The following amendments were offered:
An en bloc amendment by Mr. Deal, #1, incorporating a number of changes both technical and substantive, was adopted by a voice vote;
An amendment by Mr. Markey, #2, providing for privacy and security protections beyond current law by (1) requiring consent from a patient to share his/her health information electronically and allowing a patient to control access to his/her electronic informaiton; (2) applying protections to anyone who has the health information; (3) allowing individuals to enforce protections and get redress when there is a violation; (4) requiring notification to a person if his/her information has been violated; (5) requiring reasonable safeguards, such as encryption of data; and (6) maintaining more protective State laws, was defeated by a yea-nay vote: 20 - 24;
An amendment by Messrs. Ferguson and Towns, #3, regarding grants to integrated health systems to promote health information technologies to improve coordination of care for the uninsured, under-insured, and medically underserved, was withdrawn (re-offered at a later time in the markup; see amendment #7);
An amendment in the nature of a substitute by Messrs. Pallone and Gonzalez, #4, the "Wired for Health Care Quality Act" - based on S. 1418, which passed the Senate unanimously - (1) requires the development of standards of interoperability; (2) requires the Federal Government to abide by these standards; (3) requires a voluntary certification system for technology vendors that meets the standards so providers can be informed purchasers of information technology products; (4) includes funding in the form of grants and loans for providers and regional collaboratives to buy and implement health information technology; (5) maintains current law on Stark self-referral and anti-kickback fraud and abuse laws; and (6) includes privacy protections based upon the amendment offered by Mr. Markey (see amendment #2), was defeated by a yea-nay vote: 19 - 22;
An amendment by Mr. Norwood, #5, amending the Internal Revenue Code of 1986 regarding the purchase of qualified healthcare information technology, was withdrawn;
An amendment by Mr. Pallone, #6, providing for funding through Federal Government grants, loans leveraging private sector dollars, and a Medicare add-on payment for providers to purchase, implement, and maintain health information technology while preserving current fraud and abuse laws, was defeated by a yea-nay vote: 19 - 23;
An amendment by Messrs. Ferguson and Towns, #7, regarding $30 million in grants to integrated health systems to promote health information technologies to improve coordination of care for the uninsured, under-insured, and medically underserved, was adopted by a voice vote;
An amendment by Messrs. Brown and Gonzalez, #8, providing for funding through Federal Government grants, loans leveraging private sector dollars, and a Medicare add-on payment for providers to purchase, implement, and maintain health information technology, was defeated by a yea-nay vote: 18 - 22;
An amendment by Messrs. Stupak and Walden, #9, providing (1) grants for rural providers for the purchase, adoption, implementation, and maintenance of health information technology; (2) grants to States to establish revolving loan funds that leverage private dollars for the adoption, implementation, and maintenance of health information technology, was defeated by a yea-nay vote: 18 -22;
An amendment by Ms. Eshoo, #10, to (1) provide strong standards for interoperability; (2) require the Department of Health and Human Services to abide by these standards in new purchases; and (3) require a voluntary certification system for technology vendors that meet the standards so providers can be informed purchasers of information technology products, was defeated by a yea-nay vote: 17 - 22;
An amendment by Mr. Stupak, #11, reauthorizing the Health Resources and Services Administration's (HRSA) Telehealth program for another four years at the same authorization levels, was defeated by a yea-nay vote: 13 -21;
An amendment by Messrs. Wynn, Rush, Ms. Solis, Ms. Schakowsky, and Mr. Engel, #12, to fund safety net providers in medically underserved communities and medically underserved populations, was defeated by a voice vote;
An amendment by Messrs. Towns, Wynn, and Rush, #13, adding as a goal of the Office of the National Coordinator of Health Information Technology, the promotion of health information technology in HRSA-defined medically underserved areas, was adopted by a voice vote;
An amendment by Mr. Brown, #14, providing that the National Coordinator of Health Information Technology shall ensure that agencies and departments have policies and programs in place to prevent the unauthorized access to personally identifiable health information, was adopted by a voice vote;
An amendment by Mr. Inslee, #15, to study the impact of health information exchanges on the operation of Federal health programs, including Medicare and Medicaid, and those providers and safety net health plans that provide a disproportionate level of care for Americans enrolled in these programs, was adopted by a voice vote;
An amendment by Ms. Baldwin, #16, to (1) direct the President to make non-identifiable health information available to researchers in a timely manner; and (2) define 'non-identifiable health information' in a manner consistent with the Health Information Portability and Accountability Act, was adopted by a voice vote;
An amendment by Mrs. Wilson, #17, establishing a $10 million demonstration grant program for small physican practices located in rural areas or medically underserved urban areas for the purchase and support of health information technology, was adopted by a voice vote.
