[Pages S1713-S1714]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 386. Mr. ENZI submitted an amendment intended to be proposed to 
amendment SA 98 proposed by Mr. Inouye (for himself and Mr. Baucus) to 
the bill H.R. 1, making supplemental appropriations for job 
preservation and creation, infrastructure investment, energy efficiency 
and science, assistance to the unemployed, and State and local fiscal 
stabilization, for fiscal year ending September 30, 2009, and for other 
purposes; which was ordered to lie on the table; as follows:

       Beginning on page 292, strike line 4 and all that follows 
     through line 6 on page 293, and insert the following:

     ``SEC. 3007. FEDERAL HEALTH INFORMATION TECHNOLOGY.

       ``(a) In General.--The National Coordinator, in 
     consultation with other appropriate Federal agencies, shall 
     support the development and routine updating of qualified 
     electronic health record technology (as defined in section 
     3000) for any Federal agency that is engaged in such 
     activities on the date

[[Page S1714]]

     of enactment of this title, and shall also provide qualified 
     electronic health record technologies, consistent with 
     subsections (b) and (c), but only if such qualified 
     electronic health record technology uses open standards and 
     the Secretary and the HIT Policy Committee first determine 
     that the needs and demands of providers are not being 
     substantially and adequately met through the marketplace.
       ``(b) Certification.--In making qualified electronic health 
     record technology publicly available under subsection (a), 
     the National Coordinator shall ensure that the qualified 
     electronic health record technology described in such 
     subsection is certified under the program developed under 
     section 3001(c)(5) to be in compliance with applicable 
     standards adopted under section 3004.
       ``(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 qualified electronic health 
     record technology system provided for under subsection (a). 
     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.
       ``(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 for under this section.
       ``(e) Definition.--In this section, the term `not being 
     substantially and adequately met through the marketplace' 
     means that the Secretary and the HIT Policy Committee have 
     determined, through a comprehensive market survey or other 
     assessment as the Secretary determines appropriate, that 
     certified technologies are either not available or are not in 
     widespread use in the marketplace. In order to ensure that 
     providers of qualified electronic health record technologies 
     have adequate opportunity to comply with applicable standards 
     adopted under section 3003(a), the Secretary shall undertake 
     such market survey or assessment not earlier than 12 months 
     after the date on which such standards are adopted and 
     promulgated.''.
                                 ______