Saving Lives and Reducing Health Care Waste by Improving Diagnosis in Medicine Act

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9696 Introduced in House (IH)]

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119th CONGRESS
  2d Session
                                H. R. 9696

To improve the quality, appropriateness, and effectiveness of diagnosis
                in health care, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             July 15, 2026

 Mr. Beyer (for himself, Mr. Van Drew, and Ms. Schrier) introduced the
   following bill; which was referred to the Committee on Energy and
                                Commerce

_______________________________________________________________________

                                 A BILL

To improve the quality, appropriateness, and effectiveness of diagnosis
                in health care, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Saving Lives and Reducing Health
Care Waste by Improving Diagnosis in Medicine Act''.

SEC. 2. FINDINGS AND PURPOSE.

    Congress finds that diagnostic error is a leading cause of
preventable harm and waste in the United States health system, and the
modernization of diagnostic safety and quality infrastructure, through
applied research, data science, patient engagement, and systems
learning, is necessary to improve outcomes and reduce costs.

SEC. 3. RESEARCH AND QUALITY IMPROVEMENT PROGRAM.

    Part B of title IX of the Public Health Service Act (42 U.S.C. 299b
et seq.) is amended by adding at the end the following:

``SEC. 918. RESEARCH AND QUALITY IMPROVEMENT PROGRAM.

    ``(a) In General.--The Director shall establish a comprehensive
program of patient-centered research and quality improvement to--
            ``(1) assess and understand diagnostic errors, including
        diagnostic delays, and how to eliminate common failures in the
        diagnostic process that lead to significant patient harm; and
            ``(2) identify, develop, implement, and disseminate
        evidence-based strategies and best practices for improving
        diagnostic quality, safety, timeliness, and eliminating health
        care waste resulting from diagnostic errors and delays.
    ``(b) Activities.--The program established under subsection (a)
shall include the following:
            ``(1) Continuum of research.--A portfolio of conducted and
        supported activities that is consistent with the research,
        implementation, and dissemination activities of the Center for
        Quality Improvement and Patient Safety of the Agency for
        Healthcare Research and Quality, including--
                    ``(A) research to assess diagnostic errors and
                identify improved methods to prevent errors and the
                harm errors cause;
                    ``(B) translation and synthesis of research
                findings and development of tools for implementing
                prevention strategies into practice;
                    ``(C) implementation research to refine evidence-
                based tools for improving diagnostic processes and
                effectively integrate these solutions into practice;
                and
                    ``(D) collaboration with stakeholders across the
                health care community to disseminate and promote
                implementation of effective methods, strategies, and
                tools for wide-scale improvement, including identifying
                where digital- and artificial intelligence-enabled
                tools could be beneficial, measure and assess
                diagnostic safety, accuracy, and timeliness, and assess
                the impact of improvement on wasteful spending.
            ``(2) Research centers of diagnostic excellence.--
        Consistent with section 911(b), the health care improvement
        research centers described in such section shall link research
        directly with clinical practice in geographically diverse
        locations throughout the United States, and may include--
                    ``(A) academic medical and institutional research
                centers that combine demonstrated multidisciplinary
                expertise in diagnostic outcomes or quality improvement
                research with linkages directly or through national,
                State, or local stakeholder partner organizations to
                relevant sites of care; and
                    ``(B) provider-based research networks, including
                plan, facility, or delivery system sites of care
                (especially primary care), that can evaluate outcomes
                and evaluate and promote quality improvement
                approaches.
            ``(3) Financial assistance.--The Director may provide
        financial assistance to assist in meeting the costs of planning
        and establishing new centers, as well as operating existing and
        new centers, pursuant to section 902(c).
            ``(4) Advisory committee.--
                    ``(A) Establishment.--The Director shall establish
                a multi-stakeholder advisory committee, with members
                that include patients, family members with lived
                experience, and the patient or consumer advocacy
                organizations that represent such patients and family
                members, to support the Director in the planning,
                implementation, and evaluation of the program under
                this section.
                    ``(B) Purpose.--The committee established under
                subparagraph (A) shall ensure that the program under
                this section improves patient outcomes by--
                            ``(i) incorporating advances in data
                        science, artificial intelligence, and health
                        information technology to empower patients and
                        families and strengthen systems-based
                        approaches to improving diagnosis;
                            ``(ii) integrating the lived experience and
                        the outcomes that matter most to patients and
                        families as well as perspectives of clinicians
                        and health systems, to ensure relevance and
                        uptake in practice; and
                            ``(iii) maintains a balanced research
                        portfolio that emphasizes scientific rigor,
                        patient-centeredness, and real world
                        applicability.
    ``(c) Authorization of Appropriations.--
            ``(1) In general.--To carry out this section, there are
        authorized to be appropriated $45,000,000 for each of fiscal
        years 2027 through 2031.
            ``(2) Availability.--Amounts appropriated under this
        section shall remain available until expended.''.

SEC. 4. PATIENT SAFETY REPORTING AND LEARNING INFRASTRUCTURE.

    (a) In General.--Not later than 1 year after the date of enactment
of this Act, the Director of the Agency for Healthcare Research and
Quality shall develop and submit to Congress a strategic plan to
modernize Federal approaches and establish mechanisms that enable
patients, families, and caregivers to voluntarily report their
experiences of diagnostic error (as defined by the National Academy of
Medicine in the consensus study report titled ``Improving Diagnosis in
Health Care 2015'') and other patient-safety adverse events and near
misses (as defined in the Patient Safety Network primer titled
``Adverse Events, Near Misses, and Errors'', published on December 15,
2024) to a system that meets the requirements established in subsection
(c).
    (b) Restrictions on the Use of Reports.--
            (1) In general.--Notwithstanding any other provision of
        law, reports collected under subsection (a) shall not be
        admissible in civil or criminal proceedings, and shall be used
        solely for public health, improvement, and learning purposes.
            (2) Clarification.--Reporting under subsection (a) shall
        not preclude or affect the legal rights of patients or family
        members or caregivers of patients or remedies available to such
        parties.
    (c) Purposes.--The strategic plan required under subsection (a)
shall--
            (1) modernize Federal approaches to capturing and using
        patient-reported safety information, in a manner that--
                    (A) safeguards patient privacy;
                    (B) facilitates integration, as appropriate, with
                existing data and learning systems within the
                Department of Health and Human Services, including the
                Agency for Healthcare Research and Quality, the Centers
                for Medicare & Medicaid Services, the National
                Institutes of Health, and the Advanced Research
                Projects Agency for Health;
                    (C) considers the use of modern data-science
                methods, including natural-language processing and
                artificial intelligence, to enable detection of
                diagnostic and other safety signals from patient-
                reported data and narrative; and
                    (D) identifies opportunities to align such
                reporting mechanisms with existing Federal patient-
                experience (such as Consumer Assessment of Healthcare
                Providers and Systems), quality-measurement, and safety
                programs to minimize burden and maximize learning; and
            (2) recommend a coordinated Federal approach for piloting,
        evaluating, and scaling such reporting mechanisms to support
        continuous improvement in diagnostic safety and quality.
    (d) Consultation.--In developing the strategic plan under
subsection (a), the Director of the Agency for Healthcare Research and
Quality shall consult with the Administrator of the Centers for
Medicare & Medicaid Services, the National Coordinator for Health
Information Technology, the Chief Data Officer of the Department of
Health and Human Services, and the Chief Artificial Intelligence
Officer of the Department of Health and Human Services.
    (e) Authorization of Appropriations.--
            (1) In general.--To carry out this section, there are
        authorized to be appropriated $20,000,000 for each of fiscal
        years 2027 through 2030.
            (2) Availability.--Amounts appropriated under this section
        shall remain available until expended.

SEC. 5. FELLOWSHIPS AND TRAINING GRANTS.

    (a) Ruth Kirschstein Awards.--Section 487(a) of the Public Health
Service Act (42 U.S.C. 288(a)) is amended by adding at the end the
following:
    ``(5) For purposes of the program under this subsection, biomedical
and behavioral research includes diagnostic safety and quality
research.''.
    (b) AHRQ Programs.--Section 902(b)(1) of the Public Health Service
Act (42 U.S.C. 299a(b)(1)) is amended--
            (1) by inserting ``and diagnostic safety and quality''
        after ``subsection (a)''; and
            (2) by striking ``under section 487(d)(3)'' and inserting
        ``for purposes of carrying out section 487''.

SEC. 6. QUALITY MEASURE DEVELOPMENT.

    Section 931(c)(2) of the Public Health Service Act (42 U.S.C. 299b-
31(c)(2)) is amended--
            (1) by redesignating subparagraphs (B) through (J) as
        subparagraphs (C) through (K), respectively; and
            (2) by inserting after subparagraph (A) the following:
                    ``(B) diagnostic safety and quality;''.

SEC. 7. STANDARDIZED DATA FOR DIAGNOSIS RESEARCH AND IMPROVEMENT.

    (a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall coordinate
with relevant departmental components to promote the standardization,
interoperability, and responsible use of key data elements to support
diagnostic safety and quality research and improvement.
    (b) Consultation With Expert Panel.--In carrying out subsection
(a), the Secretary, in coordination with the Director of the Agency for
Healthcare Research and Quality, the Administrator of the Centers for
Medicare & Medicaid Services, the Director of the National Library of
Medicine, the Chief Data Officer of the Department of Health and Human
Services, and the Chief Artificial Intelligence Officer of the
Department of Health and Human Services, shall convene an expert panel
to consider and make recommendations to the National Coordinator for
Health Information Technology regarding the specific United States Core
Data for Interoperability data elements and classes needed to
accelerate diagnostic safety and quality research, training, and
quality improvement including--
            (1) the fidelity, interoperability, auditability, and
        socio-technical aspects of electronic vocabularies and
        ontologies related to presenting symptoms as stated by
        patients, chief complaints of patients, and the status of
        diagnosis (such as tentative, working, or confirmed);
            (2) the development and use of symptom-based clinical
        registries; and
            (3) enhanced data capabilities that are necessary to
        support both research and improvement of diagnostic safety and
        quality.
    (c) Report.--The Secretary shall make available a summary of the
panel's recommendations and planned actions to advance the integration
of such recommended elements into the learning infrastructure for
diagnostic safety and quality.
    (d) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for each of fiscal years 2027 through 2029, to remain available until
expended.

SEC. 8. INTERAGENCY COUNCIL ON IMPROVING DIAGNOSIS IN HEALTH CARE.

    (a) Establishment.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall establish
within the Office of the Secretary an interagency council to be known
as the Interagency Council on Improving Diagnosis in Health Care
(referred to in this section as the ``Council'').
    (b) Objectives.--The objectives of the Council shall be the
following:
            (1) Enhance the quality, appropriateness, and effectiveness
        of diagnosis in health care through--
                    (A) the establishment and support of a broad base
                of scientific research;
                    (B) the dissemination and implementation of the
                results of such research; and
                    (C) the promotion of improvements in clinical and
                health system practices.
            (2) Identify and eliminate systemic barriers to supporting
        research in improving diagnosis in health care.
            (3) Identify knowledge gaps, research and data needs, and
        opportunities congruent with agency missions to strengthen the
        clinical and translational research pipeline to improve
        diagnostic safety and quality, including potential
        collaborative research initiatives among 2 or more agencies,
        offices, institutes, or centers within the Department of Health
        and Human Services or other Federal agencies or offices.
    (c) Membership.--
            (1) Chair.--The Director of the Agency for Healthcare
        Research and Quality (or the Director's designee) shall be the
        Chair of the Council.
            (2) Members.--
                    (A) In general.--In addition to the Chair, the
                Council shall be comprised of the following:
                            (i) At least 1 designee from each of the
                        following, appointed by the head of the
                        applicable department or agency:
                                    (I) The Centers for Disease Control
                                and Prevention.
                                    (II) The Centers for Medicare &
                                Medicaid Services.
                                    (III) The Department of Veterans
                                Affairs.
                                    (IV) The Congressionally Directed
                                Medical Research Program of the
                                Department of Defense.
                                    (V) The Office of the National
                                Coordinator for Health Information
                                Technology.
                                    (VI) The Office of the Chief Data
                                Officer of the Department of Health and
                                Human Services.
                                    (VII) The Office of the Chief
                                Artificial Intelligence Officer of the
                                Department of Health and Human
                                Services.
                                    (VIII) The Center for Devices and
                                Radiological Health of the Food and
                                Drug Administration.
                            (ii) Designees from the National Institutes
                        of Health, including a least 1 designee from
                        each of the following:
                                    (I) The National Cancer Institute.
                                    (II) The National Center for
                                Advancing Translational Sciences.
                                    (III) The National Institute of
                                Allergy and Infectious Diseases.
                                    (IV) The National Heart, Lung, and
                                Blood Institute.
                                    (V) The National Institute of
                                Neurological Disorders and Stroke.
                                    (VI) The National Library of
                                Medicine.
                                    (VII) The National Institute on
                                Minority Health and Health Disparities.
                                    (VIII) The National Institute of
                                Nursing Research.
                                    (IX) The Eunice Kennedy Shriver
                                National Institute of Child Health and
                                Human Development.
                            (iii) Designees from such other national
                        research institutes and national centers as may
                        be appropriate, as determined by the Director
                        of the National Institutes of Health.
                    (B) Additional members.--In addition to the
                designees under subparagraph (A), the Council may
                include such other designees from Federal departments
                or agencies as the Chair of the Council determines
                appropriate.
                    (C) Designation.--A person appointed to the Council
                as a designee shall be a senior official or employee of
                the department or agency whose responsibilities and
                subject matter expertise are relevant to the Council's
                objectives listed in subsection (b), as determined by
                the designating official.
    (d) Strategic Plan; Reports.--
            (1) Strategic federal plan to improve diagnosis in health
        care.--Not later than 18 months after the date of enactment of
        this Act, the Council shall develop, submit to the Secretary
        and Congress, and make publicly available a strategic plan, to
        be known as the Strategic Federal Plan to Improve Diagnosis,
        that, consistent with the objectives listed in subsection (b)--
                    (A) identifies coordinated opportunities to enhance
                scientific research and reduce systemic barriers in
                order to improve diagnosis in health care; and
                    (B) includes legislative and administrative policy
                recommendations, including opportunities to remove
                barriers to, and enhance, inter-agency coordination in
                the planning, conduct, and funding of, such research.
            (2) Reports to congress.--Not later than July 31 of every
        odd-numbered year beginning with the first such year after the
        date of submission of the first Strategic Federal Plan to
        Improve Diagnosis under paragraph (1), the Council shall
        prepare, submit to the Secretary and Congress, and make
        publicly available an updated Strategic Federal Plan to Improve
        Diagnosis that includes--
                    (A) such updates as the Council determines to be
                appropriate;
                    (B) information on the overall progress of the
                Federal Government in reducing barriers to research on,
                and supporting projects to improve, diagnosis in health
                care; and
                    (C) legislative and administrative policy
                recommendations, including addressing any needs for
                greater legislative authority to meet the objectives
                listed in subsection (b).
    (e) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $1,500,000 for each of fiscal
years 2027 through 2030.
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