H. R. 3014
IN THE SENATE OF THE UNITED STATES
November 19, 2009
Received; read twice and referred to the Committee on Small Business and Entrepreneurship
To amend the Small Business Act to provide loan guarantees for the acquisition of health information technology by eligible professionals in solo and small group practices, and for other purposes.
This Act may be cited as the
Small Business Health Information
Technology Financing Act.
Small business health information technology financing program
The Small Business Act (15 U.S.C. 631 et seq.) is amended by redesignating section 44 as section 45 and by inserting the following new section after section 43:
Loan guarantees for health information technology
As used in this section:
The term health information technology means computer hardware, software, and related technology that supports the meaningful EHR use requirements set forth in section 1848(o)(2)(A) of the Social Security Act (42 U.S.C. 1395w–4(o)(2)(A)) and is purchased by an eligible professional to aid in the provision of health care in a health care setting, including, but not limited to, electronic medical records, and that provides for—
enhancement of continuity of care for patients through electronic storage, transmission, and exchange of relevant personal health data and information, such that this information is accessible at the times and places where clinical decisions will be or are likely to be made;
enhancement of communication between patients and health care providers;
improvement of quality measurement by eligible professionals enabling them to collect, store, measure, and report on the processes and outcomes of individual and population performance and quality of care;
improvement of evidence-based decision support; or
enhancement of consumer and patient empowerment.
The term eligible professional means any of the following:
A physician (as defined in section 1861(r) of the Social Security Act (42 U.S.C. 1395x(r))).
A practitioner described in section 1842(b)(18)(C) of that Act.
A physical or occupational therapist or a qualified speech-language pathologist.
A qualified audiologist (as defined in section 1861(ll)(3)(B)) of that Act.
A qualified medical transcriptionist who is either certified by or registered with the Association for Healthcare Documentation Integrity, or a successor association thereto.
A State-licensed pharmacist.
A State-licensed supplier of durable medical equipment, prosthetics, orthotics, or supplies.
A State-licensed, a State-certified, or a nationally accredited home health care provider.
The term qualified eligible professional means an eligible professional whose office can be classified as a small business concern by the Administrator for purposes of this Act under size standards established under section 3 of this Act.
The term qualified medical transcriptionist means a specialist in medical language and the healthcare documentation process who interprets and transcribes dictation by physicians and other healthcare professionals to ensure accurate, complete, and consistent documentation of healthcare encounters.
Loan guarantees for qualified eligible professionals
Subject to paragraph (2), the Administrator may guarantee up to 90 percent of the amount of a loan made to a qualified eligible professional to be used for the acquisition of health information technology for use in such eligible professional’s medical practice and for the costs associated with the installation of such technology. Except as otherwise provided in this section, the terms and conditions that apply to loans made under section 7(a) of this Act shall apply to loan guarantees made under this section.
Limitations on guarantee amounts
The maximum amount of loan principal guaranteed under this subsection may not exceed—
$350,000 with respect to any single qualified eligible professional; and
$2,000,000 with respect to a single group of affiliated qualified eligible professionals.
The Administrator may impose a guarantee fee on the borrower for the purpose of reducing the cost (as defined in section 502(5) of the Federal Credit Reform Act of 1990) of the guarantee to zero in an amount not to exceed 2 percent of the total guaranteed portion of any loan guaranteed under this section. The Administrator may also impose annual servicing fees on lenders not to exceed 0.5 percent of the outstanding balance of the guarantees on lenders’ books.
No service fees, processing fees, origination fees, application fees, points, brokerage fees, bonus points, or other fees may be charged to a loan applicant or recipient by a lender in the case of a loan guaranteed under this section.
Loans guaranteed under this section shall carry a deferral period of not less than 1 year and not more than 3 years. The Administrator shall have the authority to subsidize interest during the deferral period.
No loan may be guaranteed under this section until the meaningful EHR use requirements have been determined by the Secretary of Health and Human Services.
No loan may be guaranteed under this section after the date that is 7 years after meaningful EHR use requirements have been determined by the Secretary of Health and Human Services.
Authorization of appropriations
There are authorized to be appropriated such sums as are necessary for the cost (as defined in section 502(5) of the Federal Credit Reform Act of 1990) of guaranteeing $10,000,000,000 in loans under this section. The Administrator shall determine such program cost separately and distinctly from other programs operated by the Administrator.
Except as otherwise provided in this Act or in amendments made by this Act, after an opportunity for notice and comment, but not later than 180 days after the date of the enactment of this Act, the Administrator shall issue regulations to carry out this Act and the amendments made by this Act.
Passed the House of Representatives November 18, 2009.
Lorraine C. Miller,