119-hr4331

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4331 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 4331

 To require the Secretary of Health and Human Services to establish a 
 process to expand access to claims data under certain Federal health 
 plans in order to facilitate research and quality improvement.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 July 10, 2025

Mr. Joyce of Pennsylvania (for himself and Ms. Schrier) introduced the 
 following bill; which was referred to the Committee on Energy and 
 Commerce, and in addition to the Committee on Ways and Means, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
 committee concerned

_______________________________________________________________________

 A BILL

 To require the Secretary of Health and Human Services to establish a 
 process to expand access to claims data under certain Federal health 
 plans in order to facilitate research and quality improvement.

 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 ``Access to Claims Data Act''.

SEC. 2. EXPANDED ACCESS TO CLAIMS DATA TO FACILITATE RESEARCH AND 
 QUALITY IMPROVEMENT.

    (a) In General.--Not later than January 1, 2026, the Secretary of 
Health and Human Services shall establish a process to allow a 
qualified clinical data registry under 

section 1848
            (m) (3)
        (E) of the 
Social Security Act (42 U.S.C. 1395w-4
            (m) (3)
        (E) ) or a clinician-led 
clinical data registry under 

section 4005 of the 21st Century Cures Act 
(P.L. 114-255) to request claims data described in subsection

    (b) (in a 
form and manner determined to be appropriate by the Secretary) for the 
purposes of--

    (1) linking such data with clinical outcomes data;

    (2) conducting quality assessments and quality improvement 
 activities of providers of services (as defined in subsection

    (u) of 

section 1861 of the Social Security Act (42 U.S.C. 
 1395x) and suppliers (as defined in subsection
            (d) of such 
 section)), reporting the results of such assessments and 
 activities to such providers and suppliers, and performing 
 risk-adjusted, scientifically valid analyses and research to 
 support quality improvement or patient safety; and

    (3) publishing research and quality improvement analyses, 
 which may include deidentified combined claims and clinical 
 outcomes data.

    (b) Claims Data Described.--For purposes of subsection

    (a) , the 
claims data described in this subsection--

    (1) are--
        (A) claims data under the Medicare program under 
 title XVIII of the Social Security Act (42 U.S.C. 1395 
 et seq.); and
        (B) if the Secretary determines appropriate, claims 
 data under the Medicaid program under title XIX of such 
 Act (42 U.S.C. 1396 et seq.) and the State Children's 
 Health Insurance Program under title XXI of such Act 
 (42 U.S.C. 1397aa et seq.); and

    (2) may include provider-specific claims data, clinical 
 specialty-specific claims data, State-specific claims data, or 
 nationwide claims data.
            (c) Treatment of Qualified Clinical Data Registries and Clinician-
Led Clinical Data Registries.--For the purposes of this section, 
qualified clinical data registries and clinician-led clinical data 
registries shall not be required to be qualified entities, as defined 
in 

section 1874

    (e)

    (2) of the Social Security Act (42 U.S.C. 
1395kk

    (e)

    (2) ), or quasi-qualified entities, to access claims data 
pursuant to subsection

    (a) .
            (d) Fee.--Data described in subsection

    (b) shall be made available 
to a qualified clinical data registry or clinician-led clinical data 
registry under this section at a reasonable fee equal to the cost of 
making such data available. Any fee collected pursuant to the preceding 
sentence shall be deposited into the Centers for Medicare & Medicaid 
Services Program Management Account.
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