,i #aaf? ,,congress #b;d ,session ,h4 ,r4 #hifg ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,decemb] #ae1 #bjbj,mr4 ,bey] introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committees on ,ways & ,means1 ,ov]sight & ,re=m1 ,arm$ ,s]vices1 & ,education & ,labor1 = 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 require ! ,secret>y ( ,heal? & ,human ,s]vices to aw>d a contract to an eligible nonpr(it entity to e/abli% & ma9ta9 a heal? c>e claims database = purposes ( l[]+ ,am]icans' heal? c>e co/s1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,f$]al ,all-,pay] ,claims ,database ,act ( #bjbj4 #b4 ,e/abli%m5t & ma9t5ance ( heal? c>e claims database to l[] heal? c>e co/s 7a7 ,9 g5]al ,n lat] ?an ! date t is #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is section z ! ,secret>y71 act+ ?r\gh ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices & 9 consultation ) ! ,secret>y ( ,labor1 %all aw>d a contract 9 accordance ) subsection 7b7 to an eligible nonpr(it entity describ$ 9 su* subsection = purposes ( c>ry+ out ! requirem5ts ( su* entity "u ?is section4 7b7 ,contract ) eligible nonpr(it entity 7#a7 ,competitive proc$ures ,! ,secret>y %all aw>d ! contract describ$ 9 subsection 7a7 to an eligible nonpr(it entity describ$ 9 p>agraph 7#b7 us+ full & op5 competition proc$ures pursuant to *apt] #cc ( title #da1 ,unit$ ,/ates ,code4 7#b7 ,eligible nonpr(it entity ,an eligible nonpr(it entity describ$ 9 ?is p>agraph is a nonpr(it entity t-- 7,a7 is gov]n$ by a bo>d t includes-- 7i7 repres5tatives ( ! academic rese>* community2 & 7ii7 individuals ) exp]tise 9 employ]-sponsor$ insurance1 rese>* us+ heal? c>e claims data1 & actu>ial analysis2 & 7,b7 conducts its bus9ess 9 an op5 & transp>5t mann] t provides ! opportunity = public comm5t on its activities4 7#c7 ,consid]ations ,9 aw>d+ a contract to an eligible nonpr(it entity "u ?is section1 ! ,secret>y %all consid] ! exp]i5ce ( ea* eligible nonpr(it entity 9-- 7,a7 collect+ & aggregat+ heal? c>e claims data1 ensur+ quality assurance & security ( su* claims data1 & secur+ su* claims data2 7,b7 support+ academic rese>* on heal? c>e co/s1 sp5d+1 & utilization = & by privately insur$ pati5ts2 7,c7 work+ ) l>ge heal? insurance issu]s1 gr\p heal? plans1 & ?ird-p>ty adm9i/rators ( gr\p heal? plans to assemble a heal? c>e claims database2 7,d7 effectively collaborat+ ) & engag+ /akehold]s to develop reports2 7,e7 meet+ budgets & timel9es1 includ+ ) respect to develop+ reports2 & 7,f7 facilitat+ ! creation (1 or support+1 ,/ate all-pay] claims databases4 7#d7 ,p]iod ( contract 7,a7 ,9 g5]al ,a contract aw>d$ "u ?is section %all be = a p]iod ( #e ye>s & may be r5ew$1 subject to ! full & op5 competition proc$ures describ$ 9 p>agraph 7#a74 7,b7 ,transition ( contract ,9 ! case t a contract is n r5ew$ = a subsequ5t #e-ye> p]iod "u subp>agraph 7,a7 aft] ! use ( ! full & op5 competition proc$ures describ$ 9 p>agraph 7#a71 ! ,secret>y %all require ! entity ^: contract is expir+ to transf] all data ma9ta9$ by ! heal? c>e claims database describ$ 9 p>agraph 7#e77;,a7 to ! entity to :om ! ,secret>y has aw>d$ a contract = ! subsequ5t #e-ye> p]iod4 ,! entity ^: contract is expir+ may n disclose su* data to any o!r entity or keep su* data aft] ! expiration ( su* contract4 7#e7 ,requirem5ts ( contract ,ea* contract aw>d$ "u ?is section %all require ! entity aw>d$ su* contract to c>ry out ea* ( ! foll[+3 7,a7 ,e/abli% & ma9ta9 a heal? c>e claims database 9 accordance ) ! requirem5ts ( ! ,,hipaa privacy regulation4 7,b7 ,ensure t su* heal? c>e claims database makes available data submitt$ "u subsection 7d7 9 accordance ) ! requirem5ts ( subsection 7c74 7,c7 ,9 ! case t ! contract is n r5ew$ aft] ! end ( ! #e-ye> p]iod ( ! contract1 c>ry out ! transf] ( data requir$ pursuant to p>agraph 7#d77;,b7 9 accordance ) a s*$ule & process det]m9$ by ! ,secret>y4 7,d7 ,comply ) ! ,,hipaa privacy regulation 9 ! same mann] & to ! same ext5t z su* regulation applies to a cov]$ entity 7z def9$ pursuant to su* regulation74 7,e7 ,/rictly limit /aff access to su* heal? c>e claims database to /aff ) appropriate tra9+1 cle>ance1 & backgr\nd *ecks1 & require su* /aff to und]go regul> privacy & security tra9+4 7,f7 ,ma9ta9 effective security /&>ds = transf]r+ data f su* heal? c>e claims database & mak+ su* data available to all individuals & entities :o are au?oriz$ us]s pursuant to subsection 7c77#b74 7,g7 ,adh]e to be/ security practices ) respect to ! managem5t & use ( su* data = heal? s]vices rese>*1 9 accordance ) applicable ,f$]al privacy law4 7,h7 ,report on ! security me?ods ( ! entity to-- 7i7 ! ,secret>y2 7ii7 ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions1 ! ,committee on ,f9ance1 & ! ,committee on ,comm]ce1 ,sci5ce1 & ,transportation ( ! ,s5ate2 & 7iii7 ! ,committee on ,education & ,labor1 ! ,committee on ,en]gy & ,comm]ce1 ! ,committee on ! ,judici>y1 & ! ,committee on ,ways & ,means ( ! ,h\se ( ,repres5tatives4 7c7 ,availability ( data f heal? c>e claims database 7#a7 ,9 g5]al ,subject to p>agraph 7#b71 ! entity ma9ta9+ ! heal? c>e claims database describ$ 9 subsection 7b77#e77;,a7 %all make available1 at co/1 ! data submitt$ "u subsection 7d7-- 7,a7 to pati5ts to in=m su* pati5ts ab\t ! co/1 quality1 & value ( _! heal? c>e2 7,b7 to heal? c>e provid]s & hospitals-- 7i7 to assi/ su* provid]s & hospitals 9 mak+ in=m$ *oices :ile provid+ heal? c>e2 & 7ii7 to enable su* provid]s & hospitals to improve heal? c>e s]vices provid$ to pati5ts & heal? c>e outcomes = su* pati5ts by b5*m>k+ _! p]=mance aga9/ t ( o!r heal? c>e provid]s & hospitals2 7,c7 to gr\p heal? plans & heal? insurance issu]s (f]+ individual or gr\p heal? insurance cov]age to assi/ su* gr\p heal? plans & heal? insurance issu]s 9 evaluat+ & r$uc+ heal? c>e co/s = enrollees ( su* gr\p heal? plans & individual or gr\p heal? insurance cov]age1 respectively2 7,d7 to ,/ates to facilitate ,/ate-l$ initiatives to l[] heal? c>e co/s & improve ! quality ( heal? c>e2 7,e7 to any ,/ate all-pay] claims database & regional heal? c>e claims database op]at$ pursuant to ! au?orization ( ea* ,/ate cov]$ by su* regional heal? c>e claims database2 7,f7 to any individual or entity conduct+ rese>*2 7,g7 to ! ,secret>y ( ,def5se = purposes ( c>ry+ out ! ,,tric>e program "u *apt] #ee ( title #aj1 ,unit$ ,/ates ,code2 7,h7 to ! ,director ( ! ,(fice ( ,p]sonnel ,managem5t = purposes ( c>ry+ out ! ,f$]al ,employees ,heal? ,b5efits ,program e/abli%$ "u *apt] #hi ( title #e1 ,unit$ ,/ates ,code2 & 7,i7 to ! ,director ( ! ,congressional ,budget ,(fice1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates1 ! ,executive ,director ( ! ,m$ic>e ,paym5t ,advisory ,commission1 & ! ,executive ,director ( ! ,m$icaid & ,,*ip ,paym5t ,advisory ,commission4 7#b7 ,au?orization = access to data 7,a7 ,9 g5]al ,! entity ma9ta9+ ! heal? c>e claims database describ$ 9 subsection 7b77#e77;,a7 may only make available ! data describ$ 9 p>agraph 7#a7 to an individual or entity describ$ 9 any ( subp>agraphs 7,a7 ?r\gh 7,f7 ( su* p>agraph if su* individual or entity submits an application to su* entity reque/+ au?orization = access to su* database 9 accordance ) ?is p>agraph4 7,b7 ,application ,an application "u ?is p>agraph %all be submitt$ at su* "t1 9 su* mann]1 & conta9+ su* in=mation z ! ,secret>y may require & %all include-- 7i7 9 ! case ( an individual or entity reque/+ access to ! heal? c>e claims database describ$ 9 subsection 7b77#e77;,a7 = rese>* purposes-- 7,i7 a description ( ! uses & me?odologies = evaluat+ heal? sy/em p]=mance us+ ! data f su* database2 & 7,,ii7 docum5tation ( approval ( su* rese>* purposes by an in/itutional review bo>d1 if applicable = a p>ticul> plan ( rese>*2 & 7ii7 9 ! case ( a gr\p heal? plan1 heal? insurance issu]1 ?ird-p>ty adm9i/rator ( a gr\p heal? plan1 or heal? c>e provid] reque/+ access to su* heal? c>e claims database = ! purpose ( quality improvem5t or co/-conta9m5t1 a description ( ! int5d$ uses = ! data f su* database4 7,c7 ,data use & confid5tiality agreem5t ,^u approval ( an application "u subp>agraph 7,b71 ! au?oriz$ us] %all ent] into a data use & confid5tiality agreem5t ) ! entity t approv$ su* application1 :i* %all include a prohibition on attempts to reid5tify & disclose protect$ heal? in=mation & propriet>y f9ancial in=mation4 ,9 ! case ( an approval ( an application = quality improvem5t or co/-conta9m5t purposes "u subp>agraph 7,b77ii71 access to data f ! heal? c>e claims database describ$ 9 subsection 7b77#e77;,a7 %all be provid$ 9 a =m & mann] su* t ! au?oriz$ us] may n obta9 individually id5tifiable price in=mation ) respect to direct competitors4 7#c7 ,availability ( reports & analyses bas$ on data 7,a7 ,9 g5]al ,subject to subp>agraph 7,b71 ! entity ma9ta9+ ! heal? c>e claims database describ$ 9 subsection 7b77#e77;,a71 9 consultation ) ! advisory committee conv5$ "u subsection 7e71 %all make available to all individuals & entities :o are au?oriz$ us]s pursuant to p>agraph 7#b7 any report or analysis bas$ on data f su* database1 includ+ aggregate data sets1 free ( *>ge4 7,b7 ,cu/omiz$ reports ,gr\p heal? plans may reque/ cu/omiz$ reports f ! entity ma9ta9+ ! heal? c>e claims database describ$ 9 subsection 7b77#e77;,a71 at co/1 b subject to ! requirem5ts ( ! ,,hippa privacy regulation4 7d7 ,submission ( data to heal? c>e claims database 7#a7 ,9 g5]al ,subject to p>agraphs 7#b7 & 7#c71 a gr\p heal? plan 7?r\gh its sponsor1 ?ird-p>ty adm9i/rator1 ph>macy b5efit manag]1 or o!r entity designat$ by ! gr\p heal? plan7 or a heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age %all electronically submit to ! heal? c>e claims database ma9ta9$ "u ?is section all claims data 7includ+ claims ) respect to treatm5t ( sub/ance use disord]s & prescription drug claims7 ) respect to ! plan or gr\p or individual heal? insurance cov]age1 respectively4 7#b7 ,scope ( in=mation & =mat ( submission ,! entity ma9ta9+ ! heal? c>e claims database "u ?is section1 9 consultation ) ! advisory committee conv5$ "u subsection 7e71 %all-- 7,a7 specify ! data elem5ts requir$ to be submitt$ "u p>agraph 7#a71 :i* %all include all data relat$ to transactions describ$ 9 subp>agraphs 7,a7 & 7,e7 ( section #aagc7;a77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;d-#b7;a77#b771 includ+ all data elem5ts normally pres5t 9 su* transactions :5 adjudicat$1 & enrollm5t in=mation2 7,b7 specify ! =m & mann] = submissions "u ?is subsection & ! hi/orical p]iod to be includ$ 9 ! initial submission2 & 7,c7 (f] an automat$ submission option to m9imize adm9i/rative burd5s relat+ to ! submission ( data "u ?is subsection4 7#c7 ,de-id5tification ( data ,! entity ma9ta9+ ! heal? c>e claims database "u ?is section1 9 consultation ) ! advisory committee conv5$ "u subsection 7e71 %all-- 7,a7 e/abli% a process "u :i* data is de-id5tifi$ 9 accordance ) section #afd4ead7;a7 ( title #de1 ,code ( ,f$]al ,regulations 7or any successor regulations71 :ile reta9+ ! ability to l9k data longitud9ally = ! purposes ( rese>* on co/ & quality & ! ability to complete risk adju/m5t & geographic analysis2 7,b7 ensure t any ?ird-p>ty subcontractors :o p]=m ! de-id5tification process describ$ 9 subp>agraph 7,a7 reta9 ! m9imum necess>y in=mation to p]=m su* process & adh]e to effective security & encryption practices 9 data /orage & transmission2 7,c7 /ore claims & o!r data collect$ "u ?is subsection only 9 de-id5tifi$ =m1 9 accordance ) section #afd4ead7;a7 ( title #de1 ,code ( ,f$]al ,regulations 7or any successor regulations72 & 7,d7 ensure t data is encrypt$1 9 accordance ) ! ,,hipaa privacy regulation4 7#d7 ,o!r data 7,a7 ,m$icaid data ,! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices %all submit all heal? c>e claims data ) respect to ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 & ! ,m$icaid program "u title ,,xix ( su* ,act 7#db ,u4,s4,c4 #acif et seq47 9 accordance ) scope1 =mat1 & de-id5tification requirem5ts applicable pursuant to p>agraphs 7#b7 & 7#c74 7,b7 ,,tric>e ,! ,secret>y ( ,def5se %all submit all heal? c>e claims data ) respect to ! ,,tric>e program "u *apt] #ee ( title #aj1 ,unit$ ,/ates ,code1 9 accordance ) scope1 =mat1 & de-id5tification requirem5ts applicable pursuant to p>agraphs 7#b7 & 7#c74 7,c7 ,,fehb ,! ,director ( ! ,(fice ( ,p]sonnel ,managem5t %all submit all heal? c>e claims data ) respect to ! ,f$]al ,employee ,heal? ,b5efits program 9 accordance ) scope1 =mat1 & de-id5tification requirem5ts applicable pursuant to p>agraphs 7#b7 & 7#c74 7,d7 ,/ate data ,! entity ma9ta9+ ! heal? c>e claims database "u ?is section may collect data f ,/ate all-pay] claims databases t seek access to su* heal? c>e claims database4 ,a ,/ate may require heal? insurance issu]s & o!r pay]s to submit claims data to a ,/ate-m&at$ all-pay] claims database1 provid$ t su* data is submitt$ 9 a =m & mann] e/abli%$ by ! ,secret>y4 ,a ,/ate may also require heal? insurance issu]s & o!r pay]s to submit claims data to ! heal? c>e claims database ma9ta9$ "u ?is section1 provid$ t su* data is submitt$ 9 a =m & mann] e/abli%$ by ! ,secret>y & consi/5t ) scope1 =mat1 & de-id5tification requirem5ts applicable pursuant to p>agraphs 7#b7 & 7#c74 7#e7 ,prohibition ,any individual or entity requir$ to submit data "u ?is subsection may n place any re/rictions on ! use ( su* data by au?oriz$ us]s "u subsection 7c77#b74 7e7 ,advisory committee 7#a7 ,9 g5]al ,n lat] ?an ! date t is #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all conv5e an advisory committee 7ref]r$ to 9 ?is subsection z ! ,committee7 to advise ! ,secret>y1 any entity aw>d$ a contract "u subsection 7b71 & ,congress on ! e/abli%m5t1 op]ations1 & use ( ! heal? c>e claims database e/abli%$ & ma9ta9$ "u ?is section4 7#b7 ,memb]%ip 7,a7 ,appo9tm5t ,9 accordance ) clause 7ii71 ! ,secret>y1 9 consultation ) ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates1 %all appo9t memb]s to ! ,committee :o h di/+ui%$ !mselves 9 ! fields ( heal? s]vices rese>*1 heal? economics1 heal? in=matics1 or ! gov]nance ( ,/ate all-pay] claims databases1 or :o repres5t organizations likely to submit data to or use ! heal? c>e claims database e/abli%$ & ma9ta9$ "u ?is section1 includ+ pati5ts1 heal? c>e provid]s1 gr\p heal? plans1 heal? insurance issu]s1 & ?ird-p>ty adm9i/rators ( gr\p heal? plans4 7,b7 ,composition ,= purposes ( clause 7i7-- 7i7 ! ,secret>y %all appo9t to ! ,committee-- 7,i7 "o memb] to s]ve z ! *air ( ! ,committee2 7,,ii7 ! ,assi/ant ,secret>y = ,plann+ & ,evaluation ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices2 7,,iii7 "o repres5tative f ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices2 7,,iv7 "o repres5tative f ! ,ag5cy = ,heal? ,rese>* & ,quality2 7,v7 "o repres5tative f ! ,(fice = ,civil ,rights ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices ) exp]tise 9 data privacy & security2 & 7,,vi7 "o repres5tative ( ! ,national ,c5t] = ,heal? ,/ati/ics2 & 7ii7 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all appo9t to ! ,committee-- 7,i7 "o repres5tative f an employ] t sponsors a gr\p heal? plan2 7,,ii7 "o repres5tative f an employee organization t sponsors a gr\p heal? plan2 7,,iii7 "o academic rese>*] ) exp]tise 9 heal? economics or heal? s]vices rese>*2 7,,iv7 "o pati5t advocate2 7,v7 "o repres5tative ( ,designat$ ,/&>ds ,ma9t5ance ,organizations nam$ by ! ,secret>y ( ,heal? & ,human ,s]vices to ma9ta9 /&>ds adopt$ "u regulations promulgat$ "u section #bfd7;c7 ( ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif 7#db ,u4,s4,c4 #acbj;d-#b note72 7,,vi7 "o repres5tative ) exp]tise 9 ! gov]nance ( ,/ate all-pay] claims databases2 & 7,,vii7 two additional memb]s4 7,c7 ,t]ms & vacancies ,memb]s ( ! ,committee %all s]ve ?ree-ye> t]ms on a /agg]$ basis4 ,a vacancy on ! ,committee %all be fill$ by appo9tm5t 9 a mann] consi/5t ) ! requirem5ts ( ?is subsection n lat] ?an #ij days aft] ! vacancy arises4 7#c7 ,duties ,! ,committee %all-- 7,a7 assi/ & advise ! ,secret>y on ! managem5t ( contracts aw>d$ "u subsection 7b72 7,b7 assi/ & advise entities aw>d$ su* contracts 9 e/abli%+-- 7i7 ! appropriate uses ( data by all individuals & entities :o are au?oriz$ us]s pursuant to subsection 7c77#b71 includ+ develop+ /&>ds = ! approval ( applications submitt$ pursuant to su* subsection2 & 7ii7 ! appropriate =mats & me?ods = mak+ available to ! public reports & analyses bas$ on ! heal? c>e claims database ma9ta9$ "u ?is section2 7,c7 conduct an annual review ( :e!r data f su* heal? c>e claims database 0 us$ accord+ to ! appropriate uses describ$ 9 subp>agraph 7,b77ii72 7,d7 report1 z appropriate1 to ! ,secret>y & ,congress on ! op]ations ( su* heal? c>e claims database & opportunities to bett] a*ieve ! objectives ( ?is section2 7,e7 e/abli% additional re/rictions on rese>*]s :o receive comp5sation f entities specifi$ by ! ,committee 9 ord] to protect propriet>y f9ancial in=mation2 & 7,f7 e/abli% objectives = rese>* & public report+4 7f7 ,fund+ 7#a7 ,initial fund+ ,!re are au?oriz$ to be appropriat$1 & !re are appropriat$1 out ( monies 9 ! ,treasury n o!rwise appropriat$1 #bj1jjj1jjj = fiscal ye> #bjba1 = ! implem5tation ( ! initial contract & e/abli%m5t ( ! database "u ?is section4 7#b7 ,ongo+ fund+ ,!re are au?oriz$ to be appropriat$ #ae1jjj1jjj = ea* ( fiscal ye>s #bjbb ?r\gh #bjbf1 = purposes ( c>ry+ out ?is section 7o!r ?an ! grant program "u subsection 7h774 7g7 ,annual report ,n lat] ?an ,m>* #a1 #bjbb1 & ,m>* #a ( ea* ye> !reaft]1 ! entity ) a contract 9 effect "u subsection 7b7 %all submit to ,congress & ! ,secret>y1 & make publicly available on an int]net website1 a report conta9+ a description (-- 7#a7 tr5ds 9 ! price1 utilization1 & total sp5d+ on heal? c>e s]vices1 includ+ a geographic analysis ( diff]5ces 9 su* tr5ds2 7#b7 limitations 9 ! data set2 7#c7 progress t[>ds ! objectives ( ?is section2 & 7#d7 ! p]=mance by ! entity ( ! duties requir$ "u su* contract4 7h7 ,grants to ,/ates 7#a7 ,9 g5]al ,! ,secret>y may aw>d grants to ,/ates = ! purpose ( e/abli%+ & ma9ta9+ ,/ate all-pay] claims databases t improve transp>5cy ( heal? c>e claims data4 7#b7 ,fund+ ,!re is au?oriz$ to be appropriat$ #ajj1jjj1jjj = ! p]iod ( fiscal ye>s #bjba ?r\gh #bjbh = ! purpose ( aw>d+ grants to ,/ates "u ?is subsection4 7i7 ,exemption f public disclosure 7#a7 ,9 g5]al ,data submitt$ to ! heal? c>e claims database "u subsection 7d7 %all n be consid]$ public records & %all be exempt f any ,f$]al law relat+ to public disclosure requirem5ts4 7#b7 ,re/rictions on uses = c]ta9 proce$+s ,su* data may n be subject to discov]y or admission z public in=mation or evid5ce 9 judicial or adm9i/rative proce$+s )\t ! cons5t ( ! affect$ p>ties4 7j7 ,def9itions ,9 ?is section3 7#a7 ,,hipaa privay regulation ,! t]m ,,hipaa privacy regulation has ! mean+ giv5 su* t]m 9 section #aahj7;b77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;d-#i7;b77#c774 7#b7 ,,phsa def9itions ,! t]ms gr\p heal? plan1 gr\p heal? insurance cov]age1 heal? insurance issu]1 & individual heal? insurance cov]age h ! mean+s giv5 su* t]ms 9 section #bgia ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#ia74 7#c7 ,protect$ heal? in=mation ,! t]m protect$ heal? in=mation has ! mean+ giv5 su* t]m 9 section #afj4ajc ( title #de1 ,code ( ,f$]al ,regulations 7or any successor regulations74 7#d7 ,propriet>y f9ancial in=mation ,! t]m propriet>y f9ancial in=mation-- 7,a7 means data t w\ld disclose ! t]ms ( a specific contract betwe5 an individual heal? c>e provid] or facility & a specific gr\p heal? plan1 ,m$icaid manag$ c>e organization or o!r manag$ c>e entity1 or heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age2 & 7,b7 does n include any bill+ or paym5t in=mation f claims betwe5 su* a provid] or facility & su* a heal? plan1 manag$ c>e organization or o!r manag$ c>e entity1 or heal? insurance issu]4 7k7 ,con=m+ am5dm5ts 7#a7 ,,phsa ,subp>t ,,ii ( "p ,a ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aa et seq47 is am5d$ by add+ at ! end ! foll[+ new section3 #bgcj4 ,heal? c>e claims database report+ requirem5t ,a gr\p heal? plan & a heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age %all comply ) ! provisions ( section #a7;d7 ( ! ,f$]al ,all-,pay] ,claims ,database ,act ( #bjbj4 4 7#b7 ,,erisa 7,a7 ,9 g5]al ,subp>t ,b ( "p #g ( subtitle ,b ( title ,i ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aahe et seq47 is am5d$ by add+ at ! end ! foll[+ new section3 #gaf4 ,heal? c>e claims database report+ requirem5t ,a gr\p heal? plan & a heal? insurance issu] (f]+ gr\p heal? insurance cov]age %all comply ) ! provisions ( section #a7;d7 ( ! ,f$]al ,all-,pay] ,claims ,database ,act ( #bjbj4 4 7,b7 ,cl]ical am5dm5t ,! table ( cont5ts 9 section #a ( su* ,act is am5d$ by ins]t+ aft] ! item relat+ to section #gad ! foll[+ new items3 ,sec4 #gae4 ,additional m>ket re=ms4 ,sec4 #gaf4 ,heal? c>e claims database report+ requirem5t4 4 7#c7 ,,irc 7,a7 ,9 g5]al ,sub*apt] ,b ( *apt] #ajj ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+ new section3 #ihaf4 ,heal? c>e claims database report+ requirem5t ,a gr\p heal? plan %all comply ) ! provisions ( section #a7;d7 ( ! ,f$]al ,all-,pay] ,claims ,database ,act ( #bjbj4 4 7,b7 ,cl]ical am5dm5t ,! table ( sections = su* sub*apt] is am5d$ by add+ at ! end ! foll[+ new items3 ,sec4 #ihae4 ,additional m>ket re=ms4 ,sec4 #ihaf4 ,heal? c>e claims database report+ requirem5t4 4 #c4 ,/udy & reports by ,comptroll] ,g5]al 7a7 ,/udy ,! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all conduct a /udy on-- 7#a7 ! p]=mance ( ea* entity aw>d$ a contract "u subsection 7b7 ( section #a2 7#b7 ! privacy & security ( any data submitt$ to su* entity "u subsection 7d7 ( su* section2 & 7#c7 ! co/s incurr$ by su* entity 9 p]=m+ duties "u su* a contract4 7b7 ,reports ,n lat] ?an two ye>s aft] ! effective date ( ! fir/ contract aw>d$ "u section #a7;b71 & aga9 n lat] ?an f\r ye>s aft] su* effective date1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ,congress a report conta9+ ! results ( ! /udy conduct$ "u subsection 7a71 toge!r ) recomm5dations = su* legislation & adm9i/rative action z ! ,comptroll] ,g5]al det]m9es appropriate4