I 

118TH CONGRESS 

2D SESSION H. R. 9805 

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 

SEPTEMBER 25, 2024 

Mr. BUCSHON (for himself, Ms. SCHRIER, and Mr. KILMER) 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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE . 

4 This Act may be cited as the ‘‘Access to Claims Data 

5 Act’’. 


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1 SEC. 2. EXPANDED ACCESS TO CLAIMS DATA TO FACILI2 TATE RESEARCH AND QUALITY IMPROVE3 MENT. 

4 (a) IN GENERAL.—Not later than January 1, 2025, 

5 the Secretary of Health and Human Services shall estab6 lish a process to allow a qualified clinical data registry 

7 under section 1848(m)(3)(E) of the Social Security Act 

8 (42 U.S.C. 1395w–4(m)(3)(E)) or a clinician-led clinical 

9 data registry under section 4005 of the 21st Century 

10 Cures Act (P.L. 114–255) to request claims data de11 scribed in subsection (b) (in a form and manner deter12 mined to be appropriate by the Secretary) for the purposes 

13 of— 

14 (1) linking such data with clinical outcomes 

15 data; 

16 (2) conducting quality assessments and quality 

17 improvement activities of providers of services (as 

18 defined in subsection (u) of section 1861 of the So19 cial Security Act (42 U.S.C. 1395x) and suppliers 

20 (as defined in subsection (d) of such section), report21 ing the results of such assessments and activities to 

22 such providers and suppliers, and performing risk23 adjusted, scientifically valid analyses and research to 

24 support quality improvement or patient safety; and 


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1 (3) publishing research and quality improve2 ment analyses, which may include deidentified com3 bined claims and clinical outcomes data. 

4 (b) CLAIMS DATA DESCRIBED.—For purposes of 

5 subsection (a), the claims data described in this sub6 section— 

7 (1) are— 

8 (A) claims data under the Medicare pro9 gram under title XVIII of the Social Security 

10 Act (42 U.S.C. 1395 et seq.); and 

11 (B) if the Secretary determines appro12 priate, claims data under the Medicaid program 

13 under title XIX of such Act (42 U.S.C. 1396 et 

14 seq.) and the State Children’s Health Insurance 

15 Program under title XXI of such Act (42 

16 U.S.C. 1397aa et seq.); and 

17 (2) may include provider-specific claims data, 

18 clinical specialty-specific claims data, State-specific 

19 claims data, or nationwide claims data. 

20 (c) TREATMENT OF QUALIFIED CLINICAL DATA

21 REGISTRIES AND CLINICIAN-LED CLINICAL DATA REG22 ISTRIES.—For the purposes of this section, qualified clin23 ical data registries and clinician-led clinical data registries 

24 shall not be required to be qualified entities, as defined 

25 in section 1874(e)(2) of the Social Security Act (42 U.S.C. 


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1 1395kk(e)(2)), or quasi-qualified entities, to access claims 

2 data pursuant to subsection (a). 

3 (d) FEE.—Data described in subsection (b) shall be 

4 made available to a qualified clinical data registry or clini5 cian-led clinical data registry under this section at a rea6 sonable fee equal to the cost of making such data avail7 able. Any fee collected pursuant to the preceding sentence 

8 shall be deposited into the Centers for Medicare & Med9 icaid Services Program Management Account. 

Æ 


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