I 

113TH CONGRESS 

1ST SESSION H. R. 2843 

To amend title XI of the Social Security Act to provide for the public 

availability of Medicare claims data. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 25, 2013 

Mr. SENSENBRENNER (for himself and Mr. CUMMINGS) introduced the following bill; which was referred to the Committee on Ways and Means, 

and in addition to the Committee on Energy and Commerce, 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 title XI of the Social Security Act to provide 

for the public availability of Medicare claims 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 ‘‘Medicare Data Access 

5 for Transparency and Accountability Act’’. 


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1 SEC. 2. PUBLIC AVAILABILITY OF MEDICARE CLAIMS DATA. 

2 (a) IN GENERAL.—Section 1128J of the Social Secu3 rity Act (42 U.S.C. 1320a–7k) is amended by adding at 

4 the end the following new subsection: 

5 ‘‘(f) PUBLIC AVAILABILITY OF MEDICARE CLAIMS

6 DATA.— 

7 ‘‘(1) IN GENERAL.—The Secretary shall, to the 

8 extent consistent with applicable information, pri9 vacy, security, and disclosure laws, including the 

10 regulations promulgated under the Health Insurance 

11 Portability and Accountability Act of 1996 and sec12 tion 552a of title 5, United States Code, make avail13 able to the public claims and payment data of the 

14 Department of Health and Human Services related 

15 to title XVIII, including data on payments made to 

16 any provider of services or supplier under such title. 

17 ‘‘(2) IMPLEMENTATION.— 

18 ‘‘(A) IN GENERAL.—Not later than De19 cember 31, 2014, the Secretary shall promul20 gate regulations to carry out this subsection. 

21 ‘‘(B) REQUIREMENTS.—The regulations 

22 promulgated under subparagraph (A) shall en23 sure that— 

24 ‘‘(i) the data described in paragraph 

25 (1) is made available to the public through 


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1 a searchable database that the public can 

2 access at no cost; 

3 ‘‘(ii) such database— 

4 ‘‘(I) includes the amount paid to 

5 each provider of services or supplier 

6 under title XVIII, the items or serv7 ices for which such payment was 

8 made, and the location of the provider 

9 of services or supplier; 

10 ‘‘(II) is organized based on the 

11 specialty or the type of provider of 

12 services or supplier involved; 

13 ‘‘(III) is searchable based on the 

14 type of items or services furnished; 

15 and 

16 ‘‘(IV) includes a disclaimer that 

17 the aggregate data in the database 

18 does not reflect on the quality of the 

19 items or services furnished or of the 

20 provider of services or supplier who 

21 furnished the items or services; and 

22 ‘‘(iii) each provider of services or sup23 plier in the database is identified by a 

24 unique identifier that is available to the 

25 public (such as the National Provider IdenVerDate Mar 15 2010 02:52 Jul 30, 2013 Jkt 029200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2843.IH H2843

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1 tifier of the provider of services or sup2 plier). 

3 ‘‘(C) SCOPE OF DATA.—The database shall 

4 include data for fiscal year 2014, and each year 

5 fiscal year thereafter.’’. 

6 (b) INFORMATION NOT EXEMPT UNDER THE FREE7 DOM OF INFORMATION ACT.—The term ‘‘personnel and 

8 medical files and similar files the disclosure of which 

9 would constitute a clearly unwarranted invasion of per10 sonal privacy’’, as used in section 552(b)(6) of title 5, 

11 United States Code, does not include the information re12 quired to be made available to the public under section 

13 1128J(f) of the Social Security Act, as added by sub14 section (a). 

Æ 


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