I 
114TH CONGRESS 
1ST SESSION H. R. 1151 
To amend title IX of the Public Health Service Act to revise the operations 
of the United States Preventive Services Task Force, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 27, 2015 
Mrs. BLACKBURN (for herself and Mr. RUSH) 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 subse-
quently 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, and for other purposes. 
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 2015’’. 
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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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‘‘(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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ity Health, and the Office on Wom-
en’s Health; and 
‘‘(II) as appropriate, other Fed-
eral departments and agencies the 
programs of which have a significant 
impact upon health. 
‘‘(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; 
‘‘(ii) suggest scientific evidence for 
consideration by the Task Force related to 
reviews undertaken by the Task Force; 
‘‘(iii) provide feedback regarding the 
research plan, the evidence report, and 
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-
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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 
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 FACA.—The Task Force 
shall conduct its activities in compliance with the 
Federal Advisory Committee Act (5 U.S.C. App.).’’. 
(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 
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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-
lines published by such Task Force before the date 
of the enactment of this Act, under procedures es-
tablished by the Director of the Agency for 
Healthcare Research and Quality, the reconstituted 
Task Force shall undertake a review process con-
sistent with the following: 
(A) Interested parties may request the 
Task Force to review such previous rec-
ommendations or guidelines. 
(B) Based upon such requests, the Task 
Force shall establish a process for the review of 
previous recommendations or guidelines. 
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(C) Such process shall include public no-
tice through the Federal Register and oppor-
tunity for comment and a determination to con-
firm or modify such recommendations or guide-
lines. 
(D) The process shall, to the extent fea-
sible, be consistent with the procedures applied 
under the amendments made by subsection (a) 
for the promulgation of new recommendations. 
(c) GAO EVALUATION AND REPORT.—Not later than 
1 year after the date of enactment of this Act, the Comp-
troller General of the United States shall submit to Con-
gress a report that contains the following: 
(1) A listing of the recommendations of the 
United States Preventive Services Task Force as of 
the such date, including the date final recommenda-
tions and any subsequent updates were posted or 
published. 
(2) A comparison of such recommendations and 
relevant recommendations of other Federal health 
agencies, including the Centers for Disease Control 
and Prevention, the Centers for Medicare & Med-
icaid Services, the Department of Defense, the De-
partment of Veterans Affairs, and the Patient-Cen-
tered Outcomes Research Institute, as well as rel-
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evant recommendations from national medical pro-
fessional societies and relevant patient and disease 
advocacy organizations. 
(3) An analysis of the impact of the rec-
ommendations of the Task Force on public and pri-
vate insurance coverage, access, and outcomes, in-
cluding impact on morbidity and mortality. 
(d) ELIMINATION OF SECRETARIAL DISCRETION TO 
REMOVE CERTAIN PREVENTIVE SERVICES UNDER THE 
MEDICARE PROGRAM.—Section 1834(n) of the Social Se-
curity Act (42 U.S.C. 1395m(n)) is amended— 
(1) by striking paragraph (2); 
(2) by striking ‘‘; and’’ at the end of paragraph 
(1)(B) and inserting a period; 
(3) by redesignating subparagraphs (A) and 
(B) of paragraph (1) as paragraphs (1) and (2), re-
spectively, and moving their margins 2 ems to the 
left; and 
(4) by striking ‘‘may’’ and all that follows 
through ‘‘modify’’ and inserting ‘‘may modify’’. 
Æ 
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