I 
112TH CONGRESS 
2D SESSION 
H. R. 5998 
To amend title IX of the Public Health Service Act to revise the operations 
of the United States Preventive Services Task Force. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 21, 2012 
Mrs. BLACKBURN (for herself, Mr. BARROW, Mrs. CHRISTENSEN, and Mr. 
TERRY) introduced the following bill; which was referred to the Com-
mittee 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘USPSTF Trans-
parency and Accountability Act of 2012’’. 
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SEC. 2. CHANGES TO UNITED STATES PREVENTIVE SERV-
ICES TASK FORCE. 
(a) IN GENERAL.—Subsection (a) of section 915 of 
the Public Health Service Act (42 U.S.C. 299b–4) is 
amended— 
(1) by amending the heading to read as follows: 
‘‘UNITED
STATES
PREVENTIVE
SERVICES
TASK 
FORCE’’; 
(2) by amending paragraph (1) to read as fol-
lows: 
‘‘(1) ESTABLISHMENT AND PURPOSE.—The Di-
rector may establish and periodically convene the 
United States Preventive Services Task Force (in 
this section referred to as the ‘Task Force’). The 
Task Force shall review the scientific evidence re-
lated to the effectiveness and appropriateness of 
clinical preventive services for the purpose of devel-
oping recommendations for primary care clinicians 
and the health care community and updating pre-
vious clinical preventive recommendations.’’; 
(3) by redesignating paragraph (3) as para-
graph (5) and paragraphs (4) through (7) as para-
graphs (9) through (12), respectively; 
(4) by inserting after paragraph (2) the fol-
lowing new paragraphs: 
‘‘(3) COMPOSITION.— 
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‘‘(A) IN GENERAL.—The Task Force shall 
be composed of individuals that collectively have 
appropriate scientific expertise, including in 
fields of health sciences research, health eco-
nomics, and clinical care. The Task Force shall 
include balanced representation of practicing 
primary and specialty care providers, patient 
and health care consumers, and relevant stake-
holders from the medical products manufac-
turing community. 
‘‘(B) NOTICE.—Before appointing mem-
bers to the Task Force, the Director shall give 
persons an opportunity to nominate potential 
members. The Director shall provide for the 
publication in the Federal Register of a request 
for comments on such members and shall pro-
vide a mechanism for persons to submit such 
comments through the official website of the 
Agency. The Director shall consider any com-
ments submitted in selecting the members of 
the Task Force. 
‘‘(C) DISCLOSURE OF CONFLICTS OF IN-
TEREST.—The Director shall disclose conflicts 
of interest (including personal as well as finan-
cial conflicts of interest) of any member of the 
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Task Force that have the potential to bias (or 
may be perceived as biasing) individual deci-
sions of the Task Force. 
‘‘(4) REVIEW AND CONSULTATION.— 
‘‘(A) RESEARCH PLANS.— 
‘‘(i) IN GENERAL.—In conducting its 
reviews under paragraph (1), the Task 
Force, with the concurrence of the Direc-
tor, shall publish one or more proposed re-
search plans (in this subsection referred to 
as a ‘research plan’) to guide the Task 
Force’s systematic review of the evidence. 
Each such plan shall include an analytic 
framework, key questions, and a literature 
search strategy or research approach, and 
shall incorporate the methodological guide-
lines developed under clause (ii). The 
Agency shall provide for the publication in 
the Federal Register of a request for pub-
lic comments on each plan and shall accept 
comments during a period of at least 60 
days. Any final research plan shall be 
made available to the public and include a 
discussion of the comments received and 
responses to such comments. The Task 
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Force, with the concurrence of the Direc-
tor, may change such a research plan 
through the same process as applied to the 
initial adoption of such plan. 
‘‘(ii) CRITERIA.—The Director shall 
design and regularly update guidelines for 
proper methodological standards for incor-
poration into such research plans. Such 
guidelines shall include measures for ap-
propriate validity, for risk adjustment, for 
timeliness, for input from relevant experts 
and peers in the respective communities, 
for accounting for all relevant subpopula-
tions (including disparities by race, eth-
nicity, and socioeconomic status), and for 
other health outcome measurements. 
‘‘(iii) CONSULTATION
ON
RESEARCH 
PLANS.—The Director shall facilitate co-
ordination and interaction with other agen-
cies and departments in the creation of re-
search plans (taking into consideration re-
search and findings by other agencies and 
departments) and methodological stand-
ards under clause (ii), including with the 
National Institutes of Health, the National 
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Cancer Institute, the National Institute on 
Minority Health and Health Disparities, 
the Centers for Disease Control and Pre-
vention, the Department of Defense, the 
Department of Veterans Affairs, the Cen-
ters for Medicare & Medicaid Services, and 
the Patient-Centered Outcomes Research 
Institute. 
‘‘(iv) CONSULTATION ON DRAFT REC-
OMMENDATIONS.—Before voting on a draft 
recommendation 
statement, 
the 
Task 
Force shall consult with relevant stake-
holders, including provider groups, prac-
ticing specialists that treat the specific dis-
ease under review, and relevant patient 
and disease advocacy organizations. 
‘‘(B) EVIDENCE REPORTS.—The Director 
shall make publicly available each draft evi-
dence report and publish in the Federal Reg-
ister a request for public comments on such re-
ports. No such evidence report shall be pub-
lished prior to it being reviewed by a panel of 
external subject matter experts that includes 
provider and patient representatives. Each such 
report shall include a description of the panel 
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that conducted such review. Such description 
shall include information on each panel mem-
ber, including name, academic degree (or de-
grees), affiliations, and related expertise. 
‘‘(C) RECOMMENDATION STATEMENTS.— 
‘‘(i) PUBLICATION
OF
DRAFT
REC-
OMMENDATIONS.—The Director shall make 
publicly available each draft recommenda-
tion and shall provide for the publication 
in the Federal Register of a request for 
comments and accept comments during a 
period of not less than 60 days. 
‘‘(ii) PUBLIC AVAILABILITY OF COM-
MENTS AND INCLUSION OF DESCRIPTION 
OF
COMMENTS
IN
FINAL
STATEMENT.— 
The Director shall make such comments 
received publicly available. Any final rec-
ommendation statement shall include a de-
scription of comments received on the draft 
recommendation 
statement 
and 
rec-
ommendations of other Federal agencies or 
organizations relating to the topic of the 
statement. 
‘‘(iii) CONSIDERATION.—In publishing 
recommendation 
statements, 
the 
Task 
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Force shall consider the impact of its rec-
ommendations on the health care commu-
nity, whether a preventive service is bene-
ficial for some individuals and the need to 
encourage a discussion of benefits and 
risks for those individuals, and how its spe-
cific assignment of a grade to a product or 
service may affect coverage and access to 
such product or service under Federal pro-
grams and private health insurance cov-
erage. 
‘‘(D) GRADING
SYSTEM.—In publishing 
recommendation statements, the Task Force 
shall grade products and services consistent 
with the following: 
‘‘(i) GRADE A.—The Task Force con-
cludes that the current evidence is suffi-
cient to assess the balance of benefits and 
risks of the product or service, and, on the 
basis of such evidence, recommends the 
product or service and determines that 
there is high certainty that the net benefit 
from the product or service is substantial. 
‘‘(ii) GRADE B.—The Task Force con-
cludes that the current evidence is suffi-
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cient to assess the balance of benefits and 
risks of the product or service, and, on the 
basis of such evidence, recommends the 
product or service and determines that 
there is high certainty that the net benefit 
of the product or service is moderate or 
there is moderate certainty that the net 
benefit of the product or service is mod-
erate to substantial. 
‘‘(iii) GRADE
C.—The Task Force 
concludes that the current evidence is suf-
ficient to assess the balance of benefits and 
risks of the product or service, and, on the 
basis of such evidence, does not make a 
recommendation of the product or service 
and clinicians may provide this product or 
service to selected patients depending on 
individual circumstances. However, for 
most individuals without signs or symp-
toms there is likely to be only a small ben-
efit from this product or service. 
‘‘(iv) GRADE
D.—The Task Force 
concludes that the current evidence is suf-
ficient to assess the balance of benefits and 
risks of the product or service, and, on the 
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basis 
of 
such 
evidence, 
recommends 
against the product or service and deter-
mines that there is moderate or high cer-
tainty that the product or service has no 
net benefit or that the harm of the product 
or service outweighs the benefits. Rec-
ommendations against a preventive service 
shall only be issued in concurrence with 
the Secretary after consultation with other 
Federal health agencies and relevant pa-
tient and provider groups. 
‘‘(v) GRADE I.—The Task Force con-
cludes that the current evidence is not suf-
ficient to assess the balance of benefits and 
risks of the product or service.’’; 
(5) in paragraph (5), as redesignated by para-
graph (3)— 
(A) by striking ‘‘dissemination of the rec-
ommendations of the Task Force’’ and inserting 
‘‘dissemination of its recommendation state-
ments’’; and 
(B) by striking ‘‘Guide’s recommenda-
tions’’ and inserting ‘‘recommendations of the 
Task Force’’; 
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(6) by inserting after paragraph (5), as so re-
designated, the following new paragraphs: 
‘‘(6) PREVENTIVE
SERVICES
STAKEHOLDERS 
BOARD.— 
‘‘(A) IN GENERAL.—The Task Force shall 
convene a preventive services stakeholders 
board (in this subsection referred to as the 
‘board’) composed of representatives of appro-
priate public and private entities with an inter-
est in clinical preventive services to advise the 
Task Force on developing, updating, publishing, 
and disseminating evidence-based recommenda-
tions on the use of clinical preventive services. 
‘‘(B) MEMBERSHIP.—The members of the 
board shall include representatives of the fol-
lowing: 
‘‘(i) Patient groups. 
‘‘(ii) Providers of clinical preventive 
services, including community-based pro-
viders and specialty physicians. 
‘‘(iii) Federal departments and agen-
cies, including— 
‘‘(I) appropriate health agencies 
and offices in the Department, includ-
ing the National Institutes of Health, 
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the National Cancer Institute, the Na-
tional Institute on Minority Health 
and Health Disparities, the Centers of 
Disease Control and Prevention, the 
Administration on Aging, the Health 
Resources and Services Administra-
tion, the Centers for Medicare & Med-
icaid Services, the Office of the Sur-
geon General of the Public Health 
Service, the Office of Minority Health, 
and the Office on Women’s Health; 
and 
‘‘(II) as appropriate, other Fed-
eral departments and agencies the 
programs of which have a significant 
impact upon health, including the 
Congressionally Directed Medical Re-
search Programs, Veterans Health 
Administration and others (as deter-
mined by the Secretary). 
‘‘(iv) Private health care payors. 
‘‘(C) RESPONSIBILITIES.—In accordance 
with subsection (b)(5), the board shall— 
‘‘(i) recommend clinical preventive 
services for review by the Task Force; 
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‘‘(ii) suggest scientific evidence for 
consideration by the Task Force related to 
reviews undertaken by the Task Force; 
‘‘(iii) provide feedback regarding draft 
recommendations by the Task Force; and 
‘‘(iv) assist with efforts regarding dis-
semination of recommendations by the Di-
rector of the Agency for Healthcare Re-
search and Quality. 
‘‘(7) DISCLOSURE AND CONFLICTS OF INTER-
EST.—Members of the Task Force or the board shall 
not be considered employees of the Federal Govern-
ment by reason of service on the Task Force or the 
board, except members of the Task Force or the 
board shall be considered to be special Government 
employees within the meaning of section 107 of the 
Ethics in Government Act of 1978 (5 U.S.C. App.) 
and section 208 of title 18, United States Code, for 
the purposes of disclosure and management of con-
flicts of interest under those sections. 
‘‘(8) NO
PAY; 
RECEIPT
OF
TRAVEL
EX-
PENSES.—Members of the Task Force or the board 
shall not receive any pay for service on the Task 
Force or board, but may receive travel expenses, in-
cluding a per diem, in accordance with applicable 
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provisions of subchapter I of chapter 57 of title 5, 
United States Code.’’; and 
(7) by amending paragraph (10), as redesig-
nated by paragraph (3), to read as follows: 
‘‘(10) APPLICATION OF APA.—The Task Force 
shall conduct its activities in compliance with chap-
ter 5 of title 5, United States Code (commonly 
known as the Administrative Procedures Act).’’. 
(b) EFFECTIVE DATE; TRANSITION.— 
(1) IN
GENERAL.—Except as otherwise pro-
vided, the amendments made by subsection (a) shall 
take effect on the date of the enactment of this Act. 
The United States Preventive Services Task Force 
shall not publish any draft or final recommendations 
on or after such date except in accordance with such 
amendments. 
(2) RECONSTITUTION
OF
TASK
FORCE.—Not 
later than 180 days after the date of the enactment 
of this Act, the Director of the Agency for 
Healthcare Research and Quality shall take steps to 
reconstitute the membership of the Task Force con-
sistent with section 915(a)(3) of the Public Health 
Service Act, as amended by subsection (a). 
(3) PREVIOUSLY
PUBLISHED
RECOMMENDA-
TIONS.—With respect to recommendations or guide-
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