Version	Word Count	Changes From Previous Version	Percent Change
Introduced in House	58,444	n/a	n/a
Reported in House	59,628	126 Show Changes Hide Changes	3%

Display Version Introduced in House Reported in House

HR 598 IHRHCommentsClose CommentsPermalink

111th CONGRESSCommentsClose CommentsPermalink

1st SessionCommentsClose CommentsPermalink

H. R. 598CommentsClose CommentsPermalink

To provide for a portion of the economic recovery package relating to revenue measures, unemployment, and health.CommentsClose CommentsPermalink

IN THE HOUSE OF REPRESENTATIVESCommentsClose CommentsPermalink

January 16, 2009CommentsClose CommentsPermalink

Mr. RANGEL (for himself, Mr. STARK, and Mr. MCDERMOTT) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committees on Energy and Commerce, Science and Technology, Education and Labor, and Financial Services, 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

A BILLCommentsClose CommentsPermalink

To provide for a portion of the economic recovery package relating to revenue measures, unemployment, and health.CommentsClose CommentsPermalink

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

TITLE I--TAX PROVISIONS CommentsClose CommentsPermalink

SECTION 1000. SHORT TITLE, ETC.

(a) Short Title- This title may be cited as the ‘American Recovery and Reinvestment Tax Act of 2009’. CommentsClose CommentsPermalink





(b) Reference- Except as otherwise expressly provided, whenever in this title an amendment or repeal is expressed in terms of an amendment to, or repeal of, a section or other provision, the reference shall be considered to be made to a section or other provision of the Internal Revenue Code of 1986. CommentsClose CommentsPermalink





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





Sec. 1000. Short title, etc. CommentsClose CommentsPermalink

Subtitle A--Making Work Pay

Sec. 1001. Making work pay credit. CommentsClose CommentsPermalink

Subtitle B--Additional Tax Relief for Families With Children

Sec. 1101. Temporary iIncrease in earned income tax credit. CommentsClose CommentsPermalink





Sec. 1102. Temporary iIncrease of refundable portion of child credit. CommentsClose CommentsPermalink

Subtitle C--American Opportunity Tax Credit

Sec. 1201. American opportunity tax credit. CommentsClose CommentsPermalink

Subtitle D--Housing Incentives

Sec. 1301. Waiver of requirement to repay first-time homebuyer credit. CommentsClose CommentsPermalink





Sec. 1302. Coordination of low-income housing credit and low-income housing grants. CommentsClose CommentsPermalink

Subtitle E--Tax Incentives for Business

Part I--Temporary Investment Incentives

Sec. 1401. Special allowance for certain property acquired during 2009. CommentsClose CommentsPermalink





Sec. 1402. Temporary increase in limitations on expensing of certain depreciable business assets. CommentsClose CommentsPermalink

Part II--5-Year Carryback of Operating Losses

Sec. 1411. 5-year carryback of operating losses. CommentsClose CommentsPermalink





Sec. 1412. Exception for TARP recipients. CommentsClose CommentsPermalink

Part III--Incentives for New Jobs

Sec. 1421. Incentives to hire unemployed veterans and disconnected youth. CommentsClose CommentsPermalink

Part IV--Clarification of Regulations Related to Limitations on Certain Built-In Losses Following an Ownership Change

Sec. 1431. Clarification of regulations related to limitations on certain built-in losses following an ownership change. CommentsClose CommentsPermalink

Subtitle F--Fiscal Relief for State and Local Governments

Part I--Improved Marketability for Tax-Exempt Bonds

Sec. 1501. De minimis safe harbor exception for tax-exempt interest expense of financial institutions. CommentsClose CommentsPermalink





Sec. 1502. Modification of small issuer exception to tax-exempt interest expense allocation rules for financial institutions. CommentsClose CommentsPermalink





Sec. 1503. Temporary modification of alternative minimum tax limitations on tax-exempt bonds. CommentsClose CommentsPermalink

Part II--Tax Credit Bonds for Schools

Sec. 1511. Qualified school construction bonds. CommentsClose CommentsPermalink





Sec. 1512. Extension and expansion of qualified zone academy bonds. CommentsClose CommentsPermalink

Part III--Taxable Bond Option for Governmental Bonds

Sec. 1521. Taxable bond option for governmental bonds. CommentsClose CommentsPermalink

Part IV--Recovery Zone Bonds

Sec. 1531. Recovery zone bonds. CommentsClose CommentsPermalink





Sec. 1532. Tribal economic development bonds. CommentsClose CommentsPermalink

Part V--Repeal of Withholding Tax on Government Contractors

Sec. 1541. Repeal of withholding tax on government contractors. CommentsClose CommentsPermalink

Subtitle G--Energy Incentives

Part I--Renewable Energy Incentives

Sec. 1601. Extension of credit for electricity produced from certain renewable resources. CommentsClose CommentsPermalink





Sec. 1602. Election of investment credit in lieu of production credit. CommentsClose CommentsPermalink





Sec. 1603. Repeal of certain limitations on credit for renewable energy property. CommentsClose CommentsPermalink





Sec. 1604. Coordination with renewable energy grants. CommentsClose CommentsPermalink

Part II--Increased Allocations of New Clean Renewable Energy Bonds and Qualified Energy Conservation Bonds

Sec. 1611. Increased limitation on issuance of new clean renewable energy bonds. CommentsClose CommentsPermalink





Sec. 1612. Increased limitation on issuanceand expansion of qualified energy conservation bonds. CommentsClose CommentsPermalink

Part III--Energy Conservation Incentives

Sec. 1621. Extension and modification of credit for nonbusiness energy property. CommentsClose CommentsPermalink





Sec. 1622. Modification of credit for residential energy efficient property. CommentsClose CommentsPermalink





Sec. 1623. Temporary increase in credit for alternative fuel vehicle refueling property. CommentsClose CommentsPermalink

Part IV--Energy Research Incentives

Sec. 1631. Increased research credit for energy research. CommentsClose CommentsPermalink

Subtitle H--Other Provisions

Part I--Application of Certain Labor Standards to Projects Financed With Certain Tax-Favored Bonds

Sec. 1701. Application of certain labor standards to projects financed with certain tax-favored bonds. CommentsClose CommentsPermalink

Part II--Grants To Provide Financing for Low-Income Housing

Sec. 1711. Grants to States for low-income housing projects in lieu of low-income housing credit allocations for 2009. CommentsClose CommentsPermalink

Part III--Grants for Specified Energy Property in Lieu of Tax Credits

Sec. 1721. Grants for specified energy property in lieu of tax credits. CommentsClose CommentsPermalink

Subtitle A--Making Work Pay CommentsClose CommentsPermalink

SEC. 1001. MAKING WORK PAY CREDIT.

(a) In General- Subpart C of part IV of subchapter A of chapter 1 is amended by inserting after section 36 the following new section: CommentsClose CommentsPermalink

‘SEC. 36A. MAKING WORK PAY CREDIT.

‘(a) Allowance of Credit- In the case of an eligible individual, there shall be allowed as a credit against the tax imposed by this subtitle for the taxable year an amount equal to the lesser of-- CommentsClose CommentsPermalink





‘(1) 6.2 percent of earned income of the taxpayer, or CommentsClose CommentsPermalink





‘(2) $500 ($1,000 in the case of a joint return). CommentsClose CommentsPermalink





‘(b) Limitation Based on Modified Adjusted Gross Income- CommentsClose CommentsPermalink





‘(1) IN GENERAL- The amount allowable as a credit under subsection (a) (determined without regard to this paragraph) for the taxable year shall be reduced (but not below zero) by 2 percent of so much of the taxpayer’s modified adjusted gross income as exceeds $75,000 ($150,000 in the case of a joint return). CommentsClose CommentsPermalink





‘(2) MODIFIED ADJUSTED GROSS INCOME- For purposes of subparagraph (A), the term ‘modified adjusted gross income’ means the adjusted gross income of the taxpayer for the taxable year increased by any amount excluded from gross income under section 911, 931, or 933. CommentsClose CommentsPermalink





‘(c) Definitions- For purposes of this section-- CommentsClose CommentsPermalink





‘(1) ELIGIBLE INDIVIDUAL- The term ‘eligible individual’ means any individual other than-- CommentsClose CommentsPermalink





‘(A) any nonresident alien individual, CommentsClose CommentsPermalink





‘(B) any individual with respect to whom a deduction under section 151 is allowable to another taxpayer for a taxable year beginning in the calendar year in which the individual’s taxable year begins, and CommentsClose CommentsPermalink





‘(C) an estate or trust. CommentsClose CommentsPermalink





Such term shall not include any individual unless the requirements of section 32(c)(1)(E) are met with respect to such individual. CommentsClose CommentsPermalink





‘(2) EARNED INCOME- The term ‘earned income’ has the meaning given such term by section 32(c)(2), except that such term shall not include net earnings from self-employment which are not taken into account in computing taxable income. For purposes of the preceding sentence, any amount excluded from gross income by reason of section 112 shall be treated as earned income which is taken into account in computing taxable income for the taxable year. CommentsClose CommentsPermalink





‘(d) Termination- This section shall not apply to taxable years beginning after December 31, 2010.’. CommentsClose CommentsPermalink





(b) Treatment of Possessions- CommentsClose CommentsPermalink





(1) PAYMENTS TO POSSESSIONS- CommentsClose CommentsPermalink





(A) MIRROR CODE POSSESSION- The Secretary of the Treasury shall pay to each possession of the United States with a mirror code tax system amounts equal to the loss to that possession by reason of the amendments made by this section with respect to taxable years beginning in 2009 and 2010. Such amounts shall be determined by the Secretary of the Treasury based on information provided by the government of the respective possession. CommentsClose CommentsPermalink





(B) OTHER POSSESSIONS- The Secretary of the Treasury shall pay to each possession of the United States which does not have a mirror code tax system amounts estimated by the Secretary of the Treasury as being equal to the aggregate benefits that would have been provided to residents of such possession by reason of the amendments made by this section for taxable years beginning in 2009 and 2010 if a mirror code tax system had been in effect in such possession. The preceding sentence shall not apply with respect to any possession of the United States unless such possession has a plan, which has been approved by the Secretary of the Treasury, under which such possession will promptly distribute such payments to the residents of such possession. CommentsClose CommentsPermalink





(2) COORDINATION WITH CREDIT ALLOWED AGAINST UNITED STATES INCOME TAXES- No credit shall be allowed against United States income taxes for any taxable year under section 36A of the Internal Revenue Code of 1986 (as added by this section) to any person-- CommentsClose CommentsPermalink





(A) to whom a credit is allowed against taxes imposed by the possession by reason of the amendments made by this section for such taxable year, or CommentsClose CommentsPermalink





(B) who is eligible for a payment under a plan described in paragraph (1)(B) with respect to such taxable year. CommentsClose CommentsPermalink





(3) DEFINITIONS AND SPECIAL RULES- CommentsClose CommentsPermalink





(A) POSSESSION OF THE UNITED STATES- For purposes of this subsection, the term ‘possession of the United States’ includes the Commonwealth of Puerto Rico and the Commonwealth of the Northern Mariana Islands. CommentsClose CommentsPermalink





(B) MIRROR CODE TAX SYSTEM- For purposes of this subsection, the term ‘mirror code tax system’ means, with respect to any possession of the United States, the income tax system of such possession if the income tax liability of the residents of such possession under such system is determined by reference to the income tax laws of the United States as if such possession were the United States. CommentsClose CommentsPermalink





(C) TREATMENT OF PAYMENTS- For purposes ofsection 1324(b)(2) of title 31, United States Code, the payments under this subsection shall be treated in the same manner as a refund due from the credit allowed under section 36A of the Internal Revenue Code of 1986 (as added by this section). CommentsClose CommentsPermalink





(c) Refunds Disregarded in the Administration of Federal Programs and Federally Assisted Programs- Any credit or refund allowed or made to any individual by reason of section 36A of the Internal Revenue Code of 1986 (as added by this section) or by reason of subsection (b) of this section shall not be taken into account as income and shall not be taken into account as resources for the month of receipt and the following 2 months, for purposes of determining the eligibility of such individual or any other individual for benefits or assistance, or the amount or extent of benefits or assistance, under any Federal program or under any State or local program financed in whole or in part with Federal funds. CommentsClose CommentsPermalink





(d) Conforming Amendments- CommentsClose CommentsPermalink





(1) Section 6211(b)(4)(A) is amended by inserting ‘36A,’ after ‘36,’. CommentsClose CommentsPermalink





(2)Section 1324(b)(2) of title 31, United States Code, is amended by inserting ‘36A,’ after ‘36,’. CommentsClose CommentsPermalink





(3) The table of sections for subpart C of part IV of subchapter A of chapter 1 is amended by inserting after the item relating to section 36 the following new item: CommentsClose CommentsPermalink





‘Sec. 36A. Making work pay credit.’. CommentsClose CommentsPermalink





(e) Effective Date- This section shall apply to taxable years beginning after December 31, 2008. CommentsClose CommentsPermalink

Subtitle B--Additional Tax Relief for Families With Children CommentsClose CommentsPermalink

SEC. 1101. TEMPORARY INCREASE IN EARNED INCOME TAX CREDIT.

(a) In General- Subsection (b) of section 32 is amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(3) TEMPORARY INCREASESPECIAL RULES FOR 2009 AND 2010- In the case of any taxable year beginning in 2009 or 2010-- CommentsClose CommentsPermalink





‘(A) INCREASED CREDIT PERCENTAGE FOR 3 OR MORE QUALIFYING CHILDREN- In the case of a taxpayer with 3 or more qualifying children, the credit percentage is 45 percent. CommentsClose CommentsPermalink





‘(B) REDUCTION OF MARRIAGE PENALTY- CommentsClose CommentsPermalink





‘(i) IN GENERAL- The dollar amount in effect under paragraph (2)(B) shall be $5,000. CommentsClose CommentsPermalink





‘(ii) INFLATION ADJUSTMENT- In the case of any taxable year beginning in 2010, the $5,000 amount in clause (i) shall be increased by an amount equal to-- CommentsClose CommentsPermalink





‘(I) such dollar amount, multiplied by CommentsClose CommentsPermalink





‘(II) the cost of living adjustment determined under section 1(f)(3) for the calendar year in which the taxable year begins determined by substituting ‘calendar year 2008’ for ‘calendar year 1992’ in subparagraph (B) thereof. CommentsClose CommentsPermalink





‘(iii) ROUNDING- Subparagraph (A) of subsection (j)(2) shall apply after taking into account any increase under clause (ii).’. CommentsClose CommentsPermalink





(b) Effective Date- The amendments made by this section shall apply to taxable years beginning after December 31, 2008. CommentsClose CommentsPermalink

SEC. 1102. TEMPORARY INCREASE OF REFUNDABLE PORTION OF CHILD CREDIT.

(a) In General- Paragraph (4) of section 24(d) is amended to read as follows: CommentsClose CommentsPermalink





‘(4) SPECIAL RULE FOR 2009 AND 2010- Notwithstanding paragraph (3), in the case of any taxable year beginning in 2009 or 2010, the dollar amount in effect for such taxable year under paragraph (1)(B)(i) shall be zero.’. CommentsClose CommentsPermalink





(b) Effective Date- The amendments made by this section shall apply to taxable years beginning after December 31, 2008. CommentsClose CommentsPermalink

Subtitle C--American Opportunity Tax Credit CommentsClose CommentsPermalink

SEC. 1201. AMERICAN OPPORTUNITY TAX CREDIT.

(a) In General- Section 25A (relating to Hope scholarship credit) is amended by redesignating subsection (i) as subsection (j) and by inserting after subsection (h) the following new subsection: CommentsClose CommentsPermalink





‘(i) American Opportunity Tax Credit- In the case of any taxable year beginning in 2009 or 2010-- CommentsClose CommentsPermalink





‘(1) INCREASE IN CREDIT- The Hope Scholarship Credit shall be an amount equal to the sum of-- CommentsClose CommentsPermalink





‘(A) 100 percent of so much of the qualified tuition and related expenses paid by the taxpayer during the taxable year (for education furnished to the eligible student during any academic period beginning in such taxable year) as does not exceed $2,000, plus CommentsClose CommentsPermalink





‘(B) 25 percent of such expenses so paid as exceeds $2,000 but does not exceed $4,000. CommentsClose CommentsPermalink





‘(2) CREDIT ALLOWED FOR FIRST 4 YEARS OF POST-SECONDARY EDUCATION- Subparagraphs (A) and (C) of subsection (b)(2) shall be applied by substituting ‘4’ for ‘2’. CommentsClose CommentsPermalink





‘(3) QUALIFIED TUITION AND RELATED EXPENSES TO INCLUDE REQUIRED COURSE MATERIALS- Subsection (f)(1)(A) shall be applied by substituting ‘tuition, fees, and course materials’ for ‘tuition and fees’. CommentsClose CommentsPermalink





‘(4) INCREASE IN AGI LIMITS FOR HOPE SCHOLARSHIP CREDIT- In lieu of applying subsection (d) with respect to the Hope Scholarship Credit, such credit (determined without regard to this paragraph) shall be reduced (but not below zero) by the amount which bears the same ratio to such credit (as so determined) as-- CommentsClose CommentsPermalink





‘(A) the excess of-- CommentsClose CommentsPermalink





‘(i) the taxpayer’s modified adjusted gross income (as defined in subsection (d)(3)) for such taxable year, over CommentsClose CommentsPermalink





‘(ii) $80,000 ($160,000 in the case of a joint return), bears to CommentsClose CommentsPermalink





‘(B) $10,000 ($20,000 in the case of a joint return). CommentsClose CommentsPermalink





‘(5) CREDIT ALLOWED AGAINST ALTERNATIVE MINIMUM TAX- In the case of a taxable year to which section 26(a)(2) does not apply, so much of the credit allowed under subsection (a) as is attributable to the Hope Scholarship Credit shall not exceed the excess of-- CommentsClose CommentsPermalink





‘(A) the sum of the regular tax liability (as defined in section 26(b)) plus the tax imposed by section 55, over CommentsClose CommentsPermalink





‘(B) the sum of the credits allowable under this subpart (other than this section ubsection and sections 23, 25D, and 30D) and section 27 for the taxable year. CommentsClose CommentsPermalink





Any reference in this section or section 24, 25, 26, 25B, 904, or 1400C to a credit allowedable under this subsection shall be treated as a reference to so much of the credit allowedable under subsection (a) as is attributable to the Hope Scholarship Credit. CommentsClose CommentsPermalink





‘(6) PORTION OF CREDIT MADE REFUNDABLE- 40 percent of so much of the credit allowed under subsection (a) as is attributable to the Hope Scholarship Credit (determined after application of paragraph (4) and without regard to this paragraph and section 26(a)(2) or paragraph (5), as the case may be) shall be treated as a credit allowable under subpart C (and not allowed under subsection (a)). The preceding sentence shall not apply to any taxpayer for any taxable year if such taxpayer is a child to whom subsection (g) of section 1 applies for such taxable year. CommentsClose CommentsPermalink





‘(7) COORDINATION WITH MIDWESTERN DISASTER AREA BENEFITS- In the case of a taxpayer with respect to whom section 702(a)(1)(B) of the Heartland Disaster Tax Relief Act of 2008 applies for any taxable year, such taxpayer may elect to waive the application of this subsection to such taxpayer for such taxable year.’. CommentsClose CommentsPermalink





(b) Conforming Amendments- CommentsClose CommentsPermalink





(1) Section 24(b)(3)(B) is amended by inserting ‘25A(i),’ after ‘23,’. CommentsClose CommentsPermalink





(2) Section 25(e)(1)(C)(ii) is amended by inserting ‘25A(i),’ after ‘24,’. CommentsClose CommentsPermalink





(3) Section 26(a)(1) is amended by inserting ‘25A(i),’ after ‘24,’. CommentsClose CommentsPermalink





(4) Section 25B(g)(2) is amended by inserting ‘25A(i),’ after ‘23,’. CommentsClose CommentsPermalink





(5) Section 904(i) is amended by inserting ‘25A(i),’ after ‘24,’. CommentsClose CommentsPermalink





(6) Section 1400C(d)(2) is amended by inserting ‘25A(i),’ after ‘24,’. CommentsClose CommentsPermalink





(7)Section 1324(b)(2) of title 31, United States Code, is amended by inserting ‘25A,’ before ‘35’. CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply to taxable years beginning after December 31, 2008. CommentsClose CommentsPermalink





(d) Application of EGTRRA Sunset- The amendment made by subsection (b)(1) shall be subject to title IX of the Economic Growth and Tax Relief Reconciliation Act of 2001 in the same manner as the provision of such Act to which such amendment relates. CommentsClose CommentsPermalink





(e) Treasury Studies Regarding Education Incentives- CommentsClose CommentsPermalink





(1) STUDY REGARDING COORDINATION WITH NON-TAX EDUCATIONAL INCENTIVES- The Secretary of the Treasury, or the Secretary’s delegate, shall study how to coordinate the credit allowed under section 25A of the Internal Revenue Code of 1986 with the Federal Pell Grant program under section 401 of the Higher Education Act of 1965. CommentsClose CommentsPermalink





(2) STUDY REGARDING IMPOSITION OF COMMUNITY SERVICE REQUIREMENTS- The Secretary of the Treasury, or the Secretary’s delegate, shall study the feasibility of requiring students to perform community service as a condition of taking their tuition and related expenses into account under section 25A of the Internal Revenue Code of 1986. CommentsClose CommentsPermalink





(3) REPORT- Not later than 1 year after the date of the enactment of this Act, the Secretary of the Treasury, or the Secretary’s delegate, shall report to Congress on the results of the studies conducted under this paragraph. CommentsClose CommentsPermalink

Subtitle D--Housing Incentives CommentsClose CommentsPermalink

SEC. 1301. WAIVER OF REQUIREMENT TO REPAY FIRST-TIME HOMEBUYER CREDIT.

(a) In General- Paragraph (4) of section 36(f) is amended by adding at the end the following new subparagraph: CommentsClose CommentsPermalink





‘(D) WAIVER OF RECAPTURE FOR PURCHASES IN 2009- In the case of any credit allowed with respect to the purchase of a principal residence after December 31, 2008, and before July 1, 2009-- CommentsClose CommentsPermalink





‘(i) paragraph (1) shall not apply, and CommentsClose CommentsPermalink





‘(ii) paragraph (2) shall apply only if the disposition or cessation described in paragraph (2) with respect to such residence occurs during the 36-month period beginning on the date of the purchase of such residence by the taxpayer.’. CommentsClose CommentsPermalink





(b) Conforming Amendment- Subsection (g) of section 36 is amended by striking ‘subsection (c)’ and inserting ‘subsections (c) and (f)(4)(D)’. CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply to residences purchased after December 31, 2008. CommentsClose CommentsPermalink

SEC. 1302. COORDINATION OF LOW-INCOME HOUSING CREDIT AND LOW-INCOME HOUSING GRANTS.

Subsection (i) of section 42 of the Internal Revenue Code of 1986 is amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(9) COORDINATION WITH LOW-INCOME HOUSING GRANTS- CommentsClose CommentsPermalink





‘(A) REDUCTION IN STATE HOUSING CREDIT CEILING FOR LOW-INCOME HOUSING GRANTS RECEIVED IN 2009- For purposes of this section, the amounts described in clauses (i) through (iv) of subsection (h)(3)(C) with respect to any State for 2009 shall each be reduced by so much of such amount as is taken into account in determining the amount of any grant to such State under section 1711 of the American Recovery and Reinvestment Tax Act of 2009. CommentsClose CommentsPermalink





‘(B) SPECIAL RULE FOR BASIS- Basis of a qualified low-income building shall not be reduced by the amount of any grant described in subparagraph (A).’. CommentsClose CommentsPermalink

Subtitle E--Tax Incentives for Business CommentsClose CommentsPermalink

PART I--TEMPORARY INVESTMENT INCENTIVES

SEC. 1401. SPECIAL ALLOWANCE FOR CERTAIN PROPERTY ACQUIRED DURING 2009.

(a) In General- Paragraph (2) of section 168(k) is amended-- CommentsClose CommentsPermalink





(1) by striking ‘January 1, 2010’ and inserting ‘January 1, 2011’, and CommentsClose CommentsPermalink





(2) by striking ‘January 1, 2009’ each place it appears and inserting ‘January 1, 2010’. CommentsClose CommentsPermalink





(b) Conforming Amendments- CommentsClose CommentsPermalink





(1) The heading for subsection (k) of section 168 is amended by striking ‘January 1, 2009’ and inserting ‘January 1, 2010’. CommentsClose CommentsPermalink





(2) The heading for clause (ii) of section 168(k)(2)(B) is amended by striking ‘PRE-JANUARY 1, 2009’ and inserting ‘PRE-JANUARY 1, 2010’. CommentsClose CommentsPermalink





(3) Subparagraph (D) of section 168(k)(4) is amended-- CommentsClose CommentsPermalink





(A) by striking ‘and’ at the end of clause (i), CommentsClose CommentsPermalink





(B) by redesignating clause (ii) as clause (v), and CommentsClose CommentsPermalink





(C) by inserting after clause (i) the following new clauses: CommentsClose CommentsPermalink





‘(ii) ‘April 1, 2008’ shall be substituted for ‘January 1, 2008’ in subparagraph (A)(iii)(I) thereof, CommentsClose CommentsPermalink





‘(iii) ‘January 1, 2009’ shall be substituted for ‘January 1, 2010’ each place it appears, CommentsClose CommentsPermalink





‘(iv) ‘January 1, 2010’ shall be substituted for ‘January 1, 2011’ in subparagraph (A)(iv) thereof, and’. CommentsClose CommentsPermalink





(4) Subparagraph (B) of section 168(l)(5) is amended by striking ‘January 1, 2009’ and inserting ‘January 1, 2010’. CommentsClose CommentsPermalink





(5) Clause (ii) of section 168(n)(2)(C) is amended by striking ‘January 1, 2009’ and inserting ‘January 1, 2010’. CommentsClose CommentsPermalink





(6) Subparagraph (B) of section 1400N(d)(3) is amended by striking ‘January 1, 2009’ and inserting ‘January 1, 2010’. CommentsClose CommentsPermalink





(c) Effective Dates- CommentsClose CommentsPermalink





(1) IN GENERAL- Except as provided in paragraph (2), the amendments made by this section shall apply to property placed in service after December 31, 2008, in taxable years ending after such date. CommentsClose CommentsPermalink





(2) TECHNICAL AMENDMENT- Section 168(k)(4)(D)(ii) of the Internal Revenue Code of 1986, as added by subsection (b)(3)(C), shall apply to taxable years ending after March 31, 2008. CommentsClose CommentsPermalink

SEC. 1402. TEMPORARY INCREASE IN LIMITATIONS ON EXPENSING OF CERTAIN DEPRECIABLE BUSINESS ASSETS.

(a) In General- Paragraph (7) of section 179(b) is amended-- CommentsClose CommentsPermalink





(1) by striking ‘2008’ and inserting ‘2008, or 2009’, and CommentsClose CommentsPermalink





(2) by striking ‘2008’ in the heading thereof and inserting ‘2008, AND 2009’. CommentsClose CommentsPermalink





(b) Effective Date- The amendments made by this section shall apply to taxable years beginning after December 31, 2008. CommentsClose CommentsPermalink

PART II--5-YEAR CARRYBACK OF OPERATING LOSSES

SEC. 1411. 5-YEAR CARRYBACK OF OPERATING LOSSES.

(a) In General- Subparagraph (H) of section 172(b)(1) is amended to read as follows: CommentsClose CommentsPermalink





‘(H) CARRYBACK FOR 2008 AND 2009 NET OPERATING LOSSES- CommentsClose CommentsPermalink





In the case of a‘(i) IN GENERAL- In the case of an applicable 2008 or 2009 net operating loss for any taxable year ending during 2008 or 2009--‘(iwith respect to which the taxpayer has elected the application of this subparagraph-- CommentsClose CommentsPermalink





‘(I) such net operating loss shall be reduced by 10 percent of such loss (determined without regard to this subparagraph), CommentsClose CommentsPermalink





‘(II) subparagraph (A)(i) shall be applied by substituting ‘5’ for ‘2’,‘(iiany whole number elected by the taxpayer which is more than 2 and less than 6 for ‘2’, CommentsClose CommentsPermalink





‘(III) subparagraph (E)(ii) shall be applied by substituting ‘4’the whole number which is one less than the whole number substituted under subclause (II) for ‘2’, and CommentsClose CommentsPermalink





‘(iiiIV) subparagraph (F) shall not apply. CommentsClose CommentsPermalink





‘(ii) APPLICABLE 2008 OR 2009 NET OPERATING LOSS- For purposes of this subparagraph, the term ‘applicable 2008 or 2009 net operating loss’ means-- CommentsClose CommentsPermalink





‘(I) the taxpayer’s net operating loss for any taxable year ending in 2008 or 2009, or CommentsClose CommentsPermalink





‘(II) if the taxpayer elects to have this subclause apply in lieu of subclause (I), the taxpayer’s net operating loss for any taxable year beginning in 2008 or 2009. CommentsClose CommentsPermalink





‘(iii) ELECTION- Any election under this subparagraph shall be made in such manner as may be prescribed by the Secretary, and shall be made by the due date (including extension of time) for filing the taxpayer’s return for the taxable year of the net operating loss. Any such election, once made, shall be irrevocable. CommentsClose CommentsPermalink





‘(iv) COORDINATION WITH ALTERNATIVE TAX NET OPERATING LOSS DEDUCTION- In the case of a taxpayer who elects to have clause (ii)(II) apply, section 56(d)(1)(A)(ii) shall be applied by substituting ‘ending during 2001 or 2002 or beginning during 2008 or 2009’ for ‘ending during 2001, 2002, 2008, or 2009’.’. CommentsClose CommentsPermalink





(b) Alternative Tax Net Operating Loss Deduction- Subclause (I) of section 56(d)(1)(A)(ii) is amended to read as follows: CommentsClose CommentsPermalink





‘(I) the amount of such deduction attributable to the sum of carrybacks of net operating losses from taxable years ending during 2001, 2002, 2008, or 2009 and carryovers of net operating losses to taxable years ending during such calendarsuch taxable years, or’. CommentsClose CommentsPermalink





(c) Election To Carry Back a Fewer Number of Years- Subsection (k) of section 172 is amended by inserting ‘or may elect to apply such subsection by substituting a whole number less than 5 for ‘5’ in such subsection’ before the period at the end of the first sentence.(d) Loss From Operations of Life Insurance Companies- Subsection (b) of section 810 is amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(4) CARRYBACK FOR 2008 AND 2009 LOSSES- CommentsClose CommentsPermalink





‘(A) IN GENERAL- In the case of an applicable 2008 or 2009 loss from operations with respect to which the taxpayer has elected the application of this paragraph-- CommentsClose CommentsPermalink





‘(i) such loss from operations shall be reduced by 10 percent of such loss (determined without regard to this paragraph), and CommentsClose CommentsPermalink





‘(ii) paragraph (1)(A) shall be applied, at the election of the taxpayer, by substituting ‘5’ or ‘4’ for ‘3’. CommentsClose CommentsPermalink





‘(B) APPLICABLE 2008 OR 2009 LOSS YEARS- In the case of aFROM OPERATIONS- For purposes of this paragraph, the term ‘applicable 2008 or 2009 loss from operations’ means-- CommentsClose CommentsPermalink





‘(i) the taxpayer’s loss from operations for any taxable year ending during 2008 or 2009, the taxpayer may elect to apply paragraph (1)(A) by substituting any whole number less than 6 for ‘3’. Such election shall be made in such manner as may be prescribed by the Secretaryin 2008 or 2009, or CommentsClose CommentsPermalink





‘(ii) if the taxpayer elects to have this clause apply in lieu of clause (i), the taxpayer’s loss from operations for any taxable year beginning in 2008 or 2009. CommentsClose CommentsPermalink





‘(C) ELECTION- Any election under this paragraph shall be made in such manner as may be prescribed by the Secretary, and shall be made by the due date (including extensions of time) for filing the taxpayer’s return for the taxable year of the loss from operations. SAny such election, once made for any taxable year, shall be irrevocable for such taxable year, shall be irrevocable. CommentsClose CommentsPermalink





‘(D) COORDINATION WITH ALTERNATIVE TAX NET OPERATING LOSS DEDUCTION- In the case of a taxpayer who elects to have subparagraph (B)(ii) apply, section 56(d)(1)(A)(ii) shall be applied by substituting ‘ending during 2001 or 2002 or beginning during 2008 or 2009’ for ‘ending during 2001, 2002, 2008, or 2009’.’. CommentsClose CommentsPermalink





(d) Conforming Amendment- Section 172 is amended by striking subsection (k). CommentsClose CommentsPermalink





(e) Effective Date- CommentsClose CommentsPermalink





(1) IN GENERAL- Except as otherwise provided in this subsection, the amendments made by this section shall apply to net operating losses arising in taxable years ending after December 31, 2007. CommentsClose CommentsPermalink





(2) ALTERNATIVE TAX NET OPERATING LOSS DEDUCTION- The amendment made by subsection (b) shall apply to taxable years ending after 1997. CommentsClose CommentsPermalink





(3) LOSS FROM OPERATIONS OF LIFE INSURANCE COMPANIES- The amendment made by subsection (d) shall apply to losses from operations arising in taxable years ending after December 31, 2007. CommentsClose CommentsPermalink





(4) TRANSITIONAL RULE- In the case of a net operating loss (or, in the case of a life insurance company, a loss from operations) for a taxable year ending during 2008before the date of the enactment of this Act-- CommentsClose CommentsPermalink





(A) any election made under section 172(b)(3) or 810(b)(3) of the Internal Revenue Code of 1986 with respect to such loss may (notwithstanding such section) be revoked before the applicable date, CommentsClose CommentsPermalink





(B) any election made under section 172(kb)(1)(H) or 810(b)(4) of such Code with respect to such loss shall (notwithstanding such section) be treated as timely made if made before the applicable date, and CommentsClose CommentsPermalink





(C) any application under section 6411(a) of such Code with respect to such loss shall be treated as timely filed if filed before the applicable date. CommentsClose CommentsPermalink





For purposes of this paragraph, the term ‘applicable date’ means the date which is 60 days after the date of the enactment of this Act. CommentsClose CommentsPermalink

SEC. 1412. EXCEPTION FOR TARP RECIPIENTS.

The amendments made by this part shall not apply to-- CommentsClose CommentsPermalink





(1) any taxpayer if-- CommentsClose CommentsPermalink





(A) the Federal Government acquires, at any time, an equity interest in the taxpayer pursuant to the Emergency Economic Stabilization Act of 2008, or CommentsClose CommentsPermalink





(B) the Federal Government acquires, at any time, any warrant (or other right) to acquire any equity interest with respect to the taxpayer pursuant to such Act, CommentsClose CommentsPermalink





(2) the Federal National Mortgage Association and the Federal Home Loan Mortgage Corporation, and CommentsClose CommentsPermalink





(3) any taxpayer which at any time in 2008 or 2009 is a member of the same affiliated group (as defined in section 1504 of the Internal Revenue Code of 1986, determined without regard to subsection (b) thereof) as a taxpayer described in paragraph (1) or (2). CommentsClose CommentsPermalink

PART III--INCENTIVES FOR NEW JOBS

SEC. 1421. INCENTIVES TO HIRE UNEMPLOYED VETERANS AND DISCONNECTED YOUTH.

(a) In General- Subsection (d) of section 51 is amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(14) CREDIT ALLOWED FOR UNEMPLOYED VETERANS AND DISCONNECTED YOUTH HIRED IN 2009 OR 2010- CommentsClose CommentsPermalink





‘(A) IN GENERAL- Any unemployed veteran or disconnected youth who begins work for the employer during 2009 or 2010 shall be treated as a member of a targeted group for purposes of this subpart. CommentsClose CommentsPermalink





‘(B) DEFINITIONS- For purposes of this paragraph-- CommentsClose CommentsPermalink





‘(i) UNEMPLOYED VETERAN- The term ‘unemployed veteran’ means any veteran (as defined in paragraph (3)(B), determined without regard to clause (ii) thereof) who is certified by the designated local agency as-- CommentsClose CommentsPermalink





‘(I) having been discharged or released from active duty in the Armed Forces during 2008, 2009, or 2010, and CommentsClose CommentsPermalink





‘(II) being in receipt of unemployment compensation under State or Federal law for not less than 4 weeks during the 1-year period ending on the hiring date. CommentsClose CommentsPermalink





‘(ii) DISCONNECTED YOUTH- The term ‘disconnected youth’ means any individual who is certified by the designated local agency-- CommentsClose CommentsPermalink





‘(I) as having attained age 16 but not age 25 on the hiring date, CommentsClose CommentsPermalink





‘(II) as not regularly attending any secondary, technical, or post-secondary school during the 6-month period preceding the hiring date, CommentsClose CommentsPermalink





‘(III) as not regularly employed during such 6-month period, and CommentsClose CommentsPermalink





‘(IV) as not readily employable by reason of lacking a sufficient number of basic skills.’. CommentsClose CommentsPermalink





(b) Effective Date- The amendments made by this section shall apply to individuals who begin work for the employer after December 31, 2008. CommentsClose CommentsPermalink

PART IV--CLARIFICATION OF REGULATIONS RELATED TO LIMITATIONS ON CERTAIN BUILT-IN LOSSES FOLLOWING AN OWNERSHIP CHANGE

SEC. 1431. CLARIFICATION OF REGULATIONS RELATED TO LIMITATIONS ON CERTAIN BUILT-IN LOSSES FOLLOWING AN OWNERSHIP CHANGE.

(a) Findings- Congress finds as follows: CommentsClose CommentsPermalink





(1) The delegation of authority to the Secretary of the Treasury under section 382(m) of the Internal Revenue Code of 1986 does not authorize the Secretary to provide exemptions or special rules that are restricted to particular industries or classes of taxpayers. CommentsClose CommentsPermalink





(2) Internal Revenue Service Notice 2008-83 is inconsistent with the congressional intent in enacting such section 382(m). CommentsClose CommentsPermalink





(3) The legal authority to prescribe Internal Revenue Service Notice 2008-83 is doubtful. CommentsClose CommentsPermalink





(4) However, as taxpayers should generally be able to rely on guidance issued by the Secretary of the Treasury legislation is necessary to clarify the force and effect of Internal Revenue Service Notice 2008-83 and restore the proper application under the Internal Revenue Code of 1986 of the limitation on built-in losses following an ownership change of a bank. CommentsClose CommentsPermalink





(b) Determination of Force and Effect of Internal Revenue Service Notice 2008-83 Exempting Banks From Limitation on Certain Built-In Losses Following Ownership Change- CommentsClose CommentsPermalink





(1) IN GENERAL- Internal Revenue Service Notice 2008-83-- CommentsClose CommentsPermalink





(A) shall be deemed to have the force and effect of law with respect to any ownership change (as defined in section 382(g) of the Internal Revenue Code of 1986) occurring on or before January 16, 2009, and CommentsClose CommentsPermalink





(B) shall have no force or effect with respect to any ownership change after such date. CommentsClose CommentsPermalink





(2) BINDING CONTRACTS- Notwithstanding paragraph (1), Internal Revenue Service Notice 2008-83 shall have the force and effect of law with respect to any ownership change (as so defined) which occurs after January 16, 2009 if such change-- CommentsClose CommentsPermalink





(A) is pursuant to a written binding contract entered into on or before such date, or CommentsClose CommentsPermalink





(B) was described on or before such date in a publicis pursuant to a written agreement entered into on or before such date and such agreement was described on or before such date in a public announcement or in a filing with the Securities and Exchange Commission required by reason of such ownership change. CommentsClose CommentsPermalink

Subtitle F--Fiscal Relief for State and Local Governments CommentsClose CommentsPermalink

PART I--IMPROVED MARKETABILITY FOR TAX-EXEMPT BONDS

SEC. 1501. DE MINIMIS SAFE HARBOR EXCEPTION FOR TAX-EXEMPT INTEREST EXPENSE OF FINANCIAL INSTITUTIONS.

(a) In General- Subsection (b) of section 265 is amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(7) DE MINIMIS EXCEPTION FOR BONDS ISSUED DURING 2009 OR 2010- CommentsClose CommentsPermalink





‘(A) IN GENERAL- In applying paragraph (2)(A), there shall not be taken into account tax-exempt obligations issued during 2009 or 2010. CommentsClose CommentsPermalink





‘(B) LIMITATION- The amount of tax-exempt obligations not taken into account by reason of subparagraph (A) shall not exceed 2 percent of the amount determined under paragraph (2)(B). CommentsClose CommentsPermalink





‘(C) REFUNDINGS- For purposes of this paragraph, a refunding bond (whether a current or advance refunding) shall be treated as issued on the date of the issuance of the refunded bond (or in the case of a series of refundings, the original bond).’. CommentsClose CommentsPermalink





(b) Treatment as Financial Institution Preference Item- Clause (iv) of section 291(e)(1)(B) is amended by adding at the end the following: ‘That portion of any obligation not taken into account under paragraph (2)(A) of section 265(b) by reason of paragraph (7) of such section shall be treated for purposes of this section as having been acquired on August 7, 1986.’. CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply to obligations issued after December 31, 2008. CommentsClose CommentsPermalink

SEC. 1502. MODIFICATION OF SMALL ISSUER EXCEPTION TO TAX-EXEMPT INTEREST EXPENSE ALLOCATION RULES FOR FINANCIAL INSTITUTIONS.

(a) In General- Paragraph (3) of section 265(b) (relating to exception for certain tax-exempt obligations) is amended by adding at the end the following new subparagraph: CommentsClose CommentsPermalink





‘(G) SPECIAL RULES FOR OBLIGATIONS ISSUED DURING 2009 AND 2010- CommentsClose CommentsPermalink





‘(i) INCREASE IN LIMITATION- In the case of obligations issued during 2009 or 2010, subparagraphs (C)(i), (D)(i), and (D)(iii)(II) shall each be applied by substituting ‘$30,000,000’ for ‘$10,000,000’. CommentsClose CommentsPermalink





‘(ii) QUALIFIED 501(C)(3) BONDS TREATED AS ISSUED BY EXEMPT ORGANIZATION- In the case of a qualified 501(c)(3) bond (as defined in section 145) issued during 2009 or 2010, this paragraph shall be applied by treating the 501(c)(3) organization for whose benefit such bond was issued as the issuer. CommentsClose CommentsPermalink





‘(iii) SPECIAL RULE FOR POOLQUALIFIED FINANCINGS- In the case of a poolqualified financing issue issued during 2009 or 2010-- CommentsClose CommentsPermalink





‘(I) subparagraph (F) shall not apply, and CommentsClose CommentsPermalink





‘(II) any obligation issued as a part of such issue shall be treated as a qualified tax-exempt obligation if the requirements of this paragraph are met with respect to each qualified portion of the issue (determined by treating each qualified portion as a separate issue).‘(iii) POOL issued by the qualified borrower with respect to which such portion relates). CommentsClose CommentsPermalink





‘(iv) QUALIFIED FINANCING ISSUE- For purposes of this subparagraph, the term ‘poolqualified financing issue’ means any composite, pooled, or other conduit financing issue the proceeds of which are used directly or indirectly to make or finance loans to 2one or more ultimate borrowers all of whom are qualified borrowers.‘(ieach of whom is a qualified borrower. CommentsClose CommentsPermalink





‘(v) QUALIFIED PORTION- For purposes of this subparagraph, the term ‘qualified portion’ means that portion of the proceeds which are used with respect to each qualified borrower under the issue. CommentsClose CommentsPermalink





‘(v) i) QUALIFIED BORROWER- For purposes of this subparagraph, the term ‘qualified borrower’ means a borrower which is a State or political subdivision thereof or an organization described in section 501(c)(3) and exempt from taxation under section 501(a).’. CommentsClose CommentsPermalink





(b) Effective Date- The amendments made by this section shall apply to obligations issued after December 31, 2008. CommentsClose CommentsPermalink

SEC. 1503. TEMPORARY MODIFICATION OF ALTERNATIVE MINIMUM TAX LIMITATIONS ON TAX-EXEMPT BONDS.

(a) Interest on Private Activity Bonds Issued During 2009 and 2010 Not Treated as Tax Preference Item- Subparagraph (C) of section 57(a)(5) is amended by adding at the end a new clause: CommentsClose CommentsPermalink





‘(vi) EXCEPTION FOR BONDS ISSUED IN 2009 AND 2010- For purposes of clause (i), the term ‘private activity bond’ shall not include any bond issued after December 31, 2008, and before January 1, 2011. For purposes of the preceding sentence, a refunding bond (whether a current or advance refunding) shall be treated as issued on the date of the issuance of the refunded bond (or in the case of a series of refundings, the original bond).’. CommentsClose CommentsPermalink





(b) No Adjustment to Adjusted Current Earnings for Interest on Tax-Exempt Bonds Issued After 2008- Subparagraph (B) of section 56(g)(4) is amended by adding at the end the following new clause: CommentsClose CommentsPermalink





‘(iv) TAX EXEMPT INTEREST ON BONDS ISSUED IN 2009 AND 2010- Clause (i) shall not apply in the case of any interest on a bond issued after December 31, 2008, and before January 1, 2011. For purposes of the preceding sentence, a refunding bond (whether a current or advance refunding) shall be treated as issued on the date of the issuance of the refunded bond (or in the case of a series of refundings, the original bond).’. CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply to obligations issued after December 31, 2008. CommentsClose CommentsPermalink

PART II--TAX CREDIT BONDS FOR SCHOOLS

SEC. 1511. QUALIFIED SCHOOL CONSTRUCTION BONDS.

(a) In General- Subpart I of part IV of subchapter A of chapter 1 is amended by adding at the end the following new section: CommentsClose CommentsPermalink

‘SEC. 54F. QUALIFIED SCHOOL CONSTRUCTION BONDS.

‘(a) Qualified School Construction Bond- For purposes of this subchapter, the term ‘qualified school construction bond’ means any bond issued as part of an issue if-- CommentsClose CommentsPermalink





‘(1) 100 percent of the available project proceeds of such issue are to be used for the construction, rehabilitation, or repair of a public school facility or for the acquisition of land on which such a facility is to be constructed with part of the proceeds of such issue, CommentsClose CommentsPermalink





‘(2) the bond is issued by a State or local government within the jurisdiction of which such school is located, and CommentsClose CommentsPermalink





‘(3) the issuer designates such bond for purposes of this section. CommentsClose CommentsPermalink





‘(b) Limitation on Amount of Bonds Designated- The maximum aggregate face amount of bonds issued during any calendar year which may be designated under subsection (a) by any issuer shall not exceed the sum of-- CommentsClose CommentsPermalink





‘(1) the limitation amount allocated under subsection (d) for such calendar year to such issuer, and CommentsClose CommentsPermalink





‘(2) if such issuer is a large local educational agency (as defined in subsection (e)(4)) or is issuing on behalf of such an agency, the limitation amount allocated under subsection (e) for such calendar year to such agency. CommentsClose CommentsPermalink





‘(c) National Limitation on Amount of Bonds Designated- There is a national qualified school construction bond limitation for each calendar year. Such limitation is-- CommentsClose CommentsPermalink





‘(1) $101,000,000,000 for 2009, CommentsClose CommentsPermalink





‘(2) $101,000,000,000 for 2010, and CommentsClose CommentsPermalink





‘(3) except as provided in subsection (f), zero after 2010. CommentsClose CommentsPermalink





‘(d) 60 Percent of Limitation Allocated Among States- CommentsClose CommentsPermalink





‘(1) IN GENERAL- 60 percent of the limitation applicable under subsection (c) for any calendar year shall be allocated by the Secretary among the States in proportion to the respective numbers of children in each State who have attained age 5 but not age 18 for the most recent fiscal year ending before such calendar year. The limitation amount allocated to a State under the preceding sentence shall be allocated by the State to issuers within such State. CommentsClose CommentsPermalink





‘(2) MINIMUM ALLOCATIONS TO STATES- CommentsClose CommentsPermalink





‘(A) IN GENERAL- The Secretary shall adjust the allocations under this subsection for any calendar year for each State to the extent necessary to ensure that the sum of-- CommentsClose CommentsPermalink





‘(i) the amount allocated to such State under this subsection for such year, and CommentsClose CommentsPermalink





‘(ii) the aggregate amounts allocated under subsection (e) to large local educational agencies in such State for such year, CommentsClose CommentsPermalink





is not less than an amount equal to such State’s adjusted minimum percentage of the amount to be allocated under paragraph (1) for the calendar year. CommentsClose CommentsPermalink





‘(B) ADJUSTED MINIMUM PERCENTAGE- A State’s adjusted minimum percentage for any calendar year is the product of-- CommentsClose CommentsPermalink





‘(i) the minimum percentage described in section 1124(d) of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6334(d)) for such State for the most recent fiscal year ending before such calendar year, multiplied by CommentsClose CommentsPermalink





‘(ii) 1.68. CommentsClose CommentsPermalink





‘(3) ALLOCATIONS TO CERTAIN POSSESSIONS- The amount to be allocated under paragraph (1) to any possession of the United States other than Puerto Rico shall be the amount which would have been allocated if all allocations under paragraph (1) were made on the basis of respective populations of individuals below the poverty line (as defined by the Office of Management and Budget). In making other allocations, the amount to be allocated under paragraph (1) shall be reduced by the aggregate amount allocated under this paragraph to possessions of the United States. CommentsClose CommentsPermalink





‘(4) ALLOCATIONS FOR INDIAN SCHOOLS- In addition to the amounts otherwise allocated under this subsection, $200,000,000 for calendar year 2009, and $200,000,000 for calendar year 2010, shall be allocated by the Secretary of the Interior for purposes of the construction, rehabilitation, and repair of schools funded by the Bureau of Indian Affairs. In the case of amounts allocated under the preceding sentence, Indian tribal governments (as defined in section 7701(a)(40)) shall be treated as qualified issuers for purposes of this subchapter. CommentsClose CommentsPermalink





‘(e) 40 Percent of Limitation Allocated Among Largest School Districts- CommentsClose CommentsPermalink





‘(1) IN GENERAL- 40 percent of the limitation applicable under subsection (c) for any calendar year shall be allocated under paragraph (2) by the Secretary among local educational agencies which are large local educational agencies for such year. CommentsClose CommentsPermalink





‘(2) ALLOCATION FORMULA- The amount to be allocated under paragraph (1) for any calendar year shall be allocated among large local educational agencies in proportion to the respective amounts each such agency received for Basic Grants under subpart 2 of part A of title I of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6331 et seq.) for the most recent fiscal year ending before such calendar year. CommentsClose CommentsPermalink





‘(3) ALLOCATION OF UNUSED LIMITATION TO STATE- The amount allocated under this subsection to a large local educational agency for any calendar year may be reallocated by such agency to the State in which such agency is located for such calendar year. Any amount reallocated to a State under the preceding sentence may be allocated as provided in subsection (d)(1). CommentsClose CommentsPermalink





‘(4) LARGE LOCAL EDUCATIONAL AGENCY- For purposes of this section, the term ‘large local educational agency’ means, with respect to a calendar year, any local educational agency if such agency is-- CommentsClose CommentsPermalink





‘(A) among the 100 local educational agencies with the largest numbers of children aged 5 through 17 from families living below the poverty level, as determined by the Secretary using the most recent data available from the Department of Commerce that are satisfactory to the Secretary, or CommentsClose CommentsPermalink





‘(B) 1 of not more than 25 local educational agencies (other than those described in subparagraph (A)) that the Secretary of Education determines (based on the most recent data available satisfactory to the Secretary) are in particular need of assistance, based on a low level of resources for school construction, a high level of enrollment growth, or such other factors as the Secretary deems appropriate. CommentsClose CommentsPermalink





‘(f) Carryover of Unused Limitation- If for any calendar year-- CommentsClose CommentsPermalink





‘(1) the amount allocated under subsection (d) to any State, exceeds CommentsClose CommentsPermalink





‘(2) the amount of bonds issued during such year which are designated under subsection (a) pursuant to such allocation, CommentsClose CommentsPermalink





the limitation amount under such subsection for such State for the following calendar year shall be increased by the amount of such excess. A similar rule shall apply to the amounts allocated under subsection (d)(4) or (e).’. CommentsClose CommentsPermalink





(b) Conforming Amendments- CommentsClose CommentsPermalink





(1) Paragraph (1) of section 54A(d) is amended by striking ‘or’ at the end of subparagraph (C), by inserting ‘or’ at the end of subparagraph (D), and by inserting after subparagraph (D) the following new subparagraph: CommentsClose CommentsPermalink





‘(E) a qualified school construction bond,’. CommentsClose CommentsPermalink





(2) Subparagraph (C) of section 54A(d)(2) is amended by striking ‘and’ at the end of clause (iii), by striking the period at the end of clause (iv) and inserting ‘, and’, and by adding at the end the following new clause: CommentsClose CommentsPermalink





‘(v) in the case of a qualified school construction bond, a purpose specified in section 54F(a)(1).’. CommentsClose CommentsPermalink





(3) The table of sections for subpart I of part IV of subchapter A of chapter 1 is amended by adding at the end the following new item: CommentsClose CommentsPermalink





‘Sec. 54F. Qualified school construction bonds.’. CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply to obligations issued after December 31, 2008. CommentsClose CommentsPermalink

SEC. 1512. EXTENSION AND EXPANSION OF QUALIFIED ZONE ACADEMY BONDS.

(a) In General- Section 54E(c)(1) is amended by striking ‘and 2009’ and inserting ‘and $1,400,000,000 for 2009 and 2010’. CommentsClose CommentsPermalink





(b) Effective Date- The amendment made by this section shall apply to obligations issued after December 31, 2008. CommentsClose CommentsPermalink

PART III--TAXABLE BOND OPTION FOR GOVERNMENTAL BONDS

SEC. 1521. TAXABLE BOND OPTION FOR GOVERNMENTAL BONDS.

(a) In General- Part IV of subchapter A of chapter 1 is amended by adding at the end the following new subpart: CommentsClose CommentsPermalink

‘Subpart J--Taxable Bond Option for Governmental Bonds

‘Sec. 54AA. Taxable bond option for governmental bonds. CommentsClose CommentsPermalink

‘SEC. 54AA. TAXABLE BOND OPTION FOR GOVERNMENTAL BONDS.

‘(a) In General- If a taxpayer holds a taxable governmental bond on one or more interest payment dates of the bond during any taxable year, there shall be allowed as a credit against the tax imposed by this chapter for the taxable year an amount equal to the sum of the credits determined under subsection (b) with respect to such dates. CommentsClose CommentsPermalink





‘(b) Amount of Credit- The amount of the credit determined under this subsection with respect to any interest payment date for a taxable governmental bond is 35 percent of the amount of interest payable by the issuer with respect to such date. CommentsClose CommentsPermalink





‘(c) Limitation Based on Amount of Tax- CommentsClose CommentsPermalink





‘(1) IN GENERAL- The credit allowed under subsection (a) for any taxable year shall not exceed the excess of-- CommentsClose CommentsPermalink





‘(A) the sum of the regular tax liability (as defined in section 26(b)) plus the tax imposed by section 55, over CommentsClose CommentsPermalink





‘(B) the sum of the credits allowable under this part (other than subpart C and this subpart). CommentsClose CommentsPermalink





‘(2) CARRYOVER OF UNUSED CREDIT- If the credit allowable under subsection (a) exceeds the limitation imposed by paragraph (1) for such taxable year, such excess shall be carried to the succeeding taxable year and added to the credit allowable under subsection (a) for such taxable year (determined before the application of paragraph (1) for such succeeding taxable year). CommentsClose CommentsPermalink





‘(d) Taxable Governmental Bond- CommentsClose CommentsPermalink





‘(1) IN GENERAL- For purposes of this section, the term ‘taxable governmental bond’ means any obligation (other than a private activity bond) if-- CommentsClose CommentsPermalink





‘(A) the interest on such obligation would (but for this section) be excludable from gross income under section 103, and CommentsClose CommentsPermalink





‘(B) the issuer makes an irrevocable election to have this section apply. CommentsClose CommentsPermalink





‘(2) APPLICABLE RULES- For purposes of applying paragraph (1)-- CommentsClose CommentsPermalink





‘(A) a taxable governmental bond shall not be treated as federally guaranteed by reason of the credit allowed under subsection (a) or section 64312, CommentsClose CommentsPermalink





‘(B) the yield on a taxable governmental bond shall be determined without regard to the credit allowed under subsection (a), and CommentsClose CommentsPermalink





‘(C) a bond shall not be treated as a taxable governmental bond if the issue price has more than a de minimis amount (determined under rules similar to the rules of section 1273(a)(3)) of premium over the stated principal amount of the bond. CommentsClose CommentsPermalink





‘(e) Interest Payment Date- For purposes of this section, the term ‘interest payment date’ means any date on which the holder of record of the taxable governmental bond is entitled to a payment of interest under such bond. CommentsClose CommentsPermalink





‘(f) Special Rules- CommentsClose CommentsPermalink





‘(1) INTEREST ON TAXABLE GOVERNMENTAL BONDS INCLUDIBLE IN GROSS INCOME FOR FEDERAL INCOME TAX PURPOSES- For purposes of this title, interest on any taxable governmental bond shall be includible in gross income. CommentsClose CommentsPermalink





‘(2) APPLICATION OF CERTAIN RULES- Rules similar to the rules of subsections (f), (g), (h), and (i) of section 54A shall apply for purposes of the credit allowed under subsection (a). CommentsClose CommentsPermalink





‘(g) Special Rule for Qualified Bonds Issued Before 2011- In the case of a qualified bond issued before January 1, 2011-- CommentsClose CommentsPermalink





‘(1) ISSUER ALLOWED REFUNDABLE CREDIT- In lieu of any credit allowed under this section with respect to such bond, the issuer of such bond shall be allowed a credit as provided in section 64312. CommentsClose CommentsPermalink





‘(2) QUALIFIED BOND- For purposes of this subsection, the term ‘qualified bond’ means any taxable governmental bond issued as part of an issue if-- CommentsClose CommentsPermalink





‘(A) 100 percent of the available project proceeds (as defined in section 54A) of such issue are to be used for capital expenditures, and CommentsClose CommentsPermalink





‘(B) the issuer makes an irrevocable election to have this subsection apply. CommentsClose CommentsPermalink





‘(h) Regulations- The Secretary may prescribe such regulations and other guidance as may be necessary or appropriate to carry out this section and section 6432.’. CommentsClose CommentsPermalink





(b) Credit for Qualified Bonds Issued Before 2011- Subchapter B of chapter 65 is amended by adding at, as amended by this Act, is amended by adding at the end the following new section: CommentsClose CommentsPermalink

‘SEC. 64312. CREDIT FOR QUALIFIED BONDS ALLOWED TO ISSUER.

‘(a) In General- In the case of a qualified bond issued before January 1, 2011, the issuer of such bond shall be allowed a credit with respect to each interest payment under such bond which shall be payable by the Secretary as provided in subsection (b). CommentsClose CommentsPermalink





‘(b) Payment of Credit- The Secretary shall pay (contemporaneously with each interest payment date under such bond) to the issuer of such bond (or to any person who makes such interest payments on behalf of the issuer) 35 percent of the interest payable under such bond on such date. CommentsClose CommentsPermalink





‘(c) Application of Arbitrage Rules- For purposes of section 148, the yield on a qualified bond shall be reduced by the credit allowed under this section. CommentsClose CommentsPermalink





‘(d) Interest Payment Date- For purposes of this subsection, the term ‘interest payment date’ means each date on which interest is payable by the issuer under the terms of the bond. CommentsClose CommentsPermalink





‘(e) Qualified Bond- For purposes of this subsection, the term ‘qualified bond’ has the meaning given such term in section 54AA(hg).’. CommentsClose CommentsPermalink





(c) Conforming Amendments- CommentsClose CommentsPermalink





(1)Section 1324(b)(2) of title 31, United States Code, is amended by striking ‘or 6428’ and inserting ‘6428, or 64312,’. CommentsClose CommentsPermalink





(2) Section 54A(c)(1)(B) is amended by striking ‘subpart C’ and inserting ‘subparts C and J’. CommentsClose CommentsPermalink





(3) Sections 54(c)(2), 1397E(c)(2), and 1400N(l)(3)(B) are each amended by striking ‘and I’ and inserting ‘, I, and J’. CommentsClose CommentsPermalink





(4) Section 6401(b)(1) is amended by striking ‘and I’ and inserting ‘I, and J’. CommentsClose CommentsPermalink





(5) The table of subparts for part IV of subchapter A of chapter 1 is amended by adding at the end the following new item: CommentsClose CommentsPermalink





‘Subpart J. Taxable bond option for governmental bonds.’. CommentsClose CommentsPermalink





(6) The table of sections for subchapter B of chapter 65 is amended by adding at, as amended by this Act, is amended by adding at the end the following new item: CommentsClose CommentsPermalink





‘Sec. 64312. Credit for qualified bonds allowed to issuer on advance basis.’. CommentsClose CommentsPermalink





(d) Transitional Coordination With State Law- Except as otherwise provided by a State after the date of the enactment of this Act, the interest on any taxable governmental bond (as defined in section 54AA of the Internal Revenue Code of 1986, as added by this section) and the amount of any credit determined under such section with respect to such bond shall be treated for purposes of the income tax laws of such State as being exempt from Federal income tax. CommentsClose CommentsPermalink





(e) Effective Date- The amendments made by this section shall apply to obligations issued after the date of the enactment of this Act. CommentsClose CommentsPermalink

PART IV--RECOVERY ZONE BONDS

SEC. 1531. RECOVERY ZONE BONDS.

(a) In General- Subchapter Y of chapter 1 is amended by adding at the end the following new part: CommentsClose CommentsPermalink

‘PART III--RECOVERY ZONE BONDS

‘Sec. 1400U-1. Allocation of recovery zone bonds. CommentsClose CommentsPermalink





‘Sec. 1400U-2. Recovery zone economic development bonds. CommentsClose CommentsPermalink





‘Sec. 1400U-3. Recovery zone facility bonds. CommentsClose CommentsPermalink

‘SEC. 1400U-1. ALLOCATION OF RECOVERY ZONE BONDS.

‘(a) Allocations- CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Secretary shall allocate the national recovery zone economic development bond limitation and the national recovery zone facility bond limitation among the States in the proportion that each such State’s 2008 State employment decline bears to the aggregate of the 2008 State employment declines for all of the States. CommentsClose CommentsPermalink





‘(2) 2008 STATE EMPLOYMENT DECLINE- For purposes of this subsection, the term ‘2008 State employment decline’ means, with respect to any State, the excess (if any) of-- CommentsClose CommentsPermalink





‘(A) the number of individuals employed in such State determined for December 2007, over CommentsClose CommentsPermalink





‘(B) the number of individuals employed in such State determined for December 2008. CommentsClose CommentsPermalink





‘(3) ALLOCATIONS BY STATES- CommentsClose CommentsPermalink





‘(A) IN GENERAL- Each State with respect to which an allocation is made under paragraph (1) shall reallocate such allocation among the counties and large municipalities in such State in the proportion the each such county’s or municipality’s 2008 employment decline bears to the aggregate of the 2008 employment declines for all the counties and municipalities in such State. CommentsClose CommentsPermalink





‘(B) LARGE MUNICIPALITIES- For purposes of subparagraph (A), the term ‘large municipality’ means a municipality with a population of more than 100,000. CommentsClose CommentsPermalink





‘(C) DETERMINATION OF LOCAL EMPLOYMENT DECLINES- For purposes of this paragraph, the employment decline of any municipality or county shall be determined in the same manner as determining the State employment decline under paragraph (2), except that in the case of a municipality any portion of which is in a county, such portion shall be treated as part of such municipality and not part of such county. CommentsClose CommentsPermalink





‘(4) NATIONAL LIMITATIONS- CommentsClose CommentsPermalink





‘(A) RECOVERY ZONE ECONOMIC DEVELOPMENT BONDS- There is a national recovery zone economic development bond limitation of $10,000,000,000. CommentsClose CommentsPermalink





‘(B) RECOVERY ZONE FACILITY BONDS- There is a national recovery zone facility bond limitation of $15,000,000,000. CommentsClose CommentsPermalink





‘(b) Recovery Zone- For purposes of this part, the term ‘recovery zone’ means-- CommentsClose CommentsPermalink





‘(1) any area designated by the issuer as having significant poverty, unemployment, or rate of home foreclosures, or general distress, and CommentsClose CommentsPermalink





‘(2) any area for which a designation as an empowerment zone or renewal community is in effect. CommentsClose CommentsPermalink

‘SEC. 1400U-2. RECOVERY ZONE ECONOMIC DEVELOPMENT BONDS.

‘(a) In General- In the case of a recovery zone economic development bond-- CommentsClose CommentsPermalink





‘(1) such bond shall be treated as a qualified bond for purposes of section 64312, and CommentsClose CommentsPermalink





‘(2) subsection (b) of such section shall be applied by substituting ‘4055 percent’ for ‘35 percent’. CommentsClose CommentsPermalink





‘(b) Recovery Zone Economic Development Bond- CommentsClose CommentsPermalink





‘(1) IN GENERAL- For purposes of this section, the term ‘recovery zone economic development bond’ means any taxable governmental bond (as defined in section 54AA(d)) issued before January 1, 2011, as part of issue if-- CommentsClose CommentsPermalink





‘(A) 100 percent of the available project proceeds (as defined in section 54A) of such issue are to be used for one or more qualified economic development purposes, and CommentsClose CommentsPermalink





‘(B) the issuer designates such bond for purposes of this section. CommentsClose CommentsPermalink





‘(2) LIMITATION ON AMOUNT OF BONDS DESIGNATED- The maximum aggregate face amount of bonds which may be designated by any issuer under paragraph (1) shall not exceed the amount of the recovery zone economic development bond limitation allocated to such issuer under section 1400U-1. CommentsClose CommentsPermalink





‘(c) Qualified Economic Development Purpose- For purposes of this section, the term ‘qualified economic development purpose’ means expenditures for purposes of promoting development or other economic activity in a recovery zone, including-- CommentsClose CommentsPermalink





‘(1) capital expenditures paid or incurred with respect to property located in such zone, CommentsClose CommentsPermalink





‘(2) expenditures for public infrastructure and construction of public facilities, and CommentsClose CommentsPermalink





‘(3) expenditures for job training and educational programs. CommentsClose CommentsPermalink

‘SEC. 1400U-3. RECOVERY ZONE FACILITY BONDS.

‘(a) In General- For purposes of part IV of subchapter B (relating to tax exemption requirements for State and local bonds), the term ‘exempt facility bond’ includes any recovery zone facility bond. CommentsClose CommentsPermalink





‘(b) Recovery Zone Facility Bond- CommentsClose CommentsPermalink





‘(1) IN GENERAL- For purposes of this section, the term ‘recovery zone facility bond’ means any bond issued as part of an issue if-- CommentsClose CommentsPermalink





‘(A) 95 percent or more of the net proceeds (as defined in section 150(a)(3)) of such issue are to be used for recovery zone property, CommentsClose CommentsPermalink





‘(B) such bond is issued before January 1, 2011, and CommentsClose CommentsPermalink





‘(C) the issuer designates such bond for purposes of this section. CommentsClose CommentsPermalink





‘(2) LIMITATION ON AMOUNT OF BONDS DESIGNATED- The maximum aggregate face amount of bonds which may be designated by any issuer under paragraph (1) shall not exceed the amount of recovery zone facility bond limitation allocated to such issuer under section 1400U-1. CommentsClose CommentsPermalink





‘(c) Recovery Zone Property- For purposes of this section-- CommentsClose CommentsPermalink





‘(1) IN GENERAL- The term ‘recovery zone property’ means any property to which section 168 applies (or would apply but for section 179) if-- CommentsClose CommentsPermalink





‘(A) such property was acquired by the taxpayer by purchase (as defined in section 179(d)(2)) after the date on which the designation of the recovery zone took effect, CommentsClose CommentsPermalink





‘(B) the original use of which in the recovery zone commences with the taxpayer, and CommentsClose CommentsPermalink





‘(C) substantially all of the use of which is in the recovery zone and is in the active conduct of a qualified business by the taxpayer in such zone. CommentsClose CommentsPermalink





‘(2) QUALIFIED BUSINESS- The term ‘qualified business’ means any trade or business except that-- CommentsClose CommentsPermalink





‘(A) the rental to others of real property located in a recovery zone shall be treated as a qualified business only if the property is not residential rental property (as defined in section 168(e)(2)), and CommentsClose CommentsPermalink





‘(B) such term shall not include any trade or business consisting of the operation of any facility described in section 144(c)(6)(B). CommentsClose CommentsPermalink





‘(3) SPECIAL RULES FOR SUBSTANTIAL RENOVATIONS AND SALE-LEASEBACK- Rules similar to the rules of subsections (a)(2) and (b) of section 1397D shall apply for purposes of this subsection. CommentsClose CommentsPermalink





‘(d) Nonapplication of Certain Rules- Sections 146 (relating to volume cap) and 147(d) (relating to acquisition of existing property not permitted) shall not apply to any recovery zone facility bond.’. CommentsClose CommentsPermalink





(b) Clerical Amendment- The table of parts for subchapter Y of chapter 1 of such Code is amended by adding at the end the following new item: CommentsClose CommentsPermalink

‘Part III. Recovery Zone Bonds.’.

(c) Effective Date- The amendments made by this section shall apply to obligations issued after the date of the enactment of this Act. CommentsClose CommentsPermalink

SEC. 1532. TRIBAL ECONOMIC DEVELOPMENT BONDS.

(a) In General- Section 7871 is amended by adding at the end the following new subsection: CommentsClose CommentsPermalink





‘(f) Tribal Economic Development Bonds- CommentsClose CommentsPermalink





‘(1) ALLOCATION OF LIMITATION- CommentsClose CommentsPermalink





‘(A) IN GENERAL- The Secretary shall allocate the national tribal economic development bond limitation among the Indian tribal governments in such manner as the Secretary, in consultation with the Secretary of the Interior, determines appropriate. CommentsClose CommentsPermalink





‘(B) NATIONAL LIMITATION- There is a national tribal economic development bond limitation of $2,000,000,000. CommentsClose CommentsPermalink





‘(2) BONDS TREATED AS EXEMPT FROM TAX- In the case of a tribal economic development bond-- CommentsClose CommentsPermalink





‘(A) notwithstanding subsection (c), such bond shall be treated for purposes of this title in the same manner as if such bond were issued by a State, and CommentsClose CommentsPermalink





‘(B) section 146 shall not apply. CommentsClose CommentsPermalink





‘(3) TRIBAL ECONOMIC DEVELOPMENT BOND- CommentsClose CommentsPermalink





‘(A) IN GENERAL- For purposes of this section, the term ‘tribal economic development bond’ means any bond issued by an Indian tribal government-- CommentsClose CommentsPermalink





‘(i) the interest on which is not exempt from tax under section 103 by reason of subsection (c) (determined without regard to this subsection) but would be so exempt if issued by a State or local government, and CommentsClose CommentsPermalink





‘(ii) which is designated by the Indian tribal government as a tribal economic development bond for purposes of this subsection. CommentsClose CommentsPermalink





‘(B) EXCEPTIONS- The term tribal economic development bond shall not include any bond issued as part of an issue if any portion of the proceeds of such issue are used to finance-- CommentsClose CommentsPermalink





‘(i) any portion of a building in which class II or class III gaming (as defined in section 4 of the Indian Gaming Regulatory Act) is conducted or housed or any other property actually used in the conduct of such gaming, or CommentsClose CommentsPermalink





‘(ii) any facility located outside the Indian reservation (as defined in section 168(j)(6)). CommentsClose CommentsPermalink





‘(C) LIMITATION ON AMOUNT OF BONDS DESIGNATED- The maximum aggregate face amount of bonds which may be designated by any Indian tribal government under subparagraph (A) shall not exceed the amount of national tribal economic development bond limitation allocated to such government under paragraph (1).’. CommentsClose CommentsPermalink





(b) Study- The Secretary of the Treasury, or the Secretary’s delegate, shall conduct a study of the effects of the amendment made by subsection (a). Not later than 1 year after the date of the enactment of this Act, the Secretary of the Treasury, or the Secretary’s delegate, shall report to Congress on the results of the studies conducted under this paragraph, including the Secretary’s recommendations regarding such amendment. CommentsClose CommentsPermalink





(c) Effective Date- The amendment made by subsection (a) shall apply to obligations issued after the date of the enactment of this Act. CommentsClose CommentsPermalink

PART V--REPEAL OF WITHHOLDING TAX ON GOVERNMENT CONTRACTORS

SEC. 1541. REPEAL OF WITHHOLDING TAX ON GOVERNMENT CONTRACTORS.

Section 3402 is amended by striking subsection (t). CommentsClose CommentsPermalink

Subtitle G--Energy Incentives CommentsClose CommentsPermalink

PART I--RENEWABLE ENERGY INCENTIVES

SEC. 1601. EXTENSION OF CREDIT FOR ELECTRICITY PRODUCED FROM CERTAIN RENEWABLE RESOURCES.

(a) In General- Subsection (d) of section 45 is amended-- CommentsClose CommentsPermalink





(1) by striking ‘2010’ in paragraph (1) and inserting ‘2013’, CommentsClose CommentsPermalink





(2) by striking ‘2011’ each place it appears in paragraphs (2), (3), (4), (6), (7), and (9) and inserting ‘2014’, and CommentsClose CommentsPermalink





(3) by striking ‘2012’ in paragraph (11)(B) and inserting ‘2014’. CommentsClose CommentsPermalink





(b) Technical Amendment- Paragraph (5) of section 45(d) is amended by striking ‘and before’ and all that follows and inserting ‘and before October 3, 2008.’. CommentsClose CommentsPermalink





(c) Effective Date- CommentsClose CommentsPermalink





(1) IN GENERAL- The amendments made by subsection (a) shall apply to property placed in service after the date of the enactment of this Act. CommentsClose CommentsPermalink





(2) TECHNICAL AMENDMENT- The amendment made by subsection (b) shall take effect as if included in section 102 of the Energy Improvement and Extension Act of 2008. CommentsClose CommentsPermalink

SEC. 1602. ELECTION OF INVESTMENT CREDIT IN LIEU OF PRODUCTION CREDIT.

(a) In General- Subsection (a) of section 48 is amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(5) ELECTION TO TREAT QUALIFIED FACILITIES AS ENERGY PROPERTY- CommentsClose CommentsPermalink





‘(A) IN GENERAL- In the case of any qualified investment credit facility placed in service in 2009 or 2010-- CommentsClose CommentsPermalink





‘(i) such facility shall be treated as energy property for purposes of this section, and CommentsClose CommentsPermalink





‘(ii) the energy percentage with respect to such property shall be 30 percent. CommentsClose CommentsPermalink





‘(B) DENIAL OF PRODUCTION CREDIT- No credit shall be allowed under section 45 for any taxable year with respect to any qualified investment credit facility. CommentsClose CommentsPermalink





‘(C) QUALIFIED INVESTMENT CREDIT FACILITY- For purposes of this paragraph, the term ‘qualified investment credit facility’ means any facility described in paragraph (1), (2), (3), (4), (6), (7), (9), or (11) of section 45(d) if no credit has been allowed under section 45 with respect to such facility and the taxpayer makes an irrevocable election to have this paragraph apply to such facility.’. CommentsClose CommentsPermalink





(b) Effective Date- The amendments made by this section shall apply to facilities placed in service after December 31, 2008. CommentsClose CommentsPermalink

SEC. 1603. REPEAL OF CERTAIN LIMITATIONS ON CREDIT FOR RENEWABLE ENERGY PROPERTY.

(a) Repeal of Limitation on Credit for Qualified Small Wind Energy Property- Paragraph (4) of section 48(c) is amended by striking subparagraph (B) and by redesignating subparagraphs (C) and (D) as subparagraphs (B) and (C). CommentsClose CommentsPermalink





(b) Repeal of Limitation on Property Financed by Subsidized Energy Financing- CommentsClose CommentsPermalink





(1) IN GENERAL- Subsection (a) of section 48, as amended by section 1602, is amended by striking paragraph (4) and by redesignating paragraph (5) as paragraph (4). CommentsClose CommentsPermalink





(2) CONFORMING AMENDMENTS- CommentsClose CommentsPermalink





(A) Section 25C(e)(1) is amended by striking ‘(8), and (9)’ and inserting ‘and (8)’. CommentsClose CommentsPermalink





(B) Section 25D(e) is amended by striking paragraph (9). CommentsClose CommentsPermalink





(c) Effective Date- CommentsClose CommentsPermalink





(1) IN GENERAL- Except as provided in paragraph (2),the amendment made by this section shall apply to periods after December 31, 2008, under rules similar to the rules of section 48(m) of the Internal Revenue Code of 1986 (as in effect on the day before the date of the enactment of the Revenue Reconciliation Act of 1990). CommentsClose CommentsPermalink





(2) CONFORMING AMENDMENTS- The amendments made by subsection (b)(2) shall apply to taxable years beginning after December 31, 2008. CommentsClose CommentsPermalink

SEC. 1604. COORDINATION WITH RENEWABLE ENERGY GRANTS.

Section 48 is amended by adding at the end the following new subsection: CommentsClose CommentsPermalink





‘(d) Coordination With Department of Energy Grants- In the case of any property with respect to which the Secretary of Energy makes a grant under section 1721 of the American Recovery and Reinvestment Tax Act of 2009-- CommentsClose CommentsPermalink





‘(1) DENIAL OF PRODUCTION AND INVESTMENT CREDITS- No credit shall be determined under this section or section 45 with respect to such property for the taxable year in which such grant is made or any subsequent taxable year. CommentsClose CommentsPermalink





‘(2) RECAPTURE OF CREDITS FOR PROGRESS EXPENDITURES MADE BEFORE GRANT- If a credit was determined under this section with respect to such property for any taxable year ending before such grant is made-- CommentsClose CommentsPermalink





‘(A) the tax imposed under subtitle A on the taxpayer for the taxable year in which such grant is made shall be increased by so much of such credit as was allowed under section 38, CommentsClose CommentsPermalink





‘(B) the general business carryforwards under section 39 shall be adjusted so as to recapture the portion of such credit which was not so allowed, and CommentsClose CommentsPermalink





‘(C) the amount of such grant shall be determined without regard to any reduction in the basis of such property by reason of such credit. CommentsClose CommentsPermalink





‘(3) TREATMENT OF GRANTS- Any such grant shall-- CommentsClose CommentsPermalink





‘(A) not be includible in the gross income of the taxpayer, but CommentsClose CommentsPermalink





‘(B) shall be taken into account in determining the basis of the property to which such grant relates, except that the basis of such property shall be reduced under section 50(c) in the same manner as a credit allowed under subsection (a).’. CommentsClose CommentsPermalink

PART II--INCREASED ALLOCATIONS OF NEW CLEAN RENEWABLE ENERGY BONDS AND QUALIFIED ENERGY CONSERVATION BONDS

SEC. 1611. INCREASED LIMITATION ON ISSUANCE OF NEW CLEAN RENEWABLE ENERGY BONDS.

Subsection (c) of section 54C is amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(4) ADDITIONAL LIMITATION- The national new clean renewable energy bond limitation shall be increased by $1,600,000,000. Such increase shall be allocated by the Secretary consistent with the rules of paragraphs (2) and (3).’. CommentsClose CommentsPermalink

SEC. 1612. INCREASED LIMITATION ON ISSUANCEAND EXPANSION OF QUALIFIED ENERGY CONSERVATION BONDS.

(a) Increased Limitation- Subsection (e) of section 54D is amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(4) ADDITIONAL LIMITATION- The national qualified energy conservation bond limitation shall be increased by $2,400,000,000. Such increase shall be allocated by the Secretary consistent with the rules of paragraphs (1), (2), and (3).’. CommentsClose CommentsPermalink





(b) Loans and Grants To Implement Green Community Programs- CommentsClose CommentsPermalink





(1) IN GENERAL- Subparagraph (A) of section 54D(f)(1) is amended by inserting ‘(or loans or grants for capital expenditures to implement any green community program)’ after ‘Capital expenditures’. CommentsClose CommentsPermalink





(2) BONDS TO IMPLEMENT GREEN COMMUNITY PROGRAMS NOT TREATED AS PRIVATE ACTIVITY BONDS FOR PURPOSES OF LIMITATIONS ON QUALIFIED ENERGY CONSERVATION BONDS- Subsection (e) of section 54D, as amended by subsection (a), is amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(5) BONDS TO IMPLEMENT GREEN COMMUNITY PROGRAMS NOT TREATED AS PRIVATE ACTIVITY BONDS- For purposes of paragraph (3) and subsection (f)(2), a bond shall not be treated as a private activity bond solely because proceeds of the issue of which such bond is a part are to be used for loans or grants for capital expenditures to implement any green community program.’. CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply to obligations issued after the date of the enactment of this Act. CommentsClose CommentsPermalink

PART III--ENERGY CONSERVATION INCENTIVES

SEC. 1621. EXTENSION AND MODIFICATION OF CREDIT FOR NONBUSINESS ENERGY PROPERTY.

(a) In General- Section 25C is amended by striking subsections (a) and (b) and inserting the following new subsections: CommentsClose CommentsPermalink





‘(a) Allowance of Credit- In the case of an individual, there shall be allowed as a credit against the tax imposed by this chapter for the taxable year an amount equal to 30 percent of the sum of-- CommentsClose CommentsPermalink





‘(1) the amount paid or incurred by the taxpayer during such taxable year for qualified energy efficiency improvements, and CommentsClose CommentsPermalink





‘(2) the amount of the residential energy property expenditures paid or incurred by the taxpayer during such taxable year. CommentsClose CommentsPermalink





‘(b) Limitation- The aggregate amount of the credits allowed under this section for taxable years beginning in 2009 and 2010 with respect to any taxpayer shall not exceed $1,500.’. CommentsClose CommentsPermalink





(b) Extension- Section 25C(g)(2) is amended by striking ‘December 31, 2009’ and inserting ‘December 31, 2010’. CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply to taxable years beginning after December 31, 2008. CommentsClose CommentsPermalink

SEC. 1622. MODIFICATION OF CREDIT FOR RESIDENTIAL ENERGY EFFICIENT PROPERTY.

(a) Removal of Credit Limitation for Property Placed in Service- CommentsClose CommentsPermalink





(1) IN GENERAL- Paragraph (1) of section 25D(b) is amended to read as follows: CommentsClose CommentsPermalink





‘(1) MAXIMUM CREDIT FOR FUEL CELLS- In the case of any qualified fuel cell property expenditure, the credit allowed under subsection (a) (determined without regard to subsection (c)) for any taxable year shall not exceed $500 with respect to each half kilowatt of capacity of the qualified fuel cell property (as defined in section 48(c)(1)) to which such expenditure relates.’. CommentsClose CommentsPermalink





(2) CONFORMING AMENDMENT- Paragraph (4) of section 25D(e) is amended-- CommentsClose CommentsPermalink





(A) by striking all that precedes subparagraph (B) and inserting the following: CommentsClose CommentsPermalink





‘(4) FUEL CELL EXPENDITURE LIMITATIONS IN CASE OF JOINT OCCUPANCY- In the case of any dwelling unit with respect to which qualified fuel cell property expenditures are made and which is jointly occupied and used during any calendar year as a residence by two or more individuals the following rules shall apply: CommentsClose CommentsPermalink





‘(A) MAXIMUM EXPENDITURES FOR FUEL CELLS- The maximum amount of such expenditures which may be taken into account under subsection (a) by all such individuals with respect to such dwelling unit during such calendar year shall be $1,667 in the case of each half kilowatt of capacity of qualified fuel cell property (as defined in section 48(c)(1)) with respect to which such expenditures relate.’, and CommentsClose CommentsPermalink





(B) by striking subparagraph (C). CommentsClose CommentsPermalink





(b) Effective Date- The amendments made by this section shall apply to taxable years beginning after December 31, 2008. CommentsClose CommentsPermalink

SEC. 1623. TEMPORARY INCREASE IN CREDIT FOR ALTERNATIVE FUEL VEHICLE REFUELING PROPERTY.

(a) In General- Section 30C(e) is amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(6) SPECIAL RULE FOR PROPERTY PLACED IN SERVICE DURING 2009 AND 2010- In the case of property placed in service in taxable years beginning after December 31, 2008, and before January 1, 2011-- CommentsClose CommentsPermalink





‘(A) in the case of any such property which does not relate to hydrogen-- CommentsClose CommentsPermalink





‘(i) subsection (a) shall be applied by substituting ‘50 percent’ for ‘30 percent’, CommentsClose CommentsPermalink





‘(ii) subsection (b)(1) shall be applied by substituting ‘$50,000’ for ‘$30,000’, and CommentsClose CommentsPermalink





‘(iii) subsection (b)(2) shall be applied by substituting ‘$2,000’ for ‘$1,000’, and CommentsClose CommentsPermalink





‘(B) in the case of any such property which relates to hydrogen, subsection (b) shall be applied by substituting ‘$200,000’ for ‘$30,000’.’. CommentsClose CommentsPermalink





(b) Effective Date- The amendment made by this section shall apply to taxable years beginning after December 31, 2008. CommentsClose CommentsPermalink

PART IV--ENERGY RESEARCH INCENTIVES

SEC. 1631. INCREASED RESEARCH CREDIT FOR ENERGY RESEARCH.

(a) In General- Section 41 is amended by redesignating subsection (h) as subsection (i) and by inserting after subsection (g) the following new subsection: CommentsClose CommentsPermalink





‘(h) Energy Research Credit- In the case of any taxable year beginning in 2009 or 2010-- CommentsClose CommentsPermalink





‘(1) IN GENERAL- The credit determined under subsection (a)(1) shall be increased by 20 percent of the qualified energy research expenses for the taxable year. CommentsClose CommentsPermalink





‘(2) QUALIFIED ENERGY RESEARCH EXPENSES- For purposes of this subsection, the term ‘qualified energy research expenses’ means so much of the taxpayer’s qualified research expenses as are related to the fields of fuel cells and battery technology, renewable energy, energy conservation technology, efficient transmission and distribution of electricity, and carbon capture and sequestration. CommentsClose CommentsPermalink





‘(3) COORDINATION WITH OTHER RESEARCH CREDITS- CommentsClose CommentsPermalink





‘(A) INCREMENTAL CREDIT- The amount of qualified energy research expenses taken into account under subsection (a)(1)(A) shall not exceed the base amount. CommentsClose CommentsPermalink





‘(B) ALTERNATIVE SIMPLIFIED CREDIT- For purposes of subsection (c)(5), the amount of qualified energy research expenses taken into account for the taxable year for which the credit is being determined shall not exceed-- CommentsClose CommentsPermalink





‘(i) in the case of subsection (c)(5)(A), 50 percent of the average qualified research expenses for the 3 taxable years preceding the taxable year for which the credit is being determined, and CommentsClose CommentsPermalink





‘(ii) in the case of subsection (c)(5)(B)(ii), zero. CommentsClose CommentsPermalink





‘(C) BASIC RESEARCH AND ENERGY RESEARCH CONSORTIUM PAYMENTS- Any amount taken into account under paragraph (1) shall not be taken into account under paragraph (2) or (3) of subsection (a).’. CommentsClose CommentsPermalink





(b) Conforming Amendment- Subparagraph (B) of section 41(i)(1)(B), as redesignated by subsection (a), is amended by inserting ‘(in the case of the increase in the credit determined under subsection (h), December 31, 2010)’ after ‘December 31, 2009’. CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply to taxable years beginning after December 31, 2008. CommentsClose CommentsPermalink

Subtitle H--Other Provisions CommentsClose CommentsPermalink

PART I--APPLICATION OF CERTAIN LABOR STANDARDS TO PROJECTS FINANCED WITH CERTAIN TAX-FAVORED BONDS

SEC. 1701. APPLICATION OF CERTAIN LABOR STANDARDS TO PROJECTS FINANCED WITH CERTAIN TAX-FAVORED BONDS.

Subchapter IV of chapter 31 of the title 40, United States Code, shall apply to projects financed with the proceeds of-- CommentsClose CommentsPermalink





(1) any qualified clean renewable energy bond (as defined in section 54C of the Internal Revenue Code of 1986) issued after the date of the enactment of this Act, CommentsClose CommentsPermalink





(2) any qualified energy conservation bond (as defined in section 54D of the Internal Revenue Code of 1986) issued after the date of the enactment of this Act, CommentsClose CommentsPermalink





(3) any qualified zone academy bond (as defined in section 54E of the Internal Revenue Code of 1986) issued after the date of the enactment of this Act, CommentsClose CommentsPermalink





(4) any qualified school construction bond (as defined in section 54F of the Internal Revenue Code of 1986), and CommentsClose CommentsPermalink





(5) any recovery zone economic development bond (as defined in section 1400U-2 of the Internal Revenue Code of 1986). CommentsClose CommentsPermalink

PART II--GRANTS TO PROVIDE FINANCING FOR LOW-INCOME HOUSING

SEC. 1711. GRANTS TO STATES FOR LOW-INCOME HOUSING PROJECTS IN LIEU OF LOW-INCOME HOUSING CREDIT ALLOCATIONS FOR 2009.

(a) In General- The Secretary of the Treasury shall make a grant to the housing credit agency of each State in an amount equal to such State’s low-income housing grant election amount. CommentsClose CommentsPermalink





(b) Low-Income Housing Grant Election Amount- For purposes of this section, the term ‘low-income housing grant election amount’ means, with respect to any State, such amount as the State may elect which does not exceed 85 percent of the product of-- CommentsClose CommentsPermalink





(1) the sum of-- CommentsClose CommentsPermalink





(A) 100 percent of the State housing credit ceiling for 2009 which is attributable to amounts described in clauses (i) and (iii) of section 42(h)(3)(C) of the Internal Revenue Code of 1986, and CommentsClose CommentsPermalink





(B) 40 percent of the State housing credit ceiling for 2009 which is attributable to amounts described in clauses (ii) and (iv) of such section, multiplied by CommentsClose CommentsPermalink





(2) 10. CommentsClose CommentsPermalink





(c) Subawards for Low-Income Buildings- CommentsClose CommentsPermalink





(1) IN GENERAL- A State housing credit agency receiving a grant under this section shall use such grant to make subawards to finance the construction or acquisition and rehabilitation of qualified low-income buildings. A subaward under this section may be made to finance a qualified low-income building with or without an allocation under section 42 of the Internal Revenue Code of 1986, except that a State housing credit agency may make subawards to finance qualified low-income buildings without an allocation only if it makes a determination that such use will increase the total funds available to the State to build and rehabilitate affordable housing. In complying with such determination requirement, a State housing credit agency shall establish a process in which applicants that are allocated credits are required to demonstrate good faith efforts to obtain investment commitments for such credits before the agency makes such subawards. CommentsClose CommentsPermalink





(2) SUBAWARDS SUBJECT TO SAME REQUIREMENTS AS LOW-INCOME HOUSING CREDIT ALLOCATIONS- Any such subaward with respect to any qualified low-income building shall be made in the same manner and shall be subject to the same limitations (including rent, income, and use restrictions on such building) as an allocation of housing credit dollar amount allocated by such State housing credit agency under section 42 of the Internal Revenue Code of 1986, except that such subawards shall not be limited by, or otherwise affect (except as provided in subsection (h)(3)(J) of such section), the State housing credit ceiling applicable to such agency. CommentsClose CommentsPermalink





(3) COMPLIANCE AND ASSET MANAGEMENT- The State housing credit agency shall perform asset management functions to ensure compliance with section 42 of the Internal Revenue Code of 1986 and the long-term viability of buildings funded by any subaward under this section. The State housing credit agency may collect reasonable fees from a subaward recipient to cover expenses associated with the performance of its duties under this paragraph. The State housing credit agency may retain an agent or other private contractor to satisfy the requirements of this paragraph. CommentsClose CommentsPermalink





(4) RECAPTURE- The State housing credit agency shall impose conditions or restrictions, including a requirement providing for recapture, on any subaward under this section so as to assure that the building with respect to which such subaward is made remains a qualified low-income building during the compliance period. Any such recapture shall be payable to the Secretary of the Treasury for deposit in the general fund of the Treasury and may be enforced by means of liens or such other methods as the Secretary of the Treasury determines appropriate. CommentsClose CommentsPermalink





(d) Return of Unused Grant Funds- Any grant funds not used to make subawards under this section before January 1, 2011, shall be returned to the Secretary of the Treasury on such date. Any subawards returned to the State housing credit agency on or after such date shall be promptly returned to the Secretary of the Treasury. Any amounts returned to the Secretary of the Treasury under this subsection shall be deposited in the general fund of the Treasury. CommentsClose CommentsPermalink





(e) Definitions- Any term used in this section which is also used in section 42 of the Internal Revenue Code of 1986 shall have the same meaning for purposes of this section as when used in such section 42. Any reference in this section to the Secretary of the Treasury shall be treated as including the Secretary’s delegate. CommentsClose CommentsPermalink





(f) Appropriations- There is hereby appropriated to the Secretary of the Treasury such sums as may be necessary to carry out this section. CommentsClose CommentsPermalink

PART III--GRANTS FOR SPECIFIED ENERGY PROPERTY IN LIEU OF TAX CREDITS

SEC. 1721. GRANTS FOR SPECIFIED ENERGY PROPERTY IN LIEU OF TAX CREDITS.

(a) In General- Upon application, the Secretary of Energy shall, within 60 days of the application and subject to the requirements of this section, provide a grant to each person who places in service specified energy property during 2009 or 2010 to reimburse such person for a portion of the expense of such facility as provided in subsection (b). CommentsClose CommentsPermalink





(b) Grant Amount- CommentsClose CommentsPermalink





(1) IN GENERAL- The amount of the grant under subsection (a) with respect to any specified energy property shall be the applicable percentage of the basis of such facility. CommentsClose CommentsPermalink





(2) APPLICABLE PERCENTAGE- For purposes of paragraph (1), the term ‘applicable percentage’ means-- CommentsClose CommentsPermalink





(A) 30 percent in the case of any property described in paragraphs (1) through (4) of subsection (c), and CommentsClose CommentsPermalink





(B) 10 percent in the case of any other property. CommentsClose CommentsPermalink





(3) DOLLAR LIMITATIONS- In the case of property described in paragraph (2), (6), or (7) of subsection (c), the amount of any grant under this section with respect to such property shall not exceed the limitation described in section 48(c)(1)(B), 48(c)(2)(B), or 48(c)(3)(B) of the Internal Revenue Code of 1986, respectively, with respect to such property. CommentsClose CommentsPermalink





(c) Specified Energy Property- For purposes of this section, the term ‘specified energy property’ means any of the following: CommentsClose CommentsPermalink





(1) QUALIFIED FACILITIES- Any facility described in paragraph (1), (2), (3), (4), (6), (7), (9), or (11) of section 45(d) of the Internal Revenue Code of 1986. CommentsClose CommentsPermalink





(2) QUALIFIED FUEL CELL PROPERTY- Any qualified fuel cell property (as defined in section 48(c)(1) of such Code). CommentsClose CommentsPermalink





(3) SOLAR PROPERTY- Any property described in clause (i) or (ii) of section 48(a)(3)(A) of such Code. CommentsClose CommentsPermalink





(4) QUALIFIED SMALL WIND ENERGY PROPERTY- Any qualified small wind energy property (as defined in section 48(c)(4) of such Code). CommentsClose CommentsPermalink





(5) GEOTHERMAL PROPERTY- Any property described in clause (iii) of section 48(a)(3)(A) of such Code. CommentsClose CommentsPermalink





(6) QUALIFIED MICROTURBINE PROPERTY- Any qualified microturbine property (as defined in section 48(c)(2) of such Code). CommentsClose CommentsPermalink





(7) COMBINED HEAT AND POWER SYSTEM PROPERTY- Any combined heat and power system property (as defined in section 48(c)(3) of such Code). CommentsClose CommentsPermalink





(8) GEOTHERMAL HEATPUMP PROPERTY- Any property described in clause (vii) of section 48(a)(3)(A) of such Code. CommentsClose CommentsPermalink





(d) Application of Certain Rules- In making grants under this section, the Secretary of Energy shall apply rules similar to the rules of section 50 of the Internal Revenue Code of 1986. In applying such rules, if the facility is disposed of, or otherwise ceases to be a qualified renewable energy facility, the Secretary of Energy shall provide for the recapture of the appropriate percentage of the grant amount in such manner as the Secretary of Energy determines appropriate. CommentsClose CommentsPermalink





(e) Exception for Certain Non-Taxpayers- The Secretary of Energy shall not make any grant under this section to any Federal, State, or local government (or any political subdivision, agency, or instrumentality thereof) or any organization described in section 501(c) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code. CommentsClose CommentsPermalink





(f) Definitions- Terms used in this section which are also used in section 45 or 48 of the Internal Revenue Code of 1986 shall have the same meaning for purposes of this section as when used in such section 45 or 48. Any reference in this section to the Secretary of the Treasury shall be treated as including the Secretary’s delegate. CommentsClose CommentsPermalink





(g) Coordination Between Departments of Treasury and Energy- The Secretary of the Treasury shall provide the Secretary of Energy with such technical assistance as the Secretary of Energy may require in carrying out this section. The Secretary of Energy shall provide the Secretary of the Treasury with such information as the Secretary of the Treasury may require in carrying out the amendment made by section 1604. CommentsClose CommentsPermalink





(h) Appropriations- There is hereby appropriated to the Secretary of Energy such sums as may be necessary to carry out this section. CommentsClose CommentsPermalink





(i) Termination- The Secretary of Energy shall not make any grant to any person under this section unless the application of such person for such grant is received before October 1, 2011. CommentsClose CommentsPermalink

TITLE II--ASSISTANCE FOR UNEMPLOYED WORKERS AND STRUGGLING FAMILIES CommentsClose CommentsPermalink

SEC. 2000. SHORT TITLE, ETC.

(a) Short Title- This title may be cited as the ‘Assistance for Unemployed Workers and Struggling Families Act’. CommentsClose CommentsPermalink





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





Sec. 2000. Short title, etc. CommentsClose CommentsPermalink

Subtitle A--Unemployment Insurance

Sec. 2001. Extension of emergency unemployment compensation program. CommentsClose CommentsPermalink





Sec. 2002. Increase in unemployment compensation benefits. CommentsClose CommentsPermalink





Sec. 2003. Special transfers for unemployment compensation modernization. CommentsClose CommentsPermalink

Subtitle B--Assistance for Vulnerable Individuals

Sec. 2101. Emergency fund for TANF program. CommentsClose CommentsPermalink





Sec. 2102. One-time emergency SSI paymentpayment to SSI recipients. CommentsClose CommentsPermalink





Sec. 2103. Temporary resumption of prior child support law. CommentsClose CommentsPermalink

Subtitle A--Unemployment Insurance CommentsClose CommentsPermalink

SEC. 2001. EXTENSION OF EMERGENCY UNEMPLOYMENT COMPENSATION PROGRAM.

(a) In General- Section 4007 of the Supplemental Appropriations Act, 2008 (Public Law 110-252; 26 U.S.C. 3304 note), as amended by section 4 of the Unemployment Compensation Extension Act of 2008 (Public Law 110-449; 122 Stat. 5015), is amended-- CommentsClose CommentsPermalink





(1) by striking ‘March 31, 2009’ each place it appears and inserting ‘December 31, 2009’; CommentsClose CommentsPermalink





(2) in the heading for subsection (b)(2), by striking ‘MARCH 31, 2009’ and inserting ‘DECEMBER 31, 2009’; and CommentsClose CommentsPermalink





(3) in subsection (b)(3), by striking ‘August 27, 2009’ and inserting ‘May 31, 2010’. CommentsClose CommentsPermalink





(b) Financing Provisions- Section 4004 of such Act is amended by adding at the end the following: CommentsClose CommentsPermalink





‘(e) Transfer of Funds- Notwithstanding any other provision of law, the Secretary of the Treasury shall transfer from the general fund of the Treasury (from funds not otherwise appropriated)-- CommentsClose CommentsPermalink





‘(1) to the extended unemployment compensation account (as established by section 905 of the Social Security Act) such sums as the Secretary of Labor estimates to be necessary to make payments to States under this title by reason of the amendments made by section 2001(a) of the Assistance for Unemployed Workers and Struggling Families Act; and CommentsClose CommentsPermalink





‘(2) to the employment security administration account (as established by section 901 of the Social Security Act) such sums as the Secretary of Labor estimates to be necessary for purposes of assisting States in meeting administrative costs by reason of the amendments referred to in paragraph (1). CommentsClose CommentsPermalink





There are appropriated from the general fund of the Treasury, without fiscal year limitation, the sums referred to in the preceding sentence and such sums shall not be required to be repaid.’. CommentsClose CommentsPermalink

SEC. 2002. INCREASE IN UNEMPLOYMENT COMPENSATION BENEFITS.

(a) Federal-State Agreements- Any State which desires to do so may enter into and participate in an agreement under this section with the Secretary of Labor (hereinafter in this section referred to as the ‘Secretary’). Any State which is a party to an agreement under this section may, upon providing 30 days’ written notice to the Secretary, terminate such agreement. CommentsClose CommentsPermalink





(b) Provisions of Agreement- CommentsClose CommentsPermalink





(1) ADDITIONAL COMPENSATION- Any agreement under this section shall provide that the State agency of the State will make payments of regular compensation to individuals in amounts and to the extent that they would be determined if the State law of the State were applied, with respect to any week for which the individual is (disregarding this section) otherwise entitled under the State law to receive regular compensation, as if such State law had been modified in a manner such that the amount of regular compensation (including dependents’ allowances) payable for any week shall be equal to the amount determined under the State law (before the application of this paragraph) plus an additional $25. CommentsClose CommentsPermalink





(2) ALLOWABLE METHODS OF PAYMENT- Any additional compensation provided for in accordance with paragraph (1) shall be payable either-- CommentsClose CommentsPermalink





(A) as an amount which is paid at the same time and in the same manner as any regular compensation otherwise payable for the week involved; or CommentsClose CommentsPermalink





(B) at the option of the State, by payments which are made separately from, but on the same weekly basis as, any regular compensation otherwise payable. CommentsClose CommentsPermalink





(c) Nonreduction Rule- An agreement under this section shall not apply (or shall cease to apply) with respect to a State upon a determination by the Secretary that the method governing the computation of regular compensation under the State law of that State has been modified in a manner such that-- CommentsClose CommentsPermalink





(1) the average weekly benefit amount of regular compensation which will be payable during the period of the agreement (determined disregarding any additional amounts attributable to the modification described in subsection (b)(1)) will be less than CommentsClose CommentsPermalink





(2) the average weekly benefit amount of regular compensation which would otherwise have been payable during such period under the State law, as in effect on December 31, 2008. CommentsClose CommentsPermalink





(d) Payments to States- CommentsClose CommentsPermalink





(1) IN GENERAL- CommentsClose CommentsPermalink





(A) FULL REIMBURSEMENT- There shall be paid to each State which has entered into an agreement under this section an amount equal to 100 percent of-- CommentsClose CommentsPermalink





(i) the total amount of additional compensation (as described in subsection (b)(1)) paid to individuals by the State pursuant to such agreement; and CommentsClose CommentsPermalink





(ii) any additional administrative expenses incurred by the State by reason of such agreement (as determined by the Secretary). CommentsClose CommentsPermalink





(B) TERMS OF PAYMENTS- Sums payable to any State by reason of such State’s having an agreement under this section shall be payable, either in advance or by way of reimbursement (as determined by the Secretary), in such amounts as the Secretary estimates the State will be entitled to receive under this section for each calendar month, reduced or increased, as the case may be, by any amount by which the Secretary finds that his estimates for any prior calendar month were greater or less than the amounts which should have been paid to the State. Such estimates may be made on the basis of such statistical, sampling, or other method as may be agreed upon by the Secretary and the State agency of the State involved. CommentsClose CommentsPermalink





(2) CERTIFICATIONS- The Secretary shall from time to time certify to the Secretary of the Treasury for payment to each State the sums payable to such State under this section. CommentsClose CommentsPermalink





(3) APPROPRIATION- There are appropriated from the general fund of the Treasury, without fiscal year limitation, such sums as may be necessary for purposes of this subsection. CommentsClose CommentsPermalink





(e) Applicability- CommentsClose CommentsPermalink





(1) IN GENERAL- An agreement entered into under this section shall apply to weeks of unemployment-- CommentsClose CommentsPermalink





(A) beginning after the date on which such agreement is entered into; and CommentsClose CommentsPermalink





(B) ending before January 1, 2010. CommentsClose CommentsPermalink





(2) TRANSITION RULE FOR INDIVIDUALS REMAINING ENTITLED TO REGULAR COMPENSATION AS OF JANUARY 1, 2010- In the case of any individual who, as of the date specified in paragraph (1)(B), has not yet exhausted all rights to regular compensation under the State law of a State with respect to a benefit year that began before such date, additional compensation (as described in subsection (b)(1)) shall continue to be payable to such individual for any week beginning on or after such date for which the individual is otherwise eligible for regular compensation with respect to such benefit year. CommentsClose CommentsPermalink





(3) TERMINATION- Notwithstanding any other provision of this subsection, no additional compensation (as described in subsection (b)(1)) shall be payable for any week beginning after June 30, 2010. CommentsClose CommentsPermalink





(f) Fraud and Overpayments- The provisions of section 4005 of the Supplemental Appropriations Act, 2008 (Public Law 110-252; 122 Stat. 2356) shall apply with respect to additional compensation (as described in subsection (b)(1)) to the same extent and in the same manner as in the case of emergency unemployment compensation. CommentsClose CommentsPermalink





(g) Application to Other Unemployment Benefits- CommentsClose CommentsPermalink





(1) IN GENERAL- Each agreement under this section shall include provisions to provide that the purposes of the preceding provisions of this section shall be applied with respect to unemployment benefits described in subsection (h)(3) to the same extent and in the same manner as if those benefits were regular compensation. CommentsClose CommentsPermalink





(2) ELIGIBILITY AND TERMINATION RULES- Additional compensation (as described in subsection (b)(1))-- CommentsClose CommentsPermalink





(A) shall not be payable, pursuant to this subsection, with respect to any unemployment benefits described in subsection (h)(3) for any week beginning on or after the date specified in subsection (e)(1)(B), except in the case of an individual who was eligible to receive additional compensation (as so described) in connection with any regular compensation or any unemployment benefits described in subsection (h)(3) for any period of unemployment ending before such date; and CommentsClose CommentsPermalink





(B) shall in no event be payable for any week beginning after the date specified in subsection (e)(3). CommentsClose CommentsPermalink





(h) Definitions- For purposes of this section-- CommentsClose CommentsPermalink





(1) the terms ‘compensation’, ‘regular compensation’, ‘benefit year’, ‘State’, ‘State agency’, ‘State law’, and ‘week’ have the respective meanings given such terms under section 205 of the Federal-State Extended Unemployment Compensation Act of 1970 (26 U.S.C. 3304 note); CommentsClose CommentsPermalink





(2) the term ‘emergency unemployment compensation’ means emergency unemployment compensation under title IV of the Supplemental Appropriations Act, 2008 (Public Law 110-252; 122 Stat. 2353); and CommentsClose CommentsPermalink





(3) any reference to unemployment benefits described in this paragraph shall be considered to refer to-- CommentsClose CommentsPermalink





(A) extended compensation (as defined by section 205 of the Federal-State Extended Unemployment Compensation Act of 1970); and CommentsClose CommentsPermalink





(B) unemployment compensation (as defined by section 85(b) of the Internal Revenue Code of 1986) provided under any program administered by a State under an agreement with the Secretary. CommentsClose CommentsPermalink

SEC. 2003. SPECIAL TRANSFERS FOR UNEMPLOYMENT COMPENSATION MODERNIZATION.

(a) In General- Section 903 of the Social Security Act (42 U.S.C. 1103) is amended by adding at the end the following: CommentsClose CommentsPermalink

‘Special Transfers in Fiscal Years 2009, 2010, and 2011 for Modernization

‘(f)(1)(A) In addition to any other amounts, the Secretary of Labor shall provide for the making of unemployment compensation modernization incentive payments (hereinafter ‘incentive payments’) to the accounts of the States in the Unemployment Trust Fund, by transfer from amounts reserved for that purpose in the Federal unemployment account, in accordance with succeeding provisions of this subsection. CommentsClose CommentsPermalink





‘(B) The maximum incentive payment allowable under this subsection with respect to any State shall, as determined by the Secretary of Labor, be equal to the amount obtained by multiplying $7,000,000,000 by the same ratio as would apply under subsection (a)(2)(B) for purposes of determining such State’s share of any excess amount (as described in subsection (a)(1)) that would have been subject to transfer to State accounts, as of October 1, 2008, under the provisions of subsection (a). CommentsClose CommentsPermalink





‘(C) Of the maximum incentive payment determined under subparagraph (B) with respect to a State-- CommentsClose CommentsPermalink





‘(i) one-third shall be transferred to the account of such State upon a certification under paragraph (4)(B) that the State law of such State meets the requirements of paragraph (2); and CommentsClose CommentsPermalink





‘(ii) the remainder shall be transferred to the account of such State upon a certification under paragraph (4)(B) that the State law of such State meets the requirements of paragraph (3). CommentsClose CommentsPermalink





‘(2) The State law of a State meets the requirements of this paragraph if such State law-- CommentsClose CommentsPermalink





‘(A) uses a base period that includes the most recently completed calendar quarter before the start of the benefit year for purposes of determining eligibility for unemployment compensation; or CommentsClose CommentsPermalink





‘(B) provides that, in the case of an individual who would not otherwise be eligible for unemployment compensation under the State law because of the use of a base period that does not include the most recently completed calendar quarter before the start of the benefit year, eligibility shall be determined using a base period that includes such calendar quarter. CommentsClose CommentsPermalink





‘(3) The State law of a State meets the requirements of this paragraph if such State law includes provisions to carry out at least 2 of the following subparagraphs: CommentsClose CommentsPermalink





‘(A) An individual shall not be denied regular unemployment compensation under any State law provisions relating to availability for work, active search for work, or refusal to accept work, solely because such individual is seeking only part-time (and not full-time) workwork (as defined by the Secretary of Labor), except that the State law provisions carrying out this subparagraph may exclude an individual if a majority of the weeks of work in such individual’s base period do not include part-time work (as so defined). CommentsClose CommentsPermalink





‘(B) An individual shall not be disqualified from regular unemployment compensation for separating from employment if that separation is for any compelling family reason. For purposes of this subparagraph, the term ‘compelling family reason’ means the following: CommentsClose CommentsPermalink





‘(i) Domestic violence, verified by such reasonable and confidential documentation as the State law may require, which causes the individual reasonably to believe that such individual’s continued employment would jeopardize the safety of the individual or of any member of the individual’s immediate family (as defined by the Secretary of Labor). CommentsClose CommentsPermalink





‘(ii) The illness or disability of a member of the individual’s immediate family (as defined by thethose terms are defined by the Secretary of Labor). CommentsClose CommentsPermalink





‘(iii) The need for the individual to accompany such individual’s spouse-- CommentsClose CommentsPermalink





‘(I) to a place from which it is impractical for such individual to commute; and CommentsClose CommentsPermalink





‘(II) due to a change in location of the spouse’s employment. CommentsClose CommentsPermalink





‘(C) Weekly unemployment compensation is payable under this subparagraph to any individual who is unemployed (as determined under the State unemployment compensation law), has exhausted all rights to regular unemployment compensation under the State law, and is enrolled and making satisfactory progress in a State-approved training program or in a job training program authorized under the Workforce Investment Act of 1998. Such programs shall prepare individuals who have been separated from a declining occupation, or who have been involuntarily and indefinitely separated from employment as a result of a permanent reduction of operations at the individual’s place of employment, for entry into a high-demand occupation. The amount of unemployment compensation payable under this subparagraph to an individual for a week of unemployment shall be equal to the individual’s average weekly benefit amount (including dependents’ allowances) for the most recent benefit year, and the total amount of unemployment compensation payable under this subparagraph to any individual shall be equal to at least 26 times the individual’s average weekly benefit amount (including dependents’ allowances) for the most recent benefit year. CommentsClose CommentsPermalink





‘(D) Dependents’ allowances are provided, in the case of any individual who is entitled to receive regular unemployment compensation and who has any dependents (as defined by State law), in an amount equal to at least $15 per dependent per week, subject to any aggregate limitation on such allowances which the State law may establish (but which aggregate limitation on the total allowance for dependents paid to an individual may not be less than $50 for each week of unemployment or 50 percent of the individual’s weekly benefit amount for the benefit year, whichever is less). CommentsClose CommentsPermalink





‘(4)(A) Any State seeking an incentive payment under this subsection shall submit an application therefor at such time, in such manner, and complete with such information as the Secretary of Labor may within 60 days after the date of the enactment of this subsection prescribe (whether by regulation or otherwise), including information relating to compliance with the requirements of paragraph (2) or (3), as well as how the State intends to use the incentive payment to improve or strengthen the State’s unemployment compensation program. The Secretary of Labor shall, within 30 days after receiving a complete application, notify the State agency of the State of the Secretary’s findings with respect to the requirements of paragraph (2) or (3) (or both). CommentsClose CommentsPermalink





‘(B)(i) If the Secretary of Labor finds that the State law provisions (disregarding any State law provisions which are not then currently in effect as permanent law or which are subject to discontinuation) meet the requirements of paragraph (2) or (3), as the case may be, the Secretary of Labor shall thereupon make a certification to that effect to the Secretary of the Treasury, together with a certification as to the amount of the incentive payment to be transferred to the State account pursuant to that finding. The Secretary of the Treasury shall make the appropriate transfer within 7 days after receiving such certification. CommentsClose CommentsPermalink





‘(ii) For purposes of clause (i), State law provisions which are to take effect within 12 months after the date of their certification under this subparagraph shall be considered to be in effect as of the date of such certification. CommentsClose CommentsPermalink





‘(C)(i) No certification of compliance with the requirements of paragraph (2) or (3) may be made with respect to any State whose State law is not otherwise eligible for certification under section 303 or approvable under section 3304 of the Federal Unemployment Tax Act. CommentsClose CommentsPermalink





‘(ii) No certification of compliance with the requirements of paragraph (3) may be made with respect to any State whose State law is not in compliance with the requirements of paragraph (2). CommentsClose CommentsPermalink





‘(iii) No application under subparagraph (A) may be considered if submitted before the date of the enactment of this subsection or after the latest date necessary (as specified by the Secretary of Labor) to ensure that all incentive payments under this subsection are made before October 1, 2011. CommentsClose CommentsPermalink





‘(5)(A) Except as provided in subparagraph (B), any amount transferred to the account of a State under this subsection may be used by such State only in the payment of cash benefits to individuals with respect to their unemployment (including for dependents’ allowances and for unemployment compensation under paragraph (3)(C)), exclusive of expenses of administration. CommentsClose CommentsPermalink





‘(B) A State may, subject to the same conditions as set forth in subsection (c)(2) (excluding subparagraph (B) thereof, and deeming the reference to ‘subsections (a) and (b)’ in subparagraph (D) thereof to include this subsection), use any amount transferred to the account of such State under this subsection for the administration of its unemployment compensation law and public employment offices. CommentsClose CommentsPermalink





‘(6) Out of any money in the Federal unemployment account not otherwise appropriated, the Secretary of the Treasury shall reserve $7,000,000,000 for incentive payments under this subsection. Any amount so reserved shall not be taken into account for purposes of any determination under section 902, 910, or 1203 of the amount in the Federal unemployment account as of any given time. Any amount so reserved for which the Secretary of the Treasury has not received a certification under paragraph (4)(B) by the deadline described in paragraph (4)(C)(iii) shall, upon the close of fiscal year 2011, become unrestricted as to use as part of the Federal unemployment account. CommentsClose CommentsPermalink





‘(7) For purposes of this subsection, the terms ‘benefit year’, ‘base period’, and ‘week’ have the respective meanings given such terms under section 205 of the Federal-State Extended Unemployment Compensation Act of 1970 (26 U.S.C. 3304 note). CommentsClose CommentsPermalink

‘Special Transfer in Fiscal Year 2009 for Administration

‘(g)(1) In addition to any other amounts, the Secretary of the Treasury shall transfer from the employment security administration account to the account of each State in the Unemployment Trust Fund, within 30 days after the date of the enactment of this subsection, the amount determined with respect to such State under paragraph (2). CommentsClose CommentsPermalink





‘(2) The amount to be transferred under this subsection to a State account shall (as determined by the Secretary of Labor and certified by such Secretary to the Secretary of the Treasury) be equal to the amount obtained by multiplying $500,000,000 by the same ratio as determined under subsection (f)(1)(B) with respect to such State. CommentsClose CommentsPermalink





‘(3) Any amount transferred to the account of a State as a result of the enactment of this subsection may be used by the State agency of such State only in the payment of expenses incurred by it for-- CommentsClose CommentsPermalink





‘(A) the administration of the provisions of its State law carrying out the purposes of subsection (f)(2) or any subparagraph of subsection (f)(3); CommentsClose CommentsPermalink





‘(B) improved outreach to individuals who might be eligible for regular unemployment compensation by virtue of any provisions of the State law which are described in subparagraph (A); CommentsClose CommentsPermalink





‘(C) the improvement of unemployment benefit and unemployment tax operations, including responding to increased demand for unemployment compensation; and CommentsClose CommentsPermalink





‘(D) staff-assisted reemployment services for unemployment compensation claimants.’. CommentsClose CommentsPermalink





(b) Regulations- The Secretary of Labor may prescribe any regulations, operating instructions, or other guidance necessary to carry out the amendment made by subsection (a). CommentsClose CommentsPermalink

Subtitle B--Assistance for Vulnerable Individuals CommentsClose CommentsPermalink

SEC. 2101. EMERGENCY FUND FOR TANF PROGRAM.

(a) In General- Section 403 of the Social Security Act (42 U.S.C. 603) is amended by adding at the end the following: CommentsClose CommentsPermalink





‘(c) Emergency Fund- CommentsClose CommentsPermalink





‘(1) ESTABLISHMENT- There is established in the Treasury of the United States a fund which shall be known as the ‘Emergency Contingency Fund for State Temporary Assistance for Needy Families Programs’ (in this subsection referred to as the ‘Emergency Fund’). CommentsClose CommentsPermalink





‘(2) DEPOSITS INTO FUND- Out of any money in the Treasury of the United States not otherwise appropriated, there are appropriated such sums as are necessary for payment to the Emergency Fund. CommentsClose CommentsPermalink





‘(3) GRANTS- CommentsClose CommentsPermalink





‘(A) GRANT RELATED TO CASELOAD INCREASES- CommentsClose CommentsPermalink





‘(i) IN GENERAL- For each calendar quarter in fiscal year 2009 or 2010, the Secretary shall make a grant from the Emergency Fund to each State that-- CommentsClose CommentsPermalink





‘(I) requests a grant under this subparagraph for the quarter; and CommentsClose CommentsPermalink





‘(II) meets the requirement of clause (ii) for the quarter. CommentsClose CommentsPermalink





‘(ii) CASELOAD INCREASE REQUIREMENT- A State meets the requirement of this clause for a quarter if the average monthly assistance caseload of the State for the quarter exceeds the average monthly assistance caseload of the State for the corresponding quarter in the emergency fund base year of the State. CommentsClose CommentsPermalink





‘(iii) AMOUNT OF GRANT- Subject to paragraph (5), the amount of the grant to be made to a State under this subparagraph for a quarter shall be 80 percent of the amount (if any) by which the total expenditures of the State for basic assistance (as defined by the Secretary) in the quarter, whether under the State program funded under this part or as qualified State expenditures, exceeds the total expenditures of the State for such assistance for the corresponding quarter in the emergency fund base year of the State. CommentsClose CommentsPermalink





‘(B) GRANT RELATED TO INCREASED EXPENDITURES FOR NON-RECURRENT SHORT-TERM BENEFITS- CommentsClose CommentsPermalink





‘(i) IN GENERAL- For each calendar quarter in fiscal year 2009 or 2010, the Secretary shall make a grant from the Emergency Fund to each State that-- CommentsClose CommentsPermalink





‘(I) requests a grant under this subparagraph for the quarter; and CommentsClose CommentsPermalink





‘(II) meets the requirement of clause (ii) for the quarter. CommentsClose CommentsPermalink





‘(ii) NON-RECURRENT SHORT-TERM EXPENDITURE REQUIREMENT- A State meets the requirement of this clause for a quarter if the total expenditures of the State for non-recurrent short-term benefits in the quarter, whether under the State program funded under this part or as qualified State expenditures, exceeds the total such expenditures of the State for non-recurrent short-term benefits in the corresponding quarter in the emergency fund base year of the State. CommentsClose CommentsPermalink





‘(iii) AMOUNT OF GRANT- Subject to paragraph (5), the amount of the grant to be made to a State under this subparagraph for a quarter shall be an amount equal to 80 percent of the excess described in clause (ii). CommentsClose CommentsPermalink





‘(C) GRANT RELATED TO INCREASED EXPENDITURES FOR SUBSIDIZED EMPLOYMENT- CommentsClose CommentsPermalink





‘(i) IN GENERAL- For each calendar quarter in fiscal year 2009 or 2010, the Secretary shall make a grant from the Emergency Fund to each State that-- CommentsClose CommentsPermalink





‘(I) requests a grant under this subparagraph for the quarter; and CommentsClose CommentsPermalink





‘(II) meets the requirement of clause (ii) for the quarter. CommentsClose CommentsPermalink





‘(ii) SUBSIDIZED EMPLOYMENT EXPENDITURE REQUIREMENT- A State meets the requirement of this clause for a quarter if the total expenditures of the State for subsidized employment in the quarter, whether under the State program funded under this part or as qualified State expenditures, exceeds the total of such expenditures of the State in the corresponding quarter in the emergency fund base year of the State. CommentsClose CommentsPermalink





‘(iii) AMOUNT OF GRANT- Subject to paragraph (5), the amount of the grant to be made to a State under this subparagraph for a quarter shall be an amount equal to 80 percent of the excess described in clause (ii). CommentsClose CommentsPermalink





‘(4) AUTHORITY TO MAKE NECESSARY ADJUSTMENTS TO DATA AND COLLECT NEEDED DATA- In determining the size of the caseload of a State and the expenditures of a State for basic assistance, non-recurrent short-term benefits, and subsidized employment, during any period for which the State requests funds under this subsection, and during the emergency fund base year of the State, the Secretary may make appropriate adjustments to the data to ensure that the data reflect expenditures under the State program funded under this part and qualified State expenditures. The Secretary may develop a mechanism for collecting expenditure data, including procedures which allow States to make reasonable estimates, and may set deadlines for making revisions to the data. CommentsClose CommentsPermalink





‘(5) LIMITATION- The total amount payable to a single State under subsection (b) and this subsection for a fiscal year shall not exceed 25 percent of the State family assistance grant. CommentsClose CommentsPermalink





‘(6) LIMITATIONS ON USE OF FUNDS- A State to which an amount is paid under this subsection may use the amount only as authorized by section 404. CommentsClose CommentsPermalink





‘(7) TIMING OF IMPLEMENTATION- The Secretary shall implement this subsection as quickly as reasonably possible, pursuant to appropriate guidance to States. CommentsClose CommentsPermalink





‘(8) DEFINITIONS- In this subsection: CommentsClose CommentsPermalink





‘(A) AVERAGE MONTHLY ASSISTANCE CASELOAD- The term ‘average monthly assistance caseload’ means, with respect to a State and a quarter, the number of families receiving assistance during the quarter under the State program funded under this part or as qualified State expenditures, subject to adjustment under paragraph (4). CommentsClose CommentsPermalink





‘(B) EMERGENCY FUND BASE YEAR- CommentsClose CommentsPermalink





‘(i) IN GENERAL- The term ‘emergency fund base year’ means, with respect to a State and a category described in clause (ii), whichever of fiscal year 2007 or 2008 is the fiscal year in which the amount described by the category with respect to the State is the lesser. CommentsClose CommentsPermalink





‘(ii) CATEGORIES DESCRIBED- The categories described in this clause are the following: CommentsClose CommentsPermalink





‘(I) The average monthly assistance caseload of the State. CommentsClose CommentsPermalink





‘(II) The total expenditures of the State for non-recurrent short-term benefits, whether under the State program funded under this part or as qualified State expenditures. CommentsClose CommentsPermalink





‘(III) The total expenditures of the State for subsidized employment, whether under the State program funded under this part or as qualified State expenditures. CommentsClose CommentsPermalink





‘(C) QUALIFIED STATE EXPENDITURES- The term ‘qualified State expenditures’ has the meaning given the term in section 409(a)(7).’. CommentsClose CommentsPermalink





(b) Temporary Modification of Caseload Reduction Credit- Section 407(b)(3)(A)(i) of such Act (42 U.S.C. 607(b)(3)(A)(i)) is amended by inserting ‘(or if the immediately preceding fiscal year is fiscal year 2009 or 2010, then, at State option, during the emergency fund base year of the State with respect to the average monthly assistance caseload of the State (within the meaning of section 403(c)(8)(B)))’ before ‘under the State’. CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall take effect on the date of the enactment of this Act. CommentsClose CommentsPermalink

SEC. 2102. ONE-TIME EMERGENCY PAYMENT TO SSI PAYMENTRECIPIENTS.

(a) Payment Authority- CommentsClose CommentsPermalink





(1) IN GENERAL- At the earliest practicable date in calendar year 2009 but not later than 9120 days after the date of the enactment of this section, the Commissioner of Social Security shall make a one-time payment, subject to subsection (b)(2) of this section, to each individual who is determined by the to each individual who is determined by the Commissioner in calendar year 2009 to be an individual who-- CommentsClose CommentsPermalink





(A) is entitled to a cash benefit under the supplemental security income program under title XVI of the Social Security Act (other than pursuant to section 1611(e)(1)(B) of such Act) for at least 1 day in the calendar month in which the first payment under this section is to be made; or CommentsClose CommentsPermalink





(B)(i) was entitled to such a cash benefit (other than pursuant to section 1611(e)(1)(B) of such Act) for at least 1 day in the 2-month period preceding that calendar month; and CommentsClose CommentsPermalink





(ii) whose entitlement to that benefit ceased in that 2-month period solely because the income of the individual (and the income of the spouse, if any, of the individual) exceeded the applicable income limit described in paragraph (1)(A) or (2)(A) of section 1611(a) of such Act. CommentsClose CommentsPermalink





(2) AMOUNT OF PAYMENT- Subject to subsection (b)(1) of this section, the amount of the payment shall be-- CommentsClose CommentsPermalink





(A) in the case of an individual eligible for a payment under this section who does not have a spouse eligible for such a payment, an amount equal to the average of the cash benefits payable in the aggregate under section 1611 or 1619(a) of the Social Security Act to eligible individuals who do not have an eligible spouse, for the most recent month for which data on payment of the benefits are available, as determined by the Commissioner of Social Security; or CommentsClose CommentsPermalink





(B) in the case of an individual eligible for a payment under this section who has a spouse eligible for such a payment, an amount equal to the average of the cash benefits payable in the aggregate under section 1611 or 1619(a) of the Social Security Act to eligible individuals who have an eligible spouse, for the most recent month for which data on payment of the benefits are available, as so determined. CommentsClose CommentsPermalink





(b) Administrative Provisions- CommentsClose CommentsPermalink





(1) AUTHORITY TO WITHHOLD PAYMENT TO RECOVER PRIOR OVERPAYMENT OF SSI BENEFITS- The Commissioner of Social Security may withhold part or all of a payment otherwise required to be made under subsection (a) of this section to an individual, in order to recover a prior overpayment of benefits to the individual under the supplemental security income program under title XVI of the Social Security Act, subject to the limitations of section 1631(b) of such Act. CommentsClose CommentsPermalink





(2) AUTHORITY TO MAKE PAYMENTS OVER THE COURSE OF 2 MONTHS- The Commissioner of Social Security may provide for payments under this section to be made over the course of 2 calendar months as may be necessary for the effective and efficient administration of this section.(3)PAYMENT TO BE DISREGARDED IN DETERMINING UNDERPAYMENTS UNDER THE SSI PROGRAM- A payment under subsection (a) shall be disregarded in determining whether there has been an underpayment of benefits under the supplemental security income program under title XVI of the Social Security Act. CommentsClose CommentsPermalink





(43) NONASSIGNMENT- The provisions of section 2071631(d) of the Social Security Act shall apply with respect to payments under this section to the same extent as they apply in the case of title IXVI of such Act. CommentsClose CommentsPermalink





(c) Payments To Be Disregarded for Purposes of All Federal and Federally Assisted Programs- A payment under subsection (a) shall not be regarded as income to the recipient, and shall not be regarded as a resource of the recipient for the month of receipt and the following 6 months, for purposes of determining the eligibility of any individual for benefits or assistance, or the amount or extent of benefits or assistance, under any Federal program or under any State or local program financed in whole or in part with Federal funds. CommentsClose CommentsPermalink





(d) Appropriation- Out of any sums in the Treasury of the United States not otherwise appropriated, there are appropriated such sums as may be necessary to carry out this section. CommentsClose CommentsPermalink

SEC. 2103. TEMPORARY RESUMPTION OF PRIOR CHILD SUPPORT LAW.

During the period that begins with October 1, 2008, and ends with September 30, 2010, section 455(a)(1) of the Social Security Act shall be applied and administered as if the phrase ‘from amounts paid to the State under section 458 or’ did not appear in such section. CommentsClose CommentsPermalink

TITLE III--HEALTH INSURANCE ASSISTANCE FOR THE UNEMPLOYED CommentsClose CommentsPermalink

SEC. 3001. SHORT TITLE AND TABLE OF CONTENTS OF TITLE.

(a) Short Title of Title- This title may be cited as the ‘Health Insurance Assistance for the Unemployed Act of 2009’. CommentsClose CommentsPermalink





(b) Table of Contents of Title- The table of contents of this title is as follows: CommentsClose CommentsPermalink





Sec. 3001. Short title and table of contents of title. CommentsClose CommentsPermalink





Sec. 3002. Premium assistance for COBRA benefits and extension of COBRA benefits for older or long-term employees. CommentsClose CommentsPermalink





Sec. 3003. Temporary optional Medicaid coverage for the unemployed. CommentsClose CommentsPermalink

SEC. 3002. PREMIUM ASSISTANCE FOR COBRA BENEFITS AND EXTENSION OF COBRA BENEFITS FOR OLDER OR LONG-TERM EMPLOYEES.

(a) Premium Assistance for COBRA Continuation Coverage for Individuals and Their Families- CommentsClose CommentsPermalink





(1) PROVISION OF PREMIUM ASSISTANCE- CommentsClose CommentsPermalink





(A) REDUCTION OF PREMIUMS PAYABLE- In the case of any premium for a period of coverage beginning on or after the date of the enactment of this Act for COBRA continuation coverage with respect to any assistance eligible individual, such individual shall be treated for purposes of any COBRA continuation provision as having paid the amount of such premium if such individual pays 35 percent of the amount of such premium (as determined without regard to this subsection). CommentsClose CommentsPermalink





(B) PREMIUM REIMBURSEMENT- For provisions providing the balance of such premium, see section 6431 of the Internal Revenue Code of 1986, as added by paragraph (12). CommentsClose CommentsPermalink





(2) LIMITATION OF PERIOD OF PREMIUM ASSISTANCE- CommentsClose CommentsPermalink





(A) IN GENERAL- Paragraph (1)(A) shall not apply with respect to any assistance eligible individual for months of coverage beginning on or after the earlier of-- CommentsClose CommentsPermalink





(i) the first date that such individual is eligible for coverage under any other group health plan (other than coverage consisting of only dental, vision, counseling, or referral services (or a combination thereof), coverage under a health reimbursement arrangement or a health flexible spending arrangement, or coverage of treatment that is furnished in an on-site medical facility maintained by the employer and that consists primarily of first-aid services, prevention and wellness care, or similar care (or a combination thereof)) or is eligible for benefits under title XVIII of the Social Security Act., or CommentsClose CommentsPermalink





(ii) the earliest of-- CommentsClose CommentsPermalink





(I) the date which is 12 months after the first day of the first month that paragraph (1)(A) applies with respect to such individual, CommentsClose CommentsPermalink





(II) the date following the expiration of the maximum period of continuation coverage required under the applicable COBRA continuation coverage provision, or CommentsClose CommentsPermalink





(III) the date following the expiration of the period of continuation coverage allowed under paragraph (4)(B)(ii). CommentsClose CommentsPermalink





(B) TIMING OF ELIGIBILITY FOR ADDITIONAL COVERAGE- For purposes of subparagraph (A)(i), an individual shall not be treated as eligible for coverage under a group health plan before the first date on which such individual could be covered under such plan. CommentsClose CommentsPermalink





(C) NOTIFICATION REQUIREMENT- An assistance eligible individual shall notify in writing the group health plan with respect to which paragraph (1)(A) applies if such paragraph ceases to apply by reason of subparagraph (A)(i). Such notice shall be provided to the group health plan in such time and manner as may be specified by the Secretary of Labor. CommentsClose CommentsPermalink





(3) ASSISTANCE ELIGIBLE INDIVIDUAL- For purposes of this section, the term ‘assistance eligible individual’ means any qualified beneficiary if-- CommentsClose CommentsPermalink





(A) at any time during the period that begins with September 1, 2008, and ends with December 31, 2009, such qualified beneficiary is eligible for COBRA continuation coverage, CommentsClose CommentsPermalink





(B) such qualified beneficiary elects such coverage, and CommentsClose CommentsPermalink





(C) the qualifying event with respect to the COBRA continuation coverage consists of the involuntary termination of the covered employee’s employment and occurred during such period. CommentsClose CommentsPermalink





(4) EXTENSION OF ELECTION PERIOD AND EFFECT ON COVERAGE- CommentsClose CommentsPermalink





(A) IN GENERAL- Notwithstanding section 605(a) of the Employee Retirement Income Security Act of 1974, section 4980B(f)(5)(A) of the Internal Revenue Code of 1986, section 2205(a) of the Public Health Service Act, andsection 8905a(c)(2) of title 5, United States Code, in the case of an individual who is a qualified beneficiary described in paragraph (3)(A) as of the date of the enactment of this Act and has not made the election referred to in paragraph (3)(B) as of such date, such individual may elect the COBRA continuation coverage under the COBRA continuation coverage provisions containing such sections during the 60-day period commencing with the date on which the notification required under paragraph (7)(C) is provided to such individual. CommentsClose CommentsPermalink





(B) COMMENCEMENT OF COVERAGE; NO REACH-BACK- Any COBRA continuation coverage elected by a qualified beneficiary during an extended election period under subparagraph (A)-- CommentsClose CommentsPermalink





(i) shall commence on the date of the enactment of this Act, and CommentsClose CommentsPermalink





(ii) shall not extend beyond the period of COBRA continuation coverage that would have been required under the applicable COBRA continuation coverage provision if the coverage had been elected as required under such provision. CommentsClose CommentsPermalink





(C) PREEXISTING CONDITIONS- With respect to a qualified beneficiary who elects COBRA continuation coverage pursuant to subparagraph (A), the period-- CommentsClose CommentsPermalink





(i) beginning on the date of the qualifying event, and CommentsClose CommentsPermalink





(ii) ending with the day before the date of the enactment of this Act, CommentsClose CommentsPermalink





shall be disregarded for purposes of determining the 63-day periods referred to in section 701)(2) of the Employee Retirement Income Security Act of 1974, section 9801(c)(2) of the Internal Revenue Code of 1986, and section 2701(c)(2) of the Public Health Service Act. CommentsClose CommentsPermalink





(5) EXPEDITED REVIEW OF DENIALS OF PREMIUM ASSISTANCE- In any case in which an individual requests treatment as an assistance eligible individual and is denied such treatment by the group health plan by reason of such individual’s ineligibility for COBRA continuation coverage, the Secretary of Labor (or the Secretary of Health and Human services in connection with COBRA continuation coverage which is provided other than pursuant to part 6 of subtitle B of title I of the Employee Retirement Income Security Act of 1974), in consultation with the Secretary of the Treasury, shall provide for expedited review of such denial. An individual shall be entitled to such review upon application to such Secretary in such form and manner as shall be provided by such Secretary. Such Secretary shall make a determination regarding such individual’s eligibility within 10 business days after receipt of such individual’s application for review under this paragraph. CommentsClose CommentsPermalink





(6) DISREGARD OF SUBSIDIES FOR PURPOSES OF FEDERAL AND STATE PROGRAMS- Notwithstanding any other provision of law, any premium reduction with respect to an assistance eligible individual under this subsection shall not be considered income or resources in determining eligibility for, or the amount of assistance or benefits provided under, any other public benefit provided under Federal law or the law of any State or political subdivision thereof. CommentsClose CommentsPermalink





(7) NOTICES TO INDIVIDUALS- CommentsClose CommentsPermalink





(A) GENERAL NOTICE- CommentsClose CommentsPermalink





(i) IN GENERAL- In the case of notices provided under section 606(4) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1166(4)), section 4980B(f)(6)(D) of the Internal Revenue Code of 1986, section 2206(4) of the Public Health Service Act (42 U.S.C. 300bb-6(4)), or section 8905a(f)(2)(A) of title 5, United States Code, with respect to individuals who, during the period described in paragraph (3)(A), become entitled to elect COBRA continuation coverage, such notices shall include an additional notification to the recipient of the availability of premium reduction with respect to such coverage under this subsection. CommentsClose CommentsPermalink





(ii) ALTERNATIVE NOTICE- In the case of COBRA continuation coverage to which the notice provision under such sections does not apply, the Secretary of Labor, in consultation with the Secretary of the Treasury and the Secretary of Health and Human Services, shall, in coordination with administrators of the group health plans (or other entities) that provide or administer the COBRA continuation coverage involved, provide rules requiring the provision of such notice. CommentsClose CommentsPermalink





(iii) FORM- The requirement of the additional notification under this subparagraph may be met by amendment of existing notice forms or by inclusion of a separate document with the notice otherwise required. CommentsClose CommentsPermalink





(B) SPECIFIC REQUIREMENTS- Each additional notification under subparagraph (A) shall include-- CommentsClose CommentsPermalink





(i) the forms necessary for establishing eligibility for premium reduction under this subsection, CommentsClose CommentsPermalink





(ii) the name, address, and telephone number necessary to contact the plan administrator and any other person maintaining relevant information in connection with such premium reduction, CommentsClose CommentsPermalink





(iii) a description of the extended election period provided for in paragraph (4)(A), CommentsClose CommentsPermalink





(iv) a description of the obligation of the qualified beneficiary under paragraph (2)(C) to notify the plan providing continuation coverage of eligibility for subsequent coverage under another group health plan or eligibility for benefits under title XVIII of the Social Security Act and the penalty provided for failure to so notify the plan, and CommentsClose CommentsPermalink





(v) a description, displayed in a prominent manner, of the qualified beneficiary’s right to a reduced premium and any conditions on entitlement to the reduced premium. CommentsClose CommentsPermalink





(C) NOTICE RELATING TO RETROACTIVE COVERAGE- In the case of an individual described in paragraph (3)(A) who has elected COBRA continuation coverage as of the date of enactment of this Act or an individual described in paragraph (4)(A), the administrator of the group health plan (or other entity) involved shall provide (within 60 days after the date of enactment of this Act) for the additional notification required to be provided under subparagraph (A). CommentsClose CommentsPermalink





(D) MODEL NOTICES- Not later than 30 days after the date of enactment of this Act, the Secretary of the Labor, in consultation with the Secretary of the Treasury and the Secretary of Health and Human Services, shall prescribe models for the additional notification required under this paragraph. CommentsClose CommentsPermalink





(8) SAFEGUARDS- The Secretary of the Treasury shall provide such rules, procedures, regulations, and other guidance as may be necessary and appropriate to prevent fraud and abuse under this subsection. CommentsClose CommentsPermalink





(9) OUTREACH- The Secretary of Labor, in consultation with the Secretary of the Treasury and the Secretary of Health and Human Services, shall provide outreach consisting of public education and enrollment assistance relating to premium reduction provided under this subsection. Such outreach shall target employers, group health plan administrators, public assistance programs, States, insurers, and other entities as determined appropriate by such Secretaries. Such outreach shall include an initial focus on those individuals electing continuation coverage who are referred to in paragraph (7)(C). Information on such premium reduction, including enrollment, shall also be made available on website of the Departments of Labor, Treasury, and Health and Human Services. CommentsClose CommentsPermalink





(10) DEFINITIONS- For purposes of this subsection-- CommentsClose CommentsPermalink





(A) ADMINISTRATOR- The term ‘administrator’ has the meaning given such term in section 3(16) of the Employee Retirement Income Security Act of 1974. CommentsClose CommentsPermalink





(B) COBRA CONTINUATION COVERAGE- The term ‘COBRA continuation coverage’ means continuation coverage provided pursuant to part 6 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (other than under section 609), title XXII of the Public Health Service Act, section 4980B of the Internal Revenue Code of 1986 (other than subsection (f)(1) of such section insofar as it relates to pediatric vaccines), orsection 8905a of title 5, United States Code, or under a State program that provides continuation coverage comparable to such continuation coverage. Such term does not include coverage under a health flexible spending arrangement. CommentsClose CommentsPermalink





(C) COBRA CONTINUATION PROVISION- The term ‘COBRA continuation provision’ means the provisions of law described in subparagraph (B). CommentsClose CommentsPermalink





(D) COVERED EMPLOYEE- The term ‘covered employee’ has the meaning given such term in section 607(2) of the Employee Retirement Income Security Act of 1974. CommentsClose CommentsPermalink





(E) QUALIFIED BENEFICIARY- The term ‘qualified beneficiary’ has the meaning given such term in section 607(3) of the Employee Retirement Income Security Act of 1974. CommentsClose CommentsPermalink





(F) GROUP HEALTH PLAN- The term ‘group health plan’ has the meaning given such term in section 607(1) of the Employee Retirement Income Security Act of 1974. CommentsClose CommentsPermalink





(G) STATE- The term ‘State’ includes the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands. CommentsClose CommentsPermalink





(11) REPORTS- CommentsClose CommentsPermalink





(A) INTERIM REPORT- The Secretary of the Treasury shall submit an interim report to the Committee on Education and Labor, the Committee on Ways and Means, and the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate regarding the premium reduction provided under this subsection that includes-- CommentsClose CommentsPermalink





(i) the number of individuals provided such assistance as of the date of the report; and CommentsClose CommentsPermalink





(ii) the total amount of expenditures incurred (with administrative expenditures noted separately) in connection with such assistance as of the date of the report. CommentsClose CommentsPermalink





(B) FINAL REPORT- As soon as practicable after the last period of COBRA continuation coverage for which premium reduction is provided under this section, the Secretary of the Treasury shall submit a final report to each Committee referred to in subparagraph (A) that includes-- CommentsClose CommentsPermalink





(i) the number of individuals provided premium reduction under this section; CommentsClose CommentsPermalink





(ii) the average dollar amount (monthly and annually) of premium reductions provided to such individuals; and CommentsClose CommentsPermalink





(iii) the total amount of expenditures incurred (with administrative expenditures noted separately) in connection with premium reduction under this section. CommentsClose CommentsPermalink





(12) COBRA PREMIUM ASSISTANCE- CommentsClose CommentsPermalink





(A) IN GENERAL- Subchapter B of chapter 65 of the Internal Revenue Code of 1986 is amended by adding at the end the following new section: CommentsClose CommentsPermalink

‘SEC. 6431. COBRA PREMIUM ASSISTANCE.

‘(a) In General- The entity to whom premiums are payable under COBRA continuation coverage shall be reimbursed for the amount of premiums not paid by plan beneficiaries by reason of section 3002(a) of the Health Insurance Assistance for the Unemployed Act of 2009. Such amount shall be treated as a credit against the requirement of such entity to make deposits of payroll taxes and the liability of such entity for payroll taxes. To the extent that such amount exceeds the amount of such taxes, the Secretary shall pay to such entity the amount of such excess. No payment may be made under this subsection to an entity with respect to any assistance eligible individual until after such entity has received the reduced premium from such individual required under section 3002(a)(1)(A) of such Act. CommentsClose CommentsPermalink





‘(b) Payroll Taxes- For purposes of this section, the term ‘payroll taxes’ means-- CommentsClose CommentsPermalink





‘(1) amounts required to be deducted and withheld for the payroll period under section 3401 (relating to wage withholding), CommentsClose CommentsPermalink





‘(2) amounts required to be deducted for the payroll period under section 3102 (relating to FICA employee taxes), and CommentsClose CommentsPermalink





‘(3) amounts of the taxes imposed for the payroll period under section 3111 (relating to FICA employer taxes). CommentsClose CommentsPermalink





‘(c) Treatment of Credit- Except as otherwise provided by the Secretary, the credit described in subsection (a) shall be applied as though the employer had paid to the Secretary, on the day that the qualified beneficiary’s premium payment is received, an amount equal to such credit. CommentsClose CommentsPermalink





‘(d) Treatment of Payment- For purposes ofsection 1324(b)(2) of title 31, United States Code, any payment under this subsection shall be treated in the same manner as a refund of the credit under section 35. CommentsClose CommentsPermalink





‘(e) Reporting- CommentsClose CommentsPermalink





‘(1) IN GENERAL- Each entity entitled to reimbursement under subsection (a) for any period shall submit such reports as the Secretary may require, including-- CommentsClose CommentsPermalink





‘(A) an attestation of involuntary termination of employment for each covered employee on the basis of whose termination entitlement to reimbursement is claimed under subsection (a), and CommentsClose CommentsPermalink





‘(B) a report of the amount of payroll taxes offset under subsection (a) for the reporting period and the estimated offsets of such taxes for the subsequent reporting period in connection with reimbursements under subsection (a). CommentsClose CommentsPermalink





‘(2) TIMING OF REPORTS RELATING TO AMOUNT OF PAYROLL TAXES- Reports required under paragraph (1)(B) shall be submitted at the same time as deposits of taxes imposed by chapters 21, 22, and 24 or at such time as is specified by the Secretary. CommentsClose CommentsPermalink





‘(f) Regulations- The Secretary may issue such regulations or other guidance as may be necessary or appropriate to carry out this section, including the requirement to report information or the establishment of other methods for verifying the correct amounts of payments and credits under this section. The Secretary shall issue such regulations or guidance with respect to the application of this section to group health plans that are multiemployer plans.’. CommentsClose CommentsPermalink





(B) SOCIAL SECURITY TRUST FUNDS HELD HARMLESS- In determining any amount transferred or appropriated to any fund under the Social Security Act, section 6431 of the Internal Revenue Code of 1986 shall not be taken into account. CommentsClose CommentsPermalink





(C) CLERICAL AMENDMENT- The table of sections for subchapter B of chapter 65 of the Internal Revenue Code of 1986 is amended by adding at the end the following new item: CommentsClose CommentsPermalink





‘Sec. 6431. COBRA premium assistance.’. CommentsClose CommentsPermalink





(D) EFFECTIVE DATE- The amendments made by this paragraph shall apply to premiums to which subsection (a)(1)(A) applies. CommentsClose CommentsPermalink





(13) PENALTY FOR FAILURE TO NOTIFY HEALTH PLAN OF CESSATION OF ELIGIBILITY FOR PREMIUM ASSISTANCE- CommentsClose CommentsPermalink





(A) IN GENERAL- Part I of subchapter B of chapter 68 of the Internal Revenue Code of 1986 is amended by adding at the end the following new section: CommentsClose CommentsPermalink

‘SEC. 6720C. PENALTY FOR FAILURE TO NOTIFY HEALTH PLAN OF CESSATION OF ELIGIBILITY FOR COBRA PREMIUM ASSISTANCE.

‘(a) In General- Any person required to notify a group health plan under section 3002(a)(2)(C)) of the Health Insurance Assistance for the Unemployed Act of 2009 who fails to make such a notification at such time and in such manner as the Secretary of Labor may require shall pay a penalty of 110 percent of the premium reduction provided under such section after termination of eligibility under such subsection. CommentsClose CommentsPermalink





‘(b) Reasonable Cause Exception- No penalty shall be imposed under subsection (a) with respect to any failure if it is shown that such failure is due to reasonable cause and not to willful neglect.’. CommentsClose CommentsPermalink





(B) CLERICAL AMENDMENT- The table of sections of part I of subchapter B of chapter 68 of such Code is amended by adding at the end the following new item: CommentsClose CommentsPermalink





‘Sec. 6720C. Penalty for failure to notify health plan of cessation of eligibility for COBRA premium assistance.’. CommentsClose CommentsPermalink





(C) EFFECTIVE DATE- The amendments made by this paragraph shall apply to failures occurring after the date of the enactment of this Act. CommentsClose CommentsPermalink





(14) COORDINATION WITH HCTC- CommentsClose CommentsPermalink





(A) IN GENERAL- Subsection (g) of section 35 of the Internal Revenue Code of 1986 is amended by redesignating paragraph (9) as paragraph (10) and inserting after paragraph (8) the following new paragraph: CommentsClose CommentsPermalink





‘(9) COBRA PREMIUM ASSISTANCE- In the case of an assistance eligible individual who receives premium reduction for COBRA continuation coverage under section 3002(a) of the Health Insurance Assistance for the Unemployed Act of 2009 for any month during the taxable year, such individual shall not be treated as an eligible individual, a certified individual, or a qualifying family member for purposes of this section or section 7527 with respect to such month.’. CommentsClose CommentsPermalink





(B) EFFECTIVE DATE- The amendment made by subparagraph (A) shall apply to taxable years ending after the date of the enactment of this Act. CommentsClose CommentsPermalink





(15) EXCLUSION OF COBRA PREMIUM ASSISTANCE FROM GROSS INCOME- CommentsClose CommentsPermalink





(A) IN GENERAL- Part III of subchapter B of chapter 1 of the Internal Revenue Code of 1986 is amended by inserting after section 139B the following new section: CommentsClose CommentsPermalink

‘SEC. 139C. COBRA PREMIUM ASSISTANCE.

‘In the case of an assistance eligible individual (as defined in section 3002 of the Health Insurance Assistance for the Unemployed Act of 2009), gross income does not include any premium reduction provided under subsection (a) of such section.’. CommentsClose CommentsPermalink





(B) CLERICAL AMENDMENT- The table of sections for part III of subchapter B of chapter 1 of such Code is amended by inserting after the item relating to section 139B the following new item: CommentsClose CommentsPermalink





‘Sec. 139C. COBRA premium assistance.’. CommentsClose CommentsPermalink





(C) EFFECTIVE DATE- The amendments made by this paragraph shall apply to taxable years ending after the date of the enactment of this Act. CommentsClose CommentsPermalink





(b) Extension of COBRA Benefits for Older or Long-Term Employees- CommentsClose CommentsPermalink





(1) ERISA AMENDMENT- Section 602(2)(A) of the Employee Retirement Income Security Act of 1974 is amended by adding at the end the following new clauses: CommentsClose CommentsPermalink





‘(x) SPECIAL RULE FOR OLDER OR LONG-TERM EMPLOYEES GENERALLY- In the case of a qualifying event described in section 603(2) with respect to a covered employee who (as of such qualifying event) has attained age 55 or has completed 10 or more years of service with the entity that is the employer at the time of the qualifying event, clauses (i) and (ii) shall not apply. CommentsClose CommentsPermalink





‘(xi) YEAR OF SERVICE- For purposes of this subparagraph, the term ‘year of service’ shall have the meaning provided in section 202(a)(3).’. CommentsClose CommentsPermalink





(2) IRC AMENDMENT- Clause (i) of section 4980B(f)(2)(B) of the Internal Revenue Code of 1986 is amended by adding at the end the following new subclauses: CommentsClose CommentsPermalink





‘(X) SPECIAL RULE FOR OLDER OR LONG-TERM EMPLOYEES GENERALLY- In the case of a qualifying event described in paragraph (3)(B) with respect to a covered employee who (as of such qualifying event) has attained age 55 or has completed 10 or more years of service with the entity that is the employer at the time of the qualifying event, subclauses (I) and (II) shall not apply. CommentsClose CommentsPermalink





‘(XI) YEAR OF SERVICE- For purposes of this clause, the term ‘year of service’ shall have the meaning provided in section 202(a)(3) of the Employee Retirement Income Security Act of 1974.’. CommentsClose CommentsPermalink





(3) PHSA AMENDMENT- Section 2202(2)(A) of the Public Health Service Act is amended by adding at the end the following new clauses: CommentsClose CommentsPermalink





‘(viii) SPECIAL RULE FOR OLDER OR LONG-TERM EMPLOYEES GENERALLY- In the case of a qualifying event described in section 2203(2) with respect to a covered employee who (as of such qualifying event) has attained age 55 or has completed 10 or more years of service with the entity that is the employer at the time of the qualifying event, clauses (i) and (ii) shall not apply. CommentsClose CommentsPermalink





‘(ix) YEAR OF SERVICE- For purposes of this subparagraph, the term ‘year of service’ shall have the meaning provided in section 202(a)(3) of the Employee Retirement Income Security Act of 1974.’. CommentsClose CommentsPermalink





(4) EFFECTIVE DATE OF AMENDMENTS- The amendments made by this subsection shall apply to periods of coverage which would (without regard to the amendments made by this section) end on or after the date of the enactment of this Act. CommentsClose CommentsPermalink

SEC. 3003. TEMPORARY OPTIONAL MEDICAID COVERAGE FOR THE UNEMPLOYED.

(a) In General- Section 1902 of the Social Security Act (42 U.S.C. 1396b) is amended-- CommentsClose CommentsPermalink





(1) in subsection (a)(10)(A)(ii)-- CommentsClose CommentsPermalink





(A) by striking ‘or’ at the end of subclause (XVIII); CommentsClose CommentsPermalink





(B) by adding ‘or’ at the end of subclause (XIX); and CommentsClose CommentsPermalink





(C) by adding at the end the following new subclause CommentsClose CommentsPermalink





‘(XX) who are described in subsection (dd)(1) (relating to certain unemployed individuals and their families);’; and CommentsClose CommentsPermalink





(2) by adding at the end the following new subsection: CommentsClose CommentsPermalink





‘(dd)(1) Individuals described in this paragraph are-- CommentsClose CommentsPermalink





‘(A) individuals who-- CommentsClose CommentsPermalink





‘(i) are within one or more of the categories described in paragraph (2), as elected under the State plan; and CommentsClose CommentsPermalink





‘(ii) meet the applicable requirements of paragraph (3); and CommentsClose CommentsPermalink





‘(B) individuals who-- CommentsClose CommentsPermalink





‘(i) are the spouse, or dependent child under 19 years of age, of an individual described in subparagraph (A); and CommentsClose CommentsPermalink





‘(ii) meet the requirement of paragraph (3)(B). CommentsClose CommentsPermalink





‘(2) The categories of individuals described in this paragraph are each of the following: CommentsClose CommentsPermalink





‘(A) Individuals who are receiving unemployment compensation benefits. CommentsClose CommentsPermalink





‘(B) Individuals who were receiving, but have exhausted, unemployment compensation benefits on or after July 1, 2008. CommentsClose CommentsPermalink





‘(C) Individuals who are involuntarily unemployed and were involuntarily separated from employment on or after September 1, 2008, and before January 1, 2011, whose family gross income does not exceed a percentage specified by the State (not to exceed 200 percent) of the income official poverty line (as defined by the Office of Management and Budget, and revised annually in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981) applicable to a family of the size involved, and who, but for subsection (a)(10)(A)(ii)(XX), are not eligible for medical assistance under this title or health assistance under title XXI. CommentsClose CommentsPermalink





‘(D) Individuals who are involuntarily unemployed and were involuntarily separated from employment on or after September 1, 2008, and before January 1, 2011, who are members of households participating in the supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq), and who, but for subsection (a)(10)(A)(ii)(XX), are not eligible for medical assistance under this title or health assistance under title XXI. CommentsClose CommentsPermalink





A State plan may elect one or more of the categories described in this paragraph but may not elect the category described in subparagraph (B) unless the State plan also elects the category described in subparagraph (A). CommentsClose CommentsPermalink





‘(3) The requirements of this paragraph with respect to an individual are the following: CommentsClose CommentsPermalink





‘(A) In the case of individuals within a category described in subparagraph (A) or (B) of paragraph (2), the individual was involuntarily separated from employment on or after September 1, 2008, and before January 1, 2011, or meets such comparable requirement as the Secretary specifies through rule, guidance, or otherwise in the case of an individual who was an independent contractor. CommentsClose CommentsPermalink





‘(B) The individual is not otherwise covered under creditable coverage, as defined in section 2701(c) of the Public Health Service Act (42 U.S.C. 300gg(c)), but applied without regard to paragraph (1)(F) of such section and without regard to coverage provided by reason of the application of subsection (a)(10)(A)(ii)(XX). CommentsClose CommentsPermalink





‘(4)(A) No income or resources test shall be applied with respect to any category of individuals described in subparagraph (A), (B), or (D) of paragraph (2) who are eligible for medical assistance only by reason of the application of subsection (a)(10)(A)(ii)(XX). CommentsClose CommentsPermalink





‘(B) Nothing in this subsection shall be construed to prevent a State from imposing a resource test for the category of individuals described in paragraph (2)(C)). CommentsClose CommentsPermalink





‘(C) In the case of individuals provided medical assistance by reason of the application of subsection (a)(10)(A)(ii)(XX), the requirements of subsections (i)(22) and (x) shall not apply.’. CommentsClose CommentsPermalink





(b) 100 Percent Federal Matching Rate- CommentsClose CommentsPermalink





(1) FMAP FOR TIME-LIMITED PERIOD- The third sentence of section 1905(b) of such Act (42 U.S.C. 1396d(b)) is amended by inserting before the period at the end the following: ‘and for items and services furnished on or after the date of enactment of this Act and before January 1, 2011, to individuals who are eligible for medical assistance only by reason of the application of section 1902(a)(10)(A)(ii)(XX)’. CommentsClose CommentsPermalink





(2) CERTAIN ENROLLMENT-RELATED ADMINISTRATIVE COSTS- Notwithstanding any other provision of law, for purposes of applying section 1903(a) of the Social Security Act (42 U.S.C. 1396b(a)), with respect to expenditures incurred on or after the date of the enactment of this Act and before January 1, 2011, for costs of administration (including outreach and the modification and operation of eligibility information systems) attributable to eligibility determination and enrollment of individuals who are eligible for medical assistance only by reason of the application of section 1902(a)(10)(A)(ii)(XX) of such Act, as added by subsection (a)(1), the Federal matching percentage shall be 100 percent instead of the matching percentage otherwise applicable. CommentsClose CommentsPermalink





(c) Conforming Amendments- (1) Section 1903(f)(4) of such Act (42 U.S.C. 1396c(f)(4)) is amended by inserting ‘1902(a)(10)(A)(ii)(XX), or’ after ‘1902(a)(10)(A)(ii)(XIX),’. CommentsClose CommentsPermalink





(2) Section 1905(a) of such Act (42 U.S.C. 1396d(a)) is amended, in the matter preceding paragraph (1)-- CommentsClose CommentsPermalink





(A) by striking ‘or’ at the end of clause (xii); CommentsClose CommentsPermalink





(B) by adding ‘or’ at the end of clause (xiii); and CommentsClose CommentsPermalink





(C) by inserting after clause (xiii) the following new clause: CommentsClose CommentsPermalink





‘(xiv) individuals described in section 1902(dd)(1),’. CommentsClose CommentsPermalink

TITLE IV--HEALTH INFORMATION TECHNOLOGY CommentsClose CommentsPermalink

SEC. 4001. SHORT TITLE; TABLE OF CONTENTS OF TITLE.

(a) Short Title- This title may be cited as the ‘Health Information Technology for Economic and Clinical Health Act’ or the ‘HITECH Act’. CommentsClose CommentsPermalink





(b) Table of Contents of Title- The table of contents of this title is as follows: CommentsClose CommentsPermalink





Sec. 4001. Short title; table of contents of title. CommentsClose CommentsPermalink

Subtitle A--Promotion of Health Information Technology

Part I--Improving Health Care Quality, Safety, and Efficiency

Sec. 4101. ONCHIT; standards development and adoption. CommentsClose CommentsPermalink

‘TITLE XXX--HEALTH INFORMATION TECHNOLOGY AND QUALITY

‘Sec. 3000. Definitions. CommentsClose CommentsPermalink

‘Subtitle A--Promotion of Health Information Technology

‘Sec. 3001. Office of the National Coordinator for Health Information Technology. CommentsClose CommentsPermalink

‘Sec. 3002. HIT Policy Committee. CommentsClose CommentsPermalink

‘Sec. 3003. HIT Standards Committee. CommentsClose CommentsPermalink

‘Sec. 3004. Process for adoption of endorsed recommendations; adoption of initial set of standards, implementation specifications, and certification criteria. CommentsClose CommentsPermalink

‘Sec. 3005. Application and use of adopted standards and implementation specifications by Federal agencies. CommentsClose CommentsPermalink

‘Sec. 3006. Voluntary application and use of adopted standards and implementation specifications by private entities. CommentsClose CommentsPermalink

‘Sec. 3007. Federal health information technology. CommentsClose CommentsPermalink

‘Sec. 3008. Transitions. CommentsClose CommentsPermalink

‘Sec. 3009. Relation to HIPAA privacy and security law. CommentsClose CommentsPermalink

‘Sec. 3010. Authorization for appropriations. CommentsClose CommentsPermalink

Sec. 4102. Technical amendment. CommentsClose CommentsPermalink

Part II--Application and Use of Adopted Health Information Technology Standards; Reports

Sec. 4111. Coordination of Federal activities with adopted standards and implementation specifications. CommentsClose CommentsPermalink





Sec. 4112. Application to private entities. CommentsClose CommentsPermalink





Sec. 4113. Study and reports. CommentsClose CommentsPermalink

Subtitle B--Testing of Health Information Technology

Sec. 4201. National Institute for Standards and Technology testing. CommentsClose CommentsPermalink





Sec. 4202. Research and development programs. CommentsClose CommentsPermalink

Subtitle C--Incentives for the Use of Health Information Technology

Part I--Grants and Loans Funding

Sec. 4301. Grant, loan, and demonstration programs. CommentsClose CommentsPermalink

‘Subtitle B--Incentives for the Use of Health Information Technology

‘Sec. 3011. Immediate funding to strengthen the health information technology infrastructure. CommentsClose CommentsPermalink

‘Sec. 3012. Health information technology implementation assistance. CommentsClose CommentsPermalink

‘Sec. 3013. State grants to promote health information technology. CommentsClose CommentsPermalink

‘Sec. 3014. Competitive grants to States and Indian tribes for the development of loan programs to facilitate the widespread adoption of certified EHR technology. CommentsClose CommentsPermalink

‘Sec. 3015. Demonstration program to integrate information technology into clinical education. CommentsClose CommentsPermalink

‘Sec. 3016. Information technology professionals on health care. CommentsClose CommentsPermalink

‘Sec. 3017. General grant and loan provisions. CommentsClose CommentsPermalink

‘Sec. 3018. Authorization for appropriations. CommentsClose CommentsPermalink

Part II--Medicare Program

Sec. 4311. Incentives for eligible professionals. CommentsClose CommentsPermalink





Sec. 4312. Incentives for hospitals. CommentsClose CommentsPermalink





Sec. 4313. Treatment of payments and savings; implementation funding. CommentsClose CommentsPermalink





Sec. 4314. Study on application of HITEHR payment incentives for providers not receiving other incentive payments. CommentsClose CommentsPermalink

Part III--Medicaid Funding

Sec. 4321. Medicaid provider HIT adoption and operation payments; implementation funding. CommentsClose CommentsPermalink

Subtitle D--Privacy

Sec. 4400. Definitions. CommentsClose CommentsPermalink

Part I--Improved Privacy Provisions and Security Provisions

Sec. 4401. Application of security provisions and penalties to business associates of covered entities; annual guidance on security provisions. CommentsClose CommentsPermalink





Sec. 4402. Notification in the case of breach. CommentsClose CommentsPermalink





Sec. 4403. Education on Health Information Privacy. CommentsClose CommentsPermalink





Sec. 4404. Application of privacy provisions and penalties to business associates of covered entities. CommentsClose CommentsPermalink





Sec. 4405. Restrictions on certain disclosures and sales of health information; accounting of certain protected health information disclosures; access to certain information in electronic format. CommentsClose CommentsPermalink





Sec. 4406. Conditions on certain contacts as part of health care operations. CommentsClose CommentsPermalink





Sec. 4407. Temporary breach notification requirement for vendors of personal health records and other non-HIPAA covered entities. CommentsClose CommentsPermalink





Sec. 4408. Business associate contracts required for certain entities. CommentsClose CommentsPermalink





Sec. 4409. Clarification of application of wrongful disclosures criminal penalties. CommentsClose CommentsPermalink





Sec. 4410. Improved enforcement. CommentsClose CommentsPermalink





Sec. 4411. Audits. CommentsClose CommentsPermalink

Part II--Relationship to Other Laws; Regulatory References; Effective Date; Reports

Sec. 4421. Relationship to other laws. CommentsClose CommentsPermalink





Sec. 4422. Regulatory references. CommentsClose CommentsPermalink





Sec. 4423. Effective date. CommentsClose CommentsPermalink





Sec. 4424. Studies, reports, guidance. CommentsClose CommentsPermalink

Subtitle E--Miscellaneous Medicare Provisions

Sec. 4501. Moratoria on certain Medicare regulations. CommentsClose CommentsPermalink





Sec. 4502. Long-term care hospital technical corrections. CommentsClose CommentsPermalink

Subtitle A--Promotion of Health Information Technology CommentsClose CommentsPermalink

PART I--IMPROVING HEALTH CARE QUALITY, SAFETY, AND EFFICIENCY

SEC. 4101. ONCHIT; STANDARDS DEVELOPMENT AND ADOPTION.

The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by adding at the end the following: CommentsClose CommentsPermalink

‘TITLE XXX--HEALTH INFORMATION TECHNOLOGY AND QUALITY CommentsClose CommentsPermalink

‘SEC. 3000. DEFINITIONS.

‘In this title: CommentsClose CommentsPermalink





‘(1) CERTIFIED EHR TECHNOLOGY- The term ‘certified EHR technology’ means a qualified electronic health record that is certified pursuant to section 3001(c)(5) as meeting standards adopted under section 3004 that are applicable to the type of record involved (as determined by the Secretary, such as an ambulatory electronic health record for office-based physicians or an inpatient hospital electronic health record for hospitals). CommentsClose CommentsPermalink





‘(2) ENTERPRISE INTEGRATION- The term ‘enterprise integration’ means the electronic linkage of health care providers, health plans, the government, and other interested parties, to enable the electronic exchange and use of health information among all the components in the health care infrastructure in accordance with applicable law, and such term includes related application protocols and other related standards. CommentsClose CommentsPermalink





‘(3) HEALTH CARE PROVIDER- The term ‘health care provider’ means a hospital, skilled nursing facility, nursing facility, home health entity or other long-term care facility, health care clinic, Federally qualified health center, group practice (as defined in section 1877(h)(4) of the Social Security Act), a pharmacist, a pharmacy, a laboratory, a physician (as defined in section 1861(r) of the Social Security Act), a practitioner (as described in section 1842(b)(18)(C) of the Social Security Act), a provider operated by, or under contract with, the Indian Health Service or by an Indian tribe (as defined in the Indian Self-Determination and Education Assistance Act), tribal organization, or urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act), a rural health clinic, a covered entity under section 340B, and any other category of facility or clinician determined appropriate by the Secretary. CommentsClose CommentsPermalink





‘(4) HEALTH INFORMATION- The term ‘health information’ has the meaning given such term in section 1171(4) of the Social Security Act. CommentsClose CommentsPermalink





‘(5) HEALTH INFORMATION TECHNOLOGY- The term ‘health information technology’ means hardware, software, integrated technologies and related licenses, intellectual property, upgrades, and packaged solutions sold as services that are specifically designed for use by health care entities for the electronic creation, maintenance, or exchange of health information. CommentsClose CommentsPermalink





‘(6) HEALTH PLAN- The term ‘health plan’ has the meaning given such term in section 1171(5) of the Social Security Act. CommentsClose CommentsPermalink





‘(7) HIT POLICY COMMITTEE- The term ‘HIT Policy Committee’ means such Committee established under section 3002(a). CommentsClose CommentsPermalink





‘(8) HIT STANDARDS COMMITTEE- The term ‘HIT Standards Committee’ means such Committee established under section 3003(a). CommentsClose CommentsPermalink





‘(9) INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION- The term ‘individually identifiable health information’ has the meaning given such term in section 1171(6) of the Social Security Act. CommentsClose CommentsPermalink





‘(10) LABORATORY- The term ‘laboratory’ has the meaning given such term in section 353(a). CommentsClose CommentsPermalink





‘(11) NATIONAL COORDINATOR- The term ‘National Coordinator’ means the head of the Office of the National Coordinator for Health Information Technology established under section 3001(a). CommentsClose CommentsPermalink





‘(12) PHARMACIST- The term ‘pharmacist’ has the meaning given such term in section 804(2) of the Federal Food, Drug, and Cosmetic Act. CommentsClose CommentsPermalink





‘(13) QUALIFIED ELECTRONIC HEALTH RECORD- The term ‘qualified electronic health record’ means an electronic record of health-related information on an individual that-- CommentsClose CommentsPermalink





‘(A) includes patient demographic and clinical health information, such as medical history and problem lists; and CommentsClose CommentsPermalink





‘(B) has the capacity-- CommentsClose CommentsPermalink





‘(i) to provide clinical decision support; CommentsClose CommentsPermalink





‘(ii) to support physician order entry; CommentsClose CommentsPermalink





‘(iii) to capture and query information relevant to health care quality; and CommentsClose CommentsPermalink





‘(iv) to exchange electronic health information with, and integrate such information from other sources. CommentsClose CommentsPermalink





‘(14) STATE- The term ‘State’ means each of the several States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. CommentsClose CommentsPermalink

‘Subtitle A--Promotion of Health Information Technology CommentsClose CommentsPermalink

‘SEC. 3001. OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY.

‘(a) Establishment- There is established within the Department of Health and Human Services an Office of the National Coordinator for Health Information Technology (referred to in this section as the ‘Office’). The Office shall be headed by a National Coordinator who shall be appointed by the Secretary and shall report directly to the Secretary. CommentsClose CommentsPermalink





‘(b) Purpose- The National Coordinator shall perform the duties under subsection (c) in a manner consistent with the development of a nationwide health information technology infrastructure that allows for the electronic use and exchange of information and that-- CommentsClose CommentsPermalink





‘(1) ensures that each patient’s health information is secure and protected, in accordance with applicable law; CommentsClose CommentsPermalink





‘(2) improves health care quality, reduces medical errors, and advances the delivery of patient-centered medical care; CommentsClose CommentsPermalink





‘(3) reduces health care costs resulting from inefficiency, medical errors, inappropriate care, duplicative care, and incomplete information; CommentsClose CommentsPermalink





‘(4) provides appropriate information to help guide medical decisions at the time and place of care; CommentsClose CommentsPermalink





‘(5) ensures the inclusion of meaningful public input in such development of such infrastructure; CommentsClose CommentsPermalink





‘(6) improves the coordination of care and information among hospitals, laboratories, physician offices, and other entities through an effective infrastructure for the secure and authorized exchange of health care information; CommentsClose CommentsPermalink





‘(7) improves public health activities and facilitates the early identification and rapid response to public health threats and emergencies, including bioterror events and infectious disease outbreaks; CommentsClose CommentsPermalink





‘(8) facilitates health and clinical research and health care quality; CommentsClose CommentsPermalink





‘(9) promotes prevention of chronic diseases; CommentsClose CommentsPermalink





‘(10) promotes a more effective marketplace, greater competition, greater systems analysis, increased consumer choice, and improved outcomes in health care services; and CommentsClose CommentsPermalink





‘(11) improves efforts to reduce health disparities. CommentsClose CommentsPermalink





‘(c) Duties of the National Coordinator- CommentsClose CommentsPermalink





‘(1) STANDARDS- The National Coordinator shall review and determine whether to endorse each standard, implementation specification, and certification criterion for the electronic exchange and use of health information that is recommended by the HIT Standards Committee under section 3003 for purposes of adoption under section 3004. The Coordinator shall make such determination, and report to the Secretary such determination, not later than 45 days after the date the recommendation is received by the Coordinator. CommentsClose CommentsPermalink





‘(2) HIT POLICY COORDINATION- CommentsClose CommentsPermalink





‘(A) IN GENERAL- The National Coordinator shall coordinate health information technology policy and programs of the Department with those of other relevant executive branch agencies with a goal of avoiding duplication of efforts and of helping to ensure that each agency undertakes health information technology activities primarily within the areas of its greatest expertise and technical capability and in a manner towards a coordinated national goal. CommentsClose CommentsPermalink





‘(B) HIT POLICY AND STANDARDS COMMITTEES- The National Coordinator shall be a leading member in the establishment and operations of the HIT Policy Committee and the HIT Standards Committee and shall serve as a liaison among those two Committees and the Federal Government. CommentsClose CommentsPermalink





‘(3) STRATEGIC PLAN- CommentsClose CommentsPermalink





‘(A) IN GENERAL- The National Coordinator shall, in consultation with other appropriate Federal agencies (including the National Institute of Standards and Technology), update the Federal Health IT Strategic Plan (developed as of June 3, 2008) to include specific objectives, milestones, and metrics with respect to the following: CommentsClose CommentsPermalink





‘(i) The electronic exchange and use of health information and the enterprise integration of such information. CommentsClose CommentsPermalink





‘(ii) The utilization of an electronic health record for each person in the United States by 2014. CommentsClose CommentsPermalink





‘(iii) The incorporation of privacy and security protections for the electronic exchange of an individual’s individually identifiable health information. CommentsClose CommentsPermalink





‘(iv) Ensuring security methods to ensure appropriate authorization and electronic authentication of health information and specifying technologies or methodologies for rendering health information unusable, unreadable, or indecipherable. CommentsClose CommentsPermalink





‘(v) Specifying a framework for coordination and flow of recommendations and policies under this subtitle among the Secretary, the National Coordinator, the HIT Policy Committee, the HIT Standards Committee, and other health information exchanges and other relevant entities. CommentsClose CommentsPermalink





‘(vi) Methods to foster the public understanding of health information technology. CommentsClose CommentsPermalink





‘(vii) Strategies to enhance the use of health information technology in improving the quality of health care, reducing medical errors, reducing health disparities, improving public health, and improving the continuity of care among health care settings. CommentsClose CommentsPermalink





‘(B) COLLABORATION- The strategic plan shall be updated through collaboration of public and private entities. CommentsClose CommentsPermalink





‘(C) MEASURABLE OUTCOME GOALS- The strategic plan update shall include measurable outcome goals. CommentsClose CommentsPermalink





‘(D) PUBLICATION- The National Coordinator shall republish the strategic plan, including all updates. CommentsClose CommentsPermalink





‘(4) WEBSITE- The National Coordinator shall maintain and frequently update an Internet website on which there is posted information on the work, schedules, reports, recommendations, and other information to ensure transparency in promotion of a nationwide health information technology infrastructure. CommentsClose CommentsPermalink





‘(5) CERTIFICATION- CommentsClose CommentsPermalink





‘(A) IN GENERAL- The National Coordinator, in consultation with the Director of the National Institute of Standards and Technology, shall develop a program (either directly or by contract) for the voluntary certification of health information technology as being in compliance with applicable certification criteria adopted under this subtitle. Such program shall include testing of the technology in accordance with section 4201(b) of the HITECH Act. CommentsClose CommentsPermalink





‘(B) CERTIFICATION CRITERIA DESCRIBED- In this title, the term ‘certification criteria’ means, with respect to standards and implementation specifications for health information technology, criteria to establish that the technology meets such standards and implementation specifications. CommentsClose CommentsPermalink





‘(6) REPORTS AND PUBLICATIONS- CommentsClose CommentsPermalink





‘(A) REPORT ON ADDITIONAL FUNDING OR AUTHORITY NEEDED- Not later than 12 months after the date of the enactment of this title, the National Coordinator shall submit to the appropriate committees of jurisdiction of the House of Representatives and the Senate a report on any additional funding or authority the Coordinator or the HIT Policy Committee or HIT Standards Committee requires to evaluate and develop standards, implementation specifications, and certification criteria, or to achieve full participation of stakeholders in the adoption of a nationwide health information technology infrastructure that allows for the electronic use and exchange of health information. CommentsClose CommentsPermalink





‘(B) IMPLEMENTATION REPORT- The National Coordinator shall prepare a report that identifies lessons learned from major public and private health care systems in their implementation of health information technology, including information on whether the technologies and practices developed by such systems may be applicable to and usable in whole or in part by other health care providers. CommentsClose CommentsPermalink





‘(C) ASSESSMENT OF IMPACT OF HIT ON COMMUNITIES WITH HEALTH DISPARITIES AND UNINSURED, UNDERINSURED, AND MEDICALLY UNDERSERVED AREAS- The National Coordinator shall assess and publish the impact of health information technology in communities with health disparities and in areas with a high proportion of individuals who are uninsured, underinsured, and medically underserved individuals (including urban and rural areas) and identify practices to increase the adoption of such technology by health care providers in such communities. CommentsClose CommentsPermalink





‘(D) EVALUATION OF BENEFITS AND COSTS OF THE ELECTRONIC USE AND EXCHANGE OF HEALTH INFORMATION- The National Coordinator shall evaluate and publish evidence on the benefits and costs of the electronic use and exchange of health information and assess to whom these benefits and costs accrue. CommentsClose CommentsPermalink





‘(E) RESOURCE REQUIREMENTS- The National Coordinator shall estimate and publish resources required annually to reach the goal of utilization of an electronic health record for each person in the United States by 2014, including the required level of Federal funding, expectations for regional, State, and private investment, and the expected contributions by volunteers to activities for the utilization of such records. CommentsClose CommentsPermalink





‘(7) ASSISTANCE- The National Coordinator may provide financial assistance to consumer advocacy groups and not-for-profit entities that work in the public interest for purposes of defraying the cost to such groups and entities to participate under, whether in whole or in part, the National Technology Transfer Act of 1995 (15 U.S.C. 272 note). CommentsClose CommentsPermalink





‘(8) GOVERNANCE FOR NATIONWIDE HEALTH INFORMATION NETWORK- The National Coordinator shall establish a governance mechanism for the nationwide health information network. CommentsClose CommentsPermalink





‘(d) Detail of Federal Employees- CommentsClose CommentsPermalink





‘(1) IN GENERAL- Upon the request of the National Coordinator, the head of any Federal agency is authorized to detail, with or without reimbursement from the Office, any of the personnel of such agency to the Office to assist it in carrying out its duties under this section. CommentsClose CommentsPermalink





‘(2) EFFECT OF DETAIL- Any detail of personnel under paragraph (1) shall-- CommentsClose CommentsPermalink





‘(A) not interrupt or otherwise affect the civil service status or privileges of the Federal employee; and CommentsClose CommentsPermalink





‘(B) be in addition to any other staff of the Department employed by the National Coordinator. CommentsClose CommentsPermalink





‘(3) ACCEPTANCE OF DETAILEES- Notwithstanding any other provision of law, the Office may accept detailed personnel from other Federal agencies without regard to whether the agency described under paragraph (1) is reimbursed. CommentsClose CommentsPermalink





‘(e) Chief Privacy Officer of the Office of the National Coordinator- Not later than 12 months after the date of the enactment of this title, the Secretary shall appoint a Chief Privacy Officer of the Office of the National Coordinator, whose duty it shall be to advise the National Coordinator on privacy, security, and data stewardship of electronic health information and to coordinate with other Federal agencies (and similar privacy officers in such agencies), with State and regional efforts, and with foreign countries with regard to the privacy, security, and data stewardship of electronic individually identifiable health information. CommentsClose CommentsPermalink

‘SEC. 3002. HIT POLICY COMMITTEE.

‘(a) Establishment- There is established a HIT Policy Committee to make policy recommendations to the National Coordinator relating to the implementation of a nationwide health information technology infrastructure, including implementation of the strategic plan described in section 3001(c)(3). CommentsClose CommentsPermalink





‘(b) Duties- CommentsClose CommentsPermalink





‘(1) RECOMMENDATIONS ON HEALTH INFORMATION TECHNOLOGY INFRASTRUCTURE- The HIT Policy Committee shall recommend a policy framework for the development and adoption of a nationwide health information technology infrastructure that permits the electronic exchange and use of health information as is consistent with the strategic plan under section 3001(c)(3) and that includes the recommendations under paragraph (2). The Committee shall update such recommendations and make new recommendations as appropriate. CommentsClose CommentsPermalink





‘(2) SPECIFIC AREAS OF STANDARD DEVELOPMENT- CommentsClose CommentsPermalink





‘(A) IN GENERAL- The HIT Policy Committee shall recommend the areas in which standards, implementation specifications, and certification criteria are needed for the electronic exchange and use of health information for purposes of adoption under section 3004 and shall recommend an order of priority for the development, harmonization, and recognition of such standards, specifications, and certification criteria among the areas so recommended. Such standards and implementation specifications shall include named standards, architectures, and software schemes for the authentication and security of individually identifiable health information and other information as needed to ensure the reproducible development of common solutions across disparate entities. CommentsClose CommentsPermalink





‘(B) AREAS REQUIRED FOR CONSIDERATION- For purposes of subparagraph (A), the HIT Policy Committee shall make recommendations for at least the following areas: CommentsClose CommentsPermalink





‘(i) Technologies that protect the privacy of health information and promote security in a qualified electronic health record, including for the segmentation and protection from disclosure of specific and sensitive individually identifiable health information with the goal of minimizing the reluctance of patients to seek care (or disclose information about a condition) because of privacy concerns, in accordance with applicable law, and for the use and disclosure of limited data sets of such information. CommentsClose CommentsPermalink





‘(ii) A nationwide health information technology infrastructure that allows for the electronic use and accurate exchange of health information. CommentsClose CommentsPermalink





‘(iii) The utilization of a certified electronic health record for each person in the United States by 2014. CommentsClose CommentsPermalink





‘(iv) Technologies that as a part of a qualified electronic health record allow for an accounting of disclosures made by a covered entity (as defined for purposes of regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996) for purposes of treatment, payment, and health care operations (as such terms are defined for purposes of such regulations). CommentsClose CommentsPermalink





‘(v) The use of certified electronic health records to improve the quality of health care, such as by promoting the coordination of health care and improving continuity of health care among health care providers, by reducing medical errors, by improving population health, and by advancing research and education. CommentsClose CommentsPermalink





‘(C) OTHER AREAS FOR CONSIDERATION- In making recommendations under subparagraph (A), the HIT Policy Committee may consider the following additional areas: CommentsClose CommentsPermalink





‘(i) The appropriate uses of a nationwide health information infrastructure, including for purposes of-- CommentsClose CommentsPermalink





‘(I) the collection of quality data and public reporting; CommentsClose CommentsPermalink





‘(II) biosurveillance and public health; CommentsClose CommentsPermalink





‘(III) medical and clinical research; and CommentsClose CommentsPermalink





‘(IV) drug safety. CommentsClose CommentsPermalink





‘(ii) Self-service technologies that facilitate the use and exchange of patient information and reduce wait times. CommentsClose CommentsPermalink





‘(iii) Telemedicine technologies, in order to reduce travel requirements for patients in remote areas. CommentsClose CommentsPermalink





‘(iv) Technologies that facilitate home health care and the monitoring of patients recuperating at home. CommentsClose CommentsPermalink





‘(v) Technologies that help reduce medical errors. CommentsClose CommentsPermalink





‘(vi) Technologies that facilitate the continuity of care among health settings. CommentsClose CommentsPermalink





‘(vii) Technologies that meet the needs of diverse populations. CommentsClose CommentsPermalink





‘(viii) Any other technology that the HIT Policy Committee finds to be among the technologies with the greatest potential to improve the quality and efficiency of health care. CommentsClose CommentsPermalink





‘(3) FORUM- The HIT Policy Committee shall serve as a forum for broad stakeholder input with specific expertise in policies relating to the matters described in paragraphs (1) and (2). CommentsClose CommentsPermalink





‘(c) Membership and Operations- CommentsClose CommentsPermalink





‘(1) IN GENERAL- The National Coordinator shall provide leadership in the establishment and operations of the HIT Policy Committee. CommentsClose CommentsPermalink





‘(2) MEMBERSHIP- The membership of the HIT Policy Committee shall at least reflect providers, ancillary healthcare workers, consumers, purchasers, health plans, technology vendors, researchers, relevant Federal agencies, and individuals with technical expertise on health care quality, privacy and security, and on the electronic exchange and use of health information. CommentsClose CommentsPermalink





‘(3) CONSIDERATION- The National Coordinator shall ensure that the relevant recommendations and comments from the National Committee on Vital and Health Statistics are considered in the development of policies. CommentsClose CommentsPermalink





‘(d) Application of FACA- The Federal Advisory Committee Act (5 U.S.C. App.), other than section 14 of such Act, shall apply to the HIT Policy Committee. CommentsClose CommentsPermalink





‘(e) Publication- The Secretary shall provide for publication in the Federal Register and the posting on the Internet website of the Office of the National Coordinator for Health Information Technology of all policy recommendations made by the HIT Policy Committee under this section. CommentsClose CommentsPermalink

‘SEC. 3003. HIT STANDARDS COMMITTEE.

‘(a) Establishment- There is established a committee to be known as the HIT Standards Committee to recommend to the National Coordinator standards, implementation specifications, and certification criteria for the electronic exchange and use of health information for purposes of adoption under section 3004, consistent with the implementation of the strategic plan described in section 3001(c)(3) and beginning with the areas listed in section 3002(b)(2)(B) in accordance with policies developed by the HIT Policy Committee. CommentsClose CommentsPermalink





‘(b) Duties- CommentsClose CommentsPermalink





‘(1) STANDARD DEVELOPMENT- CommentsClose CommentsPermalink





‘(A) IN GENERAL- The HIT Standards Committee shall recommend to the National Coordinator standards, implementation specifications, and certification criteria described in subsection (a) that have been developed, harmonized, or recognized by the HIT Standards Committee. The HIT Standards Committee shall update such recommendations and make new recommendations as appropriate, including in response to a notification sent under section 3004(b)(2). Such recommendations shall be consistent with the latest recommendations made by the HIT Policy Committee. CommentsClose CommentsPermalink





‘(B) PILOT TESTING OF STANDARDS AND IMPLEMENTATION SPECIFICATIONS- In the development, harmonization, or recognition of standards and implementation specifications, the HIT Standards Committee shall, as appropriate, provide for the testing of such standards and specifications by the National Institute for Standards and Technology under section 4201 of the HITECH Act. CommentsClose CommentsPermalink





‘(C) CONSISTENCY- The standards, implementation specifications, and certification criteria recommended under this subsection shall be consistent with the standards for information transactions and data elements adopted pursuant to section 1173 of the Social Security Act. CommentsClose CommentsPermalink





‘(2) FORUM- The HIT Standards Committee shall serve as a forum for the participation of a broad range of stakeholders to provide input on the development, harmonization, and recognition of standards, implementation specifications, and certification criteria necessary for the development and adoption of a nationwide health information technology infrastructure that allows for the electronic use and exchange of health information. CommentsClose CommentsPermalink





‘(3) SCHEDULE- Not later than 90 days after the date of the enactment of this title, the HIT Standards Committee shall develop a schedule for the assessment of policy recommendations developed by the HIT Policy Committee under section 3002. The HIT Standards Committee shall update such schedule annually. The Secretary shall publish such schedule in the Federal Register. CommentsClose CommentsPermalink





‘(4) PUBLIC INPUT- The HIT Standards Committee shall conduct open public meetings and develop a process to allow for public comment on the schedule described in paragraph (3) and recommendations described in this subsection. Under such process comments shall be submitted in a timely manner after the date of publication of a recommendation under this subsection. CommentsClose CommentsPermalink





‘(c) Membership and Operations- CommentsClose CommentsPermalink





‘(1) IN GENERAL- The National Coordinator shall provide leadership in the establishment and operations of the HIT Standards Committee. CommentsClose CommentsPermalink





‘(2) MEMBERSHIP- The membership of the HIT Standards Committee shall at least reflect providers, ancillary healthcare workers, consumers, purchasers, health plans, technology vendors, researchers, relevant Federal agencies, and individuals with technical expertise on health care quality, privacy and security, and on the electronic exchange and use of health information. CommentsClose CommentsPermalink





‘(3) CONSIDERATION- The National Coordinator shall ensure that the relevant recommendations and comments from the National Committee on Vital and Health Statistics are considered in the development of standards. CommentsClose CommentsPermalink





‘(4) ASSISTANCE- For the purposes of carrying out this section, the Secretary may provide or ensure that financial assistance is provided by the HIT Standards Committee to defray in whole or in part any membership fees or dues charged by such Committee to those consumer advocacy groups and not for profit entities that work in the public interest as a part of their mission. CommentsClose CommentsPermalink





‘(d) Application of FACA- The Federal Advisory Committee Act (5 U.S.C. App.), other than section 14, shall apply to the HIT Standards Committee. CommentsClose CommentsPermalink





‘(e) Publication- The Secretary shall provide for publication in the Federal Register and the posting on the Internet website of the Office of the National Coordinator for Health Information Technology of all recommendations made by the HIT Standards Committee under this section. CommentsClose CommentsPermalink

‘SEC. 3004. PROCESS FOR ADOPTION OF ENDORSED RECOMMENDATIONS; ADOPTION OF INITIAL SET OF STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA.

‘(a) Process for Adoption of Endorsed Recommendations- CommentsClose CommentsPermalink





‘(1) REVIEW OF ENDORSED STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA- Not later than 90 days after the date of receipt of standards, implementation specifications, or certification criteria endorsed under section 3001(c), the Secretary, in consultation with representatives of other relevant Federal agencies, shall jointly review such standards, implementation specifications, or certification criteria and shall determine whether or not to propose adoption of such standards, implementation specifications, or certification criteria. CommentsClose CommentsPermalink





‘(2) DETERMINATION TO ADOPT STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA- If the Secretary determines-- CommentsClose CommentsPermalink





‘(A) to propose adoption of any grouping of such standards, implementation specifications, or certification criteria, the Secretary shall, by regulation, determine whether or not to adopt such grouping of standards, implementation specifications, or certification criteria; or CommentsClose CommentsPermalink





‘(B) not to propose adoption of any grouping of standards, implementation specifications, or certification criteria, the Secretary shall notify the National Coordinator and the HIT Standards Committee in writing of such determination and the reasons for not proposing the adoption of such recommendation. CommentsClose CommentsPermalink





‘(3) PUBLICATION- The Secretary shall provide for publication in the Federal Register of all determinations made by the Secretary under paragraph (1). CommentsClose CommentsPermalink





‘(b) Adoption of Initial Set of Standards, Implementation Specifications, and Certification Criteria- CommentsClose CommentsPermalink





‘(1) IN GENERAL- Not later than December 31, 2009, the Secretary shall, through the rulemaking process described in section 3003, adopt an initial set of standards, implementation specifications, and certification criteria for the areas required for consideration under section 3002(b)(2)(B). CommentsClose CommentsPermalink





‘(2) APPLICATION OF CURRENT STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA- The standards, implementation specifications, and certification criteria adopted before the date of the enactment of this title through the process existing through the Office of the National Coordinator for Health Information Technology may be applied towards meeting the requirement of paragraph (1). CommentsClose CommentsPermalink

‘SEC. 3005. APPLICATION AND USE OF ADOPTED STANDARDS AND IMPLEMENTATION SPECIFICATIONS BY FEDERAL AGENCIES.

‘For requirements relating to the application and use by Federal agencies of the standards and implementation specifications adopted under section 3004, see section 4111 of the HITECH Act. CommentsClose CommentsPermalink

‘SEC. 3006. VOLUNTARY APPLICATION AND USE OF ADOPTED STANDARDS AND IMPLEMENTATION SPECIFICATIONS BY PRIVATE ENTITIES.

‘(a) In General- Except as provided under section 4112 of the HITECH Act, any standard or implementation specification adopted under section 3004 shall be voluntary with respect to private entities. CommentsClose CommentsPermalink





‘(b) Rule of Construction- Nothing in this subtitle shall be construed to require that a private entity that enters into a contract with the Federal Government apply or use the standards and implementation specifications adopted under section 3004 with respect to activities not related to the contract. CommentsClose CommentsPermalink

‘SEC. 3007. FEDERAL HEALTH INFORMATION TECHNOLOGY.

‘(a) In General- The National Coordinator shall support the development, routine updating and provision of qualified EHR technology (as defined in section 3000) consistent with subsections (b) and (c) unless the Secretary determines that the needs and demands of providers are being substantially and adequately met through the marketplace. CommentsClose CommentsPermalink





‘(b) Certification- In making such EHR technology publicly available, the National Coordinator shall ensure that the qualified EHR technology described in subsection (a) is certified under the program developed under section 3001(c)(3) to be in compliance with applicable standards adopted under section 3003(a). CommentsClose CommentsPermalink





‘(c) Authorization to Charge a Nominal Fee- The National Coordinator may impose a nominal fee for the adoption by a health care provider of the health information technology system developed or approved under subsection (a) and (b). Such fee shall take into account the financial circumstances of smaller providers, low income providers, and providers located in rural or other medically underserved areas. CommentsClose CommentsPermalink





‘(d) Rule of Construction- Nothing in this section shall be construed to require that a private or government entity adopt or use the technology provided under this section. CommentsClose CommentsPermalink

‘SEC. 3008. TRANSITIONS.

‘(a) ONCHIT- To the extent consistent with section 3001, all functions, personnel, assets, liabilities, and administrative actions applicable to the National Coordinator for Health Information Technology appointed under Executive Order 13335 or the Office of such National Coordinator on the date before the date of the enactment of this title shall be transferred to the National Coordinator appointed under section 3001(a) and the Office of such National Coordinator as of the date of the enactment of this title. CommentsClose CommentsPermalink





‘(b) AHIC- CommentsClose CommentsPermalink





‘(1) To the extent consistent with sections 3002 and 3003, all functions, personnel, assets, and liabilities applicable to the AHIC Successor, Inc. doing business as the National eHealth Collaborative as of the day before the date of the enactment of this title shall be transferred to the HIT Policy Committee or the HIT Standards Committee, established under section 3002(a) or 3003(a), as appropriate, as of the date of the enactment of this title. CommentsClose CommentsPermalink





‘(2) In carrying out section 3003(b)(1)(A), until recommendations are made by the HIT Policy Committee, recommendations of the HIT Standards Committee shall be consistent with the most recent recommendations made by such AHIC Successor, Inc. CommentsClose CommentsPermalink





‘(c) Rules of Construction- CommentsClose CommentsPermalink





‘(1) ONCHIT- Nothing in section 3001 or subsection (a) shall be construed as requiring the creation of a new entity to the extent that the Office of the National Coordinator for Health Information Technology established pursuant to Executive Order 13335 is consistent with the provisions of section 3001. CommentsClose CommentsPermalink





‘(2) AHIC- Nothing in sections 3002 or 3003 or subsection (b) shall be construed as prohibiting the AHIC Successor, Inc. doing business as the National eHealth Collaborative from modifying its charter, duties, membership, and any other structure or function required to be consistent with section 3002 and 3003 in a manner that would permit the Secretary to choose to recognize such Community as the HIT Policy Committee or the HIT Standards Committee. CommentsClose CommentsPermalink

‘SEC. 3009. RELATION TO HIPAA PRIVACY AND SECURITY LAW.

‘(a) In General- With respect to the relation of this title to HIPAA privacy and security law: CommentsClose CommentsPermalink





‘(1) This title may not be construed as having any effect on the authorities of the Secretary under HIPAA privacy and security law. CommentsClose CommentsPermalink





‘(2) The purposes of this title include ensuring that the health information technology standards and implementation specifications adopted under section 3004 take into account the requirements of HIPAA privacy and security law. CommentsClose CommentsPermalink





‘(b) Definition- For purposes of this section, the term ‘HIPAA privacy and security law’ means-- CommentsClose CommentsPermalink





‘(1) the provisions of part C of title XI of the Social Security Act, section 264 of the Health Insurance Portability and Accountability Act of 1996, and subtitle D of title IV of the HITECH Act; and CommentsClose CommentsPermalink





‘(2) regulations under such provisions. CommentsClose CommentsPermalink

‘SEC. 3010. AUTHORIZATION FOR APPROPRIATIONS.

‘There is authorized to be appropriated to the Office of the National Coordinator for Health Information Technology to carry out this subtitle $250,000,000 for fiscal year 2009.’. CommentsClose CommentsPermalink

SEC. 4102. TECHNICAL AMENDMENT.

Section 1171(5) of the Social Security Act (42 U.S.C. 1320d) is amended by striking ‘or C’ and inserting ‘C, or D’. CommentsClose CommentsPermalink

PART II--APPLICATION AND USE OF ADOPTED HEALTH INFORMATION TECHNOLOGY STANDARDS; REPORTS

SEC. 4111. COORDINATION OF FEDERAL ACTIVITIES WITH ADOPTED STANDARDS AND IMPLEMENTATION SPECIFICATIONS.

(a) Spending on Health Information Technology Systems- As each agency (as defined in the Executive Order issued on August 22, 2006, relating to promoting quality and efficient health care in Federal Government administered or sponsored health care programs) implements, acquires, or upgrades health information technology systems used for the direct exchange of individually identifiable health information between agencies and with non-Federal entities, it shall utilize, where available, health information technology systems and products that meet standards and implementation specifications adopted under section 3004(b) of the Public Health Service Act, as added by section 4101. CommentsClose CommentsPermalink





(b) Federal Information Collection Activities- With respect to a standard or implementation specification adopted under section 3004(b) of the Public Health Service Act, as added by section 4101, the President shall take measures to ensure that Federal activities involving the broad collection and submission of health information are consistent with such standard or implementation specification, respectively, within three years after the date of such adoption. CommentsClose CommentsPermalink





(c) Application of Definitions- The definitions contained in section 3000 of the Public Health Service Act, as added by section 4101, shall apply for purposes of this part. CommentsClose CommentsPermalink

SEC. 4112. APPLICATION TO PRIVATE ENTITIES.

Each agency (as defined in such Executive Order issued on August 22, 2006, relating to promoting quality and efficient health care in Federal Government administered or sponsored health care programs) shall require in contracts or agreements with health care providers, health plans, or health insurance issuers that as each provider, plan, or issuer implements, acquires, or upgrades health information technology systems, it shall utilize, where available, health information technology systems and products that meet standards and implementation specifications adopted under section 3004(b) of the Public Health Service Act, as added by section 4101. CommentsClose CommentsPermalink

SEC. 4113. STUDY AND REPORTS.

(a) Report on Adoption of Nationwide System- Not later than 2 years after the date of the enactment of this Act and annually thereafter, the Secretary of Health and Human Services shall submit to the appropriate committees of jurisdiction of the House of Representatives and the Senate a report that-- CommentsClose CommentsPermalink





(1) describes the specific actions that have been taken by the Federal Government and private entities to facilitate the adoption of a nationwide system for the electronic use and exchange of health information; CommentsClose CommentsPermalink





(2) describes barriers to the adoption of such a nationwide system; and CommentsClose CommentsPermalink





(3) contains recommendations to achieve full implementation of such a nationwide system. CommentsClose CommentsPermalink





(b) Reimbursement Incentive Study and Report- CommentsClose CommentsPermalink





(1) STUDY- The Secretary of Health and Human Services shall carry out, or contract with a private entity to carry out, a study that examines methods to create efficient reimbursement incentives for improving health care quality in federally qualified health centers, rural health clinics, and free clinics. CommentsClose CommentsPermalink





(2) REPORT- Not later than 2 years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to the appropriate committees of jurisdiction of the House of Representatives and the Senate a report on the study carried out under paragraph (1). CommentsClose CommentsPermalink





(c) Aging Services Technology Study and Report- CommentsClose CommentsPermalink





(1) IN GENERAL- The Secretary of Health and Human Services shall carry out, or contract with a private entity to carry out, a study of matters relating to the potential use of new aging services technology to assist seniors, individuals with disabilities, and their caregivers throughout the aging process. CommentsClose CommentsPermalink





(2) MATTERS TO BE STUDIED- The study under paragraph (1) shall include-- CommentsClose CommentsPermalink





(A) an evaluation of-- CommentsClose CommentsPermalink





(i) methods for identifying current, emerging, and future health technology that can be used to meet the needs of seniors and individuals with disabilities and their caregivers across all aging services settings, as specified by the Secretary; CommentsClose CommentsPermalink





(ii) methods for fostering scientific innovation with respect to aging services technology within the business and academic communities; and CommentsClose CommentsPermalink





(iii) developments in aging services technology in other countries that may be applied in the United States; and CommentsClose CommentsPermalink





(B) identification of-- CommentsClose CommentsPermalink





(i) barriers to innovation in aging services technology and devising strategies for removing such barriers; and CommentsClose CommentsPermalink





(ii) barriers to the adoption of aging services technology by health care providers and consumers and devising strategies to removing such barriers. CommentsClose CommentsPermalink





(3) REPORT- Not later than 24 months after the date of the enactment of this Act, the Secretary shall submit to the appropriate committees of jurisdiction of the House of Representatives and of the Senate a report on the study carried out under paragraph (1). CommentsClose CommentsPermalink





(4) DEFINITIONS- For purposes of this subsection: CommentsClose CommentsPermalink





(A) AGING SERVICES TECHNOLOGY- The term ‘aging services technology’ means health technology that meets the health care needs of seniors, individuals with disabilities, and the caregivers of such seniors and individuals. CommentsClose CommentsPermalink





(B) SENIOR- The term ‘senior’ has such meaning as specified by the Secretary. CommentsClose CommentsPermalink

Subtitle B--Testing of Health Information Technology CommentsClose CommentsPermalink

SEC. 4201. NATIONAL INSTITUTE FOR STANDARDS AND TECHNOLOGY TESTING.

(a) Pilot Testing of Standards and Implementation Specifications- In coordination with the HIT Standards Committee established under section 3003 of the Public Health Service Act, as added by section 4101, with respect to the development of standards and implementation specifications under such section, the Director of the National Institute for Standards and Technology shall test such standards and implementation specifications, as appropriate, in order to assure the efficient implementation and use of such standards and implementation specifications. CommentsClose CommentsPermalink





(b) Voluntary Testing Program- In coordination with the HIT Standards Committee established under section 3003 of the Public Health Service Act, as added by section 4101, with respect to the development of standards and implementation specifications under such section, the Director of the National Institute of Standards and Technology shall support the establishment of a conformance testing infrastructure, including the development of technical test beds. The development of this conformance testing infrastructure may include a program to accredit independent, non-Federal laboratories to perform testing. CommentsClose CommentsPermalink

SEC. 4202. RESEARCH AND DEVELOPMENT PROGRAMS.

(a) Health Care Information Enterprise Integration Research Centers- CommentsClose CommentsPermalink





(1) IN GENERAL- The Director of the National Institute of Standards and Technology, in consultation with the Director of the National Science Foundation and other appropriate Federal agencies, shall establish a program of assistance to institutions of higher education (or consortia thereof which may include nonprofit entities and Federal Government laboratories) to establish multidisciplinary Centers for Health Care Information Enterprise Integration. CommentsClose CommentsPermalink





(2) REVIEW; COMPETITION- Grants shall be awarded under this subsection on a merit-reviewed, competitive basis. CommentsClose CommentsPermalink





(3) PURPOSE- The purposes of the Centers described in paragraph (1) shall be-- CommentsClose CommentsPermalink





(A) to generate innovative approaches to health care information enterprise integration by conducting cutting-edge, multidisciplinary research on the systems challenges to health care delivery; and CommentsClose CommentsPermalink





(B) the development and use of health information technologies and other complementary fields. CommentsClose CommentsPermalink





(4) RESEARCH AREAS- Research areas may include-- CommentsClose CommentsPermalink





(A) interfaces between human information and communications technology systems; CommentsClose CommentsPermalink





(B) voice-recognition systems; CommentsClose CommentsPermalink





(C) software that improves interoperability and connectivity among health information systems; CommentsClose CommentsPermalink





(D) software dependability in systems critical to health care delivery; CommentsClose CommentsPermalink





(E) measurement of the impact of information technologies on the quality and productivity of health care; CommentsClose CommentsPermalink





(F) health information enterprise management; CommentsClose CommentsPermalink





(G) health information technology security and integrity; and CommentsClose CommentsPermalink





(H) relevant health information technology to reduce medical errors. CommentsClose CommentsPermalink





(5) APPLICATIONS- An institution of higher education (or a consortium thereof) seeking funding under this subsection shall submit an application to the Director of the National Institute of Standards and Technology at such time, in such manner, and containing such information as the Director may require. The application shall include, at a minimum, a description of-- CommentsClose CommentsPermalink





(A) the research projects that will be undertaken by the Center established pursuant to assistance under paragraph (1) and the respective contributions of the participating entities; CommentsClose CommentsPermalink





(B) how the Center will promote active collaboration among scientists and engineers from different disciplines, such as information technology, biologic sciences, management, social sciences, and other appropriate disciplines; CommentsClose CommentsPermalink





(C) technology transfer activities to demonstrate and diffuse the research results, technologies, and knowledge; and CommentsClose CommentsPermalink





(D) how the Center will contribute to the education and training of researchers and other professionals in fields relevant to health information enterprise integration. CommentsClose CommentsPermalink





(b) National Information Technology Research and Development Program- The National High-Performance Computing Program established by section 101 of the High-Performance Computing Act of 1991 (15 U.S.C. 5511) shall coordinate Federal research and development programs related to the development and deployment of health information technology, including activities related to-- CommentsClose CommentsPermalink





(1) computer infrastructure; CommentsClose CommentsPermalink





(2) data security; CommentsClose CommentsPermalink





(3) development of large-scale, distributed, reliable computing systems; CommentsClose CommentsPermalink





(4) wired, wireless, and hybrid high-speed networking; CommentsClose CommentsPermalink





(5) development of software and software-intensive systems; CommentsClose CommentsPermalink





(6) human-computer interaction and information management technologies; and CommentsClose CommentsPermalink





(7) the social and economic implications of information technology. CommentsClose CommentsPermalink

Subtitle C--Incentives for the Use of Health Information Technology CommentsClose CommentsPermalink

PART I--GRANTS AND LOANS FUNDING

SEC. 4301. GRANT, LOAN, AND DEMONSTRATION PROGRAMS.

Title XXX of the Public Health Service Act, as added by section 4101, is amended by adding at the end the following new subtitle: CommentsClose CommentsPermalink

‘Subtitle B--Incentives for the Use of Health Information Technology CommentsClose CommentsPermalink

‘SEC. 3011. IMMEDIATE FUNDING TO STRENGTHEN THE HEALTH INFORMATION TECHNOLOGY INFRASTRUCTURE.

‘(a) In General- The Secretary of Health and Human Services shall, using amounts appropriated under section 3018, invest in the infrastructure necessary to allow for and promote the electronic exchange and use of health information for each individual in the United States consistent with the goals outlined in the strategic plan developed by the National Coordinator (and as available) under section 3001. To the greatest extent practicable, the Secretary shall ensure that any funds so appropriated shall be used for the acquisition of health information technology that meets standards and certification criteria adopted before the date of the enactment of this title until such date as the standards are adopted under section 3004. The Secretary shall invest funds through the different agencies with expertise in such goals, such as the Office of the National Coordinator for Health Information Technology, the Health Resources and Services Administration, the Agency for Healthcare Research and Quality, the Centers of Medicare & Medicaid Services, the Centers for Disease Control and Prevention, and the Indian Health Service to support the following: CommentsClose CommentsPermalink





‘(1) Health information technology architecture that will support the nationwide electronic exchange and use of health information in a secure, private, and accurate manner, including connecting health information exchanges, and which may include updating and implementing the infrastructure necessary within different agencies of the Department of Health and Human Services to support the electronic use and exchange of health information. CommentsClose CommentsPermalink





‘(2) Development and adoption of appropriate certified electronic health records for categories of providers not eligible for support under title XVIII or XIX of the Social Security Act for the adoption of such records. CommentsClose CommentsPermalink





‘(3) Training on and dissemination of information on best practices to integrate health information technology, including electronic health records, into a provider’s delivery of care, consistent with best practices learned from the Health Information Technology Research Center developed under section 302, including community health centers receiving assistance under section 330 of the Public Health Service Act, covered entities under section 340B of such Act, and providers participating in one or more of the programs under titles XVIII, XIX, and XXI of the Social Security Act (relating to Medicare, Medicaid, and the State Children’s Health Insurance Program). CommentsClose CommentsPermalink





‘(4) Infrastructure and tools for the promotion of telemedicine, including coordination among Federal agencies in the promotion of telemedicine. CommentsClose CommentsPermalink





‘(5) Promotion of the interoperability of clinical data repositories or registries. CommentsClose CommentsPermalink





‘(6) Promotion of technologies and best practices that enhance the protection of health information by all holders of individually identifiable health information. CommentsClose CommentsPermalink





‘(7) Improve and expand the use of health information technology by public health departments. CommentsClose CommentsPermalink





‘(8) Provide $300 million to support regional or sub-national efforts towards health information exchange. CommentsClose CommentsPermalink





‘(b) Coordination- The Secretary shall ensure funds under this section are used in a coordinated manner with other health information promotion activities. CommentsClose CommentsPermalink





‘(c) Additional Use of Funds- In addition to using funds as provided in subsection (a), the Secretary may use amounts appropriated under section 3018 to carry out activities that are provided for under laws in effect on the date of the enactment of this title. CommentsClose CommentsPermalink

‘SEC. 3012. HEALTH INFORMATION TECHNOLOGY IMPLEMENTATION ASSISTANCE.

‘(a) Health Information Technology Extension Program- To assist health care providers to adopt, implement, and effectively use certified EHR technology that allows for the electronic exchange and use of health information, the Secretary, acting through the Office of the National Coordinator, shall establish a health information technology extension program to provide health information technology assistance services to be carried out through the Department of Health and Human Services. The National Coordinator shall consult with other Federal agencies with demonstrated experience and expertise in information technology services, such as the National Institute of Standards and Technology, in developing and implementing this program. CommentsClose CommentsPermalink





‘(b) Health Information Technology Research Center- CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Secretary shall create a Health Information Technology Research Center (in this section referred to as the ‘Center’) to provide technical assistance and develop or recognize best practices to support and accelerate efforts to adopt, implement, and effectively utilize health information technology that allows for the electronic exchange and use of information in compliance with standards, implementation specifications, and certification criteria adopted under section 3004(b). CommentsClose CommentsPermalink





‘(2) INPUT- The Center shall incorporate input from-- CommentsClose CommentsPermalink





‘(A) other Federal agencies with demonstrated experience and expertise in information technology services such as the National Institute of Standards and Technology; CommentsClose CommentsPermalink





‘(B) users of health information technology, such as providers and their support and clerical staff and others involved in the care and care coordination of patients, from the health care and health information technology industry; and CommentsClose CommentsPermalink





‘(C) others as appropriate. CommentsClose CommentsPermalink





‘(3) PURPOSES- The purposes of the Center are to-- CommentsClose CommentsPermalink





‘(A) provide a forum for the exchange of knowledge and experience; CommentsClose CommentsPermalink





‘(B) accelerate the transfer of lessons learned from existing public and private sector initiatives, including those currently receiving Federal financial support; CommentsClose CommentsPermalink





‘(C) assemble, analyze, and widely disseminate evidence and experience related to the adoption, implementation, and effective use of health information technology that allows for the electronic exchange and use of information including through the regional centers described in subsection (c); CommentsClose CommentsPermalink





‘(D) provide technical assistance for the establishment and evaluation of regional and local health information networks to facilitate the electronic exchange of information across health care settings and improve the quality of health care; CommentsClose CommentsPermalink





‘(E) provide technical assistance for the development and dissemination of solutions to barriers to the exchange of electronic health information; and CommentsClose CommentsPermalink





‘(F) learn about effective strategies to adopt and utilize health information technology in medically underserved communities. CommentsClose CommentsPermalink





‘(c) Health Information Technology Regional Extension Centers- CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Secretary shall provide assistance for the creation and support of regional centers (in this subsection referred to as ‘regional centers’) to provide technical assistance and disseminate best practices and other information learned from the Center to support and accelerate efforts to adopt, implement, and effectively utilize health information technology that allows for the electronic exchange and use of information in compliance with standards, implementation specifications, and certification criteria adopted under section 3004. Activities conducted under this subsection shall be consistent with the strategic plan developed by the National Coordinator, (and, as available) under section 3001. CommentsClose CommentsPermalink





‘(2) AFFILIATION- Regional centers shall be affiliated with any U.S.-based nonprofit institution or organization, or group thereof, that applies and is awarded financial assistance under this section. Individual awards shall be decided on the basis of merit. CommentsClose CommentsPermalink





‘(3) OBJECTIVE- The objective of the regional centers is to enhance and promote the adoption of health information technology through-- CommentsClose CommentsPermalink





‘(A) assistance with the implementation, effective use, upgrading, and ongoing maintenance of health information technology, including electronic health records, to healthcare providers nationwide; CommentsClose CommentsPermalink





‘(B) broad participation of individuals from industry, universities, and State governments; CommentsClose CommentsPermalink





‘(C) active dissemination of best practices and research on the implementation, effective use, upgrading, and ongoing maintenance of health information technology, including electronic health records, to health care providers in order to improve the quality of healthcare and protect the privacy and security of health information; CommentsClose CommentsPermalink





‘(D) participation, to the extent practicable, in health information exchanges; and CommentsClose CommentsPermalink





‘(E) utilization, when appropriate, of the expertise and capability that exists in Federal agencies other than the Department; and CommentsClose CommentsPermalink





‘(F) integration of health information technology, including electronic health records, into the initial and ongoing training of health professionals and others in the healthcare industry that would be instrumental to improving the quality of healthcare through the smooth and accurate electronic use and exchange of health information. CommentsClose CommentsPermalink





‘(4) REGIONAL ASSISTANCE- Each regional center shall aim to provide assistance and education to all providers in a region, but shall prioritize any direct assistance first to the following: CommentsClose CommentsPermalink





‘(A) Public or not-for-profit hospitals or critical access hospitals. CommentsClose CommentsPermalink





‘(B) Federally qualified health centers (as defined in section 1861(aa)(4) of the Social Security Act). CommentsClose CommentsPermalink





‘(C) Entities that are located in rural and other areas that serve uninsured, underinsured, and medically underserved individuals (regardless of whether such area is urban or rural). CommentsClose CommentsPermalink





‘(D) Individual or small group practices (or a consortium thereof) that are primarily focused on primary care. CommentsClose CommentsPermalink





‘(5) FINANCIAL SUPPORT- The Secretary may provide financial support to any regional center created under this subsection for a period not to exceed four years. The Secretary may not provide more than 50 percent of the capital and annual operating and maintenance funds required to create and maintain such a center, except in an instance of national economic conditions which would render this cost-share requirement detrimental to the program and upon notification to Congress as to the justification to waive the cost-share requirement. CommentsClose CommentsPermalink





‘(6) NOTICE OF PROGRAM DESCRIPTION AND AVAILABILITY OF FUNDS- The Secretary shall publish in the Federal Register, not later than 90 days after the date of the enactment of this Act, a draft description of the program for establishing regional centers under this subsection. Such description shall include the following: CommentsClose CommentsPermalink





‘(A) A detailed explanation of the program and the programs goals. CommentsClose CommentsPermalink





‘(B) Procedures to be followed by the applicants. CommentsClose CommentsPermalink





‘(C) Criteria for determining qualified applicants. CommentsClose CommentsPermalink





‘(D) Maximum support levels expected to be available to centers under the program. CommentsClose CommentsPermalink





‘(7) APPLICATION REVIEW- The Secretary shall subject each application under this subsection to merit review. In making a decision whether to approve such application and provide financial support, the Secretary shall consider at a minimum the merits of the application, including those portions of the application regarding-- CommentsClose CommentsPermalink





‘(A) the ability of the applicant to provide assistance under this subsection and utilization of health information technology appropriate to the needs of particular categories of health care providers; CommentsClose CommentsPermalink





‘(B) the types of service to be provided to health care providers; CommentsClose CommentsPermalink





‘(C) geographical diversity and extent of service area; and CommentsClose CommentsPermalink





‘(D) the percentage of funding and amount of in-kind commitment from other sources. CommentsClose CommentsPermalink





‘(8) BIENNIAL EVALUATION- Each regional center which receives financial assistance under this subsection shall be evaluated biennially by an evaluation panel appointed by the Secretary. Each evaluation panel shall be composed of private experts, none of whom shall be connected with the center involved, and of Federal officials. Each evaluation panel shall measure the involved center’s performance against the objective specified in paragraph (3). The Secretary shall not continue to provide funding to a regional center unless its evaluation is overall positive. CommentsClose CommentsPermalink





‘(9) CONTINUING SUPPORT- After the second year of assistance under this subsection a regional center may receive additional support under this subsection if it has received positive evaluations and a finding by the Secretary that continuation of Federal funding to the center was in the best interest of provision of health information technology extension services. CommentsClose CommentsPermalink

‘SEC. 3013. STATE GRANTS TO PROMOTE HEALTH INFORMATION TECHNOLOGY.

‘(a) In General- The Secretary, acting through the National Coordinator, shall establish a program in accordance with this section to facilitate and expand the electronic movement and use of health information among organizations according to nationally recognized standards. CommentsClose CommentsPermalink





‘(b) Planning Grants- The Secretary may award a grant to a State or qualified State-designated entity (as described in subsection (d)) that submits an application to the Secretary at such time, in such manner, and containing such information as the Secretary may specify, for the purpose of planning activities described in subsection (b). CommentsClose CommentsPermalink





‘(c) Implementation Grants- The Secretary may award a grant to a State or qualified State-designated entity that-- CommentsClose CommentsPermalink





‘(1) has submitted, and the Secretary has approved, a plan described in subsection (c) (regardless of whether such plan was prepared using amounts awarded under paragraph (1)); and CommentsClose CommentsPermalink





‘(2) submits an application at such time, in such manner, and containing such information as the Secretary may specify. CommentsClose CommentsPermalink





‘(d) Use of Funds- Amounts received under a grant under subsection (a)(3) shall be used to conduct activities to facilitate and expand the electronic movement and use of health information among organizations according to nationally recognized standards through activities that include-- CommentsClose CommentsPermalink





‘(1) enhancing broad and varied participation in the authorized and secure nationwide electronic use and exchange of health information; CommentsClose CommentsPermalink





‘(2) identifying State or local resources available towards a nationwide effort to promote health information technology; CommentsClose CommentsPermalink





‘(3) complementing other Federal grants, programs, and efforts towards the promotion of health information technology; CommentsClose CommentsPermalink





‘(4) providing technical assistance for the development and dissemination of solutions to barriers to the exchange of electronic health information; CommentsClose CommentsPermalink





‘(5) promoting effective strategies to adopt and utilize health information technology in medically underserved communities; CommentsClose CommentsPermalink





‘(6) assisting patients in utilizing health information technology; CommentsClose CommentsPermalink





‘(7) encouraging clinicians to work with Health Information Technology Regional Extension Centers as described in section 3012, to the extent they are available and valuable; CommentsClose CommentsPermalink





‘(8) supporting public health agencies’ authorized use of and access to electronic health information; CommentsClose CommentsPermalink





‘(9) promoting the use of electronic health records for quality improvement including through quality measures reporting; and CommentsClose CommentsPermalink





‘(10) such other activities as the Secretary may specify. CommentsClose CommentsPermalink





‘(e) Plan- CommentsClose CommentsPermalink





‘(1) IN GENERAL- A plan described in this subsection is a plan that describes the activities to be carried out by a State or by the qualified State-designated entity within such State to facilitate and expand the electronic movement and use of health information among organizations according to nationally recognized standards and implementation specifications. CommentsClose CommentsPermalink





‘(2) REQUIRED ELEMENTS- A plan described in paragraph (1) shall-- CommentsClose CommentsPermalink





‘(A) be pursued in the public interest; CommentsClose CommentsPermalink





‘(B) be consistent with the strategic plan developed by the National Coordinator, (and, as available) under section 3001; CommentsClose CommentsPermalink





‘(C) include a description of the ways the State or qualified State-designated entity will carry out the activities described in subsection (b); and CommentsClose CommentsPermalink





‘(D) contain such elements as the Secretary may require. CommentsClose CommentsPermalink





‘(f) Qualified State-Designated Entity- For purposes of this section, to be a qualified State-designated entity, with respect to a State, an entity shall-- CommentsClose CommentsPermalink





‘(1) be designated by the State as eligible to receive awards under this section; CommentsClose CommentsPermalink





‘(2) be a not-for-profit entity with broad stakeholder representation on its governing board; CommentsClose CommentsPermalink





‘(3) demonstrate that one of its principal goals is to use information technology to improve health care quality and efficiency through the authorized and secure electronic exchange and use of health information; CommentsClose CommentsPermalink





‘(4) adopt nondiscrimination and conflict of interest policies that demonstrate a commitment to open, fair, and nondiscriminatory participation by stakeholders; and CommentsClose CommentsPermalink





‘(5) conform to such other requirements as the Secretary may establish. CommentsClose CommentsPermalink





‘(g) Required Consultation- In carrying out activities described in subsections (a)(2) and (a)(3), a State or qualified State-designated entity shall consult with and consider the recommendations of-- CommentsClose CommentsPermalink





‘(1) health care providers (including providers that provide services to low income and underserved populations); CommentsClose CommentsPermalink





‘(2) health plans; CommentsClose CommentsPermalink





‘(3) patient or consumer organizations that represent the population to be served; CommentsClose CommentsPermalink





‘(4) health information technology vendors; CommentsClose CommentsPermalink





‘(5) health care purchasers and employers; CommentsClose CommentsPermalink





‘(6) public health agencies; CommentsClose CommentsPermalink





‘(7) health professions schools, universities and colleges; CommentsClose CommentsPermalink





‘(8) clinical researchers; CommentsClose CommentsPermalink





‘(9) other users of health information technology such as the support and clerical staff of providers and others involved in the care and care coordination of patients; and CommentsClose CommentsPermalink





‘(10) such other entities, as may be determined appropriate by the Secretary. CommentsClose CommentsPermalink





‘(h) Continuous Improvement- The Secretary shall annually evaluate the activities conducted under this section and shall, in awarding grants under this section, implement the lessons learned from such evaluation in a manner so that awards made subsequent to each such evaluation are made in a manner that, in the determination of the Secretary, will lead towards the greatest improvement in quality of care, decrease in costs, and the most effective authorized and secure electronic exchange of health information. CommentsClose CommentsPermalink





‘(i) Required Match- CommentsClose CommentsPermalink





‘(1) IN GENERAL- For a fiscal year (beginning with fiscal year 2011), the Secretary may not make a grant under subsection (a) to a State unless the State agrees to make available non-Federal contributions (which may include in-kind contributions) toward the costs of a grant awarded under subsection (a)(3) in an amount equal to-- CommentsClose CommentsPermalink





‘(A) for fiscal year 2011, not less than $1 for each $10 of Federal funds provided under the grant; CommentsClose CommentsPermalink





‘(B) for fiscal year 2012, not less than $1 for each $7 of Federal funds provided under the grant; and CommentsClose CommentsPermalink





‘(C) for fiscal year 2013 and each subsequent fiscal year, not less than $1 for each $3 of Federal funds provided under the grant. CommentsClose CommentsPermalink





‘(2) AUTHORITY TO REQUIRE STATE MATCH FOR FISCAL YEARS BEFORE FISCAL YEAR 2011- For any fiscal year during the grant program under this section before fiscal year 2011, the Secretary may determine the extent to which there shall be required a non-Federal contribution from a State receiving a grant under this section. CommentsClose CommentsPermalink

‘SEC. 3014. COMPETITIVE GRANTS TO STATES AND INDIAN TRIBES FOR THE DEVELOPMENT OF LOAN PROGRAMS TO FACILITATE THE WIDESPREAD ADOPTION OF CERTIFIED EHR TECHNOLOGY.

‘(a) In General- The National Coordinator may award competitive grants to eligible entities for the establishment of programs for loans to health care providers to conduct the activities described in subsection (e). CommentsClose CommentsPermalink





‘(b) Eligible Entity Defined- For purposes of this subsection, the term ‘eligible entity’ means a State or Indian tribe (as defined in the Indian Self-Determination and Education Assistance Act) that-- CommentsClose CommentsPermalink





‘(1) submits to the National Coordinator an application at such time, in such manner, and containing such information as the National Coordinator may require; CommentsClose CommentsPermalink





‘(2) submits to the National Coordinator a strategic plan in accordance with subsection (d) and provides to the National Coordinator assurances that the entity will update such plan annually in accordance with such subsection; CommentsClose CommentsPermalink





‘(3) provides assurances to the National Coordinator that the entity will establish a Loan Fund in accordance with subsection (c); CommentsClose CommentsPermalink





‘(4) provides assurances to the National Coordinator that the entity will not provide a loan from the Loan Fund to a health care provider unless the provider agrees to-- CommentsClose CommentsPermalink





‘(A) submit reports on quality measures adopted by the Federal Government (by not later than 90 days after the date on which such measures are adopted), to-- CommentsClose CommentsPermalink





‘(i) the Director of the Centers for Medicare & Medicaid Services (or his or her designee), in the case of an entity participating in the Medicare program under title XVIII of the Social Security Act or the Medicaid program under title XIX of such Act; or CommentsClose CommentsPermalink





‘(ii) the Secretary in the case of other entities; CommentsClose CommentsPermalink





‘(B) demonstrate to the satisfaction of the Secretary (through criteria established by the Secretary) that any certified EHR technology purchased, improved, or otherwise financially supported under a loan under this section is used to exchange health information in a manner that, in accordance with law and standards (as adopted under section 3005) applicable to the exchange of information, improves the quality of health care, such as promoting care coordination; and CommentsClose CommentsPermalink





‘(C) comply with such other requirements as the entity or the Secretary may require; CommentsClose CommentsPermalink





‘(D) include a plan on how health care providers involved intend to maintain and support the certified EHR technology over time; CommentsClose CommentsPermalink





‘(E) include a plan on how the health care providers involved intend to maintain and support the certified EHR technology that would be purchased with such loan, including the type of resources expected to be involved and any such other information as the State or Indian tribe, respectively, may require; and CommentsClose CommentsPermalink





‘(5) agrees to provide matching funds in accordance with subsection (i). CommentsClose CommentsPermalink





‘(c) Establishment of Fund- For purposes of subsection (b)(3), an eligible entity shall establish a certified EHR technology loan fund (referred to in this subsection as a ‘Loan Fund’) and comply with the other requirements contained in this section. A grant to an eligible entity under this section shall be deposited in the Loan Fund established by the eligible entity. No funds authorized by other provisions of this title to be used for other purposes specified in this title shall be deposited in any Loan Fund. CommentsClose CommentsPermalink





‘(d) Strategic Plan- CommentsClose CommentsPermalink





‘(1) IN GENERAL- For purposes of subsection (b)(2), a strategic plan of an eligible entity under this subsection shall identify the intended uses of amounts available to the Loan Fund of such entity. CommentsClose CommentsPermalink





‘(2) CONTENTS- A strategic plan under paragraph (1), with respect to a Loan Fund of an eligible entity, shall include for a year the following: CommentsClose CommentsPermalink





‘(A) A list of the projects to be assisted through the Loan Fund during such year. CommentsClose CommentsPermalink





‘(B) A description of the criteria and methods established for the distribution of funds from the Loan Fund during the year. CommentsClose CommentsPermalink





‘(C) A description of the financial status of the Loan Fund as of the date of submission of the plan. CommentsClose CommentsPermalink





‘(D) The short-term and long-term goals of the Loan Fund. CommentsClose CommentsPermalink





‘(e) Use of Funds- Amounts deposited in a Loan Fund, including loan repayments and interest earned on such amounts, shall be used only for awarding loans or loan guarantees, making reimbursements described in subsection (g)(4)(A), or as a source of reserve and security for leveraged loans, the proceeds of which are deposited in the Loan Fund established under subsection (a). Loans under this section may be used by a health care provider to-- CommentsClose CommentsPermalink





‘(1) facilitate the purchase of certified EHR technology; CommentsClose CommentsPermalink





‘(2) enhance the utilization of certified EHR technology; CommentsClose CommentsPermalink





‘(3) train personnel in the use of such technology; or CommentsClose CommentsPermalink





‘(4) improve the secure electronic exchange of health information. CommentsClose CommentsPermalink





‘(f) Types of Assistance- Except as otherwise limited by applicable State law, amounts deposited into a Loan Fund under this subsection may only be used for the following: CommentsClose CommentsPermalink





‘(1) To award loans that comply with the following: CommentsClose CommentsPermalink





‘(A) The interest rate for each loan shall not exceed the market interest rate. CommentsClose CommentsPermalink





‘(B) The principal and interest payments on each loan shall commence not later than 1 year after the date the loan was awarded, and each loan shall be fully amortized not later than 10 years after the date of the loan. CommentsClose CommentsPermalink





‘(C) The Loan Fund shall be credited with all payments of principal and interest on each loan awarded from the Loan Fund. CommentsClose CommentsPermalink





‘(2) To guarantee, or purchase insurance for, a local obligation (all of the proceeds of which finance a project eligible for assistance under this subsection) if the guarantee or purchase would improve credit market access or reduce the interest rate applicable to the obligation involved. CommentsClose CommentsPermalink





‘(3) As a source of revenue or security for the payment of principal and interest on revenue or general obligation bonds issued by the eligible entity if the proceeds of the sale of the bonds will be deposited into the Loan Fund. CommentsClose CommentsPermalink





‘(4) To earn interest on the amounts deposited into the Loan Fund. CommentsClose CommentsPermalink





‘(5) To make reimbursements described in subsection (g)(4)(A). CommentsClose CommentsPermalink





‘(g) Administration of Loan Funds- CommentsClose CommentsPermalink





‘(1) COMBINED FINANCIAL ADMINISTRATION- An eligible entity may (as a convenience and to avoid unnecessary administrative costs) combine, in accordance with applicable State law, the financial administration of a Loan Fund established under this subsection with the financial administration of any other revolving fund established by the entity if otherwise not prohibited by the law under which the Loan Fund was established. CommentsClose CommentsPermalink





‘(2) COST OF ADMINISTERING FUND- Each eligible entity may annually use not to exceed 4 percent of the funds provided to the entity under a grant under this subsection to pay the reasonable costs of the administration of the programs under this section, including the recovery of reasonable costs expended to establish a Loan Fund which are incurred after the date of the enactment of this title. CommentsClose CommentsPermalink





‘(3) GUIDANCE AND REGULATIONS- The National Coordinator shall publish guidance and promulgate regulations as may be necessary to carry out the provisions of this section, including-- CommentsClose CommentsPermalink





‘(A) provisions to ensure that each eligible entity commits and expends funds allotted to the entity under this subsection as efficiently as possible in accordance with this title and applicable State laws; and CommentsClose CommentsPermalink





‘(B) guidance to prevent waste, fraud, and abuse. CommentsClose CommentsPermalink





‘(4) PRIVATE SECTOR CONTRIBUTIONS- CommentsClose CommentsPermalink





‘(A) IN GENERAL- A Loan Fund established under this subsection may accept contributions from private sector entities, except that such entities may not specify the recipient or recipients of any loan issued under this subsection. An eligible entity may agree to reimburse a private sector entity for any contribution made under this subparagraph, except that the amount of such reimbursement may not be greater than the principal amount of the contribution made. CommentsClose CommentsPermalink





‘(B) AVAILABILITY OF INFORMATION- An eligible entity shall make publicly available the identity of, and amount contributed by, any private sector entity under subparagraph (A) and may issue letters of commendation or make other awards (that have no financial value) to any such entity. CommentsClose CommentsPermalink





‘(h) Matching Requirements- CommentsClose CommentsPermalink





‘(1) IN GENERAL- The National Coordinator may not make a grant under subsection (a) to an eligible entity unless the entity agrees to make available (directly or through donations from public or private entities) non-Federal contributions in cash to the costs of carrying out the activities for which the grant is awarded in an amount equal to not less than $1 for each $5 of Federal funds provided under the grant. CommentsClose CommentsPermalink





‘(2) DETERMINATION OF AMOUNT OF NON-FEDERAL CONTRIBUTION- In determining the amount of non-Federal contributions that an eligible entity has provided pursuant to subparagraph (A), the National Coordinator may not include any amounts provided to the entity by the Federal Government. CommentsClose CommentsPermalink





‘(i) Effective Date- The Secretary may not make an award under this section prior to January 1, 2010. CommentsClose CommentsPermalink

‘SEC. 3015. DEMONSTRATION PROGRAM TO INTEGRATE INFORMATION TECHNOLOGY INTO CLINICAL EDUCATION.

‘(a) In General- The Secretary may award grants under this section to carry out demonstration projects to develop academic curricula integrating certified EHR technology in the clinical education of health professionals. Such awards shall be made on a competitive basis and pursuant to peer review. CommentsClose CommentsPermalink





‘(b) Eligibility- To be eligible to receive a grant under subsection (a), an entity shall-- CommentsClose CommentsPermalink





‘(1) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require; CommentsClose CommentsPermalink





‘(2) submit to the Secretary a strategic plan for integrating certified EHR technology in the clinical education of health professionals to reduce medical errors and enhance health care quality; CommentsClose CommentsPermalink





‘(3) be-- CommentsClose CommentsPermalink





‘(A) a school of medicine, osteopathic medicine, dentistry, or pharmacy, a graduate program in behavioral or mental health, or any other graduate health professions school; CommentsClose CommentsPermalink





‘(B) a graduate school of nursing or physician assistant studies; CommentsClose CommentsPermalink





‘(C) a consortium of two or more schools described in subparagraph (A) or (B); or CommentsClose CommentsPermalink





‘(D) an institution with a graduate medical education program in medicine, osteopathic medicine, dentistry, pharmacy, nursing, or physician assistance studies. CommentsClose CommentsPermalink





‘(4) provide for the collection of data regarding the effectiveness of the demonstration project to be funded under the grant in improving the safety of patients, the efficiency of health care delivery, and in increasing the likelihood that graduates of the grantee will adopt and incorporate certified EHR technology, in the delivery of health care services; and CommentsClose CommentsPermalink





‘(5) provide matching funds in accordance with subsection (d). CommentsClose CommentsPermalink





‘(c) Use of Funds- CommentsClose CommentsPermalink





‘(1) IN GENERAL- With respect to a grant under subsection (a), an eligible entity shall-- CommentsClose CommentsPermalink





‘(A) use grant funds in collaboration with 2 or more disciplines; and CommentsClose CommentsPermalink





‘(B) use grant funds to integrate certified EHR technology into community-based clinical education. CommentsClose CommentsPermalink





‘(2) LIMITATION- An eligible entity shall not use amounts received under a grant under subsection (a) to purchase hardware, software, or services. CommentsClose CommentsPermalink





‘(d) Financial Support- The Secretary may not provide more than 50 percent of the costs of any activity for which assistance is provided under subsection (a), except in an instance of national economic conditions which would render the cost-share requirement under this subsection detrimental to the program and upon notification to Congress as to the justification to waive the cost-share requirement. CommentsClose CommentsPermalink





‘(e) Evaluation- The Secretary shall take such action as may be necessary to evaluate the projects funded under this section and publish, make available, and disseminate the results of such evaluations on as wide a basis as is practicable. CommentsClose CommentsPermalink





‘(f) Reports- Not later than 1 year after the date of enactment of this title, and annually thereafter, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate, and the Committee on Energy and Commerce of the House of Representatives a report that-- CommentsClose CommentsPermalink





‘(1) describes the specific projects established under this section; and CommentsClose CommentsPermalink





‘(2) contains recommendations for Congress based on the evaluation conducted under subsection (e). CommentsClose CommentsPermalink

‘SEC. 3016. INFORMATION TECHNOLOGY PROFESSIONALS ON HEALTH CARE.

‘(a) In General- The Secretary, in consultation with the Director of the National Science Foundation, shall provide assistance to institutions of higher education (or consortia thereof) to establish or expand medical health informatics education programs, including certification, undergraduate, and masters degree programs, for both health care and information technology students to ensure the rapid and effective utilization and development of health information technologies (in the United States health care infrastructure). CommentsClose CommentsPermalink





‘(b) Activities- Activities for which assistance may be provided under subsection (a) may include the following: CommentsClose CommentsPermalink





‘(1) Developing and revising curricula in medical health informatics and related disciplines. CommentsClose CommentsPermalink





‘(2) Recruiting and retaining students to the program involved. CommentsClose CommentsPermalink





‘(3) Acquiring equipment necessary for student instruction in these programs, including the installation of testbed networks for student use. CommentsClose CommentsPermalink





‘(4) Establishing or enhancing bridge programs in the health informatics fields between community colleges and universities. CommentsClose CommentsPermalink





‘(c) Priority- In providing assistance under subsection (a), the Secretary shall give preference to the following: CommentsClose CommentsPermalink





‘(1) Existing education and training programs. CommentsClose CommentsPermalink





‘(2) Programs designed to be completed in less than six months. CommentsClose CommentsPermalink





‘(d) Financial Support- The Secretary may not provide more than 50 percent of the costs of any activity for which assistance is provided under subsection (a), except in an instance of national economic conditions which would render the cost-share requirement under this subsection detrimental to the program and upon notification to Congress as to the justification to waive the cost-share requirement. CommentsClose CommentsPermalink

‘SEC. 3017. GENERAL GRANT AND LOAN PROVISIONS.

‘(a) Reports- The Secretary may require that an entity receiving assistance under this title shall submit to the Secretary, not later than the date that is 1 year after the date of receipt of such assistance, a report that includes-- CommentsClose CommentsPermalink





‘(1) an analysis of the effectiveness of the activities for which the entity receives such assistance, as compared to the goals for such activities; and CommentsClose CommentsPermalink





‘(2) an analysis of the impact of the project on health care quality and safety. CommentsClose CommentsPermalink





‘(b) Requirement To Improve Quality of Care and Decrease in Costs- The National Coordinator shall annually evaluate the activities conducted under this title and shall, in awarding grants, implement the lessons learned from such evaluation in a manner so that awards made subsequent to each such evaluation are made in a manner that, in the determination of the National Coordinator, will result in the greatest improvement in the quality and efficiency of health care. CommentsClose CommentsPermalink

‘SEC. 3018. AUTHORIZATION FOR APPROPRIATIONS.

‘For the purposes of carrying out this subtitle, there is authorized to be appropriated such sums as may be necessary for each of the fiscal years 2009 through 2013. Amounts so appropriated shall remain available until expended.’. CommentsClose CommentsPermalink

PART II--MEDICARE PROGRAM

SEC. 4311. INCENTIVES FOR ELIGIBLE PROFESSIONALS.

(a) Incentive Payments- Section 1848 of the Social Security Act (42 U.S.C. 1395w-4) is amended by adding at the end the following new subsection: CommentsClose CommentsPermalink





‘(o) Incentives for Adoption and Meaningful Use of Certified EHR Technology- CommentsClose CommentsPermalink





‘(1) INCENTIVE PAYMENTS- CommentsClose CommentsPermalink





‘(A) IN GENERAL- Subject to the succeeding subparagraphs of this paragraph, with respect to covered professional services furnished by an eligible professional during a payment year (as defined in subparagraph (E)), if the eligible professional is a meaningful EHR user (as determined under paragraph (2)) for the reporting period with respect to such year, in addition to the amount otherwise paid under this part, there also shall be paid to the eligible professional (or to an employer or facility in the cases described in clause (A) of section 1842(b)(6)), from the Federal Supplementary Medical Insurance Trust Fund established under section 1841 an amount equal to 75 percent of the Secretary’s estimate (based on claims submitted not later than 2 months after the end of the payment year) of the allowed charges under this part for all such covered professional services furnished by the eligible professional during such year. CommentsClose CommentsPermalink





‘(B) LIMITATIONS ON AMOUNTS OF INCENTIVE PAYMENTS- CommentsClose CommentsPermalink





‘(i) IN GENERAL- In no case shall the amount of the incentive payment provided under this paragraph for an eligible professional for a payment year exceed the applicable amount specified under this subparagraph with respect to such eligible professional and such year. CommentsClose CommentsPermalink





‘(ii) AMOUNT- Subject to clause (iii), the applicable amount specified in this subparagraph for an eligible professional is as follows: CommentsClose CommentsPermalink





‘(I) For the first payment year for such professional, $15,000. CommentsClose CommentsPermalink





‘(II) For the second payment year for such professional, $12,000. CommentsClose CommentsPermalink





‘(III) For the third payment year for such professional, $8,000. CommentsClose CommentsPermalink





‘(IV) For the fourth payment year for such professional, $4,000. CommentsClose CommentsPermalink





‘(V) For the fifth payment year for such professional, $2,000. CommentsClose CommentsPermalink





‘(VI) For any succeeding payment year for such professional, $0. CommentsClose CommentsPermalink





‘(iii) PHASE DOWN FOR ELIGIBLE PROFESSIONALS FIRST ADOPTING EHR AFTER 2013- If the first payment year for an eligible professional is after 2013, then the amount specified in this subparagraph for a payment year for such professional is the same as the amount specified in clause (ii) for such payment year for an eligible professional whose first payment year is 2013. If the first payment year for an eligible professional is after 2015 then the applicable amount specified in this subparagraph for such professional for such year and any subsequent year shall be $0. CommentsClose CommentsPermalink





‘(C) NON-APPLICATION TO HOSPITAL-BASED ELIGIBLE PROFESSIONALS- CommentsClose CommentsPermalink





‘(i) IN GENERAL- No incentive payment may be made under this paragraph in the case of a hospital-based eligible professional. CommentsClose CommentsPermalink





‘(ii) HOSPITAL-BASED ELIGIBLE PROFESSIONAL- For purposes of clause (i), the term ‘hospital-based eligible professional’ means, with respect to covered professional services furnished by an eligible professional during the reporting period for a payment year, an eligible professional, such as a pathologist, anesthesiologist, or emergency physician, who furnishes substantially all of such services in a hospital setting (whether inpatient or outpatient) and through the use of the facilities and equipment, including computer equipment, of the hospital. CommentsClose CommentsPermalink





‘(D) PAYMENT- CommentsClose CommentsPermalink





‘(i) FORM OF PAYMENT- The payment under this paragraph may be in the form of a single consolidated payment or in the form of such periodic installments as the Secretary may specify. CommentsClose CommentsPermalink





‘(ii) COORDINATION OF APPLICATION OF LIMITATION FOR PROFESSIONALS IN DIFFERENT PRACTICES- In the case of an eligible professional furnishing covered professional services in more than one practice (as specified by the Secretary), the Secretary shall establish rules to coordinate the incentive payments, including the application of the limitation on amounts of such incentive payments under this paragraph, among such practices. CommentsClose CommentsPermalink





‘(iii) COORDINATION WITH MEDICAID- The Secretary shall seek, to the maximum extent practicable, to avoid duplicative requirements from Federal and State Governments to demonstrate meaningful use of certified EHR technology under this title and title XIX. In doing so, the Secretary may deem satisfaction of State requirements for such meaningful use for a payment year under title XIX to be sufficient to qualify as meaningful use under this subsection and subsection (a)(7) and vice versa. The Secretary may also adjust the reporting periods under such title and such subsections in order to carry out this clause. CommentsClose CommentsPermalink





‘(E) PAYMENT YEAR DEFINED- CommentsClose CommentsPermalink





‘(i) IN GENERAL- For purposes of this subsection, the term ‘payment year’ means a year beginning with 2011. CommentsClose CommentsPermalink





‘(ii) FIRST, SECOND, ETC. PAYMENT YEAR- The term ‘first payment year’ means, with respect to covered professional services furnished by an eligible professional, the first year for which an incentive payment is made for such services under this subsection. The terms ‘second payment year’, ‘third payment year’, ‘fourth payment year’, and ‘fifth payment year’ mean, with respect to covered professional services furnished by such eligible professional, each successive year immediately following the first payment year for such professional. CommentsClose CommentsPermalink





‘(2) MEANINGFUL EHR USER- CommentsClose CommentsPermalink





‘(A) IN GENERAL- For purposes of paragraph (1), an eligible professional shall be treated as a meaningful EHR user for a reporting period for a payment year (or, for purposes of subsection (a)(7), for a reporting period under such subsection for a year) if each of the following requirements is met: CommentsClose CommentsPermalink





‘(i) MEANINGFUL USE OF CERTIFIED EHR TECHNOLOGY- The eligible professional demonstrates to the satisfaction of the Secretary, in accordance with subparagraph (C)(i), that during such period the professional is using certified EHR technology in a meaningful manner, which shall include the use of electronic prescribing as determined to be appropriate by the Secretary. CommentsClose CommentsPermalink





‘(ii) INFORMATION EXCHANGE- The eligible professional demonstrates to the satisfaction of the Secretary, in accordance with subparagraph (C)(i), that during such period such certified EHR technology is connected in a manner that provides, in accordance with law and standards applicable to the exchange of information, for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination. CommentsClose CommentsPermalink





‘(iii) REPORTING ON MEASURES USING EHR- Subject to subparagraph (B)(ii) and using such certified EHR technology, the eligible professional submits information for such period, in a form and manner specified by the Secretary, on such clinical quality measures and such other measures as selected by the Secretary under subparagraph (B)(i). CommentsClose CommentsPermalink





The Secretary may provide for the use of alternative means for meeting the requirements of clauses (i), (ii), and (iii) in the case of an eligible professional furnishing covered professional services in a group practice (as defined by the Secretary). The Secretary shall seek to improve the use of electronic health records and health care quality over time by requiring more stringent measures of meaningful use selected under this paragraph. CommentsClose CommentsPermalink





‘(B) REPORTING ON MEASURES- CommentsClose CommentsPermalink





‘(i) SELECTION- The Secretary shall select measures for purposes of subparagraph (A)(iii) but only consistent with the following: CommentsClose CommentsPermalink





‘(I) The Secretary shall provide preference to clinical quality measures that have been endorsed by the entity with a contract with the Secretary under section 1890(a). CommentsClose CommentsPermalink





‘(II) Prior to any measure being selected under this subparagraph, the Secretary shall publish in the Federal Register such measure and provide for a period of public comment on such measure. CommentsClose CommentsPermalink





‘(III) The Secretary shall, to the extent practicable, select the same measures for purposes of subparagraph (A)(iii) as are selected for quality purposes under title XIX.

‘(ii) LIMITATION- The Secretary may not require the electronic reporting of information on clinical quality measures under subparagraph (A)(iii) unless the Secretary has the capacity to accept the information electronically, which may be on a pilot basis. CommentsClose CommentsPermalink




‘(iii) COORDINATION OF REPORTING OF INFORMATION- In selecting such measures, and in establishing the form and manner for reporting measures under subparagraph (A)(iii), the Secretary shall seek to avoid redundant or duplicative reporting otherwise required, including reporting under subsection (k)(2)(C). CommentsClose CommentsPermalink





‘(C) DEMONSTRATION OF MEANINGFUL USE OF CERTIFIED EHR TECHNOLOGY AND INFORMATION EXCHANGE- CommentsClose CommentsPermalink





‘(i) IN GENERAL- A professional may satisfy the demonstration requirement of clauses (i) and (ii) of subparagraph (A) through means specified by the Secretary, which may include-- CommentsClose CommentsPermalink





‘(I) an attestation; CommentsClose CommentsPermalink





‘(II) the submission of claims with appropriate coding (such as a code indicating that a patient encounter was documented using certified EHR technology); CommentsClose CommentsPermalink





‘(III) a survey response; CommentsClose CommentsPermalink





‘(IV) reporting under subparagraph (A)(iii); and CommentsClose CommentsPermalink





‘(V) other means specified by the Secretary. CommentsClose CommentsPermalink





‘(ii) USE OF PART D DATA- Notwithstanding sections 1860D-15(d)(2)(B) and 1860D-15(f)(2), the Secretary may use data regarding drug claims submitted for purposes of section 1860D-15 that are necessary for purposes of subparagraph (A). CommentsClose CommentsPermalink





‘(3) APPLICATION- CommentsClose CommentsPermalink





‘(A) PHYSICIAN REPORTING SYSTEM RULES- Paragraphs (5), (6), and (8) of subsection (k) shall apply for purposes of this subsection in the same manner as they apply for purposes of such subsection. CommentsClose CommentsPermalink





‘(B) COORDINATION WITH OTHER PAYMENTS- The provisions of this subsection shall not be taken into account in applying the provisions of subsection (m) of this section and of section 1833(m) and any payment under such provisions shall not be taken into account in computing allowable charges under this subsection. CommentsClose CommentsPermalink





‘(C) LIMITATIONS ON REVIEW- There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of the determination of any incentive payment under this subsection and the payment adjustment under subsection (a)(7), including the determination of a meaningful EHR user under paragraph (2), a limitation under paragraph (1)(B), and the exception under subsection (a)(7)(B). CommentsClose CommentsPermalink





‘(D) POSTING ON WEBSITE- The Secretary shall post on the Internet website of the Centers for Medicare & Medicaid Services, in an easily understandable format, a list of the names, business addresses, and business phone numbers of the eligible professionals who are meaningful EHR users and, as determined appropriate by the Secretary, of group practices receiving incentive payments under paragraph (1). CommentsClose CommentsPermalink





‘(4) CERTIFIED EHR TECHNOLOGY DEFINED- For purposes of this section, the term ‘certified EHR technology’ means a qualified electronic health record (as defined in 3000(13) of the Public Health Service Act) that is certified pursuant to section 3001(c)(5) of such Act as meeting standards adopted under section 3004 of such Act that are applicable to the type of record involved (as determined by the Secretary, such as an ambulatory electronic health record for office-based physicians or an inpatient hospital electronic health record for hospitals). CommentsClose CommentsPermalink





‘(5) DEFINITIONS- For purposes of this subsection: CommentsClose CommentsPermalink





‘(A) COVERED PROFESSIONAL SERVICES- The term ‘covered professional services’ has the meaning given such term in subsection (k)(3). CommentsClose CommentsPermalink





‘(B) ELIGIBLE PROFESSIONAL- The term ‘eligible professional’ means a physician, as defined in section 1861(r). CommentsClose CommentsPermalink





‘(C) REPORTING PERIOD- The term ‘reporting period’ means any period (or periods), with respect to a payment year, as specified by the Secretary.’. CommentsClose CommentsPermalink





(b) Incentive Payment Adjustment- Section 1848(a) of the Social Security Act (42 U.S.C. 1395w-4(a)) is amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(7) INCENTIVES FOR MEANINGFUL USE OF CERTIFIED EHR TECHNOLOGY- CommentsClose CommentsPermalink





‘(A) ADJUSTMENT- CommentsClose CommentsPermalink





‘(i) IN GENERAL- Subject to subparagraphs (B) and (D), with respect to covered professional services furnished by an eligible professional during 2016 or any subsequent payment year, if the eligible professional is not a meaningful EHR user (as determined under subsection (o)(2)) for a reporting period for the year, the fee schedule amount for such services furnished by such professional during the year (including the fee schedule amount for purposes of determining a payment based on such amount) shall be equal to the applicable percent of the fee schedule amount that would otherwise apply to such services under this subsection (determined after application of paragraph (3) but without regard to this paragraph). CommentsClose CommentsPermalink





‘(ii) APPLICABLE PERCENT- Subject to clause (iii), for purposes of clause (i), the term ‘applicable percent’ means-- CommentsClose CommentsPermalink





‘(I) for 2016, 99 percent; CommentsClose CommentsPermalink





‘(II) for 2017, 98 percent; and CommentsClose CommentsPermalink





‘(III) for 2018 and each subsequent year, 97 percent. CommentsClose CommentsPermalink





‘(iii) AUTHORITY TO DECREASE APPLICABLE PERCENTAGE FOR 2019 AND SUBSEQUENT YEARS- For 2019 and each subsequent year, if the Secretary finds that the proportion of eligible professionals who are meaningful EHR users (as determined under subsection (o)(2)) is less than 75 percent, the applicable percent shall be decreased by 1 percentage point from the applicable percent in the preceding year, but in no case shall the applicable percent be less than 95 percent. CommentsClose CommentsPermalink





‘(B) SIGNIFICANT HARDSHIP EXCEPTION- The Secretary may, on a case-by-case basis, exempt an eligible professional from the application of the payment adjustment under subparagraph (A) if the Secretary determines, subject to annual renewal, that compliance with the requirement for being a meaningful EHR user would result in a significant hardship, such as in the case of an eligible professional who practices in a rural area without sufficient Internet access. In no case may an eligible professional be granted an exemption under this subparagraph for more than 5 years. CommentsClose CommentsPermalink





‘(C) APPLICATION OF PHYSICIAN REPORTING SYSTEM RULES- Paragraphs (5), (6), and (8) of subsection (k) shall apply for purposes of this paragraph in the same manner as they apply for purposes of such subsection. CommentsClose CommentsPermalink





‘(D) NON-APPLICATION TO HOSPITAL-BASED ELIGIBLE PROFESSIONALS- No payment adjustment may be made under subparagraph (A) in the case of hospital-based eligible professionals (as defined in subsection (o)(1)(C)(ii)). CommentsClose CommentsPermalink





‘(E) DEFINITIONS- For purposes of this paragraph: CommentsClose CommentsPermalink





‘(i) COVERED PROFESSIONAL SERVICES- The term ‘covered professional services’ has the meaning given such term in subsection (k)(3). CommentsClose CommentsPermalink





‘(ii) ELIGIBLE PROFESSIONAL- The term ‘eligible professional’ means a physician, as defined in section 1861(r). CommentsClose CommentsPermalink





‘(iii) REPORTING PERIOD- The term ‘reporting period’ means, with respect to a year, a period specified by the Secretary.’. CommentsClose CommentsPermalink





(c) Application to Certain HMO-Affiliated Eligible Professionals- Section 1853 of the Social Security Act (42 U.S.C. 1395w-23) is amended by adding at the end the following new subsection: CommentsClose CommentsPermalink





‘(l) Application of Eligible Professional Incentives for Certain MA Organizations for Adoption and Meaningful Use of Certified EHR Technology- CommentsClose CommentsPermalink





‘(1) IN GENERAL- Subject to paragraphs (3) and (4), in the case of a qualifying MA organization, the provisions of sections 1848(o) and 1848(a)(7) shall apply with respect to eligible professionals described in paragraph (2) of the organization who the organization attests under paragraph (6) to be meaningful EHR users in a similar manner as they apply to eligible professionals under such sections. Incentive payments under paragraph (3) shall be made to and payment adjustments under paragraph (4) shall apply to such qualifying organizations. CommentsClose CommentsPermalink





‘(2) ELIGIBLE PROFESSIONAL DESCRIBED- With respect to a qualifying MA organization, an eligible professional described in this paragraph is an eligible professional (as defined for purposes of section 1848(o)) who-- CommentsClose CommentsPermalink





‘(A)(i) is employed by the organization,; or CommentsClose CommentsPermalink





‘(ii)(I) is employed by, or is a partner of, an entity that through contract with the organization furnishes at least 80 percent of the entity’s patient care services to enrollees of such organization; and CommentsClose CommentsPermalink





‘(II) furnishes at least 75 percent of the professional services of the eligible professional to enrollees of the organization; and CommentsClose CommentsPermalink





‘(B) furnishes, on average, at least 20 hours per week of patient care services. CommentsClose CommentsPermalink





‘(3) ELIGIBLE PROFESSIONAL INCENTIVE PAYMENTS- CommentsClose CommentsPermalink





‘(A) IN GENERAL- In applying section 1848(o) under paragraph (1), instead of the additional payment amount under section 1848(o)(1)(A) and subject to subparagraph (B), the Secretary may substitute an amount determined by the Secretary to the extent feasible and practical to be similar to the estimated amount in the aggregate that would be payable if payment for services furnished by such professionals was payable under part B instead of this part. CommentsClose CommentsPermalink





‘(B) AVOIDING DUPLICATION OF PAYMENTS- CommentsClose CommentsPermalink





‘(i) IN GENERAL- If an individual is an eligible professional described in paragraph (2) and alsoeligible professional described in paragraph (2) is eligible for the maximum incentive payment under section 1848(o)(1)(A) for the same payment period, the payment incentive shall be made only under such section and not under this subsection. CommentsClose CommentsPermalink





‘(ii) METHODS- In the case of an individual who is an eligible professional described in paragraph (2) and alseligible professional described in paragraph (2) who is eligible for an incentive payment under section 1848(o)(1)(A) but is not described in clause (i) for the same payment period, the Secretary shall develop a process-- CommentsClose CommentsPermalink





‘(I) to ensure that duplicate payments are not made with respect to an eligible professional both under this subsection and under section 1848(o)(1)(A); and CommentsClose CommentsPermalink





‘(II) to collect data from Medicare Advantage organizations to ensure against such duplicate payments. CommentsClose CommentsPermalink





‘(C) FIXED SCHEDULE FOR APPLICATION OF LIMITATION ON INCENTIVE PAYMENTS FOR ALL ELIGIBLE PROFESSIONALS- In applying section 1848(o)(1)(B)(ii) under subparagraph (A), in accordance with rules specified by the Secretary, a qualifying MA organization shall specify a year (not earlier than 2011) that shall be treated as the first payment year for all eligible professionals with respect to such organization. CommentsClose CommentsPermalink





‘(4) PAYMENT ADJUSTMENT- CommentsClose CommentsPermalink





‘(A) IN GENERAL- In applying section 1848(a)(7) under paragraph (1), instead of the payment adjustment being an applicable percent of the fee schedule amount for a year under such section, subject to subparagraph (D), the payment adjustment under paragraph (1) shall be equal to the percent specified in subparagraph (B) for such year of the payment amount otherwise provided under this section for such year. CommentsClose CommentsPermalink





‘(B) SPECIFIED PERCENT- The percent specified under this subparagraph for a year is 100 percent minus a number of percentage points equal to the product of-- CommentsClose CommentsPermalink





‘(i) the number of percentage points by which the applicable percent (under section 1848(a)(7)(A)(ii)) for the year is less than 100 percent; and CommentsClose CommentsPermalink





‘(ii) the Medicare physician expenditure proportion specified in subparagraph (C) for the year. CommentsClose CommentsPermalink





‘(C) MEDICARE PHYSICIAN EXPENDITURE PROPORTION- The Medicare physician expenditure proportion under this subparagraph for a year is the Secretary’s estimate of the proportion, of the expenditures under parts A and B that are not attributable to this part, that are attributable to expenditures for physicians’ services. CommentsClose CommentsPermalink





‘(D) APPLICATION OF PAYMENT ADJUSTMENT- In the case that a qualifying MA organization attests that not all eligible professionals are meaningful EHR users with respect to a year, the Secretary shall apply the payment adjustment under this paragraph based on the proportion of such eligible professionals that are not meaningful EHR users for such year. CommentsClose CommentsPermalink





‘(5) QUALIFYING MA ORGANIZATION DEFINED- In this subsection and subsection (m), the term ‘qualifying MA organization’ means a Medicare Advantage organization that is organized as a health maintenance organization (as defined in section 2791(b)(3) of the Public Health Service Act). CommentsClose CommentsPermalink





‘(6) MEANINGFUL EHR USER ATTESTATION- For purposes of this subsection and subsection (m), a qualifying MA organization shall submit an attestation, in a form and manner specified by the Secretary which may include the submission of such attestation as part of submission of the initial bid under section 1854(a)(1)(A)(iv), identifying-- CommentsClose CommentsPermalink





‘(A) whether each eligible professional described in paragraph (2), with respect to such organization is a meaningful EHR user (as defined in section 1848(o)(32)) for a year specified by the Secretary; and CommentsClose CommentsPermalink





‘(B) whether each eligible hospital described in subsection (m)(1), with respect to such organization, is a meaningful EHR user (as defined in section 1886(n)(3)) for an applicable period specified by the Secretary.’. CommentsClose CommentsPermalink





(d) Conforming Amendments- Section 1853 of the Social Security Act (42 U.S.C. 1395w-23) is amended-- CommentsClose CommentsPermalink





(1) in subsection (a)(1)(A), by striking ‘and (i)’ and inserting ‘(i), and (l)’; CommentsClose CommentsPermalink





(2) in subsection (c)-- CommentsClose CommentsPermalink





(A) in paragraph (1)(D)(i), by striking ‘section 1886(h)’ and inserting ‘sections 1848(o) and 1886(h)’; and CommentsClose CommentsPermalink





(B) in paragraph (6)(A), by inserting after ‘under part B,’ the following: ‘excluding expenditures attributable to subsections (a)(7) and (o) of section 1848,’; and CommentsClose CommentsPermalink





(3) in subsection (f), by inserting ‘and for payments under subsection (l)’ after ‘with the organization’. CommentsClose CommentsPermalink





(e) Conforming Amendments to e-Prescribing- CommentsClose CommentsPermalink





(1) Section 1848(a)(5)(A) of the Social Security Act (42 U.S.C. 1395w-4(a)(5)(A)) is amended-- CommentsClose CommentsPermalink





(A) in clause (i), by striking ‘or any subsequent year’ and inserting ‘, 2013, 2014, or 2015’; and CommentsClose CommentsPermalink





(B) in clause (ii), by striking ‘and each subsequent year’ and inserting ‘and 2015’. CommentsClose CommentsPermalink





(2) Section 1848(m)(2) of such Act (42 U.S.C. 1395w-4(m)(2)) is amended-- CommentsClose CommentsPermalink





(A) in subparagraph (A), by striking ‘For 2009’ and inserting ‘Subject to subparagraph (D), for 2009’; and CommentsClose CommentsPermalink





(B) by adding at the end the following new subparagraph: CommentsClose CommentsPermalink





‘(D) LIMITATION WITH RESPECT TO EHR INCENTIVE PAYMENTS- The provisions of this paragraph shall not apply to an eligible professional (or, in the case of a group practice under paragraph (3)(C), to the group practice) if, for the reporting period the eligible professional (or group practice) receives an incentive payment under subsection (o)(1)(A) with respect to a certified EHR technology (as defined in subsection (o)(6)(A4)) that has the capability of electronic prescribing.’. CommentsClose CommentsPermalink

SEC. 4312. INCENTIVES FOR HOSPITALS.

(a) Incentive Payment- Section 1886 of the Social Security Act (42 U.S.C. 1395ww) is amended by adding at the end the following new subsection: CommentsClose CommentsPermalink





‘(n) Incentives for Adoption and Meaningful Use of Certified EHR Technology- CommentsClose CommentsPermalink





‘(1) IN GENERAL- Subject to the succeeding provisions of this subsection, with respect to inpatient hospital services furnished by an eligible hospital during a payment year (as defined in paragraph (2)(G)), if the eligible hospital is a meaningful EHR user (as determined under paragraph (3)) for the reporting period with respect to such year, in addition to the amount otherwise paid under this section, there also shall be paid to the eligible hospital, from the Federal Hospital Insurance Trust Fund established under section 1817, an amount equal to the applicable amount specified in paragraph (2)(A) for the hospital for such payment year. CommentsClose CommentsPermalink





‘(2) PAYMENT AMOUNT- CommentsClose CommentsPermalink





‘(A) IN GENERAL- Subject to the succeeding subparagraphs of this paragraph, the applicable amount specified in this subparagraph for an eligible hospital for a payment year is equal to the product of the following: CommentsClose CommentsPermalink





‘(i) INITIAL AMOUNT- The sum of-- CommentsClose CommentsPermalink





‘(I) the base amount specified in subparagraph (B); plus CommentsClose CommentsPermalink





‘(II) the discharge related amount specified in subparagraph (C) for a 12-month period selected by the Secretary with respect to such payment year. CommentsClose CommentsPermalink





‘(ii) MEDICARE SHARE- The Medicare share as specified in subparagraph (D) for the hospital for a period selected by the Secretary with respect to such payment year. CommentsClose CommentsPermalink





‘(iii) TRANSITION FACTOR- The transition factor specified in subparagraph (E) for the hospital for the payment year. CommentsClose CommentsPermalink





‘(B) BASE AMOUNT- The base amount specified in this subparagraph is $2,000,000. CommentsClose CommentsPermalink





‘(C) DISCHARGE RELATED AMOUNT- The discharge related amount specified in this subparagraph for a 12-month period selected by the Secretary shall be determined as the sum of the amount, based upon total discharges (regardless of any source of payment) for the period, for each discharge up to the 23,000th discharge as follows: CommentsClose CommentsPermalink





‘(i) For the 1,150th through the 9,200th discharge, $200. CommentsClose CommentsPermalink





‘(ii) For the 9,201st through the 13,800th discharge, 50 percent of the amount specified in clause (i). CommentsClose CommentsPermalink





‘(iii) For the 13,801st through the 23,000th discharge, 30 percent of the amount specified in clause (i). CommentsClose CommentsPermalink





‘(D) MEDICARE SHARE- The Medicare share specified under this subparagraph for a hospital for a period selected by the Secretary for a payment year is equal to the fraction-- CommentsClose CommentsPermalink





‘(i) the numerator of which is the sum (for such period and with respect to the hospital) of-- CommentsClose CommentsPermalink





‘(I) the number of inpatient-bed-days (as established by the Secretary) which are attributable to individuals with respect to whom payment may be made under part A; and CommentsClose CommentsPermalink





‘(II) the number of inpatient-bed-days (as so established) which are attributable to individuals who are enrolled with a Medicare Advantage organization under part C; and CommentsClose CommentsPermalink





‘(ii) the denominator of which is the product of-- CommentsClose CommentsPermalink





‘(I) the total number of inpatient-bed-days with respect to the hospital during such period; and CommentsClose CommentsPermalink





‘(II) the total amount of the hospital’s charges during such period, not including any charges that are attributable to charity care (as such term is used for purposes of hospital cost reporting under this title), divided by the total amount of the hospital’s charges during such period. CommentsClose CommentsPermalink





Insofar as the Secretary determines that data are not available on charity care necessary to calculate the portion of the formula specified in clause (ii)(II), the Secretary shall use data on uncompensated care and may adjust such data so as to be an appropriate proxy for charity care including a downward adjustment to eliminate bad debt data from uncompensated care data. In the absence of the data necessary, with respect to a hospital, for the Secretary to compute the amount described in clause (ii)(II), the amount under such clause shall be deemed to be 1. In the absence of data, with respect to a hospital, necessary to compute the amount described in clause (i)(II), the amount under such clause shall be deemed to be 0. CommentsClose CommentsPermalink





‘(E) TRANSITION FACTOR SPECIFIED- CommentsClose CommentsPermalink





‘(i) IN GENERAL- Subject to clause (ii), the transition factor specified in this subparagraph for an eligible hospital for a payment year is as follows: CommentsClose CommentsPermalink





‘(I) For the first payment year for such hospital, 1. CommentsClose CommentsPermalink





‘(II) For the second payment year for such hospital, 3/4 . CommentsClose CommentsPermalink





‘(III) For the third payment year for such hospital, 1/2 . CommentsClose CommentsPermalink





‘(IV) For the fourth payment year for such hospital, 1/4 . CommentsClose CommentsPermalink





‘(V) For any succeeding payment year for such hospital, 0. CommentsClose CommentsPermalink





‘(ii) PHASE DOWN FOR ELIGIBLE HOSPITALS FIRST ADOPTING EHR AFTER 2013- If the first payment year for an eligible hospital is after 2013, then the transition factor specified in this subparagraph for a payment year for such hospital is the same as the amount specified in clause (i) for such payment year for an eligible hospital for which the first payment year is 2013. If the first payment year for an eligible hospital is after 2015 then the transition factor specified in this subparagraph for such hospital and for such year and any subsequent year shall be 0. CommentsClose CommentsPermalink





‘(F) FORM OF PAYMENT- The payment under this subsection for a payment year may be in the form of a single consolidated payment or in the form of such periodic installments as the Secretary may specify. CommentsClose CommentsPermalink





‘(G) PAYMENT YEAR DEFINED- CommentsClose CommentsPermalink





‘(i) IN GENERAL- For purposes of this subsection, the term ‘payment year’ means a fiscal year beginning with fiscal year 2011. CommentsClose CommentsPermalink





‘(ii) FIRST, SECOND, ETC. PAYMENT YEAR- The term ‘first payment year’ means, with respect to inpatient hospital services furnished by an eligible hospital, the first fiscal year for which an incentive payment is made for such services under this subsection. The terms ‘second payment year’, ‘third payment year’, and ‘fourth payment year’ mean, with respect to an eligible hospital, each successive year immediately following the first payment year for that hospital. CommentsClose CommentsPermalink





‘(3) MEANINGFUL EHR USER- CommentsClose CommentsPermalink





‘(A) IN GENERAL- For purposes of paragraph (1), an eligible hospital shall be treated as a meaningful EHR user for a reporting period for a payment year (or, for purposes of subsection (b)(3)(B)(ix), for a reporting period under such subsection for a fiscal year) if each of the following requirements are met: CommentsClose CommentsPermalink





‘(i) MEANINGFUL USE OF CERTIFIED EHR TECHNOLOGY- The eligible hospital demonstrates to the satisfaction of the Secretary, in accordance with subparagraph (C)(i), that during such period the hospital is using certified EHR technology in a meaningful manner. CommentsClose CommentsPermalink





‘(ii) INFORMATION EXCHANGE- The eligible hospital demonstrates to the satisfaction of the Secretary, in accordance with subparagraph (C)(i), that during such period such certified EHR technology is connected in a manner that provides, in accordance with law and standards applicable to the exchange of information, for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination. CommentsClose CommentsPermalink





‘(iii) REPORTING ON MEASURES USING EHR- Subject to subparagraph (B)(ii) and using such certified EHR technology, the eligible hospital submits information for such period, in a form and manner specified by the Secretary, on such clinical quality measures and such other measures as selected by the Secretary under subparagraph (B)(i). CommentsClose CommentsPermalink





The Secretary shall seek to improve the use of electronic health records and health care quality over time by requiring more stringent measures of meaningful use selected under this paragraph. CommentsClose CommentsPermalink





‘(B) REPORTING ON MEASURES- CommentsClose CommentsPermalink





‘(i) SELECTION- The Secretary mayshall select measures for purposes of subparagraph (A)(iii) but only consistent with the following: CommentsClose CommentsPermalink





‘(I) The Secretary shall provide preference to clinical quality measures that have been selected for purposes of applying subsection (b)(3)(B)(viii) or that have been endorsed by the entity with a contract with the Secretary under section 1890(a). CommentsClose CommentsPermalink





‘(II) Prior to any measure (other than a clinical quality measure that has been selected for purposes of applying subsection (b)(3)(B)(viii)) being selected under this subparagraph, the Secretary shall publish in the Federal Register such measure and provide for a period of public comment on such measure. CommentsClose CommentsPermalink





‘(ii) LIMITATIONS- The Secretary may not require the electronic reporting of information on clinical quality measures under subparagraph (A)(iii) unless the Secretary has the capacity to accept the information electronically, which may be on a pilot basis. CommentsClose CommentsPermalink





‘(iii) COORDINATION OF REPORTING OF INFORMATION- In selecting such measures, and in establishing the form and manner for reporting measures under subparagraph (A)(iii), the Secretary shall seek to avoid redundant or duplicative reporting with reporting otherwise required, including reporting under subsection (b)(3)(B)(viii). CommentsClose CommentsPermalink





‘(C) DEMONSTRATION OF MEANINGFUL USE OF CERTIFIED EHR TECHNOLOGY AND INFORMATION EXCHANGE- CommentsClose CommentsPermalink





‘(i) IN GENERAL- A hospital may satisfy the demonstration requirement of clauses (i) and (ii) of subparagraph (A) through means specified by the Secretary, which may include-- CommentsClose CommentsPermalink





‘(I) an attestation; CommentsClose CommentsPermalink





‘(II) the submission of claims with appropriate coding (such as a code indicating that inpatient care was documented using certified EHR technology); CommentsClose CommentsPermalink





‘(III) a survey response; CommentsClose CommentsPermalink





‘(IV) reporting under subparagraph (A)(iii); and CommentsClose CommentsPermalink





‘(V) other means specified by the Secretary. CommentsClose CommentsPermalink





‘(ii) USE OF PART D DATA- Notwithstanding sections 1860D-15(d)(2)(B) and 1860D-15(f)(2), the Secretary may use data regarding drug claims submitted for purposes of section 1860D-15 that are necessary for purposes of subparagraph (A). CommentsClose CommentsPermalink





‘(4) APPLICATION- CommentsClose CommentsPermalink





‘(A) LIMITATIONS ON REVIEW- There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of the determination of any incentive payment under this subsection and the payment adjustment under subsection (b)(3)(B)(ix), including the determination of a meaningful EHR user under paragraph (3), determination of measures applicable to services furnished by eligible hospitals under this subsection, and the exception under subsection (b)(3)(B)(ix)(II). CommentsClose CommentsPermalink





‘(B) POSTING ON WEBSITE- The Secretary shall post on the Internet website of the Centers for Medicare & Medicaid Services, in an easily understandable format, a list of the names of the eligible hospitals that are meaningful EHR users under this subsection or subsection (b)(3)(B)(ix) and other relevant data as determined appropriate by the Secretary. The Secretary shall ensure that a hospital has the opportunity to review the other relevant data that are to be made public with respect to the hospital prior to such data being made public. CommentsClose CommentsPermalink





‘(5) CERTIFIED EHR TECHNOLOGY DEFINED- The term ‘certified EHR technology’ has the meaning given such term in section 1848(o)(4). CommentsClose CommentsPermalink





‘(6) DEFINITIONS- For purposes of this subsection: CommentsClose CommentsPermalink





‘(A) ELIGIBLE HOSPITAL- The term ‘eligible hospital’ means a subsection (d) hospital. CommentsClose CommentsPermalink





‘(B) REPORTING PERIOD- The term ‘reporting period’ means any period (or periods), with respect to a payment year, as specified by the Secretary.’. CommentsClose CommentsPermalink





(b) Incentive Market Basket Adjustment- Section 1886(b)(3)(B) of the Social Security Act (42 U.S.C. 1395ww(b)(3)(B)) is amended-- CommentsClose CommentsPermalink





(1) in clause (viii)(I), by inserting ‘(or, beginning with fiscal year 2016, by one-quarter)’ after ‘2.0 percentage points’; and CommentsClose CommentsPermalink





(2) by adding at the end the following new clause: CommentsClose CommentsPermalink





‘(ix)(I) For purposes of clause (i) for fiscal year 2016 and each subsequent fiscal year, in the case of an eligible hospital (as defined in subsection (n)(6)(A)) that is not a meaningful EHR user (as defined in subsection (n)(3)) for the reporting period for such fiscal year, three-quarters of the applicable percentage increase otherwise applicable under clause (i) for such fiscal year shall be reduced by 33 1/3 percent for fiscal year 2016, 66 2/3 percent for fiscal year 2017, and 100 percent for fiscal year 2018 and each subsequent fiscal year. Such reduction shall apply only with respect to the fiscal year involved and the Secretary shall not take into account such reduction in computing the applicable percentage increase under clause (i) for a subsequent fiscal year. CommentsClose CommentsPermalink





‘(II) The Secretary may, on a case-by-case basis, exempt a subsection (d) hospital from the application of subclause (I) with respect to a fiscal year if the Secretary determines, subject to annual renewal, that requiring such hospital to be a meaningful EHR user during such fiscal year would result in a significant hardship, such as in the case of a hospital in a rural area without sufficient Internet access. In no case may a hospital be granted an exemption under this subclause for more than 5 years. CommentsClose CommentsPermalink





‘(III) For fiscal year 2016 and each subsequent fiscal year, a State in which hospitals are paid for services under section 1814(b)(3) shall adjust the payments to each subsection (d) hospital in the State that is not a meaningful EHR user (as defined in subsection (n)(3)) in a manner that is designed to result in an aggregate reduction in payments to hospitals in the State that is equivalent to the aggregate reduction that would have occurred if payments had been reduced to each subsection (d) hospital in the State in a manner comparable to the reduction under the previous provisions of this clause. The State shall report to the Secretary the methodology it will use to make the payment adjustment under the previous sentence. CommentsClose CommentsPermalink





‘(IV) For purposes of this clause, the term ‘reporting period’ means, with respect to a fiscal year, any period (or periods), with respect to the fiscal year, as specified by the Secretary.’. CommentsClose CommentsPermalink





(c) Application to Certain HMO-Affiliated Eligible Hospitals- Section 1853 of the Social Security Act (42 U.S.C. 1395w-23), as amended by section 4311(c), is further amended by adding at the end the following new subsection: CommentsClose CommentsPermalink





‘(m) Application of Eligible Hospital Incentives for Certain MA Organizations for Adoption and Meaningful Use of Certified EHR Technology- CommentsClose CommentsPermalink





‘(1) APPLICATION- Subject to paragraphs (3) and (4), in the case of a qualifying MA organization, the provisions of sections 1886(n) and 1886(b)(3)(B)(ix) shall apply with respect to eligible hospitals described in paragraph (2) of the organization which the organization attests under subsection (l)(6) to be meaningful EHR users in a similar manner as they apply to eligible hospitals under such sections. Incentive payments under paragraph (3) shall be made to and payment adjustments under paragraph (4) shall apply to such qualifying organizations. CommentsClose CommentsPermalink





‘(2) ELIGIBLE HOSPITAL DESCRIBED- With respect to a qualifying MA organization, an eligible hospital described in this paragraph is an eligible hospital that is under common corporate governance with such organization and serves individuals enrolled under an MA plan offered by such organization. CommentsClose CommentsPermalink





‘(3) ELIGIBLE HOSPITAL INCENTIVE PAYMENTS- CommentsClose CommentsPermalink





‘(A) IN GENERAL- In applying section 1886(n)(2) under paragraph (1), instead of the additional payment amount under section 1886(n)(2), there shall be substituted an amount determined by the Secretary to be similar to the estimated amount in the aggregate that would be payable if payment for services furnished by such hospitals was payable under part A instead of this part. In implementing the previous sentence, the Secretary-- CommentsClose CommentsPermalink





‘(i) shall, insofar as data to determine the discharge related amount under section 1886(n)(2)(C) for an eligible hospital are not available to the Secretary, use such alternative data and methodology to estimate such discharge related amount as the Secretary determines appropriate; and CommentsClose CommentsPermalink





‘(ii) shall, insofar as data to determine the medicare share described in section 1886(n)(2)(D) for an eligible hospital are not available to the Secretary, use such alternative data and methodology to estimate such share, which data and methodology may include use of the inpatient bed days (or discharges) with respect to an eligible hospital during the appropriate period which are attributable to both individuals for whom payment may be made under part A or individuals enrolled in an MA plan under a Medicare Advantage organization under this part as a proportion of the total number of patient-bed-days (or discharges) with respect to such hospital during such period. CommentsClose CommentsPermalink





‘(B) AVOIDING DUPLICATION OF PAYMENTS- CommentsClose CommentsPermalink





‘(i) IN GENERAL- In the case of a hospital that for a payment year is an eligible hospital described in paragraph (2), is an eligible hospital under section 1886(n), and for which at least one-third of their discharges (or bed-days) of Medicare patients for the year are covered under part A, payment for the payment year shall be made only under section 1886(n) and not under this subsection. CommentsClose CommentsPermalink





‘(ii) METHODS- In the case of a hospital that is an eligible hospital described in paragraph (2) and also is eligible for an incentive payment under section 1886(n) but is not described in clause (i) for the same payment period, the Secretary shall develop a process-- CommentsClose CommentsPermalink





‘(I) to ensure that duplicate payments are not made with respect to an eligible hospital both under this subsection and under section 1886(n); and CommentsClose CommentsPermalink





‘(II) to collect data from Medicare Advantage organizations to ensure against such duplicate payments. CommentsClose CommentsPermalink





‘(4) PAYMENT ADJUSTMENT- CommentsClose CommentsPermalink





‘(A) Subject to paragraph (3), in the case of a qualifying MA organization (as defined in section 1853(l)(5)), if, according to the attestation of the organization submitted under subsection (l)(6) for an applicable period, one or more eligible hospitals (as defined in section 1886(n)(6)(A)) that are under common corporate governance with such organization and that serve individuals enrolled under a plan offered by such organization are not meaningful EHR users (as defined in section 1886(n)(3)) with respect to a period, the payment amount payable under this section for such organization for such period shall be the percent specified in subparagraph (B) for such period of the payment amount otherwise provided under this section for such period. CommentsClose CommentsPermalink





‘(B) SPECIFIED PERCENT- The percent specified under this subparagraph for a year is 100 percent minus a number of percentage points equal to the product of-- CommentsClose CommentsPermalink





‘(i) the number of the percentage point reduction effected under section 1886(b)(3)(B)(ix)(I) for the period; and CommentsClose CommentsPermalink





‘(ii) the Medicare hospital expenditure proportion specified in subparagraph (C) for the year. CommentsClose CommentsPermalink





‘(C) MEDICARE HOSPITAL EXPENDITURE PROPORTION- The Medicare hospital expenditure proportion under this subparagraph for a year is the Secretary’s estimate of the proportion, of the expenditures under parts A and B that are not attributable to this part, that are attributable to expenditures for inpatient hospital services. CommentsClose CommentsPermalink





‘(D) APPLICATION OF PAYMENT ADJUSTMENT- In the case that a qualifying MA organization attests that not all eligible hospitals are meaningful EHR users with respect to an applicable period, the Secretary shall apply the payment adjustment under this paragraph based on a methodology specified by the Secretary, taking into account the proportion of such eligible hospitals, or discharges from such hospitals, that are not meaningful EHR users for such period.’. CommentsClose CommentsPermalink





(d) Conforming Amendments- CommentsClose CommentsPermalink





(1) Section 1814(b) of the Social Security Act (42 U.S.C. 1395f(b)) is amended-- CommentsClose CommentsPermalink





(A) in paragraph (3), in the matter preceding subparagraph (A), by inserting ‘, subject to section 1886(d)(3)(B)(ix)(III),’ after ‘then’; and CommentsClose CommentsPermalink





(B) by adding at the end the following: ‘For purposes of applying paragraph (3), there shall be taken into account incentive payments, and payment adjustments under subsection (b)(3)(B)(ix) or (n) of section 1886.’. CommentsClose CommentsPermalink





(2) Section 1851(i)(1) of the Social Security Act (42 U.S.C. 1395w-21(i)(1)) is amended by striking ‘and 1886(h)(3)(D)’ and inserting ‘1886(h)(3)(D), and 1853(m)’. CommentsClose CommentsPermalink





(3) Section 1853 of the Social Security Act (42 U.S.C. 1395w-23), as amended by section 4311(d)(1), is amended-- CommentsClose CommentsPermalink





(A) in subsection (c)-- CommentsClose CommentsPermalink





(i) in paragraph (1)(D)(i), by striking ‘1848(o)’ and inserting ‘, 1848(o), and 1886(n)’; and CommentsClose CommentsPermalink





(ii) in paragraph (6)(A), by inserting ‘and subsections (b)(3)(B)(ix) and (n) of section 1886’ after ‘section 1848’; and CommentsClose CommentsPermalink





(B) in subsection (f), by inserting ‘and subsection (m)’ after ‘under subsection (l)’. CommentsClose CommentsPermalink

SEC. 4313. TREATMENT OF PAYMENTS AND SAVINGS; IMPLEMENTATION FUNDING.

(a) Premium Hold Harmless- CommentsClose CommentsPermalink





(1) IN GENERAL- Section 1839(a)(1) of the Social Security Act (42 U.S.C. 1395r(a)(1)) is amended by adding at the end the following: ‘In applying this paragraph there shall not be taken into account additional payments under section 1848(o) and section 1853(l)(3) and the Government contribution under section 1844(a)(3).’. CommentsClose CommentsPermalink





(2) PAYMENT- Section 1844(a) of such Act (42 U.S.C. 1395w(a)) is amended-- CommentsClose CommentsPermalink





(A) in paragraph (2), by striking the period at the end and inserting ‘; plus’; and CommentsClose CommentsPermalink





(B) by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(3) a Government contribution equal to the amount of payment incentives payable under sections 1848(o) and 1853(l)(3).’. CommentsClose CommentsPermalink





(b) Medicare Improvement Fund- Section 1898 of the Social Security Act (42 U.S.C. 1395iii), as added by section 7002(a) of the Supplemental Appropriations Act, 2008 (Public Law 110-252) and as amended by section 188(a)(2) of the Medicare Improvements for Patients and Providers Act of 2008 (Public Law 110-275; 122 Stat. 2589) and by section 6 of the QI Program Supplemental Funding Act of 2008, is amended-- CommentsClose CommentsPermalink





(1) in subsection (a)-- CommentsClose CommentsPermalink





(A) by inserting ‘medicare’ before ‘fee-for-service’; and CommentsClose CommentsPermalink





(B) by inserting before the period at the end the following: ‘including, but not limited to, an increase in the conversion factor under section 1848(d) to address, in whole or in part, any projected shortfall in the conversion factor for 2014 relative to the conversion factor for 2008 and adjustments to payments for items and services furnished by providers of services and suppliers under such original medicare fee-for-service program’; and CommentsClose CommentsPermalink





(2) in subsection (b)-- CommentsClose CommentsPermalink





(A) in paragraph (1), by striking ‘during fiscal year 2014,’ and all that follows and inserting the following: ‘during-- CommentsClose CommentsPermalink





‘(A) fiscal year 2014, $22,290,000,000; and CommentsClose CommentsPermalink





‘(B) fiscal year 2020 and each subsequent fiscal year, the Secretary’s estimate, as of July 1 of the fiscal year, of the aggregate reduction in expenditures under this title during the preceding fiscal year directly resulting from the reduction in payment amounts under sections 1848(a)(7), 1853(l)(4), 1853(m)(4), and 1886(b)(3)(B)(ix).’; and CommentsClose CommentsPermalink





(B) by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(4) NO EFFECT ON PAYMENTS IN SUBSEQUENT YEARS- In the case that expenditures from the Fund are applied to, or otherwise affect, a payment rate for an item or service under this title for a year, the payment rate for such item or service shall be computed for a subsequent year as if such application or effect had never occurred.’. CommentsClose CommentsPermalink





(c) Implementation Funding- In addition to funds otherwise available, out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary of Health and Human Services for the Center for Medicare & Medicaid Services Program Management Account, $60,000,000 for each of fiscal years 2009 through 2015 and $30,000,000 for each succeeding fiscal year through fiscal year 2019, which shall be available for purposes of carrying out the provisions of (and amendments made by) this part. Amounts appropriated under this subsection for a fiscal year shall be available until expended. CommentsClose CommentsPermalink

SEC. 4314. STUDY ON APPLICATION OF HITEHR PAYMENT INCENTIVES FOR PROVIDERS NOT RECEIVING OTHER INCENTIVE PAYMENTS.

(a) Study- CommentsClose CommentsPermalink





(1) IN GENERAL- The Secretary of Health and Human Services shall conduct a study to determine the extent to which and manner in which payment incentives (such as under title XVIII or XIX of the Social Security Act) and other funding for purposes of implementing and using qualified health information technologycertified EHR technology (as defined in section 3000 of the Public Health Service Act) should be made available to health care providers who are receiving minimal or no payment incentives or other funding under this Act, under title XVIII or XIX of the Social Security Act, or otherwise, for such purposes. CommentsClose CommentsPermalink





(2) DETAILS OF STUDY- Such study shall include an examination of-- CommentsClose CommentsPermalink





(A) the adoption rates of qualified health informationcertified EHR technology by such health care providers; CommentsClose CommentsPermalink





(B) the clinical utility of such technology by such health care providers; CommentsClose CommentsPermalink





(C) whether the services furnished by such health care providers are appropriate for or would benefit from the use of such technology; CommentsClose CommentsPermalink





(D) the extent to which such health care providers work in settings that might otherwise receive an incentive payment or other funding under this Act, title XVIII or XIX of the Social Security Act, or otherwise; CommentsClose CommentsPermalink





(E) the potential costs and the potential benefits of making payment incentives and other funding available to such health care providers; and CommentsClose CommentsPermalink





(F) any other issues the Secretary deems to be appropriate. CommentsClose CommentsPermalink





(b) Report- Not later than June 30, 2010, the Secretary shall submit to Congress a report on the findings and conclusions of the study conducted under subsection (a). CommentsClose CommentsPermalink

PART III--MEDICAID FUNDING

SEC. 4321. MEDICAID PROVIDER HIT ADOPTION AND OPERATION PAYMENTS; IMPLEMENTATION FUNDING.

(a) In General- Section 1903 of the Social Security Act (42 U.S.C. 1396b) is amended-- CommentsClose CommentsPermalink





(1) in subsection (a)(3)-- CommentsClose CommentsPermalink





(A) by striking ‘and’ at the end of subparagraph (D); CommentsClose CommentsPermalink





(B) by striking ‘plus’ at the end of subparagraph (E) and inserting ‘and’; and CommentsClose CommentsPermalink





(C) by adding at the end the following new subparagraph: CommentsClose CommentsPermalink





‘(F)(i) 100 percent of so much of the sums expended during such quarter as are attributable to payments for certified EHR technology (and support services including maintenance and training that is for, or is necessary for the adoption and operation of, such technology) by Medicaid providers described in subsection (t)(1); and CommentsClose CommentsPermalink





‘(ii) 90 percent of so much of the sums expended during such quarter as are attributable to payments for reasonable administrative expenses related to the administration of payments described in clause (i) if the State meets the condition described in subsection (t)(9); plus’; and CommentsClose CommentsPermalink





(2) by inserting after subsection (s) the following new subsection: CommentsClose CommentsPermalink





‘(t)(1) For purposes of subsection (a)(3)(F), the payments for certified EHR technology (and support services including maintenance that is for, or is necessary for the operation of, such technology) by Medicaid providers described in this paragraph are payments made by the State in accordance with this subsection of 85 percent of the net allowable costs of Medicaid providers (as defined in paragraph (2)) for such technology (and support services). CommentsClose CommentsPermalink





‘(2) In this subsection and subsection (a)(3)(F), the term ‘Medicaid provider’ means-- CommentsClose CommentsPermalink





‘(A) an eligible professional (as defined in paragraph (3)(B)) who is not hospital-based and has at least 30 percent of the professional’s patient volume (as estimated in accordance with standards established by the Secretary) attributable to individuals who are receiving medical assistance under this title; and CommentsClose CommentsPermalink





‘(B)(i) a children’s hospital;, CommentsClose CommentsPermalink





‘(ii) an acute-care hospital that is not described in clause (i) and that has at least 10 percent of the hospital’s patient volume (as estimated in accordance with standards established by the Secretary) attributable to individuals who are receiving medical assistance under this title;, or CommentsClose CommentsPermalink





‘(iii) a Federally-qualified health center or rural health clinic that has at least 30 percent of the center’s or clinic’s patient volume (as estimated in accordance with standards established by the Secretary) attributable to individuals who are receiving medical assistance under this title. CommentsClose CommentsPermalink





A professional shall not qualify as a Medicaid provider under this subsection unless the professional has waived, in a manner specified by the Secretary, any right to payment under section 1848(o) with respect to the adoption or support of certified EHR technology by the professional. In applying clauses (ii) and (iii) of subparagraph (B), the standards established by the Secretary for patient volume shall include individuals enrolled in a Medicaid managed care plan (under section 1903(m) or section 1932). CommentsClose CommentsPermalink





‘(3) In this subsection and subsection (a)(3)(F): CommentsClose CommentsPermalink





‘(A) The term ‘certified EHR technology’ means a qualified electronic health record (as defined in 3000(13) of the Public Health Service Act) that is certified pursuant to section 3001(c)(5) of such Act as meeting standards adopted under section 3004 of such Act that are applicable to the type of record involved (as determined by the Secretary, such as an ambulatory electronic health record for office-based physicians or an inpatient hospital electronic health record for hospitals). CommentsClose CommentsPermalink





‘(B) The term ‘eligible professional’ means a physician as defined in paragraphs (1) and (2) of section 1861(r), and includes a nurse mid-wife and a nurse practitioner. CommentsClose CommentsPermalink





‘(C) The term ‘hospital-based’ means, with respect to an eligible professional, a professional (such as a pathologist, anesthesiologist, or emergency physician) who furnishes substantially all of the individual’s professional services in a hospital setting (whether inpatient or outpatient) and through the use of the facilities and equipment, including computer equipment, of the hospital. CommentsClose CommentsPermalink





‘(4)(A) The term ‘allowable costs’ means, with respect to certified EHR technology of a Medicaid provider, costs of such technology (and support services including maintenance and training that is for, or is necessary for the adoption and operation of, such technology) as determined by the Secretary to be reasonable. CommentsClose CommentsPermalink





‘(B) The term ‘net allowable costs’ means allowable costs reduced by any payment that is made to the provider involved from any other source that is directly attributable to payment for certified EHR technology or services described in subparagraph (A). CommentsClose CommentsPermalink





‘(C) In no case shall-- CommentsClose CommentsPermalink





‘(i) the aggregate allowable costs under this subsection (covering one or more years) with respect to a Medicaid provider described in paragraph (2)(A) for purchase and initial implementation of certified EHR technology (and services described in subparagraph (A)) exceed $25,000 or include costs over a period of longer than 5 years; CommentsClose CommentsPermalink





‘(ii) for costs not described in clause (i) relating to the operation, maintenance, or use of certified EHR technology, the annual allowable costs under this subsection with respect to such a Medicaid provider for costs not described in clause (i) for any year exceed $10,000; CommentsClose CommentsPermalink





‘(iii) payment described in paragraph (1) for costs described in clause (ii) be made with respect to such a Medicaid provider over a period of more than 5 years; CommentsClose CommentsPermalink





‘(iv) the aggregate allowable costs under this subsection with respect to such a Medicaid provider for all costs exceed $75,000; or CommentsClose CommentsPermalink





‘(v) the allowable costs, whether for purchase and initial implementation, maintenance, or otherwise, for a Medicaid provider described in paragraph (2)(B) exceed such aggregate or annual limitation as the Secretary shall establish, based on an amount determined by the Secretary as being adequate to adopt and maintain certified EHR technology, consistent with paragraph (6). CommentsClose CommentsPermalink





‘(5) Payments described in paragraph (1) are not in accordance with this subsection unless the following requirements are met: CommentsClose CommentsPermalink





‘(A) The State provides assurances satisfactory to the Secretary that amounts received under subsection (a)(3)(F) with respect to costs of a Medicaid provider are paid directly to such provider without any deduction or rebate. CommentsClose CommentsPermalink





‘(B) Such Medicaid provider is responsible for payment of the costs described in such paragraph that are not provided under this title. CommentsClose CommentsPermalink





‘(C) With respect to payments to such Medicaid provider for costs other than costs related to the initial adoption of certified EHR technology, the Medicaid provider demonstrates meaningful use of certified EHR technology through a means that is approved by the State and acceptable to the Secretary, and that may be based upon the methodologies applied under section 1848(o) or 1886(n). CommentsClose CommentsPermalink





‘(D) To the extent specified by the Secretary, the certified EHR technology is compatible with State or Federal administrative management systems. CommentsClose CommentsPermalink





‘(6)(A) In no case shall the payments described in paragraph (1), with respect to a hospital, exceed in the aggregate the product of-- CommentsClose CommentsPermalink





‘(i) the overall hospital HIT amount for the hospital computed under subparagraph (B); and CommentsClose CommentsPermalink





‘(ii) the Medicaid share for such hospital computed under subparagraph (C). CommentsClose CommentsPermalink





‘(B) For purposes of this paragraph, the overall hospital HIT amount, with respect to a hospital, is the sum of the applicable amounts specified in section 1886(n)(2)(A) for such hospital for the first 4 payment years (as estimated by the Secretary) determined as if the Medicare share specified in clause (ii) of such section were 1. The Secretary shall publish in the Federal Register the overall hospital HIT amount for each hospital eligible for payments under this subsection. In computing amounts under clause (ii) for payment years after the first payment year, the Secretary shall assume that in subsequent payment years discharges increase at an annual rate of 2 percent per year. CommentsClose CommentsPermalink





‘(C) The Medicaid share computed under this subparagraph, for a hospital for a period specified by the Secretary, shall be calculated in the same manner as the Medicare share under section 1886(n)(2)(D) for such a hospital and period, except that there shall be substituted for the numerator under clause (i) of such section the amount that is equal to the number of inpatient-bed-days (as established by the Secretary) which are attributable to individuals who are receiving medical assistance under this title and who are not described in section 1886(n)(2)(D)(i). In computing inpatient-bed-days under the previous sentence, the Secretary shall take into account inpatient-bed-days attributable to inpatient-bed-days that are paid for individuals enrolled in a Medicaid managed care plan (under section 1903(m) or section 1932). CommentsClose CommentsPermalink





‘(7) With respect to health care providers other than hospitals, the Secretary shall ensure coordination of the different programs for payment of such health care providers for adoption or use of health information technology (including certified EHR technology), as well as payments for such health care providers provided under this title or title XVIII, to assure no duplication of funding. CommentsClose CommentsPermalink





‘(8) In carrying out paragraph (5)(C), the State and Secretary shall seek, to the maximum extent practicable, to avoid duplicative requirements from Federal and State Governments to demonstrate meaningful use of certified EHR technology under this title and title XVIII. In doing so, the Secretary may deem satisfaction of requirements for such meaningful use for a payment year under title XVIII to be sufficient to qualify as meaningful use under this subsection. The Secretary may also specify the reporting periods under this subsection in order to carry out this paragraph. CommentsClose CommentsPermalink





‘(9) In order to be provided Federal financial participation under subsection (a)(3)(F)(ii), a State must demonstrate to the satisfaction of the Secretary, that the State-- CommentsClose CommentsPermalink





‘(A) is using the funds provided for the purposes of administering payments under this subsection, including tracking of meaningful use by Medicaid providers; CommentsClose CommentsPermalink





‘(B) conducting adequate oversight of the program under this subsection, including routine tracking of meaningful use attestations and reporting mechanisms; and CommentsClose CommentsPermalink





‘(C) be pursuing initiatives to encourage the adoption of certified EHR technology to promote health care quality and the exchange of health care information under this title, subject to applicable laws and regulations governing such exchange. CommentsClose CommentsPermalink





‘(10) The Secretary shall periodically submit reports to the Committee on Energy and Commerce of the House of Representatives and the Committee on Finance of the Senate on status, progress, and oversight of payments under paragraph (1).’. CommentsClose CommentsPermalink





(b) Implementation Funding- In addition to funds otherwise available, out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary of Health and Human Services for the Center for Medicare & Medicaid Services Program Management Account, $40,000,000 for each of fiscal years 2009 through 2015 and $20,000,000 for each succeeding fiscal year through fiscal year 2019, which shall be available for purposes of carrying out the provisions of (and the amendments made by) this part. Amounts appropriated under this subsection for a fiscal year shall be available until expended. CommentsClose CommentsPermalink

Subtitle D--Privacy CommentsClose CommentsPermalink

SEC. 4400. DEFINITIONS.

In this subtitle, except as specified otherwise: CommentsClose CommentsPermalink





(1) BREACH- The term ‘breach’ means the unauthorized acquisition, access, use, or disclosure of protected health information which compromises the security, privacy, or integrity of protected health information maintained by or on behalf of a person. Such term does not include any unintentional acquisition, access, use, or disclosure of such information by an employee or agent of the covered entity or business associate involved if such acquisition, access, use, or disclosure, respectively, was made in good faith and within the course and scope of the employment or other contractual relationship of such employee or agent, respectively, with the covered entity or business associate and if such information is not further acquired, accessed, used, or disclosed by such employee or agent. CommentsClose CommentsPermalink





(2) BUSINESS ASSOCIATE- The term ‘business associate’ has the meaning given such term in section 160.103 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(3) COVERED ENTITY- The term ‘covered entity’ has the meaning given such term in section 160.103 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(4) DISCLOSE- The terms ‘disclose’ and ‘disclosure’ have the meaning given the term ‘disclosure’ in section 160.103 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(5) ELECTRONIC HEALTH RECORD- The term ‘electronic health record’ means an electronic record of health-related information on an individual that is created, gathered, managed, and consulted by authorized health care clinicians and staff. CommentsClose CommentsPermalink





(6) HEALTH CARE OPERATIONS- The term ‘health care operation’ has the meaning given such term in section 164.501 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(7) HEALTH CARE PROVIDER- The term ‘health care provider’ has the meaning given such term in section 160.103 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(8) HEALTH PLAN- The term ‘health plan’ has the meaning given such term in section 1171(5) of the Social Security Act. CommentsClose CommentsPermalink





(9) NATIONAL COORDINATOR- The term ‘National Coordinator’ means the head of the Office of the National Coordinator for Health Information Technology established under section 3001(a) of the Public Health Service Act, as added by section 4101. CommentsClose CommentsPermalink





(10) PAYMENT- The term ‘payment’ has the meaning given such term in section 164.501 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(11) PERSONAL HEALTH RECORD- The term ‘personal health record’ means an electronic record of individually identifiable health information on an individual that can be drawn from multiple sources and that is managed, shared, and controlled by or for the individual. CommentsClose CommentsPermalink





(12) PROTECTED HEALTH INFORMATION- The term ‘protected health information’ has the meaning given such term in section 160.103 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(13) SECRETARY- The term ‘Secretary’ means the Secretary of Health and Human Services. CommentsClose CommentsPermalink





(14) SECURITY- The term ‘security’ has the meaning given such term in section 164.304 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(15) STATE- The term ‘State’ means each of the several States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. CommentsClose CommentsPermalink





(16) TREATMENT- The term ‘treatment’ has the meaning given such term in section 164.501 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(17) USE- The term ‘use’ has the meaning given such term in section 160.103 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(18) VENDOR OF PERSONAL HEALTH RECORDS- The term ‘vendor of personal health records’ means an entity, other than a covered entity (as defined in paragraph (3)), that offers or maintains a personal health record. CommentsClose CommentsPermalink

PART I--IMPROVED PRIVACY PROVISIONS AND SECURITY PROVISIONS

SEC. 4401. APPLICATION OF SECURITY PROVISIONS AND PENALTIES TO BUSINESS ASSOCIATES OF COVERED ENTITIES; ANNUAL GUIDANCE ON SECURITY PROVISIONS.

(a) Application of Security Provisions- Sections 164.308, 164.310, 164.312, and 164.316 of title 45, Code of Federal Regulations, shall apply to a business associate of a covered entity in the same manner that such sections apply to the covered entity. The additional requirements of this title that relate to security and that are made applicable with respect to covered entities shall also be applicable to such a business associate and shall be incorporated into the business associate agreement between the business associate and the covered entity. CommentsClose CommentsPermalink





(b) Application of Civil and Criminal Penalties- In the case of a business associate that violates any security provision specified in subsection (a), sections 1176 and 1177 of the Social Security Act (42 U.S.C. 1320d-5, 1320d-6) shall apply to the business associate with respect to such violation in the same manner such sections apply to a covered entity that violates such security provision. CommentsClose CommentsPermalink





(c) Annual Guidance- For the first year beginning after the date of the enactment of this Act and annually thereafter, the Secretary of Health and Human Services shall, in consultation with industry stakeholders, annually issue guidance on the most effective and appropriate technical safeguards for use in carrying out the sections referred to in subsection (a) and the security standards in subpart C of part 164 of title 45, Code of Federal Regulations, as such provisions are in effect as of the date before the enactment of this Act. CommentsClose CommentsPermalink

SEC. 4402. NOTIFICATION IN THE CASE OF BREACH.

(a) In General- A covered entity that accesses, maintains, retains, modifies, records, stores, destroys, or otherwise holds, uses, or discloses unsecured protected health information (as defined in subsection (h)(1)) shall, in the case of a breach of such information that is discovered by the covered entity, notify each individual whose unsecured protected health information has been, or is reasonably believed by the covered entity to have been, accessed, acquired, or disclosed as a result of such breach. CommentsClose CommentsPermalink





(b) Notification of Covered Entity by Business Associate- A business associate of a covered entity that accesses, maintains, retains, modifies, records, stores, destroys, or otherwise holds, uses, or discloses unsecured protected health information shall, following the discovery of a breach of such information, notify the covered entity of such breach. Such notice shall include the identification of each individual whose unsecured protected health information has been, or is reasonably believed by the business associate to have been, accessed, acquired, or disclosed during such breach. CommentsClose CommentsPermalink





(c) Breaches Treated as Discovered- For purposes of this section, a breach shall be treated as discovered by a covered entity or by a business associate as of the first day on which such breach is known to such entity or associate, respectively, (including any person, other than the individual committing the breach, that is an employee, officer, or other agent of such entity or associate, respectively) or should reasonably have been known to such entity or associate (or person) to have occurred. CommentsClose CommentsPermalink





(d) Timeliness of Notification- CommentsClose CommentsPermalink





(1) IN GENERAL- Subject to subsection (g), all notifications required under this section shall be made without unreasonable delay and in no case later than 60 calendar days after the discovery of a breach by the covered entity involved (or business associate involved in the case of a notification required under subsection (b)). CommentsClose CommentsPermalink





(2) BURDEN OF PROOF- The covered entity involved (or business associate involved in the case of a notification required under subsection (b)), shall have the burden of demonstrating that all notifications were made as required under this part, including evidence demonstrating the necessity of any delay. CommentsClose CommentsPermalink





(e) Methods of Notice- CommentsClose CommentsPermalink





(1) INDIVIDUAL NOTICE- Notice required under this section to be provided to an individual, with respect to a breach, shall be provided promptly and in the following form: CommentsClose CommentsPermalink





(A) Written notification by first-class mail to the individual (or the next of kin of the individual if the individual is deceased) at the last known address of the individual or the next of kin, respectively, or, if specified as a preference by the individual, by electronic mail. The notification may be provided in one or more mailings as information is available. CommentsClose CommentsPermalink





(B) In the case in which there is insufficient, or out-of-date contact information (including a phone number, e-mail address, or any other form of appropriate communication) that precludes direct written (or, if specified by the individual under subparagraph (A), electronic) notification to the individual, a substitute form of notice shall be provided, including, in the case that there are 10 or more individuals for which there is insufficient or out-of-date contact information, a conspicuous posting for a period determined by the Secretary on the home page of the website of the covered entity involved or notice in major print or broadcast media, including major media in geographic areas where the individuals affected by the breach likely reside. Such a notice in media or web posting will include a toll-free phone number where an individual can learn whether or not the individual’s unsecured protected health information is possibly included in the breach. CommentsClose CommentsPermalink





(C) In any case deemed by the covered entity involved to require urgency because of possible imminent misuse of unsecured protected health information, the covered entity, in addition to notice provided under subparagraph (A), may provide information to individuals by telephone or other means, as appropriate. CommentsClose CommentsPermalink





(2) MEDIA NOTICE- Notice shall be provided to prominent media outlets serving a State or jurisdiction, following the discovery of a breach described in subsection (a), if the unsecured protected health information of more than 500 residents of such State or jurisdiction is, or is reasonably believed to have been, accessed, acquired, or disclosed during such breach. CommentsClose CommentsPermalink





(3) NOTICE TO SECRETARY- Notice shall be provided to the Secretary by covered entities of unsecured protected health information that has been acquired or disclosed in a breach. If the breach was with respect to 500 or more individuals than such notice must be provided immediately. If the breach was with respect to less than 500 individuals, the covered entity involved may maintain a log of any such breach occurring and annually submit such a log to the Secretary documenting such breaches occuring during the year involved. CommentsClose CommentsPermalink





(4) POSTING ON HHS PUBLIC WEBSITE- The Secretary shall make available to the public on the Internet website of the Department of Health and Human Services a list that identifies each covered entity involved in a breach described in subsection (a) in which the unsecured protected health information of more than 500 individuals is acquired or disclosed. CommentsClose CommentsPermalink





(f) Content of Notification- Regardless of the method by which notice is provided to individuals under this section, notice of a breach shall include, to the extent possible, the following: CommentsClose CommentsPermalink





(1) A brief description of what happened, including the date of the breach and the date of the discovery of the breach, if known. CommentsClose CommentsPermalink





(2) A description of the types of unsecured protected health information that were involved in the breach (such as full name, Social Security number, date of birth, home address, account number, or disability code). CommentsClose CommentsPermalink





(3) The steps individuals should take to protect themselves from potential harm resulting from the breach. CommentsClose CommentsPermalink





(4) A brief description of what the covered entity involved is doing to investigate the breach, to mitigate losses, and to protect against any further breaches. CommentsClose CommentsPermalink





(5) Contact procedures for individuals to ask questions or learn additional information, which shall include a toll-free telephone number, an e-mail address, website, or postal address. CommentsClose CommentsPermalink





(g) Delay of Notification Authorized for Law Enforcement Purposes- If a law enforcement official determines that a notification, notice, or posting required under this section would impede a criminal investigation or cause damage to national security, such notification, notice, or posting shall be delayed in the same manner as provided under section 164.528(a)(2) of title 45, Code of Federal Regulations, in the case of a disclosure covered under such section. CommentsClose CommentsPermalink





(h) Unsecured Protected Health Information- CommentsClose CommentsPermalink





(1) DEFINITION- CommentsClose CommentsPermalink





(A) IN GENERAL- Subject to subparagraph (B), for purposes of this section, the term ‘unsecured protected health information’ means protected health information that is not secured through the use of a technology or methodology specified by the Secretary in the guidance issued under paragraph (2). CommentsClose CommentsPermalink





(B) EXCEPTION IN CASE TIMELY GUIDANCE NOT ISSUED- In the case that the Secretary does not issue guidance under paragraph (2) by the date specified in such paragraph, for purposes of this section, the term ‘unsecured protected health information’ shall mean protected health information that is not secured by a technology standard that renders protected health information unusable, unreadable, or indecipherable to unauthorized individuals and is developed or endorsed by a standards developing organization that is accredited by the American National Standards Institute. CommentsClose CommentsPermalink





(2) GUIDANCE- For purposes of paragraph (1) and section 407(f)(3), not later than the date that is 60 days after the date of the enactment of this Act, the Secretary shall, after consultation with stakeholders, issue (and annually update) guidance specifying the technologies and methodologies that render protected health information unusable, unreadable, or indecipherable to unauthorized individuals. CommentsClose CommentsPermalink





(i) Report to Congress on Breaches- CommentsClose CommentsPermalink





(1) IN GENERAL- Not later than 12 months after the date of the enactment of this Act and annually thereafter, the Secretary shall prepare and submit to the Committee on Finance and the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives a report containing the information described in paragraph (2) regarding breaches for which notice was provided to the Secretary under subsection (e)(3). CommentsClose CommentsPermalink





(2) INFORMATION- The information described in this paragraph regarding breaches specified in paragraph (1) shall include-- CommentsClose CommentsPermalink





(A) the number and nature of such breaches; and CommentsClose CommentsPermalink





(B) actions taken in response to such breaches. CommentsClose CommentsPermalink





(j) Regulations; Effective Date- To carry out this section, the Secretary of Health and Human Services shall promulgate interim final regulations by not later than the date that is 180 days after the date of the enactment of this title. The provisions of this section shall apply to breaches that are discovered on or after the date that is 30 days after the date of publication of such interim final regulations. CommentsClose CommentsPermalink

SEC. 4403. EDUCATION ON HEALTH INFORMATION PRIVACY.

(a) Regional Office Privacy Advisors- Not later than 6 months after the date of the enactment of this Act, the Secretary shall designate an individual in each regional office of the Department of Health and Human Services to offer guidance and education to covered entities, business associates, and individuals on their rights and responsibilities related to Federal privacy and security requirements for protected health information. CommentsClose CommentsPermalink





(b) Education Initiative on Uses of Health Information- Not later than 12 months after the date of the enactment of this Act, the Office for Civil Rights within the Department of Health and Human Services shall develop and maintain a multi-faceted national education initiative to enhance public transparency regarding the uses of protected health information, including programs to educate individuals about the potential uses of their protected health information, the effects of such uses, and the rights of individuals with respect to such uses. Such programs shall be conducted in a variety of languages and present information in a clear and understandable manner. CommentsClose CommentsPermalink

SEC. 4404. APPLICATION OF PRIVACY PROVISIONS AND PENALTIES TO BUSINESS ASSOCIATES OF COVERED ENTITIES.

(a) Application of Contract Requirements- In the case of a business associate of a covered entity that obtains or creates protected health information pursuant to a written contract (or other written arrangement) described in section 164.502(e)(2) of title 45, Code of Federal Regulations, with such covered entity, the business associate may use and disclose such protected health information only if such use or disclosure, respectively, is in compliance with each applicable requirement of section 164.504(e) of such title. The additional requirements of this subtitle that relate to privacy and that are made applicable with respect to covered entities shall also be applicable to such a business associate and shall be incorporated into the business associate agreement between the business associate and the covered entity. CommentsClose CommentsPermalink





(b) Application of Knowledge Elements Associated With Contracts- Section 164.504(e)(1)(ii) of title 45, Code of Federal Regulations, shall apply to a business associate described in subsection (a), with respect to compliance with such subsection, in the same manner that such section applies to a covered entity, with respect to compliance with the standards in sections 164.502(e) and 164.504(e) of such title, except that in applying such section 164.504(e)(1)(ii) each reference to the business associate, with respect to a contract, shall be treated as a reference to the covered entity involved in such contract. CommentsClose CommentsPermalink





(c) Application of Civil and Criminal Penalties- In the case of a business associate that violates any provision of subsection (a) or (b), the provisions of sections 1176 and 1177 of the Social Security Act (42 U.S.C. 1320d-5, 1320d-6) shall apply to the business associate with respect to such violation in the same manner as such provisions apply to a person who violates a provision of part C of title XI of such Act. CommentsClose CommentsPermalink

SEC. 4405. RESTRICTIONS ON CERTAIN DISCLOSURES AND SALES OF HEALTH INFORMATION; ACCOUNTING OF CERTAIN PROTECTED HEALTH INFORMATION DISCLOSURES; ACCESS TO CERTAIN INFORMATION IN ELECTRONIC FORMAT.

(a) Requested Restrictions on Certain Disclosures of Health Information- In the case that an individual requests under paragraph (a)(1)(i)(A) of section 164.522 of title 45, Code of Federal Regulations, that a covered entity restrict the disclosure of the protected health information of the individual, notwithstanding paragraph (a)(1)(ii) of such section, the covered entity must comply with the requested restriction if-- CommentsClose CommentsPermalink





(1) except as otherwise required by law, the disclosure is to a health plan for purposes of carrying out payment or health care operations (and is not for purposes of carrying out treatment); and CommentsClose CommentsPermalink





(2) the protected health information pertains solely to a health care item or service for which the health care provider involved has been paid out of pocket in full. CommentsClose CommentsPermalink





(b) Disclosures Required To Be Limited to the Limited Data Set or the Minimum Necessary- CommentsClose CommentsPermalink





(1) IN GENERAL- CommentsClose CommentsPermalink





(A) IN GENERAL- Subject to subparagraph (B), a covered entity shall be treated as being in compliance with section 164.502(b)(1) of title 45, Code of Federal Regulations, with respect to the use, disclosure, or request of protected health information described in such section, only if the covered entity limits such protected health information, to the extent practicable, to the limited data set (as defined in section 164.514(e)(2) of such title) or, if needed by such entity, to the minimum necessary to accomplish the intended purpose of such use, disclosure, or request, respectively. CommentsClose CommentsPermalink





(B) GUIDANCE- Not later than 18 months after the date of the enactment of this section, the Secretary shall issue guidance on what constitutes ‘minimum necessary’ for purposes of subpart E of part 164 of title 45, Code of Federal Regulation. In issuing such guidance the Secretary shall take into consideration the guidance under section 4424(c). CommentsClose CommentsPermalink





(C) SUNSET- Subparagraph (A) shall not apply on and after the effective date on which the Secretary issues the guidance under subparagraph (B). CommentsClose CommentsPermalink





(2) DETERMINATION OF MINIMUM NECESSARY- For purposes of paragraph (1), in the case of the disclosure of protected health information, the covered entity or business associate disclosing such information shall determine what constitutes the minimum necessary to accomplish the intended purpose of such disclosure. CommentsClose CommentsPermalink





(3) APPLICATION OF EXCEPTIONS- The exceptions described in section 164.502(b)(2) of title 45, Code of Federal Regulations, shall apply to the requirement under paragraph (1) as of the effective date described in section 4423 in the same manner that such exceptions apply to section 164.502(b)(1) of such title before such date. CommentsClose CommentsPermalink





(4) RULE OF CONSTRUCTION- Nothing in this subsection shall be construed as affecting the use, disclosure, or request of protected health information that has been de-identified. CommentsClose CommentsPermalink





(c) Accounting of Certain Protected Health Information Disclosures Required if Covered Entity Uses Electronic Health Record- CommentsClose CommentsPermalink





(1) IN GENERAL- In applying section 164.528 of title 45, Code of Federal Regulations, in the case that a covered entity uses or maintains an electronic health record with respect to protected health information-- CommentsClose CommentsPermalink





(A) the exception under paragraph (a)(1)(i) of such section shall not apply to disclosures through an electronic health record made by such entity of such information; and CommentsClose CommentsPermalink





(B) an individual shall have a right to receive an accounting of disclosures described in such paragraph of such information made by such covered entity during only the three years prior to the date on which the accounting is requested. CommentsClose CommentsPermalink





(2) REGULATIONS- The Secretary shall promulgate regulations on what information shall be collected about each disclosure referred to in paragraph (1)(A) not later than 18 months after the date on which the Secretary adopts standards on accounting for disclosure described in the section 3002(b)(2)(B)(iv) of the Public Health Service Act, as added by section 4101. Such regulations shall only require such information to be collected through an electronic health record in a manner that takes into account the interests of individuals in learning the circumstances under which their protected health information is being disclosed and takes into account the administrative burden of accounting for such disclosures. CommentsClose CommentsPermalink





(3) CONSTRUCTION- Nothing in this subsection shall be construed as requiring a covered entity to account for disclosures of protected health information that are not made by such covered entity or by a business associate acting on behalf of the covered entity. CommentsClose CommentsPermalink





(4) EFFECTIVE DATE- CommentsClose CommentsPermalink





(A) CURRENT USERS OF ELECTRONIC RECORDS- In the case of a covered entity insofar as it acquired an electronic health record as of January 1, 2009, paragraph (1) shall apply to disclosures, with respect to protected health information, made by the covered entity from such a record on and after January 1, 2014. CommentsClose CommentsPermalink





(B) OTHERS- In the case of a covered entity insofar as it acquires an electronic health record after January 1, 2009, paragraph (1) shall apply to disclosures, with respect to protected health information, made by the covered entity from such record on and after the later of the following: CommentsClose CommentsPermalink





(i) January 1, 2011; or CommentsClose CommentsPermalink





(ii) the date that it acquires an electronic health record. CommentsClose CommentsPermalink





(d) Review of Health Care Operations- Not later than 18 months after the date of the enactment of this title, the Secretary shall promulgate regulations to eliminate from the definition of health care operations under section 164.501 of title 45, Code of Federal Regulations, those activities that can reasonably and efficiently be conducted through the use of information that is de-identified (in accordance with the requirements of section 164.514(b) of such title) or that should require a valid authorization for use or disclosure. In promulgating such regulations, the Secretary may choose to narrow or clarify activities that the Secretary chooses to retain in the definition of health care operations and the Secretary shall take into account the report under section 424(d). In such regulations the Secretary shall specify the date on which such regulations shall apply to disclosures made by a covered entity, but in no case would such date be sooner than the date that is 24 months after the date of the enactment of this section. CommentsClose CommentsPermalink





(e) Prohibition on Sale of Electronic Health Records or Protected Health Information Obtained From Electronic Health Records- CommentsClose CommentsPermalink





(1) IN GENERAL- Except as provided in paragraph (2), a covered entity or business associate shall not directly or indirectly receive remuneration in exchange for any protected health information of an individual unless the covered entity obtained from the individual, in accordance with section 164.508 of title 45, Code of Federal Regulations, a valid authorization that includes, in accordance with such section, a specification of whether the protected health information can be further exchanged for remuneration by the entity receiving protected health information of that individual. CommentsClose CommentsPermalink





(2) EXCEPTIONS- Paragraph (1) shall not apply in the following cases: CommentsClose CommentsPermalink





(A) The purpose of the exchange is for research or public health activities (as described in sections 164.501, 164.512(i), and 164.512(b) of title 45, Code of Federal Regulations) and the price charged reflects the costs of preparation and transmittal of the data for such purpose. CommentsClose CommentsPermalink





(B) The purpose of the exchange is for the treatment of the individual and the price charges reflects not more than the costs of preparation and transmittal of the data for such purpose. CommentsClose CommentsPermalink





(C) The purpose of the exchange is the health care operation specifically described in subparagraph (iv) of paragraph (6) of the definition of health care operations in section 164.501 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(D) The purpose of the exchange is for remuneration that is provided by a covered entity to a business associate for activities involving the exchange of protected health information that the business associate undertakes on behalf of and at the specific request of the covered entity pursuant to a business associate agreement. CommentsClose CommentsPermalink





(E) The purpose of the exchange is to provide an individual with a copy of the individual’s protected health information pursuant to section 164.524 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(F) The purpose of the exchange is otherwise determined by the Secretary in regulations to be similarly necessary and appropriate as the exceptions provided in subparagraphs (A) through (E). CommentsClose CommentsPermalink





(3) REGULATIONS- The Secretary shall promulgate regulations to carry out paragraph (this subsection, including exceptions described in paragraph (2), not later than 18 months after the date of the enactment of this title. CommentsClose CommentsPermalink





(4) EFFECTIVE DATE- Paragraph (1) shall apply to exchanges occurring on or after the date that is 6 months after the date of the promulgation of final regulations implementing this subsection. CommentsClose CommentsPermalink





(f) Access to Certain Information in Electronic Format- In applying section 164.524 of title 45, Code of Federal Regulations, in the case that a covered entity uses or maintains an electronic health record with respect to protected health information of an individual-- CommentsClose CommentsPermalink





(1) the individual shall have a right to obtain from such covered entity a copy of such information in an electronic format; and CommentsClose CommentsPermalink





(2) notwithstanding paragraph (c)(4) of such section, any fee that the covered entity may impose for providing such individual with a copy of such information (or a summary or explanation of such information) if such copy (or summary or explanation) is in an electronic form shall not be greater than the entity’s labor costs in responding to the request for the copy (or summary or explanation). CommentsClose CommentsPermalink

SEC. 4406. CONDITIONS ON CERTAIN CONTACTS AS PART OF HEALTH CARE OPERATIONS.

(a) Marketing- CommentsClose CommentsPermalink





(1) IN GENERAL- A communication by a covered entity or business associate that is about a product or service and that encourages recipients of the communication to purchase or use the product or service shall not be considered a health care operation for purposes of subpart E of part 164 of title 45, Code of Federal Regulations, unless the communication is made as described in subparagraph (i), (ii), or (iii) of paragraph (1) of the definition of marketing in section 164.501 of such title. CommentsClose CommentsPermalink





(2) PAYMENT FOR CERTAIN COMMUNICATIONS- A covered entity or business associate may not receive direct or indirect payment in exchange for making any communication described in subparagraph (i), (ii), or (iii) of paragraph (1) of the definition of marketing in section 164.501 of title 45, Code of Federal Regulations, except-- CommentsClose CommentsPermalink





(A) a business associate of a covered entity may receive payment from the covered entity for making any such communication on behalf of the covered entity that is consistent with the written contract (or other written arrangement) described in section 164.502(e)(2) of such title between such business associate and covered entity; and CommentsClose CommentsPermalink





(B) a covered entity may receive payment in exchange for making any such communication if the entity obtains from the recipient of the communication, in accordance with section 164.508 of title 45, Code of Federal Regulations, a valid authorization (as described in paragraph (b) of such section) with respect to such communication. CommentsClose CommentsPermalink





(b) Fundraising- Fundraising for the benefit of a covered entity shall not be considered a health care operation for purposes of section 164.501 of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(c) Effective Date- This section shall apply to contracting occurring on or after the effective date specified under section 4423. CommentsClose CommentsPermalink

SEC. 4407. TEMPORARY BREACH NOTIFICATION REQUIREMENT FOR VENDORS OF PERSONAL HEALTH RECORDS AND OTHER NON-HIPAA COVERED ENTITIES.

(a) In General- In accordance with subsection (c), each vendor of personal health records, following the discovery of a breach of security of unsecured PHR identifiable health information that is in a personal health record maintained or offered by such vendor, and each entity described in clause (ii) or (iii) of section 4424(b)(1)(A), following the discovery of a breach of security of such information that is obtained through a product or service provided by such entity, shall-- CommentsClose CommentsPermalink





(1) notify each individual who is a citizen or resident of the United States whose unsecured PHR identifiable health information was acquired by an unauthorized person as a result of such a breach of security; and CommentsClose CommentsPermalink





(2) notify the Federal Trade Commission. CommentsClose CommentsPermalink





(b) Notification by Third Party Service Providers- A third party service provider that provides services to a vendor of personal health records or to an entity described in clause (ii) or (iii) of section 4424(b)(1)(A) in connection with the offering or maintenance of a personal health record or a related product or service and that accesses, maintains, retains, modifies, records, stores, destroys, or otherwise holds, uses, or discloses unsecured PHR identifiable health information in such a record as a result of such services shall, following the discovery of a breach of security of such information, notify such vendor or entity, respectively, of such breach. Such notice shall include the identification of each individual whose unsecured PHR identifiable health information has been, or is reasonably believed to have been, accessed, acquired, or disclosed during such breach. CommentsClose CommentsPermalink





(c) Application of Requirements for Timeliness, Method, and Content of Notifications- Subsections (c), (d), (e), and (f) of section 402 shall apply to a notification required under subsection (a) and a vendor of personal health records, an entity described in subsection (a) and a third party service provider described in subsection (b), with respect to a breach of security under subsection (a) of unsecured PHR identifiable health information in such records maintained or offered by such vendor, in a manner specified by the Federal Trade Commission. CommentsClose CommentsPermalink





(d) Notification of the Secretary- Upon receipt of a notification of a breach of security under subsection (a)(2), the Federal Trade Commission shall notify the Secretary of such breach. CommentsClose CommentsPermalink





(e) Enforcement- A violation of subsection (a) or (b) shall be treated as an unfair and deceptive act or practice in violation of a regulation under section 18(a)(1)(B) of the Federal Trade Commission Act (15 U.S.C. 57a(a)(1)(B)) regarding unfair or deceptive acts or practices. CommentsClose CommentsPermalink





(f) Definitions- For purposes of this section: CommentsClose CommentsPermalink





(1) BREACH OF SECURITY- The term ‘breach of security’ means, with respect to unsecured PHR identifiable health information of an individual in a personal health record, acquisition of such information without the authorization of the individual. CommentsClose CommentsPermalink





(2) PHR IDENTIFIABLE HEALTH INFORMATION- The term ‘PHR identifiable health information’ means individually identifiable health information, as defined in section 1171(6) of the Social Security Act (42 U.S.C. 1320d(6)), and includes, with respect to an individual, information-- CommentsClose CommentsPermalink





(A) that is provided by or on behalf of the individual; and CommentsClose CommentsPermalink





(B) that identifies the individual or with respect to which there is a reasonable basis to believe that the information can be used to identify the individual. CommentsClose CommentsPermalink





(3) UNSECURED PHR IDENTIFIABLE HEALTH INFORMATION- CommentsClose CommentsPermalink





(A) IN GENERAL- Subject to subparagraph (B), the term ‘unsecured PHR identifiable health information’ means PHR identifiable health information that is not protected through the use of a technology or methodology specified by the Secretary in the guidance issued under section 4402(h)(2). CommentsClose CommentsPermalink





(B) EXCEPTION IN CASE TIMELY GUIDANCE NOT ISSUED- In the case that the Secretary does not issue guidance under section 4402(h)(2) by the date specified in such section, for purposes of this section, the term ‘unsecured PHR identifiable health information’ shall mean PHR identifiable health information that is not secured by a technology standard that renders protected health information unusable, unreadable, or indecipherable to unauthorized individuals and that is developed or endorsed by a standards developing organization that is accredited by the American National Standards Institute. CommentsClose CommentsPermalink





(g) Regulations; Effective Date; Sunset- CommentsClose CommentsPermalink





(1) REGULATIONS; EFFECTIVE DATE- To carry out this section, the Secretary of Health and Human Services shall promulgate interim final regulations by not later than the date that is 180 days after the date of the enactment of this section. The provisions of this section shall apply to breaches of security that are discovered on or after the date that is 30 days after the date of publication of such interim final regulations. CommentsClose CommentsPermalink





(2) SUNSET- The provisions of this section shall not apply to breaches of security occurring on or after the earlier of the following the dates: CommentsClose CommentsPermalink





(A) The date on which a standard relating to requirements for entities that are not covered entities that includes requirements relating to breach notification has been promulgated by the Secretary. CommentsClose CommentsPermalink





(B) The date on which a standard relating to requirements for entities that are not covered entities that includes requirements relating to breach notification has been promulgated by the Federal Trade Commission and has taken effect. CommentsClose CommentsPermalink

SEC. 4408. BUSINESS ASSOCIATE CONTRACTS REQUIRED FOR CERTAIN ENTITIES.

Each organization, with respect to a covered entity, that provides data transmission of protected health information to such entity (or its business associate) and that requires access on a routine basis to such protected health information, such as a Health Information Exchange Organization, Regional Health Information Organization, E-prescribing Gateway, or each vendor that contracts with a covered entity to allow that covered entity to offer a personal health record to patients as part of its electronic health record, is required to enter into a written contract (or other written arrangement) described in section 164.502(e)(2) of title 45, Code of Federal Regulations and a written contract (or other arrangement) described in section 164.308(b) of such title, with such entity and shall be treated as a business associate of the covered entity for purposes of the provisions of this subtitle and subparts C and E of part 164 of title 45, Code of Federal Regulations, as such provisions are in effect as of the date of enactment of this title. CommentsClose CommentsPermalink

SEC. 4409. CLARIFICATION OF APPLICATION OF WRONGFUL DISCLOSURES CRIMINAL PENALTIES.

Section 1177(a) of the Social Security Act (42 U.S.C. 1320d-6(a)) is amended by adding at the end the following new sentence: ‘For purposes of the previous sentence, a person (including an employee or other individual) shall be considered to have obtained or disclosed individually identifiable health information in violation of this part if the information is maintained by a covered entity (as defined in the HIPAA privacy regulation described in section 1180(b)(3)) and the individual obtained or disclosed such information without authorization.’. CommentsClose CommentsPermalink

SEC. 4410. IMPROVED ENFORCEMENT.

(a) In General- Section 1176 of the Social Security Act (42 U.S.C. 1320d-5) is amended-- CommentsClose CommentsPermalink





(1) in subsection (b)(1), by striking ‘the act constitutes an offense punishable under section 1177’ and inserting ‘a penalty has been imposed under section 1177 with respect to such act’; and CommentsClose CommentsPermalink





(2) by adding at the end the following new subsection: CommentsClose CommentsPermalink





‘(c) Noncompliance Due to Willful Neglect- CommentsClose CommentsPermalink





‘(1) IN GENERAL- A violation of a provision of this part due to willful neglect is a violation for which the Secretary is required to impose a penalty under subsection (a)(1). CommentsClose CommentsPermalink





‘(2) REQUIRED INVESTIGATION- For purposes of paragraph (1), the Secretary shall formally investigate any complaint of a violation of a provision of this part if a preliminary investigation of the facts of the complaint indicate such a possible violation due to willful neglect.’. CommentsClose CommentsPermalink





(b) Effective Date; Regulations- CommentsClose CommentsPermalink





(1) The amendments made by subsection (a) shall apply to penalties imposed on or after the date that is 24 months after the date of the enactment of this title. CommentsClose CommentsPermalink





(2) Not later than 18 months after the date of the enactment of this title, the Secretary of Health and Human Services shall promulgate regulations to implement such amendments. CommentsClose CommentsPermalink





(c) Distribution of Certain Civil Monetary Penalties Collected- CommentsClose CommentsPermalink





(1) IN GENERAL- Subject to the regulation promulgated pursuant to paragraph (3), any civil monetary penalty or monetary settlement collected with respect to an offense punishable under this subtitle or section 1176 of the Social Security Act (42 U.S.C. 1320d-5) insofar as such section relates to privacy or security shall be transferred to the Office of Civil Rights of the Department of Health and Human Services to be used for purposes of enforcing the provisions of this subtitle and subparts C and E of part 164 of title 45, Code of Federal Regulations, as such provisions are in effect as of the date of enactment of this Act. CommentsClose CommentsPermalink





(2) GAO REPORT- Not later than 18 months after the date of the enactment of this title, the Comptroller General shall submit to the Secretary a report including recommendations for a methodology under which an individual who is harmed by an act that constitutes an offense referred to in paragraph (1) may receive a percentage of any civil monetary penalty or monetary settlement collected with respect to such offense. CommentsClose CommentsPermalink





(3) ESTABLISHMENT OF METHODOLOGY TO DISTRIBUTE PERCENTAGE OF CMPS COLLECTED TO HARMED INDIVIDUALS- Not later than 3 years after the date of the enactment of this title, the Secretary shall establish by regulation and based on the recommendations submitted under paragraph (2), a methodology under which an individual who is harmed by an act that constitutes an offense referred to in paragraph (1) may receive a percentage of any civil monetary penalty or monetary settlement collected with respect to such offense. CommentsClose CommentsPermalink





(4) APPLICATION OF METHODOLOGY- The methodology under paragraph (3) shall be applied with respect to civil monetary penalties or monetary settlements imposed on or after the effective date of the regulation. CommentsClose CommentsPermalink





(d) Tiered Increase in Amount of Civil Monetary Penalties- CommentsClose CommentsPermalink





(1) IN GENERAL- Section 1176(a)(1) of the Social Security Act (42 U.S.C. 1320d-5(a)(1)) is amended by striking ‘who violates a provision of this part a penalty of not more than’ and all that follows and inserting the following: ‘who violates a provision of this part-- CommentsClose CommentsPermalink





‘(A) in the case of a violation of such provision in which it is established that the person did not know (and by exercising reasonable diligence would not have known) that such person violated such provision, a penalty for each such violation of an amount that is at least the amount described in paragraph (3)(A) but not to exceed the amount described in paragraph (3)(D); CommentsClose CommentsPermalink





‘(B) in the case of a violation of such provision in which it is established that the violation was due to reasonable cause and not to willful neglect, a penalty for each such violation of an amount that is at least the amount described in paragraph (3)(B) but not to exceed the amount described in paragraph (3)(D); and CommentsClose CommentsPermalink





‘(C) in the case of a violation of such provision in which it is established that the violation was due to willful neglect-- CommentsClose CommentsPermalink





‘(i) if the violation is corrected as described in subsection (b)(3)(A), a penalty in an amount that is at least the amount described in paragraph (3)(C) but not to exceed the amount described in paragraph (3)(D); and CommentsClose CommentsPermalink





‘(ii) if the violation is not corrected as described in such subsection, a penalty in an amount that is at least the amount described in paragraph (3)(D). CommentsClose CommentsPermalink





In determining the amount of a penalty under this section for a violation, the Secretary shall base such determination on the nature and extent of the violation and the nature and extent of the harm resulting from such violation.’. CommentsClose CommentsPermalink





(2) TIERS OF PENALTIES DESCRIBED- Section 1176(a) of such Act (42 U.S.C. 1320d-5(a)) is further amended by adding at the end the following new paragraph: CommentsClose CommentsPermalink





‘(3) TIERS OF PENALTIES DESCRIBED- For purposes of paragraph (1), with respect to a violation by a person of a provision of this part-- CommentsClose CommentsPermalink





‘(A) the amount described in this subparagraph is $100 for each such violation, except that the total amount imposed on the person for all such violations of an identical requirement or prohibition during a calendar year may not exceed $25,000; CommentsClose CommentsPermalink





‘(B) the amount described in this subparagraph is $1,000 for each such violation, except that the total amount imposed on the person for all such violations of an identical requirement or prohibition during a calendar year may not exceed $100,000; CommentsClose CommentsPermalink





‘(C) the amount described in this subparagraph is $10,000 for each such violation, except that the total amount imposed on the person for all such violations of an identical requirement or prohibition during a calendar year may not exceed $250,000; and CommentsClose CommentsPermalink





‘(D) the amount described in this subparagraph is $50,000 for each such violation, except that the total amount imposed on the person for all such violations of an identical requirement or prohibition during a calendar year may not exceed $1,500,000.’. CommentsClose CommentsPermalink





(3) CONFORMING AMENDMENTS- Section 1176(b) of such Act (42 U.S.C. 1320d-5(b)) is amended-- CommentsClose CommentsPermalink





(A) by striking paragraph (2) and redesignating paragraphs (3) and (4) as paragraphs (2) and (3), respectively; and CommentsClose CommentsPermalink





(B) in paragraph (2), as so redesignated-- CommentsClose CommentsPermalink





(i) in subparagraph (A), by striking ‘in subparagraph (B), a penalty may not be imposed under subsection (a) if’ and all that follows through ‘the failure to comply is corrected’ and inserting ‘in subparagraph (B) or subsection (a)(1)(C), a penalty may not be imposed under subsection (a) if the failure to comply is corrected’; and CommentsClose CommentsPermalink





(ii) in subparagraph (B), by striking ‘(A)(ii)’ and inserting ‘(A)’ each place it appears. CommentsClose CommentsPermalink





(4) EFFECTIVE DATE- The amendments made by this subsection shall apply to violations occurring after the date of the enactment of this title. CommentsClose CommentsPermalink





(e) Enforcement Through State Attorneys General- CommentsClose CommentsPermalink





(1) IN GENERAL- Section 1176 of the Social Security Act (42 U.S.C. 1320d-5) is amended by adding at the end the following new subsection: CommentsClose CommentsPermalink





‘(c) Enforcement by State Attorneys General- CommentsClose CommentsPermalink





‘(1) CIVIL ACTION- Except as provided in subsection (b), in any case in which the attorney general of a State has reason to believe that an interest of one or more of the residents of that State has been or is threatened or adversely affected by any person who violates a provision of this part, the attorney general of the State, as parens patriae, may bring a civil action on behalf of such residents of the State in a district court of the United States of appropriate jurisdiction-- CommentsClose CommentsPermalink





‘(A) to enjoin further such violation by the defendant; or CommentsClose CommentsPermalink





‘(B) to obtain damages on behalf of such residents of the State, in an amount equal to the amount determined under paragraph (2). CommentsClose CommentsPermalink





‘(2) STATUTORY DAMAGES- CommentsClose CommentsPermalink





‘(A) IN GENERAL- For purposes of paragraph (1)(B), the amount determined under this paragraph is the amount calculated by multiplying the number of violations by up to $100. For purposes of the preceding sentence, in the case of a continuing violation, the number of violations shall be determined consistent with the HIPAA privacy regulations (as defined in section 1180(b)(3)) for violations of subsection (a). CommentsClose CommentsPermalink





‘(B) LIMITATION- The total amount of damages imposed on the person for all violations of an identical requirement or prohibition during a calendar year may not exceed $25,000. CommentsClose CommentsPermalink





‘(C) REDUCTION OF DAMAGES- In assessing damages under subparagraph (A), the court may consider the factors the Secretary may consider in determining the amount of a civil money penalty under subsection (a) under the HIPAA privacy regulations. CommentsClose CommentsPermalink





‘(3) ATTORNEY FEES- In the case of any successful action under paragraph (1), the court, in its discretion, may award the costs of the action and reasonable attorney fees to the State. CommentsClose CommentsPermalink





‘(4) NOTICE TO SECRETARY- The State shall serve prior written notice of any action under paragraph (1) upon the Secretary and provide the Secretary with a copy of its complaint, except in any case in which such prior notice is not feasible, in which case the State shall serve such notice immediately upon instituting such action. The Secretary shall have the right-- CommentsClose CommentsPermalink





‘(A) to intervene in the action; CommentsClose CommentsPermalink





‘(B) upon so intervening, to be heard on all matters arising therein; and CommentsClose CommentsPermalink





‘(C) to file petitions for appeal. CommentsClose CommentsPermalink





‘(5) CONSTRUCTION- For purposes of bringing any civil action under paragraph (1), nothing in this section shall be construed to prevent an attorney general of a State from exercising the powers conferred on the attorney general by the laws of that State. CommentsClose CommentsPermalink





‘(6) VENUE; SERVICE OF PROCESS- CommentsClose CommentsPermalink





‘(A) VENUE- Any action brought under paragraph (1) may be brought in the district court of the United States that meets applicable requirements relating to venue undersection 1391 of title 28, United States Code. CommentsClose CommentsPermalink





‘(B) SERVICE OF PROCESS- In an action brought under paragraph (1), process may be served in any district in which the defendant-- CommentsClose CommentsPermalink





‘(i) is an inhabitant; or CommentsClose CommentsPermalink





‘(ii) maintains a physical place of business. CommentsClose CommentsPermalink





‘(7) LIMITATION ON STATE ACTION WHILE FEDERAL ACTION IS PENDING- If the Secretary has instituted an action against a person under subsection (a) with respect to a specific violation of this part, no State attorney general may bring an action under this subsection against the person with respect to such violation during the pendency of that action. CommentsClose CommentsPermalink





‘(8) APPLICATION OF CMP STATUTE OF LIMITATION- A civil action may not be instituted with respect to a violation of this part unless an action to impose a civil money penalty may be instituted under subsection (a) with respect to such violation consistent with the second sentence of section 1128A(c)(1).’. CommentsClose CommentsPermalink





(2) CONFORMING AMENDMENTS- Subsection (b) of such section, as amended by subsection (d)(3), is amended-- CommentsClose CommentsPermalink





(A) in paragraph (1), by striking ‘A penalty may not be imposed under subsection (a)’ and inserting ‘No penalty may be imposed under subsection (a) and no damages obtained under subsection (c)’; CommentsClose CommentsPermalink





(B) in paragraph (2)(A)-- CommentsClose CommentsPermalink





(i) in the matter before clause (i), by striking ‘a penalty may not be imposed under subsection (a)’ and inserting ‘no penalty may be imposed under subsection (a) and no damages obtained under subsection (c)’; and CommentsClose CommentsPermalink





(ii) in clause (ii), by inserting ‘or damages’ after ‘the penalty’; CommentsClose CommentsPermalink





(C) in paragraph (2)(B)(i), by striking ‘The period’ and inserting ‘With respect to the imposition of a penalty by the Secretary under subsection (a), the period’; and CommentsClose CommentsPermalink





(D) in paragraph (3), by inserting ‘and any damages under subsection (c)’ after ‘any penalty under subsection (a)’. CommentsClose CommentsPermalink





(3) EFFECTIVE DATE- The amendments made by this subsection shall apply to violations occurring after the date of the enactment of this Act. CommentsClose CommentsPermalink





(f) Allowing Continued Use of Corrective Action- Such section is further amended by adding at the end the following new subsection: CommentsClose CommentsPermalink





‘(d) Allowing Continued Use of Corrective Action- Nothing in this section shall be construed as preventing the Office of Civil Rights of the Department of Health and Human Services from continuing, in its discretion, to use corrective action without a penalty in cases where the person did not know (and by exercising reasonable diligence would not have known) of the violation involved.’. CommentsClose CommentsPermalink

SEC. 4411. AUDITS.

The Secretary shall provide for periodic audits to ensure that covered entities and business associates that are subject to the requirements of this subtitle and subparts C and E of part 164 of title 45, Code of Federal Regulations, as such provisions are in effect as of the date of enactment of this Act, comply with such requirements. CommentsClose CommentsPermalink

PART II--RELATIONSHIP TO OTHER LAWS; REGULATORY REFERENCES; EFFECTIVE DATE; REPORTS

SEC. 4421. RELATIONSHIP TO OTHER LAWS.

(a) Application of HIPAA State Preemption- Section 1178 of the Social Security Act (42 U.S.C. 1320d-7) shall apply to a provision or requirement under this subtitle in the same manner that such section applies to a provision or requirement under part C of title XI of such Act or a standard or implementation specification adopted or established under sections 1172 through 1174 of such Act. CommentsClose CommentsPermalink





(b) Health Insurance Portability and Accountability Act- The standards governing the privacy and security of individually identifiable health information promulgated by the Secretary under sections 262(a) and 264 of the Health Insurance Portability and Accountability Act of 1996 shall remain in effect to the extent that they are consistent with this subtitle. The Secretary shall by rule amend such Federal regulations as required to make such regulations consistent with this subtitle. CommentsClose CommentsPermalink

SEC. 4422. REGULATORY REFERENCES.

Each reference in this subtitle to a provision of the Code of Federal Regulations refers to such provision as in effect on the date of the enactment of this title (or to the most recent update of such provision). CommentsClose CommentsPermalink

SEC. 4423. EFFECTIVE DATE.

Except as otherwise specifically provided, the provisions of part I shall take effect on the date that is 12 months after the date of the enactment of this title. CommentsClose CommentsPermalink

SEC. 4424. STUDIES, REPORTS, GUIDANCE.

(a) Report on Compliance- CommentsClose CommentsPermalink





(1) IN GENERAL- For the first year beginning after the date of the enactment of this Act and annually thereafter, the Secretary shall prepare and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives a report concerning complaints of alleged violations of law, including the provisions of this subtitle as well as the provisions of subparts C and E of part 164 of title 45, Code of Federal Regulations, (as such provisions are in effect as of the date of enactment of this Act) relating to privacy and security of health information that are received by the Secretary during the year for which the report is being prepared. Each such report shall include, with respect to such complaints received during the year-- CommentsClose CommentsPermalink





(A) the number of such complaints; CommentsClose CommentsPermalink





(B) the number of such complaints resolved informally, a summary of the types of such complaints so resolved, and the number of covered entities that received technical assistance from the Secretary during such year in order to achieve compliance with such provisions and the types of such technical assistance provided; CommentsClose CommentsPermalink





(C) the number of such complaints that have resulted in the imposition of civil monetary penalties or have been resolved through monetary settlements, including the nature of the complaints involved and the amount paid in each penalty or settlement; CommentsClose CommentsPermalink





(D) the number of compliance reviews conducted and the outcome of each such review; CommentsClose CommentsPermalink





(E) the number of subpoenas or inquiries issued; CommentsClose CommentsPermalink





(F) the Secretary’s plan for improving compliance with and enforcement of such provisions for the following year; and CommentsClose CommentsPermalink





(G) the number of audits performed and a summary of audit findings pursuant to section 4411. CommentsClose CommentsPermalink





(2) AVAILABILITY TO PUBLIC- Each report under paragraph (1) shall be made available to the public on the Internet website of the Department of Health and Human Services. CommentsClose CommentsPermalink





(b) Study and Report on Application of Privacy and Security Requirements to Non-HIPAA Covered Entities- CommentsClose CommentsPermalink





(1) STUDY- Not later than one year after the date of the enactment of this title, the Secretary, in consultation with the Federal Trade Commission, shall conduct a study, and submit a report under paragraph (2), on privacy and security requirements for entities that are not covered entities or business associates as of the date of the enactment of this title, including-- CommentsClose CommentsPermalink





(A) requirements relating to security, privacy, and notification in the case of a breach of security or privacy (including the applicability of an exemption to notification in the case of individually identifiable health information that has been rendered unusable, unreadable, or indecipherable through technologies or methodologies recognized by appropriate professional organization or standard setting bodies to provide effective security for the information) that should be applied to-- CommentsClose CommentsPermalink





(i) vendors of personal health records; CommentsClose CommentsPermalink





(ii) entities that offer products or services through the website of a vendor of personal health records; CommentsClose CommentsPermalink





(iii) entities that are not covered entities and that offer products or services through the s of covered entities thatwebsites of covered entities that offer individuals personal health records; CommentsClose CommentsPermalink





(iv) entities that are not covered entities and that access information in a personal health record or send information to a personal health record; and CommentsClose CommentsPermalink





(v) third party service providers used by a vendor or entity described in clause (i), (ii), (iii), or (iv) to assist in providing personal health record products or services; CommentsClose CommentsPermalink





(B) a determination of which Federal Government agency is best equipped to enforce such requirements recommended to be applied to such vendors, entities, and service providers under subparagraph (A); and CommentsClose CommentsPermalink





(C) a timeframe for implementing regulations based on such findings. CommentsClose CommentsPermalink





(2) REPORT- The Secretary shall submit to the Committee on Finance, the Committee on Health, Education, Labor, and Pensions, and the Committee on Commerce of the Senate and the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives a report on the findings of the study under paragraph (1) and shall include in such report recommendations on the privacy and security requirements described in such paragraph. CommentsClose CommentsPermalink





(c) Guidance on Implementation Specification To De-Identify Protected Health Information- Not later than 12 months after the date of the enactment of this title, the Secretary shall, in consultation with stakeholders, issue guidance on how best to implement the requirements for the de-identification of protected health information under section 164.514(b) of title 45, Code of Federal Regulations. CommentsClose CommentsPermalink





(d) GAO Report on Treatment Disclosures- Not later than one year after the date of the enactment of this title, the Comptroller General of the United States shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives a report on the best practices related to the disclosure among health care providers of protected health information of an individual for purposes of treatment of such individual. Such report shall include an examination of the best practices implemented by States and by other entities, such as health information exchanges and regional health information organizations, an examination of the extent to which such best practices are successful with respect to the quality of the resulting health care provided to the individual and with respect to the ability of the health care provider to manage such best practices, and an examination of the use of electronic informed consent for disclosing protected health information for treatment, payment, and health care operations. CommentsClose CommentsPermalink

Subtitle E--Miscellaneous Medicare Provisions CommentsClose CommentsPermalink

SEC. 4501. MORATORIA ON CERTAIN MEDICARE REGULATIONS.

(a) Delay in Phase Out of Medicare Hospice Budget Neutrality Adjustment Factor During Fiscal Year 2009- Notwithstanding any other provision of law, including the final rule published on August 8, 2008, 73 Federal Register 46464 et seq., relating to Medicare Program; Hospice Wage Index for Fiscal Year 2009, the Secretary of Health and Human Services shall not phase out or eliminate the budget neutrality adjustment factor in the Medicare hospice wage index before October 1, 2009, and the Secretary shall recompute and apply the final Medicare hospice wage index for fiscal year 2009 as if there had been no reduction in the budget neutrality adjustment factor. CommentsClose CommentsPermalink





(b) Non-Application of Phased-Out Indirect Medical Education (IME) Adjustment Factor for Fiscal Year 2009- CommentsClose CommentsPermalink





(1) IN GENERAL- Section 412.322 of title 42, Code of Federal Regulations, shall be applied without regard to paragraph (c) of such section, and the Secretary of Health and Human Services shall recompute payments for discharges occurring on or after October 1, 2008, as if such paragraph had never been in effect. CommentsClose CommentsPermalink





(2) NO EFFECT ON SUBSEQUENT YEARS- Nothing in paragraph (1) shall be construed as having any effect on the application of paragraph (d) of section 412.322 of title 42, Code of Federal Regulations. CommentsClose CommentsPermalink





(c) Funding for Implementation- In addition to funds otherwise available, for purposes of implementing the provisions of subsections (a) and (b), including costs incurred in reprocessing claims in carrying out such provisions, the Secretary of Health and Human Services shall provide for the transfer from the Federal Hospital Insurance Trust Fund established under section 1817 of the Social Security Act (42 U.S.C. 1395i) to the Centers for Medicare & Medicaid Services Program Management Account of $2,000,000 for fiscal year 2009. CommentsClose CommentsPermalink

SEC. 4502. LONG-TERM CARE HOSPITAL TECHNICAL CORRECTIONS.

(a) Payment- Subsection (c) of section 114 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173) is amended-- CommentsClose CommentsPermalink





(1) in paragraph (1)-- CommentsClose CommentsPermalink





(A) by amending the heading to read as follows: ‘DELAY IN APPLICATION OF 25 PERCENT PATIENT THRESHOLD PAYMENT ADJUSTMENT’; CommentsClose CommentsPermalink





(B) by striking ‘the date of the enactment of this Act’ and inserting ‘July 1, 2007,’; and CommentsClose CommentsPermalink





(C) in subparagraph (A), by inserting ‘or to a long-term care hospital, or satellite facility, that as of December 29, 2007, was co-located with an entity that is a provider-based, off-campus location of a subsection (d) hospital which did not provide services payable under section 1886(d) of the Social Security Act at the off-campus location’ after ‘freestanding long-term care hospitals’; and CommentsClose CommentsPermalink





(2) in paragraph (2)-- CommentsClose CommentsPermalink





(A) in subparagraph (B)(ii), by inserting ‘or that is described in section 412.22(h)(3)(i) of such title’ before the period; and CommentsClose CommentsPermalink





(B) in subparagraph (C), by striking ‘the date of the enactment of this Act’ and inserting ‘October 1, 2007 (or July 1, 2007, in the case of a satellite facility described in section 412.22(h)(3)(i) of title 42, Code of Federal Regulations)’. CommentsClose CommentsPermalink





(b) Moratorium- Subsection (d)(3)(A) of such section is amended by striking ‘if the hospital or facility’ and inserting ‘if the hospital or facility obtained a certificate of need for an increase in beds that is in a State for which such certificate of need is required and that was issued on or after April 1, 2005, and before December 29, 2007, or if the hospital or facility’. CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall be effective and apply as if included in the enactment of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173). CommentsClose CommentsPermalink