I 

115TH CONGRESS 

1ST SESSION H. R. 539 

To amend title IX of the Public Health Service Act to revise the operations 

of the United States Preventive Services Task Force, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 13, 2017 

Mrs. BLACKBURN (for herself and Mr. RUSH) 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 title IX of the Public Health Service Act to 

revise the operations of the United States Preventive 

Services Task Force, and for other purposes. 

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 ‘‘USPSTF Trans5 parency and Accountability Act of 2017’’. 


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1 SEC. 2. CHANGES TO UNITED STATES PREVENTIVE SERV2 ICES TASK FORCE. 

3 (a) IN GENERAL.—Subsection (a) of section 915 of 

4 the Public Health Service Act (42 U.S.C. 299b–4) is 

5 amended— 

6 (1) by amending the heading to read as follows: 

7 ‘‘UNITED STATES PREVENTIVE SERVICES TASK

8 FORCE’’; 

9 (2) by amending paragraph (1) to read as fol10 lows: 

11 ‘‘(1) ESTABLISHMENT AND PURPOSE.—The Di12 rector may establish and periodically convene the 

13 United States Preventive Services Task Force (in 

14 this section referred to as the ‘Task Force’). The 

15 Task Force shall review the scientific evidence and 

16 new science related to the effectiveness and appro17 priateness of clinical preventive services for the pur18 pose of developing recommendations for primary 

19 care clinicians and the health care community and 

20 updating previous clinical preventive recommenda21 tions.’’; 

22 (3) by redesignating paragraph (3) as para23 graph (5) and paragraphs (4) through (7) as para24 graphs (9) through (12), respectively; 

25 (4) by inserting after paragraph (2) the fol26 lowing new paragraphs: 


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1 ‘‘(3) COMPOSITION.— 

2 ‘‘(A) IN GENERAL.—The Task Force shall 

3 be composed of individuals that collectively have 

4 appropriate scientific expertise, including in 

5 fields of health sciences research, health eco6 nomics, health promotion, disease prevention, 

7 and clinical care. The Task Force shall include 

8 balanced representation of practicing primary 

9 and specialty care providers (including in the 

10 fields of health services research, health eco11 nomics, and clinical care), and patient and 

12 health care consumers. 

13 ‘‘(B) NOTICE.—Before appointing mem14 bers to the Task Force, the Director shall pro15 vide notice in the Federal Register to give per16 sons an opportunity to nominate potential mem17 bers. 

18 ‘‘(4) REVIEW AND CONSULTATION.— 

19 ‘‘(A) RESEARCH PLANS.— 

20 ‘‘(i) IN GENERAL.—In conducting its 

21 reviews under paragraph (1), the Task 

22 Force, shall publish one or more proposed 

23 research plans (in this subsection referred 

24 to as a ‘research plan’) to guide the Task 

25 Force’s systematic review of the evidence. 


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1 Each such plan shall include an analytic 

2 framework, key questions, and a literature 

3 search strategy or research approach, and 

4 shall incorporate the methodological guide5 lines developed under clause (ii). The 

6 Agency shall provide for the publication in 

7 the Federal Register of a request for pub8 lic comments on each plan and shall accept 

9 comments during a period of at least 45 

10 days. Any final research plan shall be 

11 made available to the public and include a 

12 discussion of the comments received and 

13 responses to such comments. The Task 

14 Force, with the concurrence of the Direc15 tor, may change such a research plan 

16 through the same process as applied to the 

17 initial adoption of such plan. 

18 ‘‘(ii) CRITERIA.—The Director shall 

19 design and regularly update guidelines for 

20 proper methodological standards for incor21 poration into such research plans. Such 

22 guidelines shall include measures for ap23 propriate validity, for risk adjustment, for 

24 timeliness, for input from relevant experts 

25 and peers in the respective communities, 


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1 for accounting for all relevant subpopula2 tions (including disparities by race, eth3 nicity, socioeconomic status, and geo4 graphic location), and for other health out5 come measurements. 

6 ‘‘(iii) CONSULTATION ON RESEARCH

7 PLANS.—The Director shall facilitate co8 ordination and interaction with other agen9 cies and departments in the creation of re10 search plans (taking into consideration re11 search and findings by other agencies and 

12 departments) and methodological stand13 ards under clause (ii), including with the 

14 National Institutes of Health, the National 

15 Cancer Institute, the National Institute on 

16 Minority Health and Health Disparities, 

17 the Centers for Disease Control and Pre18 vention, the Department of Defense, the 

19 Department of Veterans Affairs, the Cen20 ters for Medicare & Medicaid Services, and 

21 the Patient-Centered Outcomes Research 

22 Institute. 

23 ‘‘(B) EVIDENCE REPORTS.—The Director 

24 shall make publicly available each draft evi25 dence report and publish in the Federal RegVerDate Sep 11 2014 03:09 Jan 27, 2017 Jkt 069200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H539.IH H539

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1 ister a request for public comments on such re2 ports. No such evidence report shall be pub3 lished prior to it being reviewed by a panel of 

4 external subject matter experts that includes 

5 provider and patient representatives. Each such 

6 report shall include a description of the panel 

7 that conducted such review. Such description 

8 shall include information on each panel mem9 ber, including name, academic degree (or de10 grees), affiliations, and related expertise. 

11 ‘‘(C) RECOMMENDATION STATEMENTS.— 

12 ‘‘(i) PUBLICATION OF DRAFT REC13 OMMENDATIONS.—The Director shall make 

14 publicly available each draft recommenda15 tion and shall provide for the publication 

16 in the Federal Register of a request for 

17 comments and accept comments during a 

18 period of not less than 45 days. 

19 ‘‘(ii) CONSULTATION ON DRAFT REC20 OMMENDATIONS.—Before voting on a draft 

21 recommendation statement, the Task 

22 Force shall consult with relevant stake23 holders, including provider groups, prac24 ticing specialists that treat the specific disVerDate Sep 11 2014 03:09 Jan 27, 2017 Jkt 069200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H539.IH H539

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1 ease under review, and relevant patient 

2 and disease advocacy organizations. 

3 ‘‘(iii) PUBLIC AVAILABILITY OF COM4 MENTS AND INCLUSION OF DESCRIPTION

5 OF COMMENTS IN FINAL STATEMENT.— 

6 The Director shall make such comments 

7 received publicly available. Any final rec8 ommendation statement shall include a de9 scription of comments received on the draft 

10 recommendation statement and rec11 ommendations of other Federal agencies or 

12 organizations relating to the topic of the 

13 statement. 

14 ‘‘(iv) CONSIDERATION.—In publishing 

15 recommendation statements, the Task 

16 Force shall consider the impact of its rec17 ommendations on the health care commu18 nity, whether a preventive service is bene19 ficial for some individuals and the need to 

20 encourage a discussion of benefits and 

21 risks for those individuals, and how its spe22 cific assignment of a grade to a product or 

23 service may affect coverage and access to 

24 such product or service under Federal proVerDate Sep 11 2014 03:09 Jan 27, 2017 Jkt 069200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H539.IH H539

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1 grams and private health insurance cov2 erage. 

3 ‘‘(D) GRADING SYSTEM.—In publishing 

4 recommendation statements, the Task Force 

5 shall grade products and services consistent 

6 with the following, subject to subparagraph (E): 

7 ‘‘(i) GRADE A.—The Task Force con8 cludes that the current evidence is suffi9 cient to assess the balance of benefits and 

10 risks of the product or service, and, on the 

11 basis of such evidence, recommends the 

12 product or service and determines that 

13 there is high certainty that the net benefit 

14 from the product or service is substantial. 

15 ‘‘(ii) GRADE B.—The Task Force con16 cludes that the current evidence is suffi17 cient to assess the balance of benefits and 

18 risks of the product or service, and, on the 

19 basis of such evidence, recommends the 

20 product or service and determines that 

21 there is high certainty that the net benefit 

22 of the product or service is moderate or 

23 there is moderate certainty that the net 

24 benefit of the product or service is mod25 erate to substantial. 


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1 ‘‘(iii) GRADE C.—The Task Force 

2 concludes that the current evidence is suf3 ficient to assess the balance of benefits and 

4 risks of the product or service, and, on the 

5 basis of such evidence, does not make a 

6 recommendation of the product or service 

7 and clinicians may provide this product or 

8 service to selected patients depending on 

9 individual circumstances. However, for 

10 most individuals without signs or symp11 toms there is likely to be only a small ben12 efit from this product or service. 

13 ‘‘(iv) GRADE D.—The Task Force 

14 concludes that the current evidence is suf15 ficient to assess the balance of benefits and 

16 risks of the product or service, and, on the 

17 basis of such evidence, recommends 

18 against the product or service and deter19 mines that there is moderate or high cer20 tainty that the product or service has no 

21 net benefit or that the harm of the product 

22 or service outweighs the benefits. 

23 ‘‘(v) GRADE I.—The Task Force con24 cludes that the current evidence is not sufVerDate Sep 11 2014 03:09 Jan 27, 2017 Jkt 069200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H539.IH H539

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1 ficient to assess the balance of benefits and 

2 risks of the product or service. 

3 ‘‘(E) CHANGES IN GRADING SYSTEM.— 

4 ‘‘(i) IN GENERAL.—The Director may 

5 provide, by regulation, for changes in the 

6 grading system described in subparagraph 

7 (D). 

8 ‘‘(ii) IMPACT OF CHANGES.—If the 

9 Director makes a change in the grading 

10 system under clause (i) for a particular 

11 grade, the Task Force shall review and re12 grade the services previously classified 

13 within that grade. Such review and regrade 

14 may be done through an expedited process 

15 but any such change in grade shall not 

16 take effect before such review process is 

17 completed.’’; 

18 (5) in paragraph (5), as redesignated by para19 graph (3)— 

20 (A) by striking ‘‘dissemination of the rec21 ommendations of the Task Force’’ and inserting 

22 ‘‘dissemination of its recommendation state23 ments’’; and 


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1 (B) by striking ‘‘Guide’s recommenda2 tions’’ and inserting ‘‘recommendations of the 

3 Task Force’’; 

4 (6) by inserting after paragraph (5), as so re5 designated, the following new paragraphs: 

6 ‘‘(6) PREVENTIVE SERVICES ADVISORY

7 BOARD.— 

8 ‘‘(A) IN GENERAL.—The Task Force shall 

9 convene a preventive services advisory board (in 

10 this subsection referred to as the ‘board’) com11 posed of representatives of appropriate public 

12 and private entities with an interest in clinical 

13 preventive services to advise the Task Force on 

14 developing, updating, publishing, and dissemi15 nating evidence-based recommendations on the 

16 use of clinical preventive services. 

17 ‘‘(B) MEMBERSHIP.—The members of the 

18 board shall include representatives of the fol19 lowing: 

20 ‘‘(i) Patient groups. 

21 ‘‘(ii) Providers of clinical services, in22 cluding community-based providers and 

23 specialty physicians. 

24 ‘‘(iii) Federal departments and agen25 cies, including— 


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1 ‘‘(I) appropriate health agencies 

2 and offices in the Department, includ3 ing the National Institutes of Health, 

4 the National Cancer Institute, the Na5 tional Institute on Minority Health 

6 and Health Disparities, the Centers 

7 for Disease Control and Prevention, 

8 the Administration on Aging, the 

9 Health Resources and Services Ad10 ministration, the Centers for Medicare 

11 & Medicaid Services, the Office of the 

12 Surgeon General of the Public Health 

13 Service, the Department of Defense, 

14 the Department of Veterans Affairs, 

15 the Patient-Centered Outcomes Re16 search Institute, the Office of Minor17 ity Health, and the Office on Wom18 en’s Health; and 

19 ‘‘(II) as appropriate, other Fed20 eral departments and agencies the 

21 programs of which have a significant 

22 impact upon health. 

23 ‘‘(iv) Private health care payors. 

24 ‘‘(C) RESPONSIBILITIES.—In accordance 

25 with subsection (b)(5), the board shall— 


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1 ‘‘(i) recommend clinical preventive 

2 services for review by the Task Force; 

3 ‘‘(ii) suggest scientific evidence for 

4 consideration by the Task Force related to 

5 reviews undertaken by the Task Force; 

6 ‘‘(iii) provide feedback regarding the 

7 research plan, the evidence report, and 

8 draft recommendations by the Task Force; 

9 and 

10 ‘‘(iv) assist with efforts regarding dis11 semination of recommendations by the Di12 rector of the Agency for Healthcare Re13 search and Quality. 

14 ‘‘(D) MEETINGS.—The Preventive Services 

15 Advisory Board shall meet as the Chair of the 

16 Board determines to be appropriate to fulfill 

17 the responsibilities described in paragraph (C), 

18 but not fewer than 2 times each year. 

19 ‘‘(7) DISCLOSURE AND CONFLICTS OF INTER20 EST.—Prior to participating in a meeting of the 

21 Task Force or board, each member of the Task 

22 Force or board, respectively, shall disclose to the Di23 rector any potential, relevant financial interests in 

24 the same manner and to the same extent as an em25 ployee of the executive branch of the United States, 


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1 if the employee were participating in such meeting, 

2 would be required to disclose such interests under 

3 section 208 of title 18, United States Code. 

4 ‘‘(8) NO PAY; RECEIPT OF TRAVEL EX5 PENSES.—Members of the Task Force or the board 

6 shall not receive any pay for service on the Task 

7 Force or board, but may receive travel expenses, in8 cluding a per diem, in accordance with applicable 

9 provisions of subchapter I of chapter 57 of title 5, 

10 United States Code.’’; and 

11 (7) by amending paragraph (10), as redesig12 nated by paragraph (3), to read as follows: 

13 ‘‘(10) APPLICATION OF FACA.—The Task Force 

14 shall conduct its activities in compliance with the 

15 Federal Advisory Committee Act (5 U.S.C. App.).’’. 

16 (b) EFFECTIVE DATE; TRANSITION.— 

17 (1) IN GENERAL.—Except as otherwise pro18 vided, the amendments made by subsection (a) shall 

19 take effect on the date of the enactment of this Act. 

20 The United States Preventive Services Task Force 

21 shall not publish any draft or final recommendations 

22 on or after such date except in accordance with such 

23 amendments. 

24 (2) RECONSTITUTION OF TASK FORCE.—Not 

25 later than 180 days after the date of the enactment 


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1 of this Act, the Director of the Agency for 

2 Healthcare Research and Quality shall take steps to 

3 reconstitute the membership of the Task Force con4 sistent with section 915(a)(3) of the Public Health 

5 Service Act, as amended by subsection (a). 

6 (3) PREVIOUSLY PUBLISHED RECOMMENDA7 TIONS.—With respect to recommendations or guide8 lines published by such Task Force before the date 

9 of the enactment of this Act, under procedures es10 tablished by the Director of the Agency for 

11 Healthcare Research and Quality, the reconstituted 

12 Task Force shall undertake a review process con13 sistent with the following: 

14 (A) An organization may request the Task 

15 Force to review such previous recommendations 

16 or guidelines if such organization has additional 

17 peer-reviewed scientific evidence that provides 

18 new information relevant to the previous rec19 ommendation or guideline. 

20 (B) Based upon such requests, the Task 

21 Force shall establish a process for the review of 

22 previous recommendations or guidelines. 

23 (C) Such process shall include public no24 tice through the Federal Register and oppor25 tunity for comment and a determination to conVerDate Sep 11 2014 03:09 Jan 27, 2017 Jkt 069200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\H539.IH H539

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1 firm or modify such recommendations or guide2 lines. 

3 (D) The process shall, to the extent fea4 sible, be consistent with the procedures applied 

5 under the amendments made by subsection (a) 

6 for the promulgation of new recommendations. 

7 (c) GAO EVALUATION AND REPORT.—Not later than 

8 1 year after the date of enactment of this Act, the Comp9 troller General of the United States shall submit to Con10 gress a report that contains the following: 

11 (1) A listing of the recommendations of the 

12 United States Preventive Services Task Force as of 

13 such date, including the date final recommendations 

14 and any subsequent updates were posted or pub15 lished. 

16 (2) A comparison of such recommendations and 

17 relevant recommendations of other Federal health 

18 agencies, including the Centers for Disease Control 

19 and Prevention, the Centers for Medicare & Med20 icaid Services, the Department of Defense, the De21 partment of Veterans Affairs, and the Patient-Cen22 tered Outcomes Research Institute, as well as rel23 evant recommendations from national medical pro24 fessional societies and relevant patient and disease 

25 advocacy organizations. 


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1 (3) An analysis of the impact of the rec2 ommendations of the Task Force on public and pri3 vate insurance coverage, access, and outcomes, in4 cluding impact on morbidity and mortality. 

5 (d) ELIMINATION OF SECRETARIAL DISCRETION TO

6 REMOVE CERTAIN PREVENTIVE SERVICES UNDER THE

7 MEDICARE PROGRAM.—Section 1834(n) of the Social Se8 curity Act (42 U.S.C. 1395m(n)) is amended— 

9 (1) by striking paragraph (2); 

10 (2) by striking ‘‘; and’’ at the end of paragraph 

11 (1)(B) and inserting a period; 

12 (3) by redesignating subparagraphs (A) and 

13 (B) of paragraph (1) as paragraphs (1) and (2), re14 spectively, and moving their margins 2 ems to the 

15 left; and 

16 (4) by striking ‘‘may’’ and all that follows 

17 through ‘‘modify’’ and inserting ‘‘may modify’’. 

18 (e) APPLICATION TO SECRETARIAL DISCRETION TO

19 REMOVE CERTAIN PREVENTIVE SERVICES UNDER THE

20 MEDICARE PROGRAM.—Section 1834(n) of the Social Se21 curity Act (42 U.S.C. 1395m(n)) is amended by adding 

22 at the end the following flush sentence: ‘‘Effective on the 

23 date of enactment of the USPSTF Transparency and Ac24 countability Act of 2017, the Secretary may only use the 

25 authority under this subsection to modify or eliminate covVerDate Sep 11 2014 03:09 Jan 27, 2017 Jkt 069200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\H539.IH H539

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1 erage of a preventive service based on the recommendation 

2 or grade of the United States Preventive Services Task 

3 Force with respect to the service if such recommendation 

4 or grade was developed or updated in accordance with the 

5 amendments made by section 2(a) of such Act and if the 

6 Secretary has concurred with such recommendation or 

7 grade after consultation with other Federal health agen8 cies and relevant patient and provider groups.’’. 

9 (f) APPLICATION TO PHYSICIAN QUALITY MEASURES

10 UNDER THE MEDICARE PROGRAM.—Section 1848 of the 

11 Social Security Act (42 U.S.C. 1395w–4) is amended by 

12 adding at the end the following new subsection: 

13 ‘‘(t) MEASURES RELATED TO USPSTF REC14 OMMENDATIONS.—Effective on the date of enactment of 

15 the USPSTF Transparency and Accountability Act of 

16 2017, notwithstanding any other provision of this title, a 

17 quality measure related to a recommendation of the 

18 United States Preventive Services Task Force may only 

19 be applied under this section if such recommendation was 

20 developed or updated in accordance with the amendments 

21 made by section 2(a) of such Act and if the Secretary has 

22 concurred with such recommendation or grade after con23 sultation with other Federal health agencies and relevant 

24 patient and provider groups.’’. 

Æ 


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