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Ärende: Press Release (0608222) for Tue, 2006 Aug 22
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Executive Order: Promoting Quality and Efficient Health Care in Federal
Government Administered or Sponsored Health Care Programs
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For Immediate Release
Office of the Press Secretary
August 22, 2006

Executive Order: Promoting Quality and Efficient Health Care in Federal
Government Administered or Sponsored Health Care Programs


˙˙˙˙˙ President Bush Discusses Health Transparency in Minnesota ˙˙˙˙˙ Fact
Sheet: Health Care Transparency: Empowering Consumers to Save on Quality
Care ˙˙˙˙˙ In Focus: Health Care

By the authority vested in me as President by the Constitution and the laws
of the United States, and in order to promote federally led efforts to
implement more transparent and high-quality health care, it is hereby
ordered as follows:

Section 1. Purpose. It is the purpose of this order to ensure that health
care programs administered or sponsored by the Federal Government promote
quality and efficient delivery of health care through the use of health
information technology, transparency regarding health care quality and
price, and better incentives for program beneficiaries, enrollees, and
providers. It is the further purpose of this order to make relevant
information available to these beneficiaries, enrollees, and providers in a
readily useable manner and in collaboration with similar initiatives in the
private sector and non-Federal public sector. Consistent with the purpose
of improving the quality and efficiency of health care, the actions and
steps taken by Federal Government agencies should not incur additional
costs for the Federal Government.

Sec. 2. Definitions. For purposes of this order:

(a) "Agency" means an agency of the Federal Government that administers or
sponsors a Federal health care program.

(b) "Federal health care program" means the Federal Employees Health
Benefit Program, the Medicare program, programs operated directly by the
Indian Health Service, the TRICARE program for the Department of Defense
and other uniformed services, and the health care program operated by the
Department of Veterans Affairs. For purposes of this order, "Federal health
care program" does not include State operated or funded federally
subsidized programs such as Medicaid, the State Children's Health Insurance
Program, or services provided to Department of Veterans' Affairs
beneficiaries under 38 U.S.C. 1703.

(c) "Interoperability" means the ability to communicate and exchange data
accurately, effectively, securely, and consistently with different
information technology systems, software applications, and networks in
various settings, and exchange data such that clinical or operational
purpose and meaning of the data are preserved and unaltered.

(d) "Recognized interoperability standards" means interoperability
standards recognized by the Secretary of Health and Human Services (the
"Secretary"), in accordance with guidance developed by the Secretary, as
existing on the date of the implementation, acquisition, or upgrade of
health information technology systems under subsections (1) or (2) of
section 3(a) of this order.

Sec. 3. Directives for Agencies. Agencies shall perform the following
functions:

(a) Health Information Technology.

(1) For Federal Agencies. As each agency implements, acquires, or upgrades
health information technology systems used for the direct exchange of
health information between agencies and with non-Federal entities, it shall
utilize, where available, health information technology systems and
products that meet recognized interoperability standards.

(2) For Contracting Purposes. Each agency 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
recognized interoperability standards.

(b) Transparency of Quality Measurements.

(1) In General. Each agency shall implement programs measuring the quality
of services supplied by health care providers to the beneficiaries or
enrollees of a Federal health care program. Such programs shall be based
upon standards established by multi-stakeholder entities identified by the
Secretary or by another agency subject to this order. Each agency shall
develop its quality measurements in collaboration with similar initiatives
in the private and non-Federal public sectors.

(2) Facilitation. An agency satisfies the requirements of this subsection
if it participates in the aggregation of claims and other appropriate data
for the purposes of quality measurement. Such aggregation shall be based
upon standards established by multi-stakeholder entities identified by the
Secretary or by another agency subject to this order.

(c) Transparency of Pricing Information. Each agency shall make available
(or provide for the availability) to the beneficiaries or enrollees of a
Federal health care program (and, at the option of the agency, to the
public) the prices that it, its health insurance issuers, or its health
insurance plans pay for procedures to providers in the health care program
with which the agency, issuer, or plan contracts. Each agency shall also,
in collaboration with multi-stakeholder groups such as those described in
subsection (b)(1), participate in the development of information regarding
the overall costs of services for common episodes of care and the treatment
of common chronic diseases.

(d) Promoting Quality and Efficiency of Care. Each agency shall develop and
identify, for beneficiaries, enrollees, and providers, approaches that
encourage and facilitate the provision and receipt of high-quality and
efficient health care. Such approaches may include pay-for-performance
models of reimbursement consistent with current law. An agency will satisfy
the requirements of this subsection if it makes available to beneficiaries
or enrollees consumer-directed health care insurance products.

Sec. 4. Implementation Date. Agencies shall comply with the requirements of
this order by January 1, 2007.

Sec. 5. Administration and Judicial Review.

(a) This order does not assume or rely upon additional Federal resources or
spending to promote quality and efficient health care. Further, the actions
directed by this order shall be carried out subject to the availability of
appropriations and to the maximum extent permitted by law.

(b) This order shall be implemented in new contracts or new contract cycles
as they may be renewed from time to time. Renegotiation outside of the
normal contract cycle processes should be avoided.

(c) This order is not intended to, and does not, create any right or
benefit, substantive or procedural, enforceable at law or in equity against
the United States, its departments, agencies, or entities, its officers,
employees, or agents, or any other person.

GEORGE W. BUSH

THE WHITE HOUSE,

August 22, 2006.

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