I 
113TH CONGRESS 
1ST SESSION H. R. 2143 
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 
MAY 23, 2013 
Mrs. BLACKBURN (for herself, Mr. BARROW of Georgia, Mr. TERRY, and Mrs. 
CHRISTENSEN) 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. 
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 2013’’. 
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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 and 
new science related to the effectiveness and appro-
priateness of clinical preventive services for the pur-
pose of developing recommendations for primary 
care clinicians and the health care community and 
updating previous clinical preventive recommenda-
tions.’’; 
(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: 
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‘‘(3) COMPOSITION.— 
‘‘(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, health promotion, disease prevention, 
and clinical care. The Task Force shall include 
balanced representation of practicing primary 
and specialty care providers, patient and health 
care consumers, and relevant stakeholders from 
the medical products manufacturing commu-
nity. 
‘‘(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. 
‘‘(4) REVIEW AND CONSULTATION.— 
‘‘(A) RESEARCH PLANS.— 
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‘‘(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 
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. 
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‘‘(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, socioeconomic status, and geo-
graphic location), and for other health out-
come 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 
Cancer Institute, the National Institute on 
Minority Health and Health Disparities, 
the Centers for Disease Control and Pre-
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vention, the Department of Defense, the 
Department of Veterans Affairs, the Cen-
ters for Medicare & Medicaid Services, and 
the Patient-Centered Outcomes Research 
Institute. 
‘‘(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 
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 
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comments and accept comments during a 
period of not less than 60 days. 
‘‘(ii) 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. 
‘‘(iii) 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. 
‘‘(iv) CONSIDERATION.—In publishing 
recommendation 
statements, 
the 
Task 
Force shall consider the impact of its rec-
ommendations on the health care commu-
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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, subject to subparagraph (E): 
‘‘(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-
cient 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 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 
basis 
of 
such 
evidence, 
recommends 
against the product or service and deter-
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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. 
‘‘(E) CHANGES IN GRADING SYSTEM.— 
‘‘(i) IN GENERAL.—The Director may 
provide, by regulation, for changes in the 
grading system described in subparagraph 
(D). 
‘‘(ii) IMPACT
OF
CHANGES.—If the 
Director makes a change in the grading 
system under clause (i) for a particular 
grade, the Task Force shall review and re-
grade the services previously classified 
within that grade. Such review and regrade 
may be done through an expedited process 
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but any such change in grade shall not 
take effect before such review process is 
completed.’’; 
(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’’; 
(6) by inserting after paragraph (5), as so re-
designated, the following new paragraphs: 
‘‘(6) 
PREVENTIVE
SERVICES
ADVISORY 
BOARD.— 
‘‘(A) IN GENERAL.—The Task Force shall 
convene a preventive services advisory board (in 
this subsection referred to as the ‘board’) com-
posed of representatives of appropriate public 
and private entities with an interest in clinical 
preventive services to advise the Task Force on 
developing, updating, publishing, and dissemi-
nating evidence-based recommendations on the 
use of clinical preventive services. 
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‘‘(B) MEMBERSHIP.—The members of the 
board shall include representatives of the fol-
lowing: 
‘‘(i) Patient groups. 
‘‘(ii) Providers of clinical services, in-
cluding community-based providers 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, 
the National Cancer Institute, the Na-
tional Institute on Minority Health 
and Health Disparities, the Centers 
for Disease Control and Prevention, 
the Administration on Aging, the 
Health Resources and Services Ad-
ministration, the Centers for Medicare 
& Medicaid Services, the Office of the 
Surgeon General of the Public Health 
Service, the Department of Defense, 
the Department of Veterans Affairs, 
the Patient-Centered Outcomes Re-
search Institute, the Office of Minor-
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