Health Equity and Accountability Act of 2026

In this title:

(1) Access.— The term access, with respect to health information, means access described in section 164.524 of title 45, Code of Federal Regulations (or any successor regulations).

(2) Certified electronic health record technology.— The term certified EHR technology—

(A) has the meaning given such term in section 3000 of the Public Health Service Act (42 U.S.C. 300jj);

(B) includes the health information infrastructure for interoperability, access, exchange, and use of electronic health information required under title XXX of the Public Health Service Act (42 U.S.C. 300jj et seq.); and

(C) is not limited to electronic health records maintained by doctors.

(3) EHR.— The term EHR—

(A) means an electronic health record;

(B) includes the health information infrastructure for interoperability, access, exchange, and use of electronic health information required under title XXX of the Public Health Service Act (42 U.S.C. 300jj et seq.); and

(C) is not limited to electronic health records maintained by doctors.

(4) Electronic health record.— The term electronic health record has the meaning given the term “qualified electronic health record” in section 3000 of the Public Health Service Act (42 U.S.C. 300jj).

(5) Interoperability.— The term interoperability has the meaning given such term in section 3000 of the Public Health Service Act (42 U.S.C. 300jj).

(a) In general.— The Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration, shall expand and intensify the programs and activities of the Administration (directly or through grants or contracts) to provide technical assistance and resources to health centers (as defined in section 330(a) of the Public Health Service Act (42 U.S.C. 254b(a))) to adopt and meaningfully use certified EHR technology for the management of chronic diseases and health conditions and reduction of health disparities.

(b) Funding initiatives.— The activities under subsection (a) may include funding initiatives, including establishing basic connectivity such as 5G internet for telemedicine capabilities, grant funding to implement the next generation of EHR, and funding for technology hardware.

(a) National Coordinator for Health Information Technology.—

(1) In general.— Not later than 18 months after the date of enactment of this Act, the National Coordinator for Health Information Technology (referred to in this title as the “National Coordinator”) shall—

(A) conduct an evaluation of the level of interoperability, access, use, and accessibility of EHRs in racial and ethnic minority communities, focusing on whether patients in such communities have providers who use EHRs, and the degree to which patients in such communities can access, exchange, and use without special effort their health information in those EHRs;

(B) include in such evaluation an indication of whether such providers—

(i) are participating in the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) or a State plan under title XIX of such Act (42 U.S.C. 1396 et seq.) (or a waiver of such plan);

(ii) have received incentive payments or incentive payment adjustments under Medicare and Medicaid Electronic Health Records Incentive Programs (as defined in subsection (c)(2));

(iii) are MIPS eligible professionals, as defined in paragraph (1)(C) of section 1848(q) of the Social Security Act (42 U.S.C. 1395w–4(q)), for purposes of the Merit-Based Incentive Payment System under such section; or

(iv) have been recruited by any of the Health Information Technology Regional Extension Centers established under section 3012 of the Public Health Service Act (42 U.S.C. 300jj–32); and

(C) publish the results of such evaluation, including the indications under subparagraph (B), the race and ethnicity of such providers, and the populations served by such providers.

(2) Evaluation of interoperability.— The evaluation of the level of interoperability described in paragraph (1)(A) shall consider exchange of electronic health information, usability of exchanged electronic health information, effective application and use of the exchanged electronic health information, and impact on outcomes of interoperability.

(3) Certification criterion.— Not later than 1 year after the date of enactment of this Act, the National Coordinator shall—

(A) promulgate a certification criterion and module of certified EHR technology that stratifies quality measures for purposes of the Merit-Based Incentive Payment System by disparity characteristics, including race, ethnicity, language, gender, gender identity, sexual orientation, socio-economic status, and disability status, as such characteristics are defined for purposes of certified EHR technology; and

(B) report to the Centers for Medicare & Medicaid Services the quality measures stratified by race and at least 2 other disparity characteristics.

(b) National Center for Health Statistics.— Not later than one year after the date of enactment of this Act, the Director of the National Center for Health Statistics shall provide to Congress a report that details the adoption of certified electronic health record systems and electronic information sharing in physicians’ offices in communities of color and rural communities during fiscal years 2023 thorough 2026.

(c) Centers for Medicare & Medicaid Services.—

(1) In general.— As part of the process of collecting information, with respect to a provider, at registration and attestation for purposes of Medicare and Medicaid Electronic Health Records Incentive Programs (as defined in paragraph (2)) or the Merit-Based Incentive Payment System under section 1848(q) of the Social Security Act (42 U.S.C. 1395w–4(q)), the Secretary of Health and Human Services shall collect the race and ethnicity of such provider.

(2) Medicare and Medicaid Electronic Health Records Incentive Programs defined.— For purposes of paragraph (1), the term Medicare and Medicaid Electronic Health Records Incentive Programs means the incentive programs under the following:

(A) Subsection (l)(3) of section 1814(l)(3) of the Social Security Act (42 U.S.C. 1395f).

(B) Subsections (a)(7) and (o) of section 1848 of such Act (42 U.S.C. 1395w–4).

(C) Subsections (l) and (m) of section 1853 of such Act (42 U.S.C. 1395w–23).

(D) Subsections (b)(3)(B)(ix)(I) and (n) of section 1886 of such Act (42 U.S.C. 1395ww).

(E) Subsections (a)(3)(F) and (t) of section 1903 such Act (42 U.S.C. 1396b).

(d) National Coordinator’s assessment of impact of HIT.— Section 3001(c)(6)(C) of the Public Health Service Act (42 U.S.C. 300jj–11(c)(6)(C)) is amended—

(1) in the heading by inserting “, racial and ethnic minority communities,” after “health disparities”;

(2) by inserting “, in communities with a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g)), including people with disabilities in such groups,” after “communities with health disparities”;

(3) by striking “The National Coordinator” and inserting the following:

“(i) In general.— The National Coordinator”; and

(4) by adding at the end the following:

“(ii) Criteria.— In any publication under clause (i), the National Coordinator shall include best practices for encouraging partnerships between the Federal Government, States, private entities, national nonprofit intermediaries, and community-based organizations to expand outreach and education for and the adoption of certified EHR technology in communities with a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g)), while also maintaining the accessibility requirements of section 508 of the Rehabilitation Act of 1973 to encourage patient involvement in patient health care. The National Coordinator shall—

(I) not later than 6 months after the submission of the report required under section 8302(b) of the Health Equity and Accountability Act of 2026, establish criteria for evaluating the impact of health information technology on communities with a high proportion of individuals from racial and ethnic minority groups (as so defined) taking into account the findings in such report; and

(II) not later than 1 year after the submission of such report, publish the results of an evaluation of such impact.”.

(a) In general.— Covered entities shall ensure that electronic and information technology in their health programs or activities does not exclude individuals from participation in, deny individuals the benefits of, or subject individuals to discrimination under any health program or activity on the basis of race, color, national origin, sex, age, or disability.

(b) Covered entities.— In this section, the term covered entity means—

(1) an entity that operates a health program or activity, any part of which receives Federal financial assistance;

(2) an entity established under title I of the Patient Protection and Affordable Care Act (Public Law 114–148) that administers a health program or activity; or

(3) the Department of Health and Human Services.

The National Coordinator shall—

(1) not later than 18 months after the date of enactment of this Act, propose a rule for providing access to patients, through certified EHR technology, to their personal health information in a computable format, including using patient portals or third-party applications (as described in section 3009(e) of the Public Health Service Act (42 U.S.C. 300jj–19(e))), in the 10 most common non-English languages;

(2) hold a public hearing to identify best practices for carrying out paragraph (1); and

(3) not later than 6 months after the public hearing under paragraph (2), promulgate a final regulation with respect to paragraph (1).

Section 3011 of the Public Health Service Act (42 U.S.C. 300jj–31) is amended—

(1) in subsection (a), in the matter preceding paragraph (1), by inserting “, including with respect to communities with a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g))” before the colon at the end; and

(2) by adding at the end the following new subsection:

“(e) Annual report on expenditures.— The National Coordinator shall report annually to Congress on activities and expenditures under this section.”.

Section 3014(e) of the Public Health Service Act (42 U.S.C. 300jj–34(e)) is amended, in the matter preceding paragraph (1), by inserting “, including with respect to communities with a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g))” after “health care provider to”.

Section 3018 of the Public Health Service Act (42 U.S.C. 300jj–38) is amended by striking “fiscal years 2009 through 2013” and inserting “fiscal years 2027 through 2032”.

Section 3001(c)(6) of the Public Health Service Act (42 U.S.C. 300jj–11(c)(6)) is amended by adding at the end the following new subparagraph:

“(F) Data collection and assessments conducted in coordination with minority-serving institutions.—

(i) In general.— In carrying out subparagraph (C) with respect to communities with a high proportion of individuals from racial and ethnic minority groups (as defined in section 1707(g)), the National Coordinator shall, to the greatest extent possible, coordinate with an entity described in clause (ii).

(ii) Minority-serving institutions.— For purposes of clause (i), an entity described in this clause is a historically Black college or university, a Hispanic-serving institution, a Tribal College or University, or an Asian-American-, Native American-, or Pacific Islander-serving institution with an accredited public health, health policy, or health services research program.”.

(a) In general.— Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services shall—

(1) enter into an agreement with the National Academies of Sciences, Engineering, and Medicine to conduct a study on the development, implementation, and effectiveness of health information technology within medically underserved areas; and

(2) submit a report to Congress describing the results of such study, including any recommendations for legislative or administrative action.

(b) Study.— The study described in subsection (a)(1) shall—

(1) identify barriers to successful implementation of health information technology in medically underserved areas;

(2) survey a cross-section of individuals in medically underserved areas and report their opinions about the various topics of study;

(3) examine the degree of interoperability among health information technology and users of health information technology in medically underserved areas, including patients, providers, and community services, which such examination shall consider the exchange of electronic health information, usability of exchanged electronic health information, effective application and use of the exchanged electronic health information, and impact on outcomes of interoperability;

(4) examine the impact of health information technology on providing quality care and reducing the cost of care to individuals in such areas, including the impact of such technology on improved health outcomes for individuals, including which technology worked for which population and how it improved health outcomes for that population;

(5) examine the impact of health information technology on improving health care-related decisions by both patients and providers in such areas;

(6) identify specific best practices for using health information technology to foster the consistent provision of accessibility and reasonable policy accommodations in health care to individuals with disabilities in such areas;

(7) assess the feasibility and costs associated with the use of health information technology in such areas;

(8) evaluate whether the adoption and use of electronic health records is effective in reducing health disparities, including analysis of clinical quality measures reported by providers who are participating in the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) or a State plan under title XIX of such Act (42 U.S.C. 1396 et seq.) (or a waiver of such plan), pursuant to programs to encourage the adoption and use of certified EHR technology;

(9) identify providers in medically underserved areas that are not electing to adopt and use EHRs and determine what barriers are preventing those providers from adopting and using such records; and

(10) examine urban and rural community health systems and determine the impact that health information technology may have on the capacity of primary health providers in those systems.

(c) Medically underserved area.— In this section, the term medically underserved area means—

(1) a population that has been designated as a medically underserved population under section 330(b)(3) of the Public Health Service Act (42 U.S.C. 254b(b)(3));

(2) an area that has been designated as a health professional shortage area under section 332 of the Public Health Service Act (42 U.S.C. 254e);

(3) an area or population that has been designated as a medically underserved community under section 799B of the Public Health Service Act (42 U.S.C. 295p); or

(4) another area or population that—

(A) experiences significant barriers to accessing quality health services; and

(B) has a high prevalence of diseases or conditions described in title VII, with such diseases or conditions having a disproportionate impact on racial and ethnic minority groups (as defined in section 1707(g) of the Public Health Service Act (42 U.S.C. 300u–6(g))) or a subgroup of people with disabilities who have specific functional impairments.

(a) In general.— Not later than 18 months after the date of enactment of this Act, the Secretary of Health and Human Services shall—

(1) enter into an agreement with the Office of the National Coordinator of Health Information Technology to conduct a study, in consultation with relevant stakeholders, on the impact of digital health technology on medically underserved areas (as defined in section 8302(c)); and

(2) submit a report to Congress describing the results of such study, including any recommendations for legislative or administrative action.

(b) Study.— The study described in subsection (a)(1) shall—

(1) examine the overall prevalence, and historical and existing practices and their respective prevalence, of use and misuse of de-identified protected health information to discriminate against or benefit medically underserved areas;

(2) identify best practices and tools to leverage the benefits and prevent misuse of de-identified protected health information to discriminate against medically underserved areas;

(3) examine the overall prevalence, and historical and existing practices and their respective prevalence, of use and misuse of de-identified personal health information other than protected health information to discriminate against or benefit medically underserved areas; and

(4) identify best practices and tools to leverage the benefits and prevent misuse of de-identified personal health information other than protected health information to discriminate against medically underserved areas.

(c) Definition of protected health information.— In this section, the term protected health information has the meaning given such term in section 160.103 of title 45, Code of Federal Regulations (or any successor regulations).

(a) In general.— Section 1903(t)(2)(B) of the Social Security Act (42 U.S.C. 1396b(t)(2)(B)) is amended—

(1) in clause (i), by striking “, or” and inserting a semicolon;

(2) in clause (ii), by striking the period at the end and inserting a semicolon; and

(3) by inserting after clause (ii) the following new clauses:

“(iii) a rehabilitation facility (as defined in section 1886(j)(1)) that furnishes acute or subacute rehabilitation services;

(iv) a long-term care hospital described in section 1886(d)(1)(B)(iv); or

(v) a home health agency (as defined in section 1861(o)).”.

(b) Effective date.— The amendments made by subsection (a) shall apply with respect to amounts expended under section 1903(a)(3)(F) of the Social Security Act (42 U.S.C. 1396b(a)(3)(F)) for calendar quarters beginning on or after the date of the enactment of this Act.

(a) In general.— Section 1903(t)(3)(B)(v) of the Social Security Act (42 U.S.C. 1396b(t)(3)(B)(v)) is amended to read as follows:

“(v) physician assistant.”.

(b) Effective date.— The amendment made by subsection (a) shall apply with respect to amounts expended under section 1903(a)(3)(F) of the Social Security Act (42 U.S.C. 1396b(a)(3)(F)) for calendar quarters beginning on or after the date of the enactment of this Act.

Section 1834(m)(4)(C) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)) is amended—

(1) in clause (i), in the matter preceding subclause (I), by striking “clause (iii)” and inserting “clauses (iii) and (iv)”; and

(2) by adding at the end the following new clause:

“(iv) Removal of geographic requirements.— The geographic requirements described in clause (i) shall not apply with respect to telehealth services furnished on or after the first day after the end of the period for which clause (iii) applies.”.

(a) Expanding the home as an originating site.— Section 1834(m)(4)(C)(ii)(X) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)(ii)(X)) is amended to read as follows:

“(X)

(aa) Prior to the date described in item (bb), the home of an individual but only for purposes of section 1881(b)(3)(B) or telehealth services described in paragraph (7) or clause (iii).

(bb) On or after the first day after the end of the period for which clause (iii) applies, the home of an individual.”.

(b) Allowing additional originating sites.— Section 1834(m)(4)(C)(ii) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)(ii)) is amended by adding at the end the following new subclause:

“(XII) Any other site determined appropriate by the Secretary at which an eligible telehealth individual is located at the time a telehealth service is furnished via a telecommunications system.”.

(c) Parameters for new originating sites.— Section 1834(m)(4)(C) of the Social Security Act (42 U.S.C. 1395m(m)(4)(C)), as amended by section 8501, is amended by adding at the end the following new clause:

“(v) Requirements for new sites.—

(I) In general.— The Secretary may establish requirements for the furnishing of telehealth services at sites described in clause (ii)(XII) to provide for beneficiary and program integrity protections.

(II) Clarification.— Nothing in this clause shall be construed to preclude the Secretary from establishing requirements for other originating sites described in clause (ii).”.

(d) No originating site facility fee for new sites.— Section 1834(m)(2)(B)(ii) of the Social Security Act (42 U.S.C. 1395m(m)(2)(B)(ii)) is amended—

(1) in the heading, by striking “if originating site is the home” and inserting “for certain sites”; and

(2) by striking “paragraph (4)(C)(ii)(X)” and inserting “subclause (X) or (XII) of paragraph (4)(C)”.