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Meaningful Access to Federal Health Plan Claims Data Act of 2021
12/31/2022, 5:36 AM
Summary of Bill HR 5394
This data would include information on the cost, quality, and outcomes of health care services provided under federal health plans. By making this data more accessible, the bill seeks to empower federal employees to make more informed decisions about their health care and to hold health plans accountable for the quality and cost of care they provide.
The bill also includes provisions to protect the privacy and security of health plan claims data, ensuring that individuals' personal health information is not improperly disclosed or used. Additionally, the bill requires OPM to establish standards for the format and content of health plan claims data to ensure consistency and usability. Overall, the Meaningful Access to Federal Health Plan Claims Data Act of 2021 aims to increase transparency and accountability in federal health plans, ultimately improving the quality and affordability of health care for federal employees and their dependents.
Congressional Summary of HR 5394
Meaningful Access to Federal Health Plan Claims Data Act of 2021
This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish a program that allows clinician-led clinical data registries to access Medicare claims data for purposes of research, quality of care measurement, and reporting. (Clinician-led clinical data registries are data repositories operated by clinician organizations and that collect information about particular diseases and related medical procedures and therapies.)
The new program must allow for various types of data queries, including provider, state, and nationwide claims data. Such data may be used for public reports about provider performance, specified nonpublic analyses (e.g., medical research), and fee-based data services. Registries must apply to the CMS for access. Additionally, registries and their authorized users must enter into data use agreements and are subject to monetary penalties for breaching such agreements.
The bill also allows for Medicare coverage of new and emerging items and services for purposes of evidence collection in relation to such items and services.
