Expanding the Availability of Medicare Data Act

Bill: 113-hr-4418
Sponsor: Rep. Ryan, Paul [R-WI-1]
Introduced: 2014-04-07 in the House
Policy area: Health
Subjects: Child health
Government information and archives
Health care costs and insurance
Health care quality
Health information and medical records
Medicaid
Medical research
Medicare
Performance measurement
Poverty and welfare assistance
Right of privacy
User charges and fees

Summary:
action_date: 2014-04-07
text: 
Expanding the Availability of Medicare Data Act - Expands the kinds of uses of Medicare data available to qualified entities for quality and patient care improvement activities.
 
(A &quot;qualified entity&quot; is a public or private entity that: [1] is qualified to use claims data to evaluate the performance of service providers and suppliers on measures of quality, efficiency, effectiveness, and resource use; and [2] agrees to meet specified requirements, such as ensuring data security.) 
Authorizes a qualified entity to use claims data combined with non-claims data the entity has received, as well as information derived from evaluation of service provider and supplier performance, to conduct additional non-public analyses and provide or sell them to authorized users for non-public use (including to assist service providers and suppliers to develop and participate in quality and patient care improvement activities, including new models of care).
 
Defines &quot;authorized users&quot; as service providers, suppliers, employers, health insurance issuers, medical societies or hospital associations, or any other entities approved by the Secretary of Health and Human Services (HHS).
 
Prohibits a qualified entity from charging a fee to provide Medicare claims data.
 
Requires a qualified entity and an authorized user to enter into a data use agreement, and prohibits the use of data or analyses for marketing purposes or, except in certain circumstances, its redisclosure.
 
Directs the Secretary to provide Medicare data to qualified clinical data registries for purposes of linking it with clinical outcomes data and performing risk-adjusted, scientifically valid analyses and research to support quality improvement or patient safety. Requires charging a fee to a registry for such data.
 
Amends title XVIII (Medicare) of the Social Security Act (SSA) to include among standardized extracts of Medicare claims data that may be made available to qualified entities, if the Secretary determines appropriate, also claims data under SSA titles XIX (Medicaid) and XXI (State Children's Health Insurance) (CHIP).
 
Requires any fees charged for making standardized extracts available to qualified entities to be deposited into the Centers for Medicare & Medicaid Services Program Management Account (currently, into the Federal Supplementary Medical Insurance Trust Fund).


Legislative actions:
action_date: 2014-04-11
text: Referred to the Subcommittee on Health.
action_date: 2014-04-07
text: 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.
action_date: 2014-04-07
text: 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.
action_date: 2014-04-07
text: Introduced in House
action_date: 2014-04-07
text: Introduced in House