II 

113TH CONGRESS 

1ST SESSION S. 1758 

To amend title XVIII of the Social Security Act to increase access to Medicare 

data. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 21, 2013 

Ms. BALDWIN (for herself and Mr. THUNE) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to increase 

access to Medicare data. 

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 ‘‘Quality Data, Quality 

5 Healthcare Act of 2013’’. 

6 SEC. 2. EXPANDING THE AVAILABILITY OF MEDICARE 

7 DATA. 

8 (a) EXPANDING USE OF MEDICARE DATA BY QUALI9 FIED ENTITIES.—Section 1874(e) of the Social Security 

10 Act (42 U.S.C. 1395kk(e)) is amended— 


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1 (1) in paragraph (3), in the first sentence, by 

2 inserting ‘‘or, such claims data in sufficient detail to 

3 identify cost and utilization, as appropriate’’ before 

4 the period at the end; and 

5 (2) by adding at the end the following new 

6 paragraph: 

7 ‘‘(5) EXPANDING USE OF MEDICARE DATA BY

8 QUALIFIED ENTITIES.— 

9 ‘‘(A) IN GENERAL.—Beginning January 1, 

10 2014, notwithstanding paragraph (4)(B) and 

11 the second sentence of paragraph (4)(D), a 

12 qualified entity may— 

13 ‘‘(i) use data received by such entity 

14 under this section, and information derived 

15 from the evaluation described in paragraph 

16 (4)(D), for additional non-public analyses 

17 (as determined appropriate by the Sec18 retary); or 

19 ‘‘(ii) subject to subparagraph (C), 

20 provide or sell such data and analyses to 

21 entities described in subparagraph (B) for 

22 non-public use (including for the purposes 

23 of assisting providers of services and sup24 pliers to develop and participate in quality 


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1 and patient care improvement activities, 

2 including developing new models of care). 

3 ‘‘(B) ENTITIES DESCRIBED.—The entities 

4 described in this subparagraph are the fol5 lowing: 

6 ‘‘(i) A health care provider. 

7 ‘‘(ii) A health insurance issuer (as de8 fined in section 2791 of the Public Health 

9 Service Act). 

10 ‘‘(iii) An employer (as defined in sec11 tion 3(5) of the Employee Retirement In12 surance Security Act of 1974). 

13 ‘‘(iv) Any organization affiliated with 

14 or representing an entity described in 

15 clause (i), (ii), or (iii), such as a medical 

16 society. 

17 ‘‘(v) A public health authority (as de18 fined for purposes of the Health Insurance 

19 Portability and Accountability Act of 

20 1996). 

21 ‘‘(vi) A State or local government 

22 agency. 

23 ‘‘(vii) A research organization that 

24 certifies that it will only use the data or 


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1 analyses for the public good and not for 

2 proprietary purposes. 

3 ‘‘(viii) Any other entity the Secretary 

4 determines appropriate to further the goals 

5 of this paragraph. 

6 ‘‘(C) REQUIREMENTS.— 

7 ‘‘(i) DATA USE AGREEMENT.—A 

8 qualified entity may only provide data or 

9 analysis to an entity under subparagraph 

10 (A)(ii) pursuant to a data use agreement 

11 with the entity. Under such agreement, the 

12 entity— 

13 ‘‘(I) may not re-sell such data or 

14 analyses; and 

15 ‘‘(II) shall comply with the pri16 vacy and security policies of the quali17 fied entity in using such data or anal18 yses. 

19 ‘‘(ii) CIVIL MONEY PENALTY.— 

20 ‘‘(I) IN GENERAL.—If the Sec21 retary determines that an entity de22 scribed in subparagraph (B) know23 ingly used such data and analyses for 

24 purposes other than as authorized 

25 under this paragraph, the entity shall 


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1 be subject to a civil money penalty in 

2 an amount determined by the Sec3 retary for each such violation. 

4 ‘‘(II) PROCEDURES.—The provi5 sions of section 1128A (other than 

6 subsections (a) and (b) of such sec7 tion) shall apply to a civil money pen8 alty under subclause (I) in the same 

9 manner as such provisions apply to a 

10 penalty or proceeding under section 

11 1128A(a).’’. 

12 (b) ACCESS TO MEDICARE DATA TO QUALIFIED

13 CLINICAL DATA REGISTRIES TO FACILITATE QUALITY

14 IMPROVEMENT.—Section 1848(m)(3)(E) of the Social Se15 curity Act (42 U.S.C. 1395w–4(m)(3)(E)) is amended by 

16 adding at the end the following new clause: 

17 ‘‘(vi) ACCESS TO MEDICARE DATA TO

18 FACILITATE QUALITY IMPROVEMENT.— 

19 ‘‘(I) IN GENERAL.—Consistent 

20 with applicable laws and regulations 

21 with respect to privacy and other rel22 evant matters, beginning January 1, 

23 2014, the Secretary shall, subject to 

24 subclause (II), provide claims data 

25 under this title (in a form and manVerDate Mar 15 2010 00:56 Nov 27, 2013 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1758.IS S1758

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1 ner determined to be appropriate) to 

2 qualified clinical data registries under 

3 this subparagraph for purposes of 

4 linking such data with clinical out5 comes data and preforming and dis6 seminating risk-adjusted, scientifically 

7 valid research to support quality im8 provement. 

9 ‘‘(II) LIMITATION.—A qualified 

10 clinical data registry may not publicly 

11 report any data made available under 

12 subclause (I) that individually identi13 fies a provider of services or supplier 

14 unless the registry obtains the consent 

15 of the provider of services or supplier 

16 prior to such reporting.’’. 

Æ 


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