high. Additional States that have developed price 
transparency tools from their APCDs include New 
Hampshire, Maine, Massachusetts, Colorado, Mary-
land, and Rhode Island. 
(14) According to the APCD Council, a learn-
ing collaborative of public and private organizations 
working on developing and establishing APCDs, at 
least 18 States have enacted State laws establishing 
APCDs. 
(15) While many States have or are considering 
establishing APCDs, current APCDs vary in the 
types of data collected, the types of users allowed to 
access the data, the types of data that can be pub-
lished, and how much authorized users are charged 
to access the data. 
(16) A 2016 Supreme Court decision, Gobeille 
v. Liberty Mutual Insurance Co., prohibited States 
from requiring claim submissions to APCDs from 
large employers that pay for health benefits directly 
instead of purchasing health coverage from insur-
ance companies. This limited the data that States 
could mandate for inclusion in an APCD. 
(17) Supporting the establishment of APCDs is 
an important way to promote transparency and un-
derstanding of overall health care spending. 
VerDate Sep 11 2014 
00:45 Mar 03, 2020
Jkt 099200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H6004.IH
H6004
pamtmann on DSKBC07HB2PROD with BILLS
(18) State APCDs should be encouraged to col-
lect data from more types of payers; make it easier 
and more affordable for APCD data to be used to 
assist patients and providers in making informed 
choices about care; make it easier and more afford-
able for APCD data to be used for efforts to bring 
health care cost growth under control and improve 
insurance coverage; and permit their data to be used 
to report provider-level prices. 
SEC. 2. REQUIRING THE SECRETARY OF HEALTH AND 
HUMAN SERVICES TO ESTABLISH A GRANT 
PROGRAM FOR PURPOSES OF FACILITATING 
STATE EFFORTS TO ESTABLISH OR MAINTAIN 
ALL-PAYER CLAIMS DATABASES. 
Part C of title XXVII of the Public Health Service 
Act (42 U.S.C. 300gg–91 et seq.) is amended by adding 
at the end the following new section: 
‘‘SEC. 2795. ALL-PAYER CLAIMS DATABASE GRANT PRO-
GRAM. 
‘‘(a) IN GENERAL.—Not later than 1 year after the 
date of the enactment of this section, the Secretary shall 
establish a grant program (in this section referred to as 
the ‘program’) for purposes of awarding grants to States 
to facilitate such States in establishing or maintaining an 
all-payer claims database. 
VerDate Sep 11 2014 
00:45 Mar 03, 2020
Jkt 099200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H6004.IH
H6004
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(b) USE OF FUNDS.—A State use funds from a 
grant awarded under the program for any of the following: 
‘‘(1) To establish a State or regional all-payer 
claims database or to maintain an existing such 
database. 
‘‘(2) To expand the capabilities of an existing 
such database (such as through improving the collec-
tion of data contained in such database or improving 
the dissemination of such data). 
‘‘(c) ELIGIBILITY.—To be eligible to receive a grant 
under the program, a State (or compact of States) shall 
submit to the Secretary an application at such time, in 
such manner, and containing such information as the Sec-
retary may specify. Such information shall include the fol-
lowing: 
‘‘(1) A specification of how the State (or com-
pact of States) will ensure uniform data collection 
through the all-payer claims database. 
‘‘(2) A description of privacy and security pro-
tections for data submitted to such database, includ-
ing a specification of how the State (or compact of 
States) will ensure that— 
‘‘(A) no individually identifiable health in-
formation is disclosed to the public; 
VerDate Sep 11 2014 
00:45 Mar 03, 2020
Jkt 099200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H6004.IH
H6004
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(B) access to such information is limited 
to staff with appropriate security and privacy 
training; 
‘‘(C) effective security standards for trans-
ferring such data or making such data available 
to authorized uses of such database are main-
tained; 
‘‘(D) a process for providing access to such 
data for such users is secure and maintains the 
confidentiality of any individually identifiable 
health information is established; 
‘‘(E) such database adheres to best secu-
rity practices relating to the management and 
use of such data, consistent with any applicable 
Federal law; and 
‘‘(F) users of such database are prohibited 
from attempting to reidentify such data and pe-
nalized for any such attempt. 
‘‘(3) A specification of whether submission of 
data to such database is (or will be) mandatory or 
voluntary. 
‘‘(4) A specification of which type of entities 
(such as group health plans, health insurance issues, 
nonfederal governmental plans, and Federal health 
VerDate Sep 11 2014 
00:45 Mar 03, 2020
Jkt 099200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H6004.IH
H6004
pamtmann on DSKBC07HB2PROD with BILLS
care programs) are (or will be) submitting such data 
to such database. 
‘‘(5) A description of the types of claims in-
cluded in such database (such as medical claims, 
pharmacy claims, and dental claims). 
‘‘(6) A description of the data release policy in 
effect (or proposed to be put into effect) with respect 
to data contained in such database, including a de-
scription of the type of users who are (or will be) au-
thorized to access such data (such as employers, em-
ployee organizations, health care providers, research-
ers, and policymakers). 
‘‘(7) Any other information determined appro-
priate by the Secretary. 
‘‘(d) AWARD PRIORITY.—In making grants under the 
program, the Secretary shall prioritize applications sub-
mitted under subsection (c) that demonstrate any of the 
following (with higher priority being given to applications 
that demonstrate the greatest number of the following): 
‘‘(1) The all-payer claims database to be estab-
lished, maintained, or expanded through such grant 
requires mandatory reporting of claims data to such 
database. 
‘‘(2) Such database will transition to require 
such mandatory reporting. 
VerDate Sep 11 2014 
00:45 Mar 03, 2020
Jkt 099200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H6004.IH
H6004
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(3) Data contained in such database is (or will 
be) easily accessible and affordable for users to ac-
cess. 
‘‘(4) Such database permits (or will permit) 
such data to be viewed in a provider-specific manner. 
‘‘(5) A history of (or planned) partnerships 
with users of such database to facilitate the use of 
such data in— 
‘‘(A) informing individuals about the cost, 
quality, and value of health care; 
‘‘(B) assisting health care providers, in-
cluding hospitals, in working with individuals to 
make informed decisions regarding health care; 
‘‘(C) enabling health care providers, in-
cluding hospitals, and communities to improve 
the furnishing of items and services and health 
outcomes for individuals through comparisons 
of such outcomes with other such providers and 
hospitals; 
‘‘(D) enabling entities that pay for items 
and services, including employers, employee or-
ganizations, group health plans, and health in-
surance issuers, to develop value-based pur-
chasing models and improve the quality and 
cost of care furnished to employees or enrollees; 
VerDate Sep 11 2014 
00:45 Mar 03, 2020
Jkt 099200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H6004.IH
H6004
pamtmann on DSKBC07HB2PROD with BILLS
‘‘(E) enabling group health plans and 
health insurance issuers to evaluate network de-
sign, network construction, and the cost of care 
furnished to enrollees; 
‘‘(F) facilitating State-led initiatives to 
lower health care costs and improve health care 
quality; or 
‘‘(G) promoting competition based on qual-
ity and cost. 
‘‘(e) PRIVACY REGULATIONS.—The Secretary shall 
promulgate regulations specifying the extent and manner 
to which any applicable Federal law or regulation relating 
to privacy shall apply to activities carried out pursuant 
to a grant made under the program and may issue any 
additional regulation determined necessary by the Sec-
retary to ensure appropriate confidentiality of data associ-
ated with such activities. 
‘‘(f) DISCLOSURE OF DATA.—Any State (or compact 
of States) receiving a grant under the program to estab-
lish, maintain, or expand an all-payer claims database 
shall work to make all information contained in such data-
base available to the Director of the Congressional Budget 
Office, the Comptroller General of the United States, the 
Executive Director of the Medicare Payment Advisory 
Commission, and the Executive Director of the Medicaid 
VerDate Sep 11 2014 
00:45 Mar 03, 2020
Jkt 099200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H6004.IH
H6004
pamtmann on DSKBC07HB2PROD with BILLS
and CHIP Advisory Committee upon request, subject to 
any regulation described in subsection (e) and State law. 
Such information may be made available in the form of 
raw data, summary reports, or such other format deter-
mined appropriate by the requesting entity and the State 
(or compact of States). 
‘‘(g) DEFINITION.—For purposes of this section, the 
term ‘all-payer claims database’ means, with respect to a 
State (or compact of States), a State or regional database 
operated by (or under contract with) a State (or compact 
of States) that may include medical claims, pharmacy 
claims, dental claims, member eligibility, and provider files 
which are collected from private and public payers. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated $100,000,000 to carry 
out this section.’’. 
SEC. 3. ALLOWING FOR COLLECTION OF INFORMATION 
FROM SELF-INSURED GROUP HEALTH PLANS. 
Section 514(b) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1144(b)) is amended by 
adding at the end the following new paragraph: 
‘‘(10) Subsection (a) shall not apply to any State law 
requiring a group health plan (including a self-insured 
group health plan) to provide claims data to an all-payer 
VerDate Sep 11 2014 
00:45 Mar 03, 2020
Jkt 099200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H6004.IH
H6004
pamtmann on DSKBC07HB2PROD with BILLS
claims database (as defined in section 2795(g) of the Pub-
lic Health Service Act).’’. 
Æ 
VerDate Sep 11 2014 
00:45 Mar 03, 2020
Jkt 099200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6301
E:\BILLS\H6004.IH
H6004
pamtmann on DSKBC07HB2PROD with BILLS