I 
113TH CONGRESS 
2D SESSION 
H. R. 4418 
To amend title XVIII of the Social Security Act to increase access to Medicare 
data. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 7, 2014 
Mr. RYAN of Wisconsin (for himself and Mr. KIND) 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 sub-
sequently 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 XVIII of the Social Security Act to increase 
access to Medicare data. 
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 ‘‘Expanding the Avail-
ability of Medicare Data Act’’. 
SEC. 2. EXPANDING AVAILABILITY OF MEDICARE DATA. 
(a) EXPANDING USES
OF MEDICARE DATA
BY 
QUALIFIED ENTITIES.— 
(1) ADDITIONAL ANALYSES.— 
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(A) IN
GENERAL.—Subject to subpara-
graph (B), to the extent consistent with appli-
cable information, privacy, security, and disclo-
sure laws (including paragraph (3)), notwith-
standing paragraph (4)(B) of section 1874(e) of 
the Social Security Act (42 U.S.C. 1395kk(e)) 
and the second sentence of paragraph (4)(D) of 
such section, beginning July 1, 2015, a quali-
fied entity may use the combined data described 
in paragraph (4)(B)(iii) of such section received 
by such entity under such section, and informa-
tion derived from the evaluation described in 
such paragraph (4)(D), to conduct additional 
non-public analyses (as determined appropriate 
by the Secretary) and provide or sell such anal-
yses to authorized users for non-public use (in-
cluding for the purposes of assisting providers 
of services and suppliers to develop and partici-
pate in quality and patient care improvement 
activities, including developing new models of 
care). 
(B) LIMITATIONS WITH RESPECT TO ANAL-
YSES.— 
(i) EMPLOYERS.—Any analyses pro-
vided or sold under subparagraph (A) to 
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an 
employer 
described 
in 
paragraph 
(9)(A)(iii) may only be used by such em-
ployer for purposes of providing health in-
surance to employees and retirees of the 
employer. 
(ii) HEALTH INSURANCE ISSUERS.—A 
qualified entity may not provide or sell an 
analysis to a health insurance issuer de-
scribed in paragraph (9)(A)(iv) unless the 
issuer is providing the qualified entity with 
data under section 1874(e)(4)(B)(iii) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395kk(e)(4)(B)(iii)). 
(2) ACCESS TO CERTAIN DATA.— 
(A) ACCESS.—To the extent consistent 
with applicable information, privacy, security, 
and disclosure laws (including paragraph (3)), 
notwithstanding paragraph (4)(B) of section 
1874(e) of the Social Security Act (42 U.S.C. 
1395kk(e)) and the second sentence of para-
graph (4)(D) of such section, beginning July 1, 
2015, a qualified entity may— 
(i) provide or sell the combined data 
described in paragraph (4)(B)(iii) of such 
section to authorized users described in 
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clauses (i), (ii), and (v) of paragraph 
(9)(A) for non-public use, including for the 
purposes described in subparagraph (B); 
or 
(ii) subject to subparagraph (C), pro-
vide Medicare claims data to authorized 
users described in clauses (i), (ii), and (v), 
of paragraph (9)(A) for non-public use, in-
cluding for the purposes described in sub-
paragraph (B). 
(B) PURPOSES DESCRIBED.—The purposes 
described in this subparagraph are assisting 
providers of services and suppliers in developing 
and participating in quality and patient care 
improvement activities, including developing 
new models of care. 
(C) MEDICARE
CLAIMS
DATA
MUST
BE 
PROVIDED AT NO COST.—A qualified entity may 
not charge a fee for providing the data under 
subparagraph (A)(ii). 
(3) PROTECTION OF INFORMATION.— 
(A) IN GENERAL.—Except as provided in 
subparagraph (B), an analysis or data that is 
provided or sold under paragraph (1) or (2) 
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