I 
116TH CONGRESS 
1ST SESSION H. R. 1390 
To amend titles XVIII and XIX of the Social Security Act to promote 
the ability of individuals entitled to benefits under part A or enrolled 
under part B of the Medicare program and individuals enrolled under 
a State plan under the Medicaid program to access their personal medical 
claim data, including their providers, prescriptions, tests, and diagnoses, 
through a mobile health record application of the individual’s choosing, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 27, 2019 
Mrs. BROOKS of Indiana (for herself and Ms. CLARKE of New York) intro-
duced 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 titles XVIII and XIX of the Social Security Act 
to promote the ability of individuals entitled to benefits 
under part A or enrolled under part B of the Medicare 
program and individuals enrolled under a State plan 
under the Medicaid program to access their personal 
medical claim data, including their providers, prescrip-
tions, tests, and diagnoses, through a mobile health 
record application of the individual’s choosing, and for 
other purposes. 
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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 ‘‘Mobile Health Record 
Act of 2019’’. 
SEC. 2. FINDINGS; SENSE OF CONGRESS. 
(a) FINDINGS.—Congress finds the following: 
(1) The Centers for Medicare & Medicaid Serv-
ices’ (CMS) Blue Button 2.0 Program was an-
nounced in April 2018 to build upon CMS’s Blue 
Button Program. 
(2) The Blue Button 2.0 Program provides 4 
years of Medicare part A, B, and D data for 53 mil-
lion Medicare beneficiaries through an Application 
Programming Interface (API). The data contains a 
variety of information including, but not limited to, 
a list of a patient’s providers, prescriptions, tests, 
and diagnoses. The Blue Button 2.0 Program re-
quires the use of CMS-approved applications to 
allow beneficiaries to download coded data. 
(3) Mobile applications currently exist that have 
the power to decode the Medicare Blue Button data 
and present it in a user-friendly, easy-to-read and 
understand format. Prior to Blue Button 2.0, the 
Blue Button Program allowed beneficiaries to 
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download such data, but the information was not de-
coded into the easy-to-read and understand format 
that a mobile application provides. 
(4) The Blue Button 2.0 Program was created 
to empower patients with the use of these applica-
tions, but additional steps need to be taken in order 
to ensure the program reaches its intended purpose 
of providing patients with their personal medical 
claim information to prevent harmful medical errors 
and reducing redundant spending. 
(5) According to a study published by Johns 
Hopkins University in 2016, more than 250,000 
deaths per year are due to medical error, making it 
the third leading cause of death in the United 
States. Further, millions of dollars are wasted on 
duplicative or unnecessary tests and procedures. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that the Centers for Medicare & Medicaid Services’ 
Blue Button 2.0 Program has the potential to positively 
influence patient behavior, improve patient safety and 
health outcomes, and help reduce unnecessary health care 
expenditures, but action needs to be taken to help the ini-
tiative meet the program’s goals. 
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SEC. 3. PROMOTING PATIENT ACCESS TO PERSONAL MED-
ICAL CLAIM INFORMATION, INCLUDING A PA-
TIENT’S PROVIDERS, PRESCRIPTIONS, TESTS, 
AND DIAGNOSES, THROUGH THE USE OF MO-
BILE HEALTH RECORD APPLICATIONS. 
(a) MEDICARE.—Title XVIII of the Social Security 
Act (42 U.S.C. 1395 et seq.) is amended by adding at 
the end the following new section: 
‘‘SEC. 1899C. MOBILE ACCESS TO PERSONAL MEDICAL IN-
FORMATION PROGRAM. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN GENERAL.—Not later than January 1, 
2020, the Secretary shall establish a program to be 
known as the ‘Mobile Access to Personal Medical In-
formation Program’ (in this section referred to as 
the ‘Program’) for purposes of creating a developer- 
friendly, standards-based API that enables individ-
uals entitled to benefits under part A or enrolled 
under part B to connect their claims data to the ap-
plications, services, and research programs they 
trust while allowing such individuals to retain full 
control over how the copy of the data they receive 
can be used and by whom. The Program shall pro-
vide such an individual access to the personal med-
ical claim information of the individual through a 
mobile health record application of the individual’s 
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choice approved by the Secretary under subsection 
(b). Such information shall be made available 
through such application in a manner similar to how 
such information is made available under the Blue 
Button 2.0 program (or a successor program). 
‘‘(2) ENCOURAGING USE OF PROGRAM.—In car-
rying out the Program, the Secretary shall consider 
establishing methods for encouraging individuals de-
scribed in paragraph (1) to access their personal 
medical claim information under the Program. Such 
methods may include— 
‘‘(A) providing individuals described in 
paragraph (1) access to a one-time financial in-
centive to download for free or at a discounted 
price a CMS-approved mobile health record ap-
plication of their choice that can be used to ac-
cess their personal medical claim information 
under the Program; 
‘‘(B) paying a reasonable fee per download 
to the application developer to be capped at a 
fair market value; or 
‘‘(C) other methods determined appro-
priate by the Secretary. 
For purposes of the previous sentence, the Secretary 
shall consult with application developers, insurers, 
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and other appropriate entities determined by the 
Secretary, to establish appropriate methods of finan-
cial incentive payment for applications approved to 
participate in the program. 
‘‘(b) MOBILE HEALTH RECORD APPLICATIONS.— 
‘‘(1) APPROVAL.—The Secretary shall establish 
a process under which the Secretary, in consultation 
with staff with appropriate technical expertise, ap-
proves mobile health record applications for use 
under the Program. Such process shall include re-
quirements providing that such application— 
‘‘(A) demonstrates the capacity to provide 
the personal medical claim information of an in-
dividual described in subsection (a) to such in-
dividual in an easily accessible format; 
‘‘(B) utilizes a machine-readable, struc-
tured, coded format conforming to a data con-
tent standard approved by the Secretary; 
‘‘(C) has the ability to aggregate data from 
multiple sources; 
‘‘(D) is encrypted (or contains other data 
security safeguards determined appropriate by 
the Secretary) and conforms to other cybersecu-
rity standards and best practices determined 
appropriate by the Secretary; 
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‘‘(E) provides for a mechanism through 
which the Secretary may track the number of 
times and frequency with which such individual 
accesses the personal medical claim information 
of such individual; 
‘‘(F) does not use a third-party service for 
ad revenue or for any other means; and 
‘‘(G) meets such other requirements as 
may be specified by the Secretary. 
‘‘(2) ANNUAL
REVIEW
OF
APPROVAL.—The 
Secretary shall, not less than annually and in con-
sultation with staff with appropriate technical exper-
tise, review each mobile health record application ap-
proved under paragraph (1) to determine whether 
such application continues to meet the requirements 
specified in such paragraph. The Secretary shall re-
voke the approval of any such application that fails 
to meet such requirements. 
‘‘(c) INFORMATION
ON PROGRAM.—The Secretary 
shall, through the public website of the Centers for Medi-
care & Medicaid Services, mailed notices, through a notice 
at the time of enrollment of an individual in part A or 
part B, public awareness campaigns, the notice described 
in section 1804(a), the provision of personalized preven-
tion plan services (as defined in section 1861(hhh)), or 
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otherwise (as determined appropriate by the Secretary), 
ensure that individuals described in subsection (a) receive 
information not less than twice each year regarding the 
Program, including a list of mobile health record applica-
tions approved under subsection (b)(1). 
‘‘(d) CYBERSECURITY AND DATA PRIVACY.— 
‘‘(1) CONSULTATION.—In carrying out the Pro-
gram, the Secretary shall consult with the National 
Coordinator for Health Information Technology and 
other Federal agencies determined appropriate by 
the Secretary to ensure the compliance of entities 
participating in the Program with all applicable pro-
visions of the regulations promulgated by the Sec-
retary under part C of title XI and section 264 of 
the Health Insurance Portability and Accountability 
Act of 1996. 
‘‘(2) ADDITIONAL
CYBERSECURITY
PROTEC-
TIONS.—In carrying out the Program, the Secretary 
shall consult with appropriate Federal agencies, in-
cluding the National Institute for Standards and 
Technology, and appropriate public-private partner-
ships (such as the Sector Coordinating Councils), in-
cluding the Healthcare and Public Health Sector Co-
ordinating Council, to ensure that relevant and ap-
plicable cybersecurity guidelines are followed when 
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establishing the Program (including when estab-
lishing standards and best practices under sub-
section (b)(1)(D) and standards and criteria under 
subsection (e)(1)(C)). 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) MOBILE HEALTH RECORD APPLICATION.— 
The term ‘mobile health record application’ means a 
software application that— 
‘‘(A) runs on a mobile device (such as a 
mobile phone or handheld computing platform); 
‘‘(B) allows an individual to access the in-
dividual’s personal medical claim information; 
and 
‘‘(C) meets such cybersecurity and data se-
curity standards and criteria as the Secretary 
may specify, which may be similar to such 
standards and criteria used under the Blue 
Button 2.0 program (or a successor program). 
‘‘(2) PERSONAL
MEDICAL
CLAIM
INFORMA-
TION.—The term ‘personal medical claim informa-
tion’ means, with respect to an individual— 
‘‘(A) a list of claims for items and services 
furnished to such individual payable under part 
A or part B, including any prescriptions or 
tests; 
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‘‘(B) a list of providers and suppliers who 
furnished such items and services; 
‘‘(C) any diagnoses made by such providers 
and suppliers; 
‘‘(D) Medicare Advantage encounter data 
from an MA or MA–PD plan under part C; and 
‘‘(E) prescription drug event data.’’. 
(b) MEDICAID.—Section 1903 of the Social Security 
Act (42 U.S.C. 1396b) is amended by adding at the end 
the following new subsection: 
‘‘(aa) PAYMENTS FOR MOBILE ACCESS TO PERSONAL 
MEDICAL CLAIM INFORMATION.— 
‘‘(1) PAYMENTS.—In addition to payments oth-
erwise provided under subsection (a), in the case of 
a State that elects to develop, or purchase from a 
private entity, a mobile health record application 
through which an individual enrolled under the State 
plan (or a waiver of such plan) may access the per-
sonal medical claim information of such individual, 
the Secretary shall pay to such State, for each quar-
ter beginning on or after the date of the enactment 
of the Mobile Health Record Act of 2019, an 
amount equal to 90 percent of so much of the sums 
expended during such quarter as are attributable to 
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the development, or purchase, of such mobile health 
record application. 
‘‘(2) DEFINITIONS.—In this subsection: 
‘‘(A) MOBILE HEALTH RECORD APPLICA-
TION.—The term ‘mobile health record applica-
tion’ has the meaning given such term in sec-
tion 1899C(e). 
‘‘(B) PERSONAL MEDICAL CLAIM INFORMA-
TION.—The term ‘personal medical claim infor-
mation’ means, with respect to a State and an 
individual enrolled under the State plan (or a 
waiver of such plan)— 
‘‘(i) a list of claims for items and 
services furnished to such individual under 
the State plan (or waiver), including any 
prescriptions or tests; 
‘‘(ii) a list of providers and suppliers 
who furnished such items and services; and 
‘‘(iii) any diagnoses made by such 
providers and suppliers.’’. 
Æ 
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