H.R. 9805House118th Congress (2023-2025)In Committee

Access to Claims Data Act

Introduced September 25, 2024

AI-Generated Summary

Updated January 20, 2026 at 7:23 PM UTC

The Access to Claims Data Act directs the Secretary of Health and Human Services to create a process, by January 1 2025, that lets qualified clinical data registries and clinician‑led registries obtain federal health‑plan claims data. The goal is to enable researchers and quality‑improvement programs to link claims with clinical outcomes, assess provider performance, and publish findings. The law covers Medicare claims and, if deemed appropriate, Medicaid and CHIP claims, affecting registries, health‑care providers, and ultimately patients.

Key Provisions

  • HHS must establish a process by Jan 1 2025 for qualified clinical data registries or clinician‑led registries to request federal claims data.
  • The data that can be requested includes Medicare claims and, at HHS’s discretion, Medicaid and State Children’s Health Insurance Program claims, and may be broken down by provider, specialty, state, or nationwide.
  • Registries are not required to meet the “qualified entity” or “quasi‑qualified entity” definitions to access the data.
  • Requested data can be used to link with clinical outcomes, conduct quality assessments and improvement activities, and publish de‑identified research analyses.
  • A reasonable fee covering only the cost of providing the data may be charged, with any fees deposited into the CMS Program Management Account.

Legislative Activity

Stay on top of the latest movement without scrolling through every action

2 earlier actions
HouseCommittee Latest Action

Referred to the Subcommittee on Health.

December 17, 2024

View full timeline
HouseIntro Referral

Introduced in House

September 25, 2024

HouseIntro Referral

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

September 25, 2024

HouseCommittee

Referred to the Subcommittee on Health.

December 17, 2024

Bill Text

Latest available legislative text

Reading Mode
Latest
Introduced in HouseIssued September 25, 2024

I

118th CONGRESS

2d Session

H. R. 9805

IN THE HOUSE OF REPRESENTATIVES

September 25, 2024

Mr. Bucshon (for himself, Ms. Schrier, and Mr. Kilmer) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement.

1.

Short title

This Act may be cited as the Access to Claims Data Act.

2.

Expanded access to claims data to facilitate research and quality improvement

(a)

In general

Not later than January 1, 2025, the Secretary of Health and Human Services shall establish a process to allow a qualified clinical data registry under section 1848(m)(3)(E) of the Social Security Act (42 U.S.C. 1395w–4(m)(3)(E)) or a clinician-led clinical data registry under section 4005 of the 21st Century Cures Act (P.L. 114–255) to request claims data described in subsection (b) (in a form and manner determined to be appropriate by the Secretary) for the purposes of—

(1)

linking such data with clinical outcomes data;

(2)

conducting quality assessments and quality improvement activities of providers of services (as defined in subsection (u) of section 1861 of the Social Security Act (42 U.S.C. 1395x) and suppliers (as defined in subsection (d) of such section), reporting the results of such assessments and activities to such providers and suppliers, and performing risk-adjusted, scientifically valid analyses and research to support quality improvement or patient safety; and

(3)

publishing research and quality improvement analyses, which may include deidentified combined claims and clinical outcomes data.

(b)

Claims data described

For purposes of subsection (a), the claims data described in this subsection—

(1)

are—

(A)

claims data under the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.); and

(B)

if the Secretary determines appropriate, claims data under the Medicaid program under title XIX of such Act (42 U.S.C. 1396 et seq.) and the State Children’s Health Insurance Program under title XXI of such Act (42 U.S.C. 1397aa et seq.); and

(2)

may include provider-specific claims data, clinical specialty-specific claims data, State-specific claims data, or nationwide claims data.

(c)

Treatment of qualified clinical data registries and clinician-Led clinical data registries

For the purposes of this section, qualified clinical data registries and clinician-led clinical data registries shall not be required to be qualified entities, as defined in section 1874(e)(2) of the Social Security Act (42 U.S.C. 1395kk(e)(2)), or quasi-qualified entities, to access claims data pursuant to subsection (a).

(d)

Fee

Data described in subsection (b) shall be made available to a qualified clinical data registry or clinician-led clinical data registry under this section at a reasonable fee equal to the cost of making such data available. Any fee collected pursuant to the preceding sentence shall be deposited into the Centers for Medicare & Medicaid Services Program Management Account.