,i #aae? ,,congress #a/ ,session ,h4 ,r4 #dfac ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,decemb] #aa1 #bjag,mrs4 ,mc,morris ,rodg]s 7= h]self1 ,mr4 ,kelly ( ,p5nsylvania1 ,mr4 ,hudson1 ,mrs4 ,blackburn1 ,mr4 ,long1 ,mr4 ,bi%op ( ,mi*igan1 ,mr4 ,pauls51 & ,mr4 ,kri%namoor?i7 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 all[ ! use ( claims1 eligibility1 & paym5t data to produce reports1 analyses1 & pres5tations to b5efit ,m$ic>e1 & o!r simil> heal? insurance programs1 entities1 rese>*]s1 & heal? c>e provid]s1 to help develop co/ sav+ approa*es1 /&>ds1 & ref]5ce mat]ials & to support m$ical c>e & improv$ paym5t models4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,ensur+ ,pati5t ,access to ,heal?c>e ,records ,act ( #bjag4 #b4 ,promotion ( access to data1 via rese>* & us] fri5dly pres5tations & applications 7a7 ,9 g5]al ,subtitle ,d ( ! ,heal? ,in=mation ,te*nology = ,economic & ,cl9ical ,heal? ,act 7#db ,u4,s4,c4 #agiba et seq47 is am5d$ by add+ at ! end ! foll[+3 #c ,heal? c>e cle>+h\ses2 data process+ to emp[] pati5ts & improve ! heal? c>e sy/em #acdea4 ,mod]niz+ ! role ( cle>+h\ses 9 heal? c>e 7a7 ,ef=ts ,to promote access to & lev]ag+ ( heal? in=mation 7#a7 ,9 g5]al ,! ,secret>y %all1 ?r\gh ! updat+ ( exi/+ policies & developm5t ( policies t support dynamic te*nology solutions1 promote pati5t access to in=mation relat$ to _! c>e1 includ+ real _w outcomes & economic data 7includ+ claims1 eligibility1 & paym5t data71 9 a mann] t w\ld ensure t su* in=mation is available 9 a =m conv5i5t = ! pati5t1 9 a reasonable mann]1 & )\t burd5+ ! heal? c>e provid] involv$4 7#b7 ,requirem5t ,activities c>ri$ out "u p>agraph 7#a7 %all include ! developm5t ( policies to enable cov]$ entities ) access to heal? in=mation to-- 7,a7 provide pati5t access to in=mation relat$ to _! c>e1 includ+ real _w outcomes & economic data2 7,b7 develop1 9 accordance ) ,,hipaa-relat$ provisions 7z def9$ 9 subsection 7j771 pati5t engagem5t tools1 reports1 analyses1 & pres5tations bas$ on population heal?1 epidemiological1 & heal? s]vices outcomes data1 t may demon/rate a fiscal or treatm5t b5efit to pati5ts & heal? plan enrollees2 & 7,c7 promote transp>5cy reg>d+ ! use & disclosure ( heal? in=mation by heal? c>e cle>+h\ses 9 accordance ) ! notice provisions ( subsection 7e74 7b7 ,treatm5t z cov]$ entity = specifi$ functions 7#a7 ,9 g5]al ,) respect to ! use & disclosure ( protect$ heal? in=mation1 ! ,secret>y %all-- 7,a7 n consid] heal? c>e cle>+h\ses t engage 9 ! functions describ$ 9 p>agraph 7#c7 to be bus9ess associates1 includ+ subcontractor bus9ess associates1 "u ,,hipaa-relat$ provisions 7z def9$ 9 subsection 7j77#c77 reg>dless ( ! role ( su* cle>+h\ses 9 collect+ or receiv+ ! in=mation2 & 7,b7 consid] su* cle>+h\ses to be cov]$ entities "u su* provisions ( law = all purposes4 ,su* cle>+h\ses %all n be consid]$ bus9ess associates1 or subcontractor bus9ess associates1 = translation ( data into & out ( /&>d =mat1 analytic1 cl\d comput+1 or any o!r purpose4 7#b7 ,data accuracy & security requirem5t ,9 ord] to use heal? data z au?oriz$ by ?is section1 a cle>+h\se or o!r cov]$ entity engag+ 9 activities au?oriz$ "u ?is section %all be c]tifi$ to h ! necess>y exp]tise & te*nical infra/ructure to ensure ! accuracy & security ( su* claims1 eligibility1 & paym5t data ?r\gh receipt ( an accr$itation by ! ,electronic ,heal?c>e ,network ,accr$itation ,commission1 or by an equival5t accr$itation program det]m9$ appropriate by ! ,secret>y4 7#c7 ,enhanc+ treatm5t1 quality improvem5t1 rese>*1 public heal? ef=ts & o!r functions 7,a7 ,equival5t au?ority to o!r cov]$ entities ,subject to p>agraph 7#b71 a heal? c>e cle>+h\se %all-- 7i7 9 addition to c>ry+ out claims process+ functions1 be p]mitt$ to use & disclose protect$ heal? in=mation )\t obta9+ individual au?orization to ! same ext5t z o!r cov]$ entities1 includ+ = purposes ( treatm5t1 paym5t1 heal? c>e op]ations z p]mitt$ by section #afd4ejf ( title #de1 ,code ( ,f$]al ,regulations1 rese>*1 & public heal? z p]mitt$ by section #afd4eab ( title #de1 ,code ( ,f$]al ,regulations1 & creat+ de-id5tifi$ in=mation z p]mitt$ by section #afd4ejb7;d7 ( title #de1 ,code ( ,f$]al ,regulations2 & 7ii7 use or disclose protect$ heal? in=mation z requir$ by section #afd4ejb7;a77#b7 ( title #de1 ,code ( ,f$]al ,regulations4 7,b7 ,additional au?ority 7i7 ,a heal? c>e cle>+h\se %all be p]mitt$ to provide an individual or ! p]sonal repres5tative ( su* individual access to ! protect$ heal? in=mation ( su* individual z describ$ 9 subsection 7d74 7ii7 ,all cov]$ entities1 includ+ a heal? c>e cle>+h\se1 %all1 subject to subsection 7c77#b71 be p]mitt$ to-- 7,i7 on behalf ( cov]$ entities1 use & disclose protect$ heal? in=mation = heal? c>e op]ations purposes 7z def9$ by section #afd4eja ( title #de1 ,code ( ,f$]al ,regulations7 )\t respect to :e!r ! recipi5t ( ! in=mation has or _h a relation%ip ) ! individual2 7,,ii7 ^u ! reque/ ( a cov]$ entity1 b5*m>k 7z def9$ by ! ,secret>y pursuant to rulemak+7 ! op]ations ( su* cov]$ entity aga9/ ! op]ations ( "o or m o!r cov]$ entities t h elect$ to p>ticipate 9 su* b5*m>k+2 & 7,,iii7 use & disclose protect$ heal? in=mation to facilitate cl9ical trial recruitm5t1 except t 9 ! case ! cov]$ entity provides a consum]-fac+ portal or website t in=ms individuals ( cl9ical trials conduct$ by ! cov]$ entity1 ! cov]$ entity %all secure opt-9 cons5t f ! individual1 or ! individual's p]sonal repres5tative1 prior to contact+ an individual reg>d+ su* cl9ical trials unless su* cov]$ entity already has a relation%ip ) ! individual4 7,c7 ,cl>ification ,no?+ 9 ?is p>agraph %all exp& ! au?ority ( a heal? c>e cle>+h\se or any o!r cov]$ entity to use or disclose protect$ heal? in=mation = m>ket+ purposes "u sections #afd4eja & #afd4ejh7;a77#c7 ( title #de1 ,code ( ,f$]al ,regulations4 7c7 ,au?orities relat+ to data process+ 7#a7 ,9 g5]al ,9 c>ry+ out ,,hipaa-relat$ provisions1 ! ,secret>y %all p]mit a heal? c>e cle>+h\se to aggregate protect$ heal? in=mation1 )9 ! cle>+h\se & among o!r cle>+h\ses1 t ! cle>+h\se possesses 9 ord] to c>ry out ! functions describ$ 9 subsection 7b77#c74 ,subject to section #afd4ejb7;a77#e77;i7 ( title #de1 ,code ( ,f$]al ,regulations1 a heal? c>e cle>+h\se may c>ry out ! functions describ$ 9 subsection 7b77#c7 )\t obta9+ individual au?orization "u section #afd4ejh ( title #de1 ,code ( ,f$]al ,regulations4 7#b7 ,privacy ,= purposes ( clauses 7ii7 ?r\gh 7iv7 ( subsection 7b77#c77;,b71 ) respect to any report1 analysis1 or pres5tation provid$ by ! cov]$ entity to a ?ird p>ty1 su* report1 analysis1 or pres5tation-- 7,a7 %all include only de-id5tifi$ data2 or 7,b7 %all include1 subject to a qualify+ data use agreem5t 7z def9$ 9 subsection 7j771 protect$ heal? in=mation4 7#c7 ,cl>ification2 ,fee p]mitt$ 7,a7 ,9 g5]al ,no?+ 9 ?is p>agraph %all be con/ru$ z affect+ an individual's "r to access claims & paym5t records 9 ,,hipaa /&>d =mat1 9 accordance ) section #afd4ebd ( title #de1 ,code ( ,f$]al ,regulations4 7,b7 ,fee p]mitt$ ,if an individual or a p]sonal repres5tative ( ! individual reque/s a copy ( records 9 ,,hipaa /&>d =mat a heal? c>e cle>+h\se may *>ge a reasonable1 co/-bas$ fee s f> z su* fee is 9 accordance ) section #afd4ebd7;c77#d7 ( title #de1 ,code ( ,f$]al ,regulations4 7d7 ,compreh5sive records at ! reque/ ( an individual 7#a7 ,9 g5]al ,:5 a heal? c>e cle>+h\se receives a writt5 reque/ f an individual or ! p]sonal repres5tative ( ! individual = ! protect$ heal? in=mation ( ! individual1 ! cle>+h\se %all provide to ! individual a compreh5sive record ( su* in=mation 7across heal? c>e provid]s & heal? plans & longitud9al 9 scope71 unless ! cle>+h\se det]m9es 9 its sole discretion t provid+ a compreh5sive record is n te*nologically feasible4 7#b7 ,pur*ase f o!r cle>+h\ses ,9 prep>+ a compreh5sive record = an individual "u p>agraph 7#a71 a heal? c>e cle>+h\se may1 ) ! p]mission ( ! individual1 pur*ase ! protect$ heal? in=mation ( ! individual f "o or m o!r heal? cle>+h\ses 7& ! am\nt ( su* pur*ase may be includ$ 9 a fee t is fair m>ket value1 z def9$ 9 subsection 7j77#b71 *>g$ to ! individual4 7e7 ,situations n involv+ direct int]action ) individuals ,sections #afd4djj ?r\gh #afd4dad 7relat+ to brea* notification7 & sections #afd4ebj ?r\gh #afd4ebh 7relat+ to individual rights7 ( title #de1 ,code ( ,f$]al ,regulations1 %all apply to a heal? c>e cle>+h\se t engages 9 ! functions describ$ 9 subsection 7b77#c7 to ! ext5t t su* cle>+h\se has curr5t contact in=mation pursuant to direct int]action ) ! individual involv$4 ,if ! cle>+h\se does n h direct int]action ) ! individual involv$1 ! cle>+h\se %all provide notice ( any brea* ( unsecur$ protect$ heal? in=mation to ! cov]$ entity t does h direct int]action ) ! individual involv$4 ,! cle>+h\se %all n be requir$ to report a brea* if ! protect$ heal? in=mation is r5d]$ unusable1 unreadable1 or indeciph]able to unau?oriz$ p]sons ?r\gh ! use ( a te*nology or me?odology specifi$ by ! ,secret>y 9 ! guidance issu$ "u section #acdjb7;h77#b74 ,! cle>+h\se %all also provide a notice ( privacy practices on its website4 7f7 ,transition 7#a7 ,9 g5]al ,except :]e specifically /at$1 no?+ 9 ?is section %all be con/ru$ to apply to cle>+h\ses to ! exclusion ( o!r cov]$ entities or to provide a heal? c>e cle>+h\se great] au?ority to use & disclose protect$ heal? in=mation ?an t provid$ to ano!r cov]$ entity4 7#b7 ,exi/+ agreem5ts ,) respect to agreem5ts ent]$ into by a heal? c>e cle>+h\se prior to ! date ( enactm5t ( ?is section1 a provision ( su* an agreem5t t conflicts ) ?is section %all n h any legal =ce or effect4 ,! prec$+ s5t5ce may n be con/ru$ z affect+ any provision ( an agreem5t t does n conflict ) ?is section4 7g7 ,safe h>bor & cl>ification ( liability ,9 ! case ( a heal? c>e cle>+h\se t engages 9 a function describ$ 9 subsection 7b71 only t cle>+h\se may be held liable = a violation ( a ,,hipaa-relat$ provision 7& a cov]$ entity t provid$ data or data access to ! cle>+h\se %all n be liable = su* violations74 7h7 ,en=cem5t ,section #acdaj7;a77#b7 %all apply to ?is section 9 ! same mann] z su* section applies to p>ts #a & #b4 7i7 ,relation to o!r laws 7#a7 ,application ( ,,hite* rule ,section #acdba %all apply to ?is section 9 ! same mann] z su* section applies to p>ts #a & #b1 except to ! ext5t t su* section #acdba conc]ns section #aagh7;a77#b77;,b7 ( ! ,social ,security ,act4 7#b7 ,/ate laws reg>d+ unfair or deceptive acts or practices ,?is "p %all n be con/ru$ to preempt ! law ( any ,/ate t prohibits unfair or deceptive acts or practices or limit ! au?ority ( ,/ate attorneys g5]al to en=ce su* laws4 7j7 ,def9itions ,9 ?is "p3 7#a7 ,de-id5tifi$ ,! t]m de-id5tifi$1 ) respect to heal? in=mation1 means su* in=mation t is n individually id5tifiable z det]m9$ 9 accordance ) ! /&>ds "u section #afd4ead7;b7 ( title #de1 ,code ( ,f$]al ,regulations4 7#b7 ,fair m>ket value ,! t]m fair m>ket value means ! price t a p]son reasonably kn[l$geable & int]e/$ 9 buy+ a giv5 product or s]vice w\ld pay to a p]son reasonably kn[l$geable & int]e/$ 9 sell+ ! product or s]vice4 7#c7 ,heal? c>e cle>+h\se ,! t]m heal? c>e cle>+h\se has ! mean+ giv5 su* t]m 9 section #aaga ( ! ,social ,security ,act4 7#d7 ,,hipaa-relat$ provision ,! t]m ,,hipaa-relat$ provision means ! provisions ( ea* ( ! foll[+3 7,a7 ,?is subtitle4 7,b7 ,"p ,c ( title ,,xi ( ! ,social ,security ,act4 7,c7 ,regulations promulgat$ pursuant to sections #bfb7;a7 & #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif or ?is subtitle4 7#e7 ,individual ,! t]m individual1 ) respect to protect$ heal? in=mation1 has ! mean+ applicable "u section #afj4ajc ( title #de1 ,code ( ,f$]al ,regulations4 7#f7 ,qualify+ data use agreem5t ,! t]m qualify+ data use agreem5t means an agreem5t1 :i* may be electronic1 t-- 7,a7 e/abli%es ! p]mitt$ uses & disclosures ( protect$ heal? in=mation by ! recipi5t2 7,b7 limits su* uses & disclosures to ! orig9al purpose ( disclosure "u subsection 7b77#c77;,b72 & 7,c7 provides t ! data recipi5t w-- 7i7 n use or fur!r disclose ! in=mation o!r ?an z p]mitt$ by ! qualify+ data use agreem5t or z o!rwise requir$ by law2 7ii7 use appropriate safegu>ds to prev5t use or disclosure ( ! in=mation o!r ?an z provid$ = by ! qualify+ data use agreem5t2 & 7iii7 ensure t any ag5ts to :om x provides ! data agree to ! same re/rictions & conditions t apply to ! data recipi5t ) respect to su* in=mation4 4 7b7 ,regulations ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices %all promulgate regulations to c>ry out ! am5dm5t made by subsection 7a74 7c7 ,con=m+ am5dm5t ,section #aaga7b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;d7#b77 is am5d$ by ins]t+ be=e ! p]iod ! foll[+3 or receives a /&>d transaction f ano!r entity & processes or facilitates ! process+ ( heal? in=mation into non/&>d =mat or non/&>d data cont5t = ! receiv+ entity4 ,su* t]m also includes an entity t c>ries out su* process+ functions1 transmits /&>d heal? c>e claims1 transmits heal? c>e claim paym5ts or provides advice on su*1 & transmits any /&>d transactions on behalf ( a ,,hipaa-cov]$ entity & 9 addition1 engages 9 any au?ority ( su* entity describ$ 9 subsection 7b77#c7 ( section #acdea ( ! ,heal? ,in=mation ,te*nology = ,economic & ,cl9ical ,heal? ,act4