Promoting Quality and Efficient Health Care in Federal Government Administered or Sponsored Health Care Programs
Signed August 22, 2006·George W. Bush·71 FR 51089
Source
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Plain-language summary
Directs federal agencies that administer or sponsor health care programs—including the Federal Employees Health Benefit Program, Medicare, Indian Health Service programs, TRICARE, and the Department of Veterans Affairs health program—to promote quality and efficiency in health care. Agencies must use health information technology systems meeting recognized interoperability standards when implementing, acquiring, or upgrading such systems, and require the same of contracted providers, plans, or insurers. Agencies must also measure and disclose the quality of care provided to beneficiaries, make pricing information for procedures available to beneficiaries and enrollees, and develop approaches such as pay-for-performance models to encourage efficient, high-quality care. These efforts are to be coordinated with private-sector and non-federal public initiatives. The order excludes Medicaid, the State Children's Health Insurance Program, and certain veterans' services. Agencies were required to comply by January 1, 2007, subject to available appropriations, and the order states it creates no enforceable legal rights.
Not written or reviewed by a person. Read the full order below for anything you intend to rely on.
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Claimed authority
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
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The order, in full
Executive Order 13410 of August 22, 2006
Promoting Quality and Efficient Health Care in
Federal Government Administered or Sponsored Health
Care Programs
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.
(Presidential Sig.)B
THE WHITE HOUSE,
August 22, 2006.Reproduced from the Federal Register plain-text record, signed August 22, 2006. Typesetting artifacts are removed; no wording is changed.