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SECTION 1. SHORT TITLE.

This Act may be cited as the ''Expanding Access to Medical Records
Act''.

SEC. 2. FULL ACCESS TO MEDICARE INFORMATION BY THE AUTHORIZED
REPRESENTATIVE OF A DECEASED BENEFICIARY.

(a) In General.--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:

''full access to medicare information by the authorized representative
of a deceased beneficiary

''Sec. 1899. (a) In General.--In the case of the death of an
individual entitled to, or enrolled for, benefits under part A or
enrolled for benefits under part B, the Secretary shall--
''(1) make available to the authorized representative of
the individual all information concerning the individual's
benefits under this title, including--
''(A) the coverage and status of such benefits (as
of the day before the individual's death); and
''(B) billing, claims, and payment information
regarding items and services furnished to the
individual under this title (on or before such day);
and
''(2) provide such authorized representative access to any
source of information maintained by the Federal government with
respect to such benefits, including online databases, that the
individual had access to during his or her lifetime.
''(b) Definition of Authorized Representative; Special Rules.--
''(1) In general.--In this section, the term 'authorized
representative' means an executor, administrator, or other
individual who has authority to act on the deceased
individual's behalf (as determined by the Secretary under
paragraph (2)).
''(2) Determination of authorized representative.--
''(A) In general.--The Secretary shall establish
procedures under which the Secretary determines whether
an individual is an authorized representative of the
deceased individual. Under such procedures, the
individual seeking such determination shall provide
evidence (in such form and such manner as specified by
the Secretary) of the individual's legal authority to
act on behalf of the deceased individual.
''(B) Timeline for determination.--The Secretary
shall make a determination under subparagraph (A) not
later than 30 days after receipt of the evidence
described in such subparagraph.
''(3) Notification and access to information.--After making
a determination under paragraph (2) with respect to an
individual, the Secretary shall--
''(A) notify the individual of the determination
not later than 7 days after the date on which the
determination is made; and
''(B) in the case where such individual is so
determined to be the authorized representative of the
deceased individual, as soon as practicable--
''(i) make available to the authorized
representative the information described in
paragraph (1) of subsection (a); and
''(ii) provide the authorized
representative access to the sources described
in paragraph (2) of such subsection.''.
(b) Effective Date.--The amendment made by this section shall take
effect on the date that is 60 days after the date of enactment of this
Act.

SEC. 3. FULL ACCESS TO MEDICAID INFORMATION BY THE AUTHORIZED
REPRESENTATIVE OF A DECEASED BENEFICIARY.

(a) In General.--Title XIX of the Social Security Act (42 U.S.C.
1396 et seq.) is amended by adding at the end the following new
section:

''full access to medicaid information by the authorized representative
of a deceased beneficiary

''Sec. 1943. (a) In General.--In the case of the death of an
individual enrolled under the State plan for medical assistance or
under a waiver of such plan, the State Medicaid agency shall--
''(1) make available to the authorized representative of
the individual all information concerning the individual's
benefits under this title, including--
''(A) the coverage and status of such benefits (as
of the day before the individual's death); and
''(B) billing, claims, and payment information
regarding items and services furnished to the
individual under this title (on or before such day);
and
''(2) provide such authorized representative access to any
source of information maintained by the State with respect to
such benefits, including online databases, that the individual
had access to during his or her lifetime.
''(b) Definition of Authorized Representative; Special Rules.--
''(1) In this section, the term 'authorized representative'
means an executor, administrator, or other individual who has
authority to act on the deceased individual's behalf (as
determined by the State Medicaid agency under paragraph (2)).
''(2) Determination of authorized representative.--
''(A) In general.--The State Medicaid agency shall
establish procedures under which such agency determines
whether an individual qualifies as an authorized
representative of the deceased individual. Under such
procedures, the individual seeking such a determination
shall provide evidence (in such form and such manner as
specified by the State Medicaid Agency) of the
individual's legal authority to act on behalf of the
deceased individual.
''(B) Timeline for determination.--The State
Medicaid agency shall make a determination under
subparagraph (A) not later than 30 days after receipt
of the evidence described in such subparagraph.
''(3) Notification and access to information.--After making
a determination under paragraph (2) with respect to an
individual, the State Medicaid Agency shall--
''(A) notify the individual of the determination
not later than 7 days after the date on which the
determination is made; and
''(B) in the case where such individual is so
determined to be the authorized representative of the
deceased individual, as soon as practicable--
''(i) make available to the authorized
representative the information described in
paragraph (1) of subsection (a); and
''(ii) provide the authorized
representative access to the sources described
in paragraph (2) of such subsection.
''(c) Definition of State Medicaid Agency.--The term 'State
Medicaid agency' means the State agency responsible for administering
the State plan established under this title or any waiver of such
plan.''.
(b) Effective Date.--
(1) In general.--Except as provided in paragraph (2), the
amendment made by this section shall take effect on the date
that is 60 days after the date of enactment of this Act.
(2) Extension of effective date for state law amendment.--
In the case of a State plan under this title which the
Secretary of Health and Human Services determines requires
State legislation in order for the plan to meet the additional
requirements imposed by the amendment made by subsection (a),
the State plan shall not be regarded as failing to comply with
the requirements of such title solely on the basis of its
failure to meet these additional requirements before the first
day of the first calendar quarter beginning after the close of
the first regular session of the State legislature that begins
after the date of the enactment of this Act. For purposes of
the previous sentence, in the case of a State that has a 2-year
legislative session, each year of the session is considered to
be a separate regular session of the State legislature.
Expanding Access to Medical Records Act - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to require the Secretary of Health and Human Services (HHS) grant the authorized representative of a deceased beneficiary full access to information with respect to the deceased beneficiary's benefits under the Medicare and Medicaid programs.

SECTION 1. SHORT TITLE.

This Act may be cited as the ''Health Care OverUse Reform Today Act
(HealthCOURT Act) of 2009''.

SEC. 2. ESTABLISHMENT OF PERFORMANCE-BASED QUALITY MEASURES.

Not later than January 1, 2010, the Secretary of Health and Human
Services shall submit to Congress a proposal for a formalized process
for the development of performance-based quality measures that could be
applied to physicians' services under the Medicare program under title
XVIII of the Social Security Act. Such proposal shall be in concert and
agreement with the Physician Consortium for Performance Improvement and
shall only utilize measures agreed upon by each physician specialty
organization.

SEC. 3. AFFIRMATIVE DEFENSE BASED ON COMPLIANCE WITH BEST PRACTICE
GUIDELINES.

(a) Selection and Issuance of Best Practices Guidelines.--
(1) In general.--The Secretary of Health and Human Services
(in this section referred to as the ''Secretary'') shall
provide for the selection and issuance of best practice
guidelines (each in this subsection referred to as a
''guideline'') in accordance with paragraphs (2) and (3).
(2) Development process.--Not later than 90 days after the
date of the enactment of this Act, the Secretary shall enter
into a contract with a qualified physician consensus-building
organization (such as the Physician Consortium for Performance
Improvement), in concert and agreement with physician specialty
organizations, to develop guidelines for treatment of medical
conditions for application under subsection (b). Under the
contract, the organization shall take into consideration any
endorsed performance-based quality measures described in
section 2. Under the contract and not later than 18 months
after the date of the enactment of this Act, the organization
shall submit best practice guidelines for issuance as
guidelines under paragraph (3).
(3) Issuance.--
(A) In general.--Not later than 2 years after the
date of the enactment of this Act, the Secretary shall
issue, by regulation, after notice and opportunity for
public comment, guidelines that have been recommended
under paragraph (2) for application under subsection
(b).
(B) Limitation.--The Secretary may not issue
guidelines unless they have been approved or endorsed
by qualified physician consensus-building organization
involved and physician specialty organizations.
(C) Dissemination.--The Secretary shall broadly
disseminate the guidelines so issued.
(b) Limitation on Damages.--
(1) Limitation on noneconomic damages.--In any health care
lawsuit, no noneconomic damages may awarded with respect to
treatment that is within a guideline issued under subsection
(a).
(2) Limitation on punitive damages.--In any health care
lawsuit, no punitive damages may be awarded against a health
care practitioner based on a claim that such treatment caused
the claimant harm if--
(A) such treatment was subject to the quality
review by a qualified physician consensus-building
organization;
(B) such treatment was approved in a guideline that
underwent full review by such organization, public
comment, approval by the Secretary, and dissemination
as described in subparagraph (a); and
(C) such medical treatment is generally recognized
among qualified experts (including medical providers
and relevant physician specialty organizations) as
safe, effective, and appropriate.
(c) Use.--
(1) Introduction as evidence.--Guidelines under subsection
(a) may not be introduced as evidence of negligence or
deviation in the standard of care in any civil action unless
they have previously been introduced by the defendant.
(2) No presumption of negligence.--There would be no
presumption of negligence if a participating physician does not
adhere to such guidelines.
(d) Construction.--Nothing in this section shall be construed as
preventing a State from--
(1) replacing their current medical malpractice rules with
rules that rely, as a defense, upon a health care provider's
compliance with a guideline issued under subsection (a); or
(2) applying additional guidelines or safe-harbors that are
in addition to, but not in lieu of, the guidelines issued under
subsection (a).

SEC. 4. STATE GRANTS TO CREATE ADMINISTRATIVE HEALTH CARE TRIBUNALS.

Part P of title III of the Public Health Service Act (42 U.S.C.
280g et seq.) is amended by adding at the end the following:

''SEC. 399T. STATE GRANTS TO CREATE ADMINISTRATIVE HEALTH CARE
TRIBUNALS.

''(a) In General.--The Secretary may award grants to States for the
development, implementation, and evaluation of administrative health
care tribunals that comply with this section, for the resolution of
disputes concerning injuries allegedly caused by health care providers.
''(b) Conditions for Demonstration Grants.--To be eligible to
receive a grant under this section, a State shall submit to the
Secretary an application at such time, in such manner, and containing
such information as may be required by the Secretary. A grant shall be
awarded under this section on such terms and conditions as the
Secretary determines appropriate.
''(c) Representation by Counsel.--A State that receives a grant
under this section may not preclude any party to a dispute before an
administrative health care tribunal operated under such grant from
obtaining legal representation during any review by the expert panel
under subsection (d), the administrative health care tribunal under
subsection (e), or a State court under subsection (f).
''(d) Expert Panel Review and Early Offer Guidelines.--
''(1) In general.--Prior to the submission of any dispute
concerning injuries allegedly caused by health care providers
to an administrative health care tribunal under this section,
such allegations shall first be reviewed by an expert panel.
''(2) Composition.--
''(A) In general.--The members of each expert panel
under this subsection shall be appointed by the head of
the State agency responsible for health. Each expert
panel shall be composed of no fewer than 3 members and
not more than 7 members. At least one-half of such
members shall be medical experts (either physicians or
health care professionals).
''(B) Licensure and expertise.--Each physician or
health care professional appointed to an expert panel
under subparagraph (A) shall--
''(i) be appropriately credentialed or
licensed in 1 or more States to deliver health
care services; and
''(ii) typically treat the condition, make
the diagnosis, or provide the type of treatment
that is under review.
''(C) Independence.--
''(i) In general.--Subject to clause (ii),
each individual appointed to an expert panel
under this paragraph shall--
''(I) not have a material familial,
financial, or professional relationship
with a party involved in the dispute
reviewed by the panel; and
''(II) not otherwise have a
conflict of interest with such a party.
''(ii) Exception.--Nothing in clause (i)
shall be construed to prohibit an individual
who has staff privileges at an institution
where the treatment involved in the dispute was
provided from serving as a member of an expert
panel merely on the basis of such affiliation,
if the affiliation is disclosed to the parties
and neither party objects.
''(D) Practicing health care professional in same
field.--
''(i) In general.--In a dispute before an
expert panel that involves treatment, or the
provision of items or services--
''(I) by a physician, the medical
experts on the expert panel shall be
practicing physicians (allopathic or
osteopathic) of the same or similar
specialty as a physician who typically
treats the condition, makes the
diagnosis, or provides the type of
treatment under review; or
''(II) by a health care
professional other than a physician, at
least two medical experts on the expert
panel shall be practicing physicians
(allopathic or osteopathic) of the same
or similar specialty as the health care
professional who typically treats the
condition, makes the diagnosis, or
provides the type of treatment under
review, and, if determined appropriate
by the State agency, an additional
medical expert shall be a practicing
health care professional (other than
such a physician) of such a same or
similar specialty.
''(ii) Practicing defined.--In this
paragraph, the term 'practicing' means, with
respect to an individual who is a physician or
other health care professional, that the
individual provides health care services to
individual patients on average at least 2 days
a week.
''(E) Pediatric expertise.--In the case of dispute
relating to a child, at least 1 medical expert on the
expert panel shall have expertise described in
subparagraph (D)(i) in pediatrics.
''(3) Determination.--After a review under paragraph (1),
an expert panel shall make a determination as to the liability
of the parties involved and compensation.
''(4) Acceptance.--If the parties to a dispute before an
expert panel under this subsection accept the determination of
the expert panel concerning liability and compensation, such
compensation shall be paid to the claimant and the claimant
shall agree to forgo any further action against the health care
providers involved.
''(5) Failure to accept.--If any party decides not to
accept the expert panel's determination, the matter shall be
referred to an administrative health care tribunal created
pursuant to this section.
''(e) Administrative Health Care Tribunals.--
''(1) In general.--Upon the failure of any party to accept
the determination of an expert panel under subsection (d), the
parties shall have the right to request a hearing concerning
the liability or compensation involved by an administrative
health care tribunal established by the State involved.
''(2) Requirements.--In establishing an administrative
health care tribunal under this section, a State shall--
''(A) ensure that such tribunals are presided over
by special judges with health care expertise;
''(B) provide authority to such judges to make
binding rulings, rendered in written decisions, on
standards of care, causation, compensation, and related
issues with reliance on independent expert witnesses
commissioned by the tribunal;
''(C) establish gross negligence as the legal
standard for the tribunal;
''(D) allow the admission into evidence of the
recommendation made by the expert panel under
subsection (d); and
''(E) provide for an appeals process to allow for
review of decisions by State courts.
''(f) Review by State Court After Exhaustion of Administrative
Remedies.--
''(1) Right to file.--If any party to a dispute before a
health care tribunal under subsection (e) is not satisfied with
the determinations of the tribunal, the party shall have the
right to file their claim in a State court of competent
jurisdiction.
''(2) Forfeit of awards.--Any party filing an action in a
State court in accordance with paragraph (1) shall forfeit any
compensation award made under subsection (e).
''(3) Admissibility.--The determinations of the expert
panel and the administrative health care tribunal pursuant to
subsections (d) and (e) with respect to a State court
proceeding under paragraph (1) shall be admissible into
evidence in any such State court proceeding.
''(g) Definition.--In this section, the term 'health care provider'
has the meaning given such term for purposes of part A of title VII.
''(h) Authorization of Appropriations.--There are authorized to be
appropriated for any fiscal year such sums as may be necessary for
purposes of making grants to States under this section.''.

SEC. 5. SENSE OF CONGRESS REGARDING HEALTH INSURER LIABILITY.

It is the sense of Congress that a health insurance issuer should
be liable for damages for harm caused when it makes a decision as to
what care is medically necessary and appropriate.
Health Care OverUse Reform Today Act (HealthCOURT Act) of 2009 - Directs the Secretary of Health and Human Services (HHS) to propose to Congress a formalized process for the development of performance-based quality measures that could be applied to physicians' services under title XVIII (Medicare) of the Social Security Act. Requires the proposal: (1) to be in concert and agreement with the Physician Consortium for Performance Improvement; and (2) utilize only measures agreed upon by each physician specialty organization.

Directs the Secretary to: (1) provide for the selection and issuance of best practice guidelines for treatment of medical conditions; and (2) contract with a qualified physician consensus-building organization (such as the Physician Consortium for Performance Improvement), in concert and agreement with physician specialty organizations, to develop such guidelines.

Prohibits the award of any noneconomic damages in any health care lawsuit with respect to treatment that is within an issued guideline.

Prohibits the award of punitive damages against a health care practitioner in such a lawsuit based on a claim that medical treatment caused the claimant harm if the treatment: (1) was subject to quality review by a qualified physician consensus-building organization; (2) was approved in a guideline that underwent full review by such organization, public comment, the Secretary's approval, and dissemination; and (3) is generally recognized among qualified experts as safe, effective, and appropriate.

Amends the Public Health Service Act to authorize the Secretary to award grants to states for the development, implementation, and evaluation of administrative health care tribunals for the resolution of disputes concerning injuries allegedly caused by health care providers.

Expresses the sense of Congress that a health insurance issuer should be liable for damages for a harm caused when it makes a decision as to what care is medically necessary and appropriate.

SECTION 1. SHORT TITLE.

This Act may be cited as the ''HUBZone Revitalization Act of
2015''.

SEC. 2. HUBZONE QUALIFIED DISASTER AREAS.

(a) In General.--The Small Business Act (15 U.S.C. 631 et seq.) is
amended--
(1) in section 3(p) (15 U.S.C. 632(p))--
(A) in paragraph (1)--
(i) in subparagraph (D), by striking
''or'';
(ii) in subparagraph (E), by striking the
period at the end and inserting ''; or''; and
(iii) by adding at the end the following:
''(F) qualified disaster areas.''; and
(B) in paragraph (4), by adding at the end the
following:
''(E) Qualified disaster area.--
''(i) In general.--The term 'qualified
disaster area' means any census tract or
nonmetropolitan county located in an area for
which the President has declared a major
disaster under section 401 of the Robert T.
Stafford Disaster Relief and Emergency
Assistance Act (42 U.S.C. 5170) or located in
an area in which a catastrophic incident has
occurred, if--
''(I) in the case of a census
tract, the census tract ceased to be a
qualified census tract during the
period beginning 5 years before and
ending 2 years after the date on
which--
''(aa) the President
declared the major disaster; or
''(bb) the catastrophic
incident occurred; or
''(II) in the case of a
nonmetropolitan county, the
nonmetropolitan county ceased to be a
qualified nonmetropolitan county during
the period beginning 5 years before and
ending 2 years after the date on
which--
''(aa) the President
declared the major disaster; or
''(bb) the catastrophic
incident occurred.
''(ii) Treatment.--A qualified disaster
area shall only be treated as a HUBZone--
''(I) in the case of a major
disaster declared by the President,
during the 5-year period beginning on
the date on which the President
declared the major disaster for the
area in which the census tract or
nonmetropolitan county, as applicable,
is located; and
''(II) in the case of a
catastrophic incident, during the 10-
year period beginning on the date on
which the catastrophic incident
occurred in the area in which the
census tract or nonmetropolitan county,
as applicable, is located.''; and
(2) in section 31(c)(3) (15 U.S.C. 657a(c)(3)), by
inserting ''the Administrator of the Federal Emergency
Management Agency,'' after ''the Secretary of Labor,''.
(b) Applicability.--The amendments made by subsection (a) shall
apply to a major disaster declared by the President under section 401
of the Robert T. Stafford Disaster Relief and Emergency Assistance Act
(42 U.S.C. 5170) or a catastrophic incident that occurs on or after the
date of enactment of this Act.

SEC. 3. BASE CLOSURE HUBZONES.

(a) In General.--Section 3(p)(5)(A)(i)(I) of the Small Business Act
(15 U.S.C. 632(p)(5)(A)(i)(I)) is amended--
(1) in item (aa), by striking ''or'' at the end;
(2) by redesignating item (bb) as item (cc); and
(3) by inserting after item (aa) the following:
''(bb) pursuant to
subparagraph (A), (B), (C),
(D), or (E) of paragraph (3),
that its principal office is
located in a HUBZone described
in paragraph (1)(E) (relating
to base closure areas) (in this
item referred to as the 'base
closure HUBZone'), and that not
fewer than 35 percent of its
employees reside in--

''(AA) a HUBZone;

''(BB) the census
tract in which the base
closure HUBZone is
wholly contained;

''(CC) a census
tract the boundaries of
which intersect the
boundaries of the base
closure HUBZone; or

''(DD) a census
tract the boundaries of
which are contiguous to
a census tract
described in subitem
(BB) or (CC); or''.

(b) Period for Base Closure Areas.--
(1) Amendments.--
(A) In general.--Section 152(a)(2) of title I of
division K of the Consolidated Appropriations Act, 2005
(15 U.S.C. 632 note) is amended by striking ''5 years''
and inserting ''8 years''.
(B) Conforming amendment.--Section 1698(b)(2) of
National Defense Authorization Act for Fiscal Year 2013
(15 U.S.C. 632 note) is amended by striking ''5 years''
and inserting ''8 years''.
(2) Effective date; applicability.--The amendments made by
paragraph (1) shall--
(A) take effect on the date of enactment of this
Act; and
(B) apply to--
(i) a base closure area (as defined in
section 3(p)(4)(D) of the Small Business Act
(15 U.S.C. 632(p)(4)(D))) that, on the day
before the date of enactment of this Act, is
treated as a HUBZone described in section
3(p)(1)(E) of the Small Business Act (15 U.S.C.
632(p)(1)(E)) under--
(I) section 152(a)(2) of title I of
division K of the Consolidated
Appropriations Act, 2005 (15 U.S.C. 632
note); or
(II) section 1698(b)(2) of National
Defense Authorization Act for Fiscal
Year 2013 (15 U.S.C. 632 note); and
(ii) a base closure area relating to the
closure of a military instillation under the
authority described in clauses (i) through (iv)
of section 3(p)(4)(D) of the Small Business Act
(15 U.S.C. 632(p)(4)(D)) that occurs on or
after the date of enactment of this Act.
. HUBZone Revitalization Act of 2015 (Sec. 2) This bill amends the Small Business Act to redefine HUBZones (historically underutilized business Zones) eligible for certain assistance to include a qualified disaster area (a specified census tract or nonmetropolitan county located in a major declared disaster area or in an area where a catastrophic incident has occurred). A qualified disaster area shall be treated as a HUBZone for 5 years after it has been declared a major disaster area or for 10 years after a catastrophic incident has occurred within it. The Federal Emergency Management Agency shall provide the Small Business Administration with any data it needs to verify a small business's eligibility for the HUBZone small business loan program. (Sec. 3) HUBZones shall now also include areas that can be used by small businesses whose principal offices are located in base closure HUBZones, with at least 35% of their employees residing in: a HUBZone, a census tract in which the base closure HUBZone is wholly contained, a census tract that intersects the boundaries of the base closure HUBZone, or census tract contiguous with these census tracts. This bill also amends the Consolidated Appropriations Act, 2005 to extend HUBZone eligibility assistance for base closure areas from five years to eight years after their closure.