PUBLIC LAW 109�41�JULY 29, 2005 PATIENT SAFETY AND QUALITY IMPROVEMENT ACT OF 2005 VerDate 14-DEC-2004 11:17 Aug 05, 2005 Jkt 039139 PO 00041 Frm 00001 Fmt 6579 Sfmt 6579 E:\PUBLAW\PUBL041.109 APPS10 PsN: PUBL041 119 STAT. 424 PUBLIC LAW 109�41�JULY 29, 2005 Public Law 109�41 109th Congress An Act To amend title IX of the Public Health Service Act to provide for the improvement of patient safety and to reduce the incidence of events that adversely effect patient safety. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE; TABLE OF CONTENTS. (a) SHORT TITLE.�This Act may be cited as the ��Patient Safety and Quality Improvement Act of 2005��. (b) TABLE OF CONTENTS.�The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. Sec. 2. Amendments to Public Health Service Act. ��P ART C�P ATIENT SAFETY IMPROVEMENT ��Sec. 921. Definitions. ��Sec. 922. Privilege and confidentiality protections. ��Sec. 923. Network of patient safety databases. ��Sec. 924. Patient safety organization certification and listing. ��Sec. 925. Technical assistance. ��Sec. 926. Severability. SEC. 2. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT. (a) IN GENERAL.�Title IX of the Public Health Service Act (42 U.S.C. 299 et seq.) is amended� (1) in section 912(c), by inserting ��, in accordance with part C,�� after ��The Director shall��; (2) by redesignating part C as part D; (3) by redesignating sections 921 through 928, as sections 931 through 938, respectively; (4) in section 938(1) (as so redesignated), by striking ��921�� and inserting ��931��; and (5) by inserting after part B the following: ��PART C�PATIENT SAFETY IMPROVEMENT ��SEC. 921. DEFINITIONS. ��In this part: ��(1) HIPAA CONFIDENTIALITY REGULATIONS.�The term �HIPAA confidentiality regulations� means regulations promul- gated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (Public Law 104�191; 110 Stat. 2033). 42 USC 299b�21. 42 USC 299c�7. 42 USC 299c�299c�7. 42 USC 299b�1. Patient Safety and Quality Improvement Act of 2005. July 29, 2005 [S. 544] VerDate 14-DEC-2004 18:17 Aug 16, 2005 Jkt 039139 PO 00041 Frm 00002 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL041.109 APPS24 PsN: PUBL041 119 STAT. 425PUBLIC LAW 109�41�JULY 29, 2005 ��(2) I DENTIFIABLE PATIENT SAFETY WORK PRODUCT.�The term �identifiable patient safety work product� means patient safety work product that� ��(A) is presented in a form and manner that allows the identification of any provider that is a subject of the work product, or any providers that participate in activities that are a subject of the work product; ��(B) constitutes individually identifiable health information as that term is defined in the HIPAA confiden- tiality regulations; or ��(C) is presented in a form and manner that allows the identification of an individual who reported information in the manner specified in section 922(e). ��(3) N ONIDENTIFIABLE PATIENT SAFETY WORK PRODUCT.� The term �nonidentifiable patient safety work product� means patient safety work product that is not identifiable patient safety work product (as defined in paragraph (2)). ��(4) P ATIENT SAFETY ORGANIZATION.�The term �patient safety organization� means a private or public entity or compo- nent thereof that is listed by the Secretary pursuant to section 924(d). ��(5) P ATIENT SAFETY ACTIVITIES.�The term �patient safety activities� means the following activities: ��(A) Efforts to improve patient safety and the quality of health care delivery. ��(B) The collection and analysis of patient safety work product. ��(C) The development and dissemination of information with respect to improving patient safety, such as rec- ommendations, protocols, or information regarding best practices. ��(D) The utilization of patient safety work product for the purposes of encouraging a culture of safety and of providing feedback and assistance to effectively minimize patient risk. ��(E) The maintenance of procedures to preserve con- fidentiality with respect to patient safety work product. ��(F) The provision of appropriate security measures with respect to patient safety work product. ��(G) The utilization of qualified staff. ��(H) Activities related to the operation of a patient safety evaluation system and to the provision of feedback to participants in a patient safety evaluation system. ��(6) P ATIENT SAFETY EVALUATION SYSTEM.�The term �patient safety evaluation system� means the collection, manage- ment, or analysis of information for reporting to or by a patient safety organization. ��(7) P ATIENT SAFETY WORK PRODUCT.� ��(A) I N GENERAL.�Except as provided in subparagraph (B), the term �patient safety work product� means any data, reports, records, memoranda, analyses (such as root cause analyses), or written or oral statements� ��(i) which� ��(I) are assembled or developed by a provider for reporting to a patient safety organization and are reported to a patient safety organization; or VerDate 14-DEC-2004 11:17 Aug 05, 2005 Jkt 039139 PO 00041 Frm 00003 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL041.109 APPS10 PsN: PUBL041 119 STAT. 426 PUBLIC LAW 109�41�JULY 29, 2005 ��(II) are developed by a patient safety organization for the conduct of patient safety activities; and which could result in improved patient safety, health care quality, or health care outcomes; or ��(ii) which identify or constitute the deliberations or analysis of, or identify the fact of reporting pursuant to, a patient safety evaluation system. ��(B) C LARIFICATION.� ��(i) Information described in subparagraph (A) does not include a patient�s medical record, billing and dis- charge information, or any other original patient or provider record. ��(ii) Information described in subparagraph (A) does not include information that is collected, main- tained, or developed separately, or exists separately, from a patient safety evaluation system. Such separate information or a copy thereof reported to a patient safety organization shall not by reason of its reporting be considered patient safety work product. ��(iii) Nothing in this part shall be construed to limit� ��(I) the discovery of or admissibility of information described in this subparagraph in a criminal, civil, or administrative proceeding; ��(II) the reporting of information described in this subparagraph to a Federal, State, or local governmental agency for public health surveil- lance, investigation, or other public health pur- poses or health oversight purposes; or ��(III) a provider�s recordkeeping obligation with respect to information described in this subparagraph under Federal, State, or local law. ��(8) P ROVIDER.�The term �provider� means� ��(A) an individual or entity licensed or otherwise authorized under State law to provide health care services, including� ��(i) a hospital, nursing facility, comprehensive out- patient rehabilitation facility, home health agency, hos- pice program, renal dialysis facility, ambulatory sur- gical center, pharmacy, physician or health care practi- tioner�s office, long term care facility, behavior health residential treatment facility, clinical laboratory, or health center; or ��(ii) a physician, physician assistant, nurse practi- tioner, clinical nurse specialist, certified registered nurse anesthetist, certified nurse midwife, psycholo- gist, certified social worker, registered dietitian or nutrition professional, physical or occupational thera- pist, pharmacist, or other individual health care practi- tioner; or ��(B) any other individual or entity specified in regula- tions promulgated by the Secretary. VerDate 14-DEC-2004 11:17 Aug 05, 2005 Jkt 039139 PO 00041 Frm 00004 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL041.109 APPS10 PsN: PUBL041 119 STAT. 427PUBLIC LAW 109�41�JULY 29, 2005 ��SEC. 922. PRIVILEGE AND CONFIDENTIALITY PROTECTIONS. ��(a) P RIVILEGE.�Notwithstanding any other provision of Fed- eral, State, or local law, and subject to subsection (c), patient safety work product shall be privileged and shall not be� ��(1) subject to a Federal, State, or local civil, criminal, or administrative subpoena or order, including in a Federal, State, or local civil or administrative disciplinary proceeding against a provider; ��(2) subject to discovery in connection with a Federal, State, or local civil, criminal, or administrative proceeding, including in a Federal, State, or local civil or administrative disciplinary proceeding against a provider; ��(3) subject to disclosure pursuant to section 552 of title 5, United States Code (commonly known as the Freedom of Information Act) or any other similar Federal, State, or local law; ��(4) admitted as evidence in any Federal, State, or local governmental civil proceeding, criminal proceeding, administra- tive rulemaking proceeding, or administrative adjudicatory pro- ceeding, including any such proceeding against a provider; or ��(5) admitted in a professional disciplinary proceeding of a professional disciplinary body established or specifically authorized under State law. ��(b) C ONFIDENTIALITY OF PATIENT SAFETY WORK PRODUCT.� Notwithstanding any other provision of Federal, State, or local law, and subject to subsection (c), patient safety work product shall be confidential and shall not be disclosed. ��(c) E XCEPTIONS.�Except as provided in subsection (g)(3)� ��(1) E XCEPTIONS FROM PRIVILEGE AND CONFIDENTIALITY.� Subsections (a) and (b) shall not apply to (and shall not be construed to prohibit) one or more of the following disclosures: ��(A) Disclosure of relevant patient safety work product for use in a criminal proceeding, but only after a court makes an in camera determination that such patient safety work product contains evidence of a criminal act and that such patient safety work product is material to the pro- ceeding and not reasonably available from any other source. ��(B) Disclosure of patient safety work product to the extent required to carry out subsection (f)(4)(A). ��(C) Disclosure of identifiable patient safety work product if authorized by each provider identified in such work product. ��(2) E XCEPTIONS FROM CONFIDENTIALITY.�Subsection (b) shall not apply to (and shall not be construed to prohibit) one or more of the following disclosures: ��(A) Disclosure of patient safety work product to carry out patient safety activities. ��(B) Disclosure of nonidentifiable patient safety work product. ��(C) Disclosure of patient safety work product to grantees, contractors, or other entities carrying out research, evaluation, or demonstration projects authorized, funded, certified, or otherwise sanctioned by rule or other means by the Secretary, for the purpose of conducting research to the extent that disclosure of protected health information would be allowed for such purpose under the HIPAA confidentiality regulations. 42 USC 299b�22. VerDate 14-DEC-2004 11:17 Aug 05, 2005 Jkt 039139 PO 00041 Frm 00005 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL041.109 APPS10 PsN: PUBL041 119 STAT. 428 PUBLIC LAW 109�41�JULY 29, 2005 ��(D) Disclosure by a provider to the Food and Drug Administration with respect to a product or activity regu- lated by the Food and Drug Administration. ��(E) Voluntary disclosure of patient safety work product by a provider to an accrediting body that accredits that provider. ��(F) Disclosures that the Secretary may determine, by rule or other means, are necessary for business oper- ations and are consistent with the goals of this part. ��(G) Disclosure of patient safety work product to law enforcement authorities relating to the commission of a crime (or to an event reasonably believed to be a crime) if the person making the disclosure believes, reasonably under the circumstances, that the patient safety work product that is disclosed is necessary for criminal law enforcement purposes. ��(H) With respect to a person other than a patient safety organization, the disclosure of patient safety work product that does not include materials that� ��(i) assess the quality of care of an identifiable provider; or ��(ii) describe or pertain to one or more actions or failures to act by an identifiable provider. ��(3) E XCEPTION FROM PRIVILEGE.�Subsection (a) shall not apply to (and shall not be construed to prohibit) voluntary disclosure of nonidentifiable patient safety work product. ��(d) C ONTINUED PROTECTION OF INFORMATION AFTER DISCLO- SURE.� ��(1) I N GENERAL.�Patient safety work product that is dis- closed under subsection (c) shall continue to be privileged and confidential as provided for in subsections (a) and (b), and such disclosure shall not be treated as a waiver of privilege or confidentiality, and the privileged and confidential nature of such work product shall also apply to such work product in the possession or control of a person to whom such work product was disclosed. ��(2) E XCEPTION.�Notwithstanding paragraph (1), and sub- ject to paragraph (3)� ��(A) if patient safety work product is disclosed in a criminal proceeding, the confidentiality protections pro- vided for in subsection (b) shall no longer apply to the work product so disclosed; and ��(B) if patient safety work product is disclosed as pro- vided for in subsection (c)(2)(B) (relating to disclosure of nonidentifiable patient safety work product), the privilege and confidentiality protections provided for in subsections (a) and (b) shall no longer apply to such work product. ��(3) C ONSTRUCTION.�Paragraph (2) shall not be construed as terminating or limiting the privilege or confidentiality protec- tions provided for in subsection (a) or (b) with respect to patient safety work product other than the specific patient safety work product disclosed as provided for in subsection (c). ��(4) L IMITATIONS ON ACTIONS.� ��(A) P ATIENT SAFETY ORGANIZATIONS.� ��(i) I N GENERAL.�A patient safety organization shall not be compelled to disclose information collected or developed under this part whether or not such VerDate 14-DEC-2004 11:17 Aug 05, 2005 Jkt 039139 PO 00041 Frm 00006 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL041.109 APPS10 PsN: PUBL041 119 STAT. 429PUBLIC LAW 109�41�JULY 29, 2005 information is patient safety work product unless such information is identified, is not patient safety work product, and is not reasonably available from another source. ��(ii) N ONAPPLICATION.�The limitation contained in clause (i) shall not apply in an action against a patient safety organization or with respect to disclosures pursuant to subsection (c)(1). ��(B) P ROVIDERS.�An accrediting body shall not take an accrediting action against a provider based on the good faith participation of the provider in the collection, development, reporting, or maintenance of patient safety work product in accordance with this part. An accrediting body may not require a provider to reveal its communications with any patient safety organization established in accordance with this part. ��(e) R EPORTER PROTECTION.� ��(1) I N GENERAL.�A provider may not take an adverse employment action, as described in paragraph (2), against an individual based upon the fact that the individual in good faith reported information� ��(A) to the provider with the intention of having the information reported to a patient safety organization; or ��(B) directly to a patient safety organization. ��(2) A DVERSE EMPLOYMENT ACTION.�For purposes of this subsection, an �adverse employment action� includes� ��(A) loss of employment, the failure to promote an individual, or the failure to provide any other employment- related benefit for which the individual would otherwise be eligible; or ��(B) an adverse evaluation or decision made in relation to accreditation, certification, credentialing, or licensing of the individual. ��(f) E NFORCEMENT.� ��(1) C IVIL MONETARY PENALTY.�Subject to paragraphs (2) and (3), a person who discloses identifiable patient safety work product in knowing or reckless violation of subsection (b) shall be subject to a civil monetary penalty of not more than $10,000 for each act constituting such violation. ��(2) P ROCEDURE.�The provisions of section 1128A of the Social Security Act, other than subsections (a) and (b) and the first sentence of subsection (c)(1), shall apply to civil money penalties under this subsection in the same manner as such provisions apply to a penalty or proceeding under section 1128A of the Social Security Act. ��(3) R ELATION TO HIPAA.�Penalties shall not be imposed both under this subsection and under the regulations issued pursuant to section 264(c)(1) of the Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. 1320d-2 note) for a single act or omission. ��(4) E QUITABLE RELIEF.� ��(A) I N GENERAL.�Without limiting remedies available to other parties, a civil action may be brought by any aggrieved individual to enjoin any act or practice that violates subsection (e) and to obtain other appropriate equi- table relief (including reinstatement, back pay, and restora- tion of benefits) to redress such violation. VerDate 14-DEC-2004 11:17 Aug 05, 2005 Jkt 039139 PO 00041 Frm 00007 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL041.109 APPS10 PsN: PUBL041 119 STAT. 430 PUBLIC LAW 109�41�JULY 29, 2005 ��(B) A GAINST STATE EMPLOYEES.�An entity that is a State or an agency of a State government may not assert the privilege described in subsection (a) unless before the time of the assertion, the entity or, in the case of and with respect to an agency, the State has consented to be subject to an action described in subparagraph (A), and that consent has remained in effect. ��(g) R ULE OF CONSTRUCTION.�Nothing in this section shall be construed� ��(1) to limit the application of other Federal, State, or local laws that provide greater privilege or confidentiality protections than the privilege and confidentiality protections provided for in this section; ��(2) to limit, alter, or affect the requirements of Federal, State, or local law pertaining to information that is not privi- leged or confidential under this section; ��(3) except as provided in subsection (i), to alter or affect the implementation of any provision of the HIPAA confiden- tiality regulations or section 1176 of the Social Security Act (or regulations promulgated under such section); ��(4) to limit the authority of any provider, patient safety organization, or other entity to enter into a contract requiring greater confidentiality or delegating authority to make a disclo- sure or use in accordance with this section; ��(5) as preempting or otherwise affecting any State law requiring a provider to report information that is not patient safety work product; or ��(6) to limit, alter, or affect any requirement for reporting to the Food and Drug Administration information regarding the safety of a product or activity regulated by the Food and Drug Administration. ��(h) C LARIFICATION.�Nothing in this part prohibits any person from conducting additional analysis for any purpose regardless of whether such additional analysis involves issues identical to or similar to those for which information was reported to or assessed by a patient safety organization or a patient safety evaluation system. ��(i) C LARIFICATION OF APPLICATION OF HIPAA CONFIDENTIALITY REGULATIONS TO PATIENT SAFETY ORGANIZATIONS.�For purposes of applying the HIPAA confidentiality regulations� ��(1) patient safety organizations shall be treated as busi- ness associates; and ��(2) patient safety activities of such organizations in rela- tion to a provider are deemed to be health care operations (as defined in such regulations) of the provider. ��(j) R EPORTS ON STRATEGIES TO IMPROVE PATIENT SAFETY.� ��(1) D RAFT REPORT.�Not later than the date that is 18 months after any network of patient safety databases is oper- ational, the Secretary, in consultation with the Director, shall prepare a draft report on effective strategies for reducing med- ical errors and increasing patient safety. The draft report shall include any measure determined appropriate by the Secretary to encourage the appropriate use of such strategies, including use in any federally funded programs. The Secretary shall make the draft report available for public comment and submit the draft report to the Institute of Medicine for review. Public information. VerDate 14-DEC-2004 11:17 Aug 05, 2005 Jkt 039139 PO 00041 Frm 00008 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL041.109 APPS10 PsN: PUBL041 119 STAT. 431PUBLIC LAW 109�41�JULY 29, 2005 ��(2) F INAL REPORT.�Not later than 1 year after the date described in paragraph (1), the Secretary shall submit a final report to the Congress. ��SEC. 923. NETWORK OF PATIENT SAFETY DATABASES. ��(a) I N GENERAL.�The Secretary shall facilitate the creation of, and maintain, a network of patient safety databases that pro- vides an interactive evidence-based management resource for pro- viders, patient safety organizations, and other entities. The network of databases shall have the capacity to accept, aggregate across the network, and analyze nonidentifiable patient safety work product voluntarily reported by patient safety organizations, pro- viders, or other entities. The Secretary shall assess the feasibility of providing for a single point of access to the network for qualified researchers for information aggregated across the network and, if feasible, provide for implementation. ��(b) D ATA STANDARDS.�The Secretary may determine common formats for the reporting to and among the network of patient safety databases maintained under subsection (a) of nonidentifiable patient safety work product, including necessary work product ele- ments, common and consistent definitions, and a standardized com- puter interface for the processing of such work product. To the extent practicable, such standards shall be consistent with the administrative simplification provisions of part C of title XI of the Social Security Act. ��(c) U SE OF INFORMATION.�Information reported to and among the network of patient safety databases under subsection (a) shall be used to analyze national and regional statistics, including trends and patterns of health care errors. The information resulting from such analyses shall be made available to the public and included in the annual quality reports prepared under section 913(b)(2). ��SEC. 924. PATIENT SAFETY ORGANIZATION CERTIFICATION AND LISTING. ��(a) C ERTIFICATION.� ��(1) I NITIAL CERTIFICATION.�An entity that seeks to be a patient safety organization shall submit an initial certification to the Secretary that the entity� ��(A) has policies and procedures in place to perform each of the patient safety activities described in section 921(5); and ��(B) upon being listed under subsection (d), will comply with the criteria described in subsection (b). ��(2) S UBSEQUENT CERTIFICATIONS.�An entity that is a patient safety organization shall submit every 3 years after the date of its initial listing under subsection (d) a subsequent certification to the Secretary that the entity� ��(A) is performing each of the patient safety activities described in section 921(5); and ��(B) is complying with the criteria described in sub- section (b). ��(b) C RITERIA.� ��(1) I N GENERAL.�The following are criteria for the initial and subsequent certification of an entity as a patient safety organization: ��(A) The mission and primary activity of the entity are to conduct activities that are to improve patient safety and the quality of health care delivery. Deadlines. 42 USC 299b�24. Public information. 42 USC 299b�23. VerDate 14-DEC-2004 11:17 Aug 05, 2005 Jkt 039139 PO 00041 Frm 00009 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL041.109 APPS10 PsN: PUBL041 119 STAT. 432 PUBLIC LAW 109�41�JULY 29, 2005 ��(B) The entity has appropriately qualified staff (whether directly or through contract), including licensed or certified medical professionals. ��(C) The entity, within each 24-month period that begins after the date of the initial listing under subsection (d), has bona fide contracts, each of a reasonable period of time, with more than 1 provider for the purpose of receiving and reviewing patient safety work product. ��(D) The entity is not, and is not a component of, a health insurance issuer (as defined in section 2791(b)(2)). ��(E) The entity shall fully disclose� ��(i) any financial, reporting, or contractual rela- tionship between the entity and any provider that con- tracts with the entity; and ��(ii) if applicable, the fact that the entity is not managed, controlled, and operated independently from any provider that contracts with the entity. ��(F) To the extent practical and appropriate, the entity collects patient safety work product from providers in a standardized manner that permits valid comparisons of similar cases among similar providers. ��(G) The utilization of patient safety work product for the purpose of providing direct feedback and assistance to providers to effectively minimize patient risk. ��(2) A DDITIONAL CRITERIA FOR COMPONENT ORGANIZA- TIONS.�If an entity that seeks to be a patient safety organiza- tion is a component of another organization, the following are additional criteria for the initial and subsequent certification of the entity as a patient safety organization: ��(A) The entity maintains patient safety work product separately from the rest of the organization, and establishes appropriate security measures to maintain the confiden- tiality of the patient safety work product. ��(B) The entity does not make an unauthorized disclo- sure under this part of patient safety work product to the rest of the organization in breach of confidentiality. ��(C) The mission of the entity does not create a conflict of interest with the rest of the organization. ��(c) R EVIEW OF CERTIFICATION.� ��(1) I N GENERAL.� ��(A) I NITIAL CERTIFICATION.�Upon the submission by an entity of an initial certification under subsection (a)(1), the Secretary shall determine if the certification meets the requirements of subparagraphs (A) and (B) of such subsection. ��(B) S UBSEQUENT CERTIFICATION.�Upon the submis- sion by an entity of a subsequent certification under sub- section (a)(2), the Secretary shall review the certification with respect to requirements of subparagraphs (A) and (B) of such subsection. ��(2) N OTICE OF ACCEPTANCE OR NON-ACCEPTANCE.�If the Secretary determines that� ��(A) an entity�s initial certification meets requirements referred to in paragraph (1)(A), the Secretary shall notify the entity of the acceptance of such certification; or VerDate 14-DEC-2004 11:17 Aug 05, 2005 Jkt 039139 PO 00041 Frm 00010 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL041.109 APPS10 PsN: PUBL041 119 STAT. 433PUBLIC LAW 109�41�JULY 29, 2005 ��(B) an entity�s initial certification does not meet such requirements, the Secretary shall notify the entity that such certification is not accepted and the reasons therefor. ��(3) D ISCLOSURES REGARDING RELATIONSHIP TO PRO- VIDERS.�The Secretary shall consider any disclosures under subsection (b)(1)(E) by an entity and shall make public findings on whether the entity can fairly and accurately perform the patient safety activities of a patient safety organization. The Secretary shall take those findings into consideration in deter- mining whether to accept the entity�s initial certification and any subsequent certification submitted under subsection (a) and, based on those findings, may deny, condition, or revoke acceptance of the entity�s certification. ��(d) L ISTING.�The Secretary shall compile and maintain a listing of entities with respect to which there is an acceptance of a certification pursuant to subsection (c)(2)(A) that has not been revoked under subsection (e) or voluntarily relinquished. ��(e) R EVOCATION OF ACCEPTANCE OF CERTIFICATION.� ��(1) I N GENERAL.�If, after notice of deficiency, an oppor- tunity for a hearing, and a reasonable opportunity for correc- tion, the Secretary determines that a patient safety organiza- tion does not meet the certification requirements under sub- section (a)(2), including subparagraphs (A) and (B) of such subsection, the Secretary shall revoke the Secretary�s accept- ance of the certification of such organization. ��(2) S UPPLYING CONFIRMATION OF NOTIFICATION TO PRO- VIDERS.�Within 15 days of a revocation under paragraph (1), a patient safety organization shall submit to the Secretary a confirmation that the organization has taken all reasonable actions to notify each provider whose patient safety work product is collected or analyzed by the organization of such revocation. ��(3) P UBLICATION OF DECISION.�If the Secretary revokes the certification of an organization under paragraph (1), the Secretary shall� ��(A) remove the organization from the listing main- tained under subsection (d); and ��(B) publish notice of the revocation in the Federal Register. ��(f) S TATUS OF DATA AFTER REMOVAL FROM LISTING.� ��(1) N EW DATA.�With respect to the privilege and confiden- tiality protections described in section 922, data submitted to an entity within 30 days after the entity is removed from the listing under subsection (e)(3)(A) shall have the same status as data submitted while the entity was still listed. ��(2) P ROTECTION TO CONTINUE TO APPLY.�If the privilege and confidentiality protections described in section 922 applied to patient safety work product while an entity was listed, or to data described in paragraph (1), such protections shall continue to apply to such work product or data after the entity is removed from the listing under subsection (e)(3)(A). ��(g) D ISPOSITION OF WORK PRODUCT AND DATA.�If the Sec- retary removes a patient safety organization from the listing as provided for in subsection (e)(3)(A), with respect to the patient safety work product or data described in subsection (f)(1) that the patient safety organization received from another entity, such former patient safety organization shall� Federal Register, publication. Deadline. VerDate 14-DEC-2004 11:17 Aug 05, 2005 Jkt 039139 PO 00041 Frm 00011 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL041.109 APPS10 PsN: PUBL041 119 STAT. 434 PUBLIC LAW 109�41�JULY 29, 2005 LEGISLATIVE HISTORY�S. 544 (H.R. 3205): HOUSE REPORTS: No. 109�197 accompanying H.R. 3205 (Comm. on Energy and Commerce). CONGRESSIONAL RECORD, Vol. 151 (2005): July 21, considered and passed Senate. July 27, considered and passed House. WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 41 (2005): July 29, Presidential remarks. � ��(1) with the approval of the other entity and a patient safety organization, transfer such work product or data to such patient safety organization; ��(2) return such work product or data to the entity that submitted the work product or data; or ��(3) if returning such work product or data to such entity is not practicable, destroy such work product or data. ��SEC. 925. TECHNICAL ASSISTANCE. ��The Secretary, acting through the Director, may provide tech- nical assistance to patient safety organizations, including convening annual meetings for patient safety organizations to discuss method- ology, communication, data collection, or privacy concerns. ��SEC. 926. SEVERABILITY. ��If any provision of this part is held to be unconstitutional, the remainder of this part shall not be affected.��. (b) AUTHORIZATION OF APPROPRIATIONS.�Section 937 of the Public Health Service Act (as redesignated by subsection (a)) is amended by adding at the end the following: ��(e) P ATIENT SAFETY AND QUALITY IMPROVEMENT.�For the pur- pose of carrying out part C, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2006 through 2010.��. (c) GAO STUDY ON IMPLEMENTATION.� (1) STUDY.�The Comptroller General of the United States shall conduct a study on the effectiveness of part C of title IX of the Public Health Service Act (as added by subsection (a)) in accomplishing the purposes of such part. (2) REPORT.�Not later than February 1, 2010, the Comp- troller General shall submit a report on the study conducted under paragraph (1). Such report shall include such rec- ommendations for changes in such part as the Comptroller General deems appropriate. Approved July 29, 2005. 42 USC 299c�6. 42 USC 299b�26. 42 USC 299b�25. VerDate 14-DEC-2004 12:59 Aug 05, 2005 Jkt 039139 PO 00041 Frm 00012 Fmt 6580 Sfmt 6580 E:\PUBLAW\PUBL041.109 APPS10 PsN: PUBL041