under paragraph (1) shall include, at a minimum, the following:CommentsClose CommentsPermalink





(A) An examination of the provision of acute and rehabilitative care to trauma patients with musculoskeletal conditions or injuries.CommentsClose CommentsPermalink





(B) An examination of epidemiological data on trauma patients with musculoskeletal conditions or injuries, including the number of such patients, the number of such conditions and injuries, and the types of such conditions and injuries.CommentsClose CommentsPermalink





(C) An evaluation of the ability of a patient with an orthopaedic condition or injury originating from musculoskeletal trauma to access specialty care relevant to that condition or injury.CommentsClose CommentsPermalink





(D) An examination of the impact of trauma rehabilitation care on musculoskeletal health and the ability of trauma patients with musculoskeletal conditions or injuries to access postacute rehabilitative services.CommentsClose CommentsPermalink





(3) REPORT- Not later than 2 years after the date of enactment of this Act, the Secretary shall submit to Congress a report on the results of the study under paragraph (1), including recommendations for improving the treatment of trauma patients with musculoskeletal injuries.CommentsClose CommentsPermalink

SEC. 104. TRANSPLANTS, TISSUES, AND REPLACEMENT JOINTS.

(a) Transplantation Transmission Sentinel Network- Section 372(b)(2) of the Public Health Service Act (42 U.S.C. 274(b)(2)) is amended--CommentsClose CommentsPermalink





(1) in subparagraph (N) by striking ‘and’ at the end;CommentsClose CommentsPermalink





(2) in subparagraph (O) by striking the period at the end and inserting ‘, and’; andCommentsClose CommentsPermalink





(3) by adding at the end the following:CommentsClose CommentsPermalink





‘(P) establish and operate a national Web-based system, to be known as the ‘Transplantation Transmission Sentinel Network’, for the detection, reporting, and tracking of disease transmission from organ, tissue, or eye donors to organ, tissue and eye transplant recipients.’.CommentsClose CommentsPermalink





(b) Accreditation of Establishments and Personnel Engaged in the Manufacture of Human Cells, Tissues, or Cellular or Tissue-Based Products-CommentsClose CommentsPermalink





(1) IN GENERAL- The Secretary shall issue regulations relating to the accreditation of--CommentsClose CommentsPermalink





(A) establishments; andCommentsClose CommentsPermalink





(B) personnel who participate in the recovery, processing, storage, labeling, packaging, or distribution of human cells, tissues, or cellular or tissue-based products for such establishments.CommentsClose CommentsPermalink





(2) AUTHORITY OF SECRETARY- In issuing the regulations under paragraph (1), the Secretary shall--CommentsClose CommentsPermalink





(A) establish an accreditation process modeled after the Joint Commission (previously known as the Joint Commission on Accreditation of Healthcare Organizations); orCommentsClose CommentsPermalink





(B) adopt an accreditation process established by a private entity that is in effect on the date of enactment of this Act.CommentsClose CommentsPermalink





(3) DEFINITIONS- For purposes of this subsection, the following definitions apply:CommentsClose CommentsPermalink





(A) ESTABLISHMENT- The term ‘establishment’ has the meaning given such term in section 1271.3 of title 21, Code of Federal Regulations (or any successor regulation).CommentsClose CommentsPermalink





(B) HUMAN CELLS, TISSUES, OR CELLULAR OR TISSUE-BASED PRODUCTS- The term ‘human cells, tissues, or cellular or tissue-based products’ has the meaning given such term in section 1271.3 of title 21, Code of Federal Regulations (or any successor regulation).CommentsClose CommentsPermalink





(c) National Joint Replacement Registry Study-CommentsClose CommentsPermalink





(1) STUDY- The Secretary shall conduct a study evaluating the advantages and disadvantages of establishing a national registry for the purpose of tracking the safety and effectiveness of artificial joints used to replace joints in beneficiaries of the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).CommentsClose CommentsPermalink





(2) CONTENTS OF PROPOSED REGISTRY- In evaluating the proposed registry under paragraph (1), the Secretary shall assume that the registry includes, at a minimum, information on--CommentsClose CommentsPermalink





(A) the type of joint replaced;CommentsClose CommentsPermalink





(B) the side of the body on which the joint is replaced;CommentsClose CommentsPermalink





(C) whether more than one operation was required in connection with an artificial joint replacement; andCommentsClose CommentsPermalink





(D) uniform identifiers for the artificial joint (including the device lot number and catalog number).CommentsClose CommentsPermalink





(3) REPORT- Not later than 2 years after the date of enactment of this Act, the Secretary shall submit to Congress a report on the results of the study under paragraph (1) and recommendation for changes to the Medicare program, including any necessary changes to the Medicare claims form, to allow for the collection of information required for the registry.CommentsClose CommentsPermalink

SEC. 105. TRAFFIC AND WORKPLACE SAFETY.

(a) Traffic Safety Study-CommentsClose CommentsPermalink





(1) STUDY- The Secretary, in consultation with the Secretary of Transportation, shall conduct a study, using epidemiological methods, on the frequency, severity, and likely causes of severe trauma to extremities resulting from motor vehicle crashes.CommentsClose CommentsPermalink





(2) REPORT- Not later than 2 years after the date of enactment of this Act, the Secretary shall submit to Congress a report on the results of the study under paragraph (1).CommentsClose CommentsPermalink





(3) MOTOR VEHICLE DEFINED- For purposes of this subsection, the term ‘motor vehicle’ has the meaning given such term in section 405 of title 23, United States Code.CommentsClose CommentsPermalink





(b) Workplace Safety Study-CommentsClose CommentsPermalink





(1) IN GENERAL- The Secretary, in consultation with the Secretary of Labor, shall conduct a study, within the research framework of the National Occupational Research Agenda coordinated by the National Institute for Occupational Safety and Health, on--CommentsClose CommentsPermalink





(A) the number of workplace-related musculoskeletal injuries and conditions; andCommentsClose CommentsPermalink





(B) medical treatments provided to individuals to treat such injuries and conditions.CommentsClose CommentsPermalink





(2) COLLECTION METHODOLOGY- In conducting the study under paragraph (1), the Secretary shall collect information in a manner that allows such information to be reported based on the type of musculoskeletal injury or condition and the race and ethnicity of the individual with such injury or condition.CommentsClose CommentsPermalink





(3) REQUEST FOR INFORMATION FROM STATE WORKERS COMPENSATION BOARDS- The Secretary may request that the head of each State agency that has jurisdiction over workers compensation submit information relevant to the study under paragraph (1) to the Secretary.CommentsClose CommentsPermalink





(4) REPORT- Not later than 2 years after the date of enactment of this Act, the Secretary shall submit to Congress a report on the results of the study under paragraph (1), categorized by type of injury or condition and race and ethnicity.CommentsClose CommentsPermalink

SEC. 106. PUBLIC EDUCATION CAMPAIGN.

(a) In General- The Secretary, in consultation with the Secretary of Education, the Secretary of Transportation, the Consumer Product Safety Commission, and the Chair of the President’s Council on Physical Fitness and Sports, shall conduct a national public awareness program on musculoskeletal health.CommentsClose CommentsPermalink





(b) Contents of Program- The program shall include, at a minimum, the following components:CommentsClose CommentsPermalink





(1) GENERAL INFORMATION FOR THE PUBLIC- A component providing education to the general public on musculoskeletal health, including education on healthy lifestyle practices relating to musculoskeletal health.CommentsClose CommentsPermalink





(2) EDUCATION FOR HEALTH PROFESSIONALS- A component providing education to health professionals on musculoskeletal health, including--CommentsClose CommentsPermalink





(A) specific information on musculoskeletal health in medically underserved populations (as defined in section 330(b)(3) of the Public Health Service Act (42 U.S.C. 254b(b)(3))); andCommentsClose CommentsPermalink





(B) the impact of musculoskeletal diseases and conditions on racial and ethnic minority populations.CommentsClose CommentsPermalink





(3) EDUCATION FOR GIRLS- A component that utilizes the program popularly known as ‘powerful bones, powerful girls’ to educate girls between 9 and 12 years of age on optimal bone health and the methods to achieve such health, with a focus on reducing the risk that such girls will develop osteoporosis as adults.CommentsClose CommentsPermalink





(4) EDUCATION FOR SPECIAL POPULATIONS- A component providing education to the following populations that address the specific needs of those populations:CommentsClose CommentsPermalink





(A) Populations of the United States that have disproportionately high levels of musculoskeletal disease and injury.CommentsClose CommentsPermalink





(B) Populations of the United States that have disproportionally low levels of access to orthopaedic services.CommentsClose CommentsPermalink





(C) Racial and ethnic minority populations of the United States.CommentsClose CommentsPermalink

SEC. 107. ORTHOPAEDIC PHYSICIAN WORKFORCE TRAINING STUDY.

(a) Study- The Secretary, acting through the Administrator of the Health Resource Services Administration, shall conduct a study on the amount of funding available for graduate medical education in orthopaedics from all sources and the impact of that amount of funding on the availability of physicians trained in orthopaedics.CommentsClose CommentsPermalink





(b) Report- Not later than 2 years after the date of enactment of this Act, the Secretary shall submit to Congress a report on the results of the study under subsection (a).CommentsClose CommentsPermalink

SEC. 108. BONE DENSITY UNDER THE MEDICARE PROGRAM.

(a) Standard Measurement Tool for Bone Density Study-CommentsClose CommentsPermalink





(1) STUDY- The Secretary, in consultation with the Director of the Agency for Healthcare Research and Quality, the Director of the National Institute of Biomedical Imaging and Bioengineering, and the Administrator of the Centers for Medicare & Medicaid Services, shall conduct a study on--CommentsClose CommentsPermalink





(A) the cost-effectiveness of all available methods for measuring bone mass in beneficiaries of the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) for the purpose of identifying the most cost-effective method;CommentsClose CommentsPermalink





(B) the cost-effectiveness of different time intervals between each bone mass screening for each such beneficiary for the purpose of identifying the most cost-effective interval;CommentsClose CommentsPermalink





(C) the frequency with which the cost-effectiveness of such methods and intervals should be reviewed based on anticipated changes in technology.CommentsClose CommentsPermalink





(2) REPORT-CommentsClose CommentsPermalink





(A) IN GENERAL- Not later than 2 years after the date of enactment of this Act, the Secretary shall submit to Congress and the Secretary of Commerce a report on the results of the study under paragraph (1).CommentsClose CommentsPermalink





(B) CONTENTS OF REPORT- The report under subparagraph (A) shall include, at a minimum, the following:CommentsClose CommentsPermalink





(i) The most cost-effective method for measuring bone mass in beneficiaries of the Medicare program and a recommendation for the adoption of such method by the Medicare program.CommentsClose CommentsPermalink





(ii) The most cost-effective interval between bone mass screenings for such beneficiaries and recommendation for the adoption of such interval by the Medicare program.CommentsClose CommentsPermalink





(3) UNITED STATES PREVENTIVE SERVICES TASK FORCE- In making the recommendations under paragraph (2)(B), the Secretary shall take into consideration any relevant guidelines in the most recent Guide to Clinical Preventive Services by the United States Preventive Services Task Force.CommentsClose CommentsPermalink





(4) REVISIONS TO RECOMMENDATIONS- The Secretary shall monitor developments in technology used to measure bone density and prepare and submit to Congress and the Secretary of Commerce reports updating the recommendations made under paragraph (2)(B), as needed.CommentsClose CommentsPermalink





(b) Standard Unit for Measuring Bone Density-CommentsClose CommentsPermalink





(1) REPORT- Not later than three years after the date of enactment of this Act, the Secretary of Commerce, acting through the Director of the National Institutes of Standards and Technology, shall prepare and submit to Congress a report on recommendations concerning a standard unit for the measurement of bone mass for use by the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).CommentsClose CommentsPermalink





(2) CONSIDERATIONS FOR RECOMMENDATIONS- In proposing the recommendations under paragraph (1), the Secretary of Commerce shall take into consideration the recommendations made under subsection (a)(2)(B), including any applicable updates to such recommendations made under subsection (a)(4), and the accuracy and utility of the recommended standard measurement unit as a diagnostic tool.CommentsClose CommentsPermalink

SEC. 109. ACCESS TO ORTHOPAEDIC SERVICES FOR BENEFICIARIES OF MEDICAID AND SCHIP.

(a) Report- Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall prepare and submit a report to Congress on access to orthopaedic services--CommentsClose CommentsPermalink





(1) by beneficiaries of the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396a et seq.); andCommentsClose CommentsPermalink





(2) by beneficiaries of the State Children’s Health Insurance program under title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.).CommentsClose CommentsPermalink





(b) Focus on Barriers To Access Affecting Children- The report under this section shall include, at a minimum, information on barriers to access to orthopaedic services that disproportionately affect children who are beneficiaries of the Medicaid program or the State Children’s Health Insurance program.CommentsClose CommentsPermalink

SEC. 110. AGE-RELATED PROGRAMS.

(a) State-Based Examples of Network Innovation, Opportunity, and Replication Grant Program- The Secretary shall award grants to State agencies in a manner similar to the manner in which grants were awarded under the program of the Department of Health and Human Services popularly known as the ‘State-based Examples of Network Innovation, Opportunity, and Replication Grant Program’ for the purpose of allowing such State agencies to establish or expand health and aging activities for seniors in the areas of clinical preventive services, physical activity, chronic disease self-management, and oral health.CommentsClose CommentsPermalink





(b) Childhood Musculoskeletal Diseases, Conditions, and Injuries Report- Not later than 2 years after the date of enactment of this Act, the Surgeon General of the Public Health Service shall prepare and submit to Congress a report on the burdens and costs associated with childhood musculoskeletal diseases, conditions, and injuries in the United States.CommentsClose CommentsPermalink

SEC. 111. MINORITY HEALTH DISPARITIES.

The Secretary, acting through the Deputy Assistant Secretary for Minority Health, shall treat musculoskeletal diseases and conditions as a priority for programs and grants affiliated with the Office of Minority Health and may incorporate musculoskeletal diseases and conditions into the initiatives of such Office.CommentsClose CommentsPermalink

TITLE II--THIRD LONGITUDINAL STUDY ON AGINGCommentsClose CommentsPermalink

SEC. 201. THIRD LONGITUDINAL STUDY ON AGING.

(a) In General- The Secretary, acting through the Director of the National Center for Health Statistics and in consultation with the Director of the National Institute on Aging, shall conduct a third longitudinal study on aging in the United States in a manner similar to the manner in which the second longitudinal study on aging was conducted.CommentsClose CommentsPermalink





(b) Duration- The duration of the third longitudinal study under subsection (a) shall be at least 6 years.CommentsClose CommentsPermalink





(c) Availability of Data- Data collected through the third longitudinal study under subsection (a) shall be made available to the public in a time and manner similar to the time and manner in which data from the second longitudinal study on aging was made available to the public.CommentsClose CommentsPermalink