alties if they use or disclose protected health infor-
mation in violation of the HIPAA Privacy Rule. 
(5) Clearinghouses play a unique, central role 
in the health care system, interacting with both 
health care providers and plans. Clearinghouses con-
vert information from providers into claims-proc-
essing standard electronic formats and then submit 
the claims to the plans and finally send providers 
the plan payments. 
(6) Claims and other data held by clearing-
houses could be analyzed longitudinally and geo-
graphically, providing powerful analytical tools that 
could benefit the overall health care system and fa-
cilitate medical innovation in the 21st Century. 
(7) Clearinghouses are unable to unlock the 
benefits of such claims and other data because the 
HIPAA Privacy Rule assigns clearinghouses a dual 
role. Such clearinghouses are not only covered enti-
ties, but are also business associates. The latter role 
substantially restricts the ability of clearinghouses to 
analyze claims data. 
(8) Clearinghouses should not be considered 
business associates and should instead have the 
same ability to use and disclose health-related data 
as other types of covered entities. 
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(9) Eliminating the business-associate role of 
clearinghouses would not affect the applicability of 
the civil and criminal penalties that enforce the 
HIPAA Privacy Rule. Clearinghouses would con-
tinue to be subject to such penalties in their role as 
covered entities. 
(10) In addition to the uses of health-related in-
formation that the HIPAA Privacy Rule currently 
authorizes for covered entities, there are several par-
ticular analytical uses that should be authorized spe-
cifically for clearinghouses because of the unique 
benefits that would result from authorizing those 
uses. Although these particular new analytical uses 
should be authorized for clearinghouses, the disclo-
sure of health information pursuant to these uses 
should be subject to the protection principles cur-
rently underlying the HIPAA Privacy Rule, includ-
ing enforcement principles. 
SEC. 3. TREATMENT OF CERTAIN HIPAA-RELATED ACTIVI-
TIES OF HEALTH CARE CLEARINGHOUSES. 
(a) IN GENERAL.—Subtitle D of the Health Informa-
tion Technology for Economic and Clinical Health Act (42 
U.S.C. 17921 et seq.) is amended by adding at the end 
the following: 
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‘‘PART 5—HEALTH CARE CLEARINGHOUSES; ANA-
LYTICAL FUNCTIONS TOWARD IMPROVING 
THE HEALTH CARE SYSTEM 
‘‘SEC. 13451. AUTHORITY REGARDING ANALYTICAL FUNC-
TIONS TOWARD IMPROVING THE HEALTH 
CARE SYSTEM. 
‘‘(a) IN GENERAL.—With respect to the use and dis-
closure of protected health information, the Secretary— 
‘‘(1) shall not consider health care clearing-
houses to be business associates under this subtitle, 
part C of title XI of the Social Security Act, or the 
regulations promulgated pursuant to section 264(c) 
of the Health Insurance Portability and Account-
ability Act of 1996 for purposes of carrying out ac-
tivities described in section 1171(2) of the Social Se-
curity Act and subsections (b) and (c) of this sec-
tion; and 
‘‘(2) shall consider such clearinghouses to be 
covered entities under such provisions of law for 
such purposes. 
‘‘(b) CERTAIN FUNCTIONS.—The functions that may 
be carried out by a health care clearinghouse pursuant to 
subsection (a) include the following: 
‘‘(1) Promptly upon the request of individuals, 
providing such individuals with access to their pro-
tected health information as permitted by section 
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164.502(a)(1)(i) of title 45, Code of Federal Regula-
tions. In carrying out the previous sentence, the 
clearinghouse may charge such an individual a fee, 
not to exceed the fair market value, for preparing 
the record of such information involved. 
‘‘(2) Promptly upon the request of individuals, 
providing such individuals with access to their pro-
tected health information as required by section 
164.502(a)(2)(i) of title 45, Code of Federal Regula-
tions. In carrying out the previous sentence, the 
clearinghouse may charge such an individual a fee, 
not to exceed the fair market value, for preparing 
the record of such information involved. 
‘‘(3) With respect to the access of patients to 
experimental treatments and diagnostics, notifying 
patients that they may be appropriate candidates as 
subjects in clinical research, and conducting research 
to identify such patients, pursuant to the pre-
paratory-research provisions of section 164.512(i) of 
title 45, Code of Federal Regulations, and pursuant 
to the regulations referred to in paragraph (1) of 
this subsection. 
‘‘(4) Making public health disclosures author-
ized by sections 164.512(b) or 164.514(e) of title 
45, Code of Federal Regulations, including notifying 
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manufacturers of drugs or devices about adverse 
events related to their products pursuant to such 
section 164.512(b). 
‘‘(5) Research as authorized by sections 
164.512(i) or 164.514(e) of title 45, Code of Federal 
Regulations. 
‘‘(6) Consistent with the applicable require-
ments of section 164.514 of title 45, Code of Fed-
eral Regulations, creating de-identified health infor-
mation or a limited data set. 
‘‘(c) ADDITIONAL FUNCTIONS.— 
‘‘(1) IN GENERAL.—In addition to the functions 
that may be carried out by a health care clearing-
house pursuant to subsection (a), such a clearing-
house may, subject only to the privacy protections 
under paragraph (2), aggregate, use, and disclose 
data the clearinghouse possesses in order to carry 
out the following functions: 
‘‘(A) Prepare reports, analyses, and pres-
entations on the quality and costs of health care 
services, including in specific geographic areas, 
in order to assist individuals select health care 
services and providers. 
‘‘(B) Prepare reports, analyses, and pres-
entations of health-services outcomes data, in-
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