I 

116TH CONGRESS 

1ST SESSION H. R. 1390 

To amend titles XVIII and XIX of the Social Security Act to promote 

the ability of individuals entitled to benefits under part A or enrolled 

under part B of the Medicare program and individuals enrolled under 

a State plan under the Medicaid program to access their personal medical 

claim data, including their providers, prescriptions, tests, and diagnoses, 

through a mobile health record application of the individual’s choosing, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 27, 2019 

Mrs. BROOKS of Indiana (for herself and Ms. CLARKE of New York) 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 amend titles XVIII and XIX of the Social Security Act 

to promote the ability of individuals entitled to benefits 

under part A or enrolled under part B of the Medicare 

program and individuals enrolled under a State plan 

under the Medicaid program to access their personal 

medical claim data, including their providers, prescriptions, tests, and diagnoses, through a mobile health 

record application of the individual’s choosing, and for 

other purposes. 


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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 ‘‘Mobile Health Record 

5 Act of 2019’’. 

6 SEC. 2. FINDINGS; SENSE OF CONGRESS. 

7 (a) FINDINGS.—Congress finds the following: 

8 (1) The Centers for Medicare & Medicaid Serv9 ices’ (CMS) Blue Button 2.0 Program was an10 nounced in April 2018 to build upon CMS’s Blue 

11 Button Program. 

12 (2) The Blue Button 2.0 Program provides 4 

13 years of Medicare part A, B, and D data for 53 mil14 lion Medicare beneficiaries through an Application 

15 Programming Interface (API). The data contains a 

16 variety of information including, but not limited to, 

17 a list of a patient’s providers, prescriptions, tests, 

18 and diagnoses. The Blue Button 2.0 Program re19 quires the use of CMS-approved applications to 

20 allow beneficiaries to download coded data. 

21 (3) Mobile applications currently exist that have 

22 the power to decode the Medicare Blue Button data 

23 and present it in a user-friendly, easy-to-read and 

24 understand format. Prior to Blue Button 2.0, the 

25 Blue Button Program allowed beneficiaries to 


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1 download such data, but the information was not de2 coded into the easy-to-read and understand format 

3 that a mobile application provides. 

4 (4) The Blue Button 2.0 Program was created 

5 to empower patients with the use of these applica6 tions, but additional steps need to be taken in order 

7 to ensure the program reaches its intended purpose 

8 of providing patients with their personal medical 

9 claim information to prevent harmful medical errors 

10 and reducing redundant spending. 

11 (5) According to a study published by Johns 

12 Hopkins University in 2016, more than 250,000 

13 deaths per year are due to medical error, making it 

14 the third leading cause of death in the United 

15 States. Further, millions of dollars are wasted on 

16 duplicative or unnecessary tests and procedures. 

17 (b) SENSE OF CONGRESS.—It is the sense of Con18 gress that the Centers for Medicare & Medicaid Services’ 

19 Blue Button 2.0 Program has the potential to positively 

20 influence patient behavior, improve patient safety and 

21 health outcomes, and help reduce unnecessary health care 

22 expenditures, but action needs to be taken to help the ini23 tiative meet the program’s goals. 


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1 SEC. 3. PROMOTING PATIENT ACCESS TO PERSONAL MED2 ICAL CLAIM INFORMATION, INCLUDING A PA3 TIENT’S PROVIDERS, PRESCRIPTIONS, TESTS, 

4 AND DIAGNOSES, THROUGH THE USE OF MO5 BILE HEALTH RECORD APPLICATIONS. 

6 (a) MEDICARE.—Title XVIII of the Social Security 

7 Act (42 U.S.C. 1395 et seq.) is amended by adding at 

8 the end the following new section: 

9 ‘‘SEC. 1899C. MOBILE ACCESS TO PERSONAL MEDICAL IN10 FORMATION PROGRAM. 

11 ‘‘(a) ESTABLISHMENT.— 

12 ‘‘(1) IN GENERAL.—Not later than January 1, 

13 2020, the Secretary shall establish a program to be 

14 known as the ‘Mobile Access to Personal Medical In15 formation Program’ (in this section referred to as 

16 the ‘Program’) for purposes of creating a developer17 friendly, standards-based API that enables individ18 uals entitled to benefits under part A or enrolled 

19 under part B to connect their claims data to the ap20 plications, services, and research programs they 

21 trust while allowing such individuals to retain full 

22 control over how the copy of the data they receive 

23 can be used and by whom. The Program shall pro24 vide such an individual access to the personal med25 ical claim information of the individual through a 

26 mobile health record application of the individual’s 


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1 choice approved by the Secretary under subsection 

2 (b). Such information shall be made available 

3 through such application in a manner similar to how 

4 such information is made available under the Blue 

5 Button 2.0 program (or a successor program). 

6 ‘‘(2) ENCOURAGING USE OF PROGRAM.—In car7 rying out the Program, the Secretary shall consider 

8 establishing methods for encouraging individuals de9 scribed in paragraph (1) to access their personal 

10 medical claim information under the Program. Such 

11 methods may include— 

12 ‘‘(A) providing individuals described in 

13 paragraph (1) access to a one-time financial in14 centive to download for free or at a discounted 

15 price a CMS-approved mobile health record ap16 plication of their choice that can be used to ac17 cess their personal medical claim information 

18 under the Program; 

19 ‘‘(B) paying a reasonable fee per download 

20 to the application developer to be capped at a 

21 fair market value; or 

22 ‘‘(C) other methods determined appro23 priate by the Secretary. 

24 For purposes of the previous sentence, the Secretary 

25 shall consult with application developers, insurers, 


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1 and other appropriate entities determined by the 

2 Secretary, to establish appropriate methods of finan3 cial incentive payment for applications approved to 

4 participate in the program. 

5 ‘‘(b) MOBILE HEALTH RECORD APPLICATIONS.— 

6 ‘‘(1) APPROVAL.—The Secretary shall establish 

7 a process under which the Secretary, in consultation 

8 with staff with appropriate technical expertise, ap9 proves mobile health record applications for use 

10 under the Program. Such process shall include re11 quirements providing that such application— 

12 ‘‘(A) demonstrates the capacity to provide 

13 the personal medical claim information of an in14 dividual described in subsection (a) to such in15 dividual in an easily accessible format; 

16 ‘‘(B) utilizes a machine-readable, struc17 tured, coded format conforming to a data con18 tent standard approved by the Secretary; 

19 ‘‘(C) has the ability to aggregate data from 

20 multiple sources; 

21 ‘‘(D) is encrypted (or contains other data 

22 security safeguards determined appropriate by 

23 the Secretary) and conforms to other cybersecu24 rity standards and best practices determined 

25 appropriate by the Secretary; 


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1 ‘‘(E) provides for a mechanism through 

2 which the Secretary may track the number of 

3 times and frequency with which such individual 

4 accesses the personal medical claim information 

5 of such individual; 

6 ‘‘(F) does not use a third-party service for 

7 ad revenue or for any other means; and 

8 ‘‘(G) meets such other requirements as 

9 may be specified by the Secretary. 

10 ‘‘(2) ANNUAL REVIEW OF APPROVAL.—The 

11 Secretary shall, not less than annually and in con12 sultation with staff with appropriate technical exper13 tise, review each mobile health record application ap14 proved under paragraph (1) to determine whether 

15 such application continues to meet the requirements 

16 specified in such paragraph. The Secretary shall re17 voke the approval of any such application that fails 

18 to meet such requirements. 

19 ‘‘(c) INFORMATION ON PROGRAM.—The Secretary 

20 shall, through the public website of the Centers for Medi21 care & Medicaid Services, mailed notices, through a notice 

22 at the time of enrollment of an individual in part A or 

23 part B, public awareness campaigns, the notice described 

24 in section 1804(a), the provision of personalized preven25 tion plan services (as defined in section 1861(hhh)), or 


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1 otherwise (as determined appropriate by the Secretary), 

2 ensure that individuals described in subsection (a) receive 

3 information not less than twice each year regarding the 

4 Program, including a list of mobile health record applica5 tions approved under subsection (b)(1). 

6 ‘‘(d) CYBERSECURITY AND DATA PRIVACY.— 

7 ‘‘(1) CONSULTATION.—In carrying out the Pro8 gram, the Secretary shall consult with the National 

9 Coordinator for Health Information Technology and 

10 other Federal agencies determined appropriate by 

11 the Secretary to ensure the compliance of entities 

12 participating in the Program with all applicable pro13 visions of the regulations promulgated by the Sec14 retary under part C of title XI and section 264 of 

15 the Health Insurance Portability and Accountability 

16 Act of 1996. 

17 ‘‘(2) ADDITIONAL CYBERSECURITY PROTEC18 TIONS.—In carrying out the Program, the Secretary 

19 shall consult with appropriate Federal agencies, in20 cluding the National Institute for Standards and 

21 Technology, and appropriate public-private partner22 ships (such as the Sector Coordinating Councils), in23 cluding the Healthcare and Public Health Sector Co24 ordinating Council, to ensure that relevant and ap25 plicable cybersecurity guidelines are followed when 


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1 establishing the Program (including when estab2 lishing standards and best practices under sub3 section (b)(1)(D) and standards and criteria under 

4 subsection (e)(1)(C)). 

5 ‘‘(e) DEFINITIONS.—In this section: 

6 ‘‘(1) MOBILE HEALTH RECORD APPLICATION.— 

7 The term ‘mobile health record application’ means a 

8 software application that— 

9 ‘‘(A) runs on a mobile device (such as a 

10 mobile phone or handheld computing platform); 

11 ‘‘(B) allows an individual to access the in12 dividual’s personal medical claim information; 

13 and 

14 ‘‘(C) meets such cybersecurity and data se15 curity standards and criteria as the Secretary 

16 may specify, which may be similar to such 

17 standards and criteria used under the Blue 

18 Button 2.0 program (or a successor program). 

19 ‘‘(2) PERSONAL MEDICAL CLAIM INFORMA20 TION.—The term ‘personal medical claim informa21 tion’ means, with respect to an individual— 

22 ‘‘(A) a list of claims for items and services 

23 furnished to such individual payable under part 

24 A or part B, including any prescriptions or 

25 tests; 


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1 ‘‘(B) a list of providers and suppliers who 

2 furnished such items and services; 

3 ‘‘(C) any diagnoses made by such providers 

4 and suppliers; 

5 ‘‘(D) Medicare Advantage encounter data 

6 from an MA or MA–PD plan under part C; and 

7 ‘‘(E) prescription drug event data.’’. 

8 (b) MEDICAID.—Section 1903 of the Social Security 

9 Act (42 U.S.C. 1396b) is amended by adding at the end 

10 the following new subsection: 

11 ‘‘(aa) PAYMENTS FOR MOBILE ACCESS TO PERSONAL

12 MEDICAL CLAIM INFORMATION.— 

13 ‘‘(1) PAYMENTS.—In addition to payments oth14 erwise provided under subsection (a), in the case of 

15 a State that elects to develop, or purchase from a 

16 private entity, a mobile health record application 

17 through which an individual enrolled under the State 

18 plan (or a waiver of such plan) may access the per19 sonal medical claim information of such individual, 

20 the Secretary shall pay to such State, for each quar21 ter beginning on or after the date of the enactment 

22 of the Mobile Health Record Act of 2019, an 

23 amount equal to 90 percent of so much of the sums 

24 expended during such quarter as are attributable to 


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1 the development, or purchase, of such mobile health 

2 record application. 

3 ‘‘(2) DEFINITIONS.—In this subsection: 

4 ‘‘(A) MOBILE HEALTH RECORD APPLICA5 TION.—The term ‘mobile health record applica6 tion’ has the meaning given such term in sec7 tion 1899C(e). 

8 ‘‘(B) PERSONAL MEDICAL CLAIM INFORMA9 TION.—The term ‘personal medical claim infor10 mation’ means, with respect to a State and an 

11 individual enrolled under the State plan (or a 

12 waiver of such plan)— 

13 ‘‘(i) a list of claims for items and 

14 services furnished to such individual under 

15 the State plan (or waiver), including any 

16 prescriptions or tests; 

17 ‘‘(ii) a list of providers and suppliers 

18 who furnished such items and services; and 

19 ‘‘(iii) any diagnoses made by such 

20 providers and suppliers.’’. 

Æ 


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