,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #ddah  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,april #g1 #bjad ,mr4 
,ryan ( ,wiscons9 7= himself & ,mr4     
,k9d7 introduc$ ! foll[+ bill2 :i* 0    
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
increase access to ,m$ic>e data4  #a4   
,%ort title ,?is ,act may be cit$ z !   
,exp&+ ! ,availability ( ,m$ic>e ,data  
,act4  #b4 ,exp&+ availability ( ,m$ic>e
 data  7a7 ,exp&+ uses ( ,m$ic>e data by
 qualifi$ entities  7#a7 ,additional    
analyses  7,a7 ,9 g5]al ,subject to     
subp>agraph 7,b71 to ! ext5t consi/5t ) 
applicable in=mation1 privacy1 security1
 & disclosure laws 7includ+ p>agraph    
7#c771 not)/&+ p>agraph 7#d77;,b7 (     
section #ahgd7;e7 ( ! ,social ,security 

,act 7#db ,u4,s4,c4 #aciekk7e77 & !     
second s5t5ce ( p>agraph 7#d77;,d7 ( su*
 section1 beg9n+ ,july #a1 #bjae1 a     
qualifi$ entity may use ! comb9$ data   
describ$ 9 p>agraph 7#d77;,b77iii7 ( su*
 section receiv$ by su* entity "u su*   
section1 & in=mation d]iv$ f !          
evaluation describ$ 9 su* p>agraph      
7#d77;,d71 to conduct additional        
non-public analyses 7z det]m9$          
appropriate by ! ,secret>y7 & provide or
 sell su* analyses to au?oriz$ us]s =   
non-public use 7includ+ = ! purposes (  
assi/+ provid]s ( s]vices & suppli]s to 
develop & p>ticipate 9 quality & pati5t 
c>e improvem5t activities1 includ+      
develop+ new models ( c>e74  7,b7       
,limitations ) respect to analyses  7i7 
,employ]s ,any analyses provid$ or sold 
"u subp>agraph 7,a7 to an employ]       
describ$ 9 p>agraph 7#i77;,a77iii7 may  
only be us$ by su* employ] = purposes ( 
provid+ heal? insurance to employees &  
retirees ( ! employ]4  7ii7 ,heal?      
insurance issu]s ,a qualifi$ entity may 

n provide or sell an analysis to a heal?
 insurance issu] describ$ 9 p>agraph    
7#i77;,a77iv7 unless ! issu] is provid+ 
! qualifi$ entity ) data "u section     
#ahgd7;e77#d77;,b77iii7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#aciekk7e77#d77;,b77iii774  7#b7 ,access
 to c]ta9 data  7,a7 ,access ,to ! ext5t
 consi/5t ) applicable in=mation1       
privacy1 security1 & disclosure laws    
7includ+ p>agraph 7#c771 not)/&+        
p>agraph 7#d77;,b7 ( section #ahgd7;e7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciekk7e77 & ! second s5t5ce (        
p>agraph 7#d77;,d7 ( su* section1 beg9n+
 ,july #a1 #bjae1 a qualifi$ entity     
may--  7i7 provide or sell ! comb9$ data
 describ$ 9 p>agraph 7#d77;,b77iii7 (   
su* section to au?oriz$ us]s describ$ 9 
clauses 7i71 7ii71 & 7v7 ( p>agraph     
7#i77;,a7 = non-public use1 includ+ = ! 
purposes describ$ 9 subp>agraph 7,b72 or
  7ii7 subject to subp>agraph 7,c71     
provide ,m$ic>e claims data to au?oriz$ 
us]s describ$ 9 clauses 7i71 7ii71 &    

7v71 ( p>agraph 7#i77;,a7 = non-public  
use1 includ+ = ! purposes describ$ 9    
subp>agraph 7,b74  7,b7 ,purposes       
describ$ ,! purposes describ$ 9 ?is     
subp>agraph are assi/+ provid]s (       
s]vices & suppli]s 9 develop+ &         
p>ticipat+ 9 quality & pati5t c>e       
improvem5t activities1 includ+ develop+ 
new models ( c>e4  7,c7 ,m$ic>e claims  
data mu/ be provid$ at no co/ ,a        
qualifi$ entity may n *>ge a fee =      
provid+ ! data "u subp>agraph 7,a77ii74 
7#c7 ,protection ( in=mation  7,a7 ,9   
g5]al ,except z provid$ 9 subp>agraph   
7,b71 an analysis or data t is provid$  
or sold "u p>agraph 7#a7 or 7#b7 %all n 
conta9 in=mation t individually         
id5tifies a pati5t4  7,b7 ,in=mation on 
pati5ts ( ! provid] ( s]vices or suppli]
 ,to ! ext5t consi/5t ) applicable      
in=mation1 privacy1 security1 &         
disclosure laws1 an analysis or data t  
is provid$ or sold to a provid] (       
s]vices or suppli] "u p>agraph 7#a7 or  
7#b7 may conta9 in=mation t individually

 id5tifies a pati5t ( su* provid] or    
suppli]1 includ+ ) respect to items &   
s]vices furni%$ to ! pati5t by o!r      
provid]s ( s]vices or suppli]s4  7,c7   
,prohibition on us+ analyses or data =  
m>ket+ purposes ,an au?oriz$ us] %all n 
use an analysis or data provid$ or sold 
"u p>agraph 7#a7 or 7#b7 = m>ket+       
purposes4  7#d7 ,data use agreem5t ,a   
qualifi$ entity & an au?oriz$ us]       
describ$ 9 clauses 7i71 7ii71 & 7v7 (   
p>agraph 7#i77;,a7 %all ent] into an    
agreem5t reg>d+ ! use ( any data t !    
qualifi$ entity is provid+ or sell+ to !
 au?oriz$ us] "u p>agraph 7#b74 ,su*    
agreem5t %all describe ! requirem5ts =  
privacy & security ( ! data &1 z det]m9$
 appropriate by ! ,secret>y1 any        
prohibitions on us+ su* data to l9k to  
o!r individually id5tifiable s\rces (   
in=mation4 ,if ! au?oriz$ us] is n a    
cov]$ entity "u ! rules promulgat$      
pursuant to ! ,heal? ,insurance         
,portability & ,acc\ntability ,act (    
#aiif1 ! agreem5t %all id5tify !        

relevant regulations1 z det]m9$ by !    
,secret>y1 t ! us] %all comply ) z if x 
7 act+ 9 ! capacity ( su* a cov]$       
entity4  7#e7 ,no r$isclosure ( analyses
 or data  7,a7 ,9 g5]al ,except z       
provid$ 9 subp>agraph 7,b71 an au?oriz$ 
us] t is provid$ or sold an analysis or 
data "u p>agraph 7#a7 or 7#b7 %all n    
r$isclose or make public su* analysis or
 data or any analysis us+ su* data4     
7,b7 ,p]mitt$ r$isclosure ,a provid] (  
s]vices or suppli] t is provid$ or sold 
an analysis or data "u p>agraph 7#a7 or 
7#b7 may1 z det]m9$ by ! ,secret>y1     
r$isclose su* analysis or data = !      
purposes ( p]=mance improvem5t & c>e    
coord9ation activities b %all n make    
public su* analysis or data or any      
analysis us+ su* data4  7#f7            
,opportunity = provid]s ( s]vices &     
suppli]s to review ,prior to a qualifi$ 
entity provid+ or sell+ an analysis to  
an au?oriz$ us] "u p>agraph 7#a71 to !  
ext5t t su* analysis w\ld individually  
id5tify a provid] ( s]vices or suppli]  

:o is n be+ provid$ or sold su*         
analysis1 su* qualifi$ entity %all      
provide su* provid] or suppli] ) !      
opportunity to appeal & correct errors 9
 ! mann] describ$ 9 section             
#ahgd7;e77#d77;,c77ii7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciekk7e77#d77;,c77ii774  7#g7         
,assessm5t = a brea*  7,a7 ,9 g5]al ,9 !
 case ( a brea* ( a data use agreem5t "u
 ?is section or section #ahgd7;e7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#aciekk7e771 ! ,secret>y %all impose an 
assessm5t on ! qualifi$ entity bo? 9 !  
case (--  7i7 an agreem5t betwe5 !      
,secret>y & a qualifi$ entity2 &  7ii7  
an agreem5t betwe5 a qualifi$ entity &  
an au?oriz$ us]4  7,b7 ,assessm5t ,!    
assessm5t "u subp>agraph 7,a7 %all be an
 am\nt up to #ajj = ea* individual      
entitl$ to1 or enroll$ =1 b5efits "u "p 
,a ( title ,,xviii ( ! ,social ,security
 ,act or enroll$ = b5efits "u "p ,b (   
su* title--  7i7 9 ! case ( an agreem5t 
describ$ 9 subp>agraph 7,a77i71 = :om ! 

,secret>y provid$ data on to ! qualifi$ 
entity "u p>agraph 7#b72 &  7ii7 9 !    
case ( an agreem5t describ$ 9           
subp>agraph 7,a77ii71 = :om ! qualifi$  
entity provid$ data on to ! au?oriz$ us]
 "u p>agraph 7#b74  7,c7 ,deposit (     
am\nts collect$ ,any am\nts collect$    
pursuant to ?is p>agraph %all be        
deposit$ 9 ,f$]al ,supplem5t>y ,m$ical  
,insurance ,tru/ ,fund "u section #ahda 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #aciet74  7#h7 ,annual reports
 ,any qualifi$ entity t provides or     
sells an analysis or data "u p>agraph   
7#a7 or 7#b7 %all annually submit to !  
,secret>y a report t includes--  7,a7 a 
summ>y ( ! analyses provid$ or sold1    
includ+ ! numb] ( su* analyses1 ! numb] 
( pur*as]s ( su* analyses1 & ! total    
am\nt ( fees receiv$ = su* analyses2    
7,b7 a description ( ! topics & purposes
 ( su* analyses2  7,c7 in=mation on !   
entities :o receiv$ ! data "u p>agraph  
7#b71 ! uses ( ! data1 & ! total am\nt (
 fees receiv$ = provid+1 sell+1 or %>+ !

 data2 &  7,d7 o!r in=mation det]m9$    
appropriate by ! ,secret>y4  7#i7       
,def9itions ,9 ?is subsection &         
subsection 7b73  7,a7 ,au?oriz$ us] ,!  
t]m au?oriz$ us] means ! foll[+3  7i7 ,a
 provid] ( s]vices4  7ii7 ,a suppli]4   
7iii7 ,an employ] 7z def9$ 9 section    
#c7e7 ( ! ,employee ,retirem5t          
,insurance ,security ,act ( #aigd74     
7iv7 ,a heal? insurance issu] 7z def9$ 9
 section #bgia ( ! ,public ,heal?       
,s]vice ,act74  7v7 ,a m$ical society or
 hospital association4  7vi7 ,any entity
 n describ$ 9 clauses 7i7 ?r\gh 7v7 t is
 approv$ by ! ,secret>y 7o!r ?an an     
employ] or heal? insurance issu] n      
describ$ 9 clauses 7iii7 & 7iv71        
respectively1 z det]m9$ by ! ,secret>y74
  7,b7 ,provid] ( s]vices ,! t]m provid]
 ( s]vices has ! mean+ giv5 su* t]m 9   
section #ahfa7u7 ( ! ,social ,security  
,act 7#db ,u4,s4,c4 #aciex7u774  7,c7   
,qualifi$ entity ,! t]m qualifi$ entity 
has ! mean+ giv5 su* t]m 9 section      
#ahgd7;e77#b7 ( ! ,social ,security ,act

 7#db ,u4,s4,c4 #aciekk7e774  7,d7      
,secret>y ,! t]m ,secret>y means !      
,secret>y ( ,heal? & ,human ,s]vices4   
7,e7 ,suppli] ,! t]m suppli] has ! mean+
 giv5 su* t]m 9 section #ahfa7;d7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7d774  7b7 ,access to ,m$ic>e data
 by qualifi$ cl9ical data regi/ries ,to 
facilitate quality improvem5t  7#a7     
,access  7,a7 ,9 g5]al ,to ! ext5t      
consi/5t ) applicable in=mation1        
privacy1 security1 & disclosure laws1   
beg9n+ ,july #a1 #bjae1 ! ,secret>y     
%all1 at ! reque/ ( a qualifi$ cl9ical  
data regi/ry "u section                 
#ahdh7m77#c77;,e7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4                     
#aciew-#d7m77#c77;,e771 provide ! data  
describ$ 9 subp>agraph 7,b7 79 a =m &   
mann] det]m9$ to be appropriate7 to su* 
qualifi$ cl9ical data regi/ry = purposes
 ( l9k+ su* data ) cl9ical outcomes data
 & p]=m+ risk-adju/$1 sci5tifically     
valid analyses & rese>* to support      
quality improvem5t or pati5t safety1    

provid$ t any public report+ ( su*      
analyses or rese>* t id5tifies a provid]
 ( s]vices or suppli] %all only be      
conduct$ ) ! opportunity ( su* provid]  
or suppli] to appeal & correct errors 9 
! mann] describ$ 9 subsection 7a77#f74  
7,b7 ,data describ$ ,! data describ$ 9  
?is subp>agraph is--  7i7 claims data "u
 ! ,m$ic>e program "u title ,,xviii ( ! 
,social ,security ,act2 &  7ii7 if !    
,secret>y det]m9es appropriate1 claims  
data "u ! ,m$icaid program "u title     
,,xix ( su* ,act & ! ,/ate ,*ildr5's    
,heal? ,insurance ,program "u title     
,,xxi ( su* ,act4  7#b7 ,fee ,data      
describ$ 9 p>agraph 7#a77;,b7 %all be   
provid$ to a qualifi$ cl9ical data      
regi/ry "u p>agraph 7#a7 at a fee equal 
to ! co/ ( provid+ su* data4 ,any fee   
collect$ pursuant to ! prec$+ s5t5ce    
%all be deposit$ 9 ! ,c5t]s = ,m$ic>e   
,m$icaid ,s]vices ,program ,managem5t   
,acc\nt4  7c7 ,expansion ( data         
available to qualifi$ entities ,section 
#ahgd7;e7 ( ! ,social ,security ,act    

7#db ,u4,s4,c4 #aciekk7e77 is am5d$--   
7#a7 9 ! subsection head+1 by /rik+     
,m$ic>e2 &  7#b7 9 p>agraph 7#c7--  7,a7
 by ins]t+ aft] ! fir/ s5t5ce ! foll[+  
new s5t5ce3 ,beg9n+ ,july #a1 #bjae1 if 
! ,secret>y det]m9es appropriate1 ! data
 describ$ 9 ?is p>agraph may also       
include /&>diz$ extracts 7z det]m9$ by !
 ,secret>y7 ( claims data "u titles     
,,xix & ,,xxi = assi/ance provid$ "u su*
 titles = "o or m specifi$ geographic   
areas & "t p]iods reque/$ by a qualifi$ 
entity42 &  7,b7 9 ! la/ s5t5ce1 by     
ins]t+ or "u titles ,,xix or ,,xxi be=e 
! p]iod at ! end4  7d7 ,revision (      
placem5t ( fees ,section                
#ahgd7;e77#d77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#aciekk7e77#d77;,a77 is am5d$1 9 !      
second s5t5ce--  7#a7 by ins]t+ 1 =     
p]iods prior to ,july #a1 #bjae1 aft]   
deposit$2 &  7#b7 by ins]t+ ! foll[+    
be=e ! p]iod at ! end3 1 &1 beg9n+ ,july
 #a1 #bjae1 into ! ,c5t]s = ,m$ic>e     
,m$icaid ,s]vices ,program ,managem5t   

,acc\nt4