,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #cddg  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #bg1 #bjag,ms4  
,j5k9s ( ,kansas 7= h]self1 ,mr4        
,?ompson ( ,cali=nia1 ,mr4 ,h>p]1 & ,mr4
 ,b5 ,ray ,lujn ( ,new ,mexico7         
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 provide       
prescription drug plans "u "p ,d ( !    
,m$ic>e program ) p>ts ,a & ,b ,m$ic>e  
claims data to promote ! appropriate use
 ( m$ications & improve heal? outcomes4 
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,fur!r+ ,access to ,coord9at$         
,treatm5t = ,s5iors ,act ( #bjag or !   
,,facts ,act ( #bjag4  #b4 ,provid+     
prescription drug plans ) p>ts ,a & ,b  
claims data to promote ! appropriate use

 ( m$ications & improve heal? outcomes  
,section #ahfj;,d-#d7;c7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajd7;c77 is am5d$ by add+ at !  
end ! foll[+ new p>agraph3  7#g7        
,provid+ prescription drug plans ) p>ts 
,a & ,b claims data to promote !        
appropriate use ( m$ications & improve  
heal? outcomes  7,a7 ,process ,subject  
to subp>agraph 7,c71 ! ,secret>y %all   
e/abli% a process "u :i* a ,,pdp sponsor
 ( a prescription drug plan may submit a
 reque/ = ! ,secret>y to provide !      
sponsor1 on a p]iodic basis & 9 an      
electronic =mat1 beg9n+ 9 plan ye>      
#bjbj1 data describ$ 9 subp>agraph 7,d7 
) respect to enrollees 9 su* plan4 ,su* 
data %all be provid$ )\t reg>d to :e!r  
su* enrollees are describ$ 9 clause 7ii7
 ( p>agraph 7#b77;,a74  7,b7 ,purposes  
,a ,,pdp sponsor may use ! data provid$ 
to ! sponsor pursuant to subp>agraph    
7,a7 = any ( ! foll[+ purposes3  7i7 ,to
 optimize !rapeutic outcomes ?r\gh      
improv$ m$ication use1 z su* phrase is  

us$ 9 clause 7i7 ( p>agraph 7#b77;,a74  
7ii7 ,to improve c>e coord9ation s z to 
prev5t adv]se heal? outcomes1 su* z     
prev5table em]g5cy dep>tm5t visits &    
hospital readmissions4  7iii7 ,= any o!r
 purpose det]m9$ appropriate by !       
,secret>y4  7,c7 ,limitations on data   
use ,a ,,pdp sponsor %all n use data    
provid$ to ! sponsor pursuant to        
subp>agraph 7,a7 = any ( ! foll[+       
purposes3  7i7 ,to in=m cov]age         
det]m9ations "u ?is "p4  7ii7 ,to       
conduct retroactive reviews ( m$ically  
accept$ indications det]m9ations4  7iii7
 ,to direct enrollm5t *anges to a       
diff]5t prescription drug plan or an    
,,ma-,,pd plan (f]$ by ! same p>5t      
organization4  7iv7 ,to in=m m>ket+ (   
b5efits4  7v7 ,= any o!r purpose t !    
,secret>y det]m9es is necess>y to       
include 9 ord] to protect ! id5tity (   
individuals entitl$ to1 or enroll$ =1   
b5efits "u ?is title & to protect !     
security ( p]sonal heal? in=mation4     
7,d7 ,data describ$ ,! data describ$ 9  

?is subp>agraph are /&>diz$ extracts 7z 
det]m9$ by ! ,secret>y7 ( claims data "u
 p>ts ,a & ,b = items & s]vices furni%$ 
"u su* p>ts = "t p]iods specifi$ by !   
,secret>y4 ,su* data %all include data z
 curr5t z practicable4  4