# What the Meaningful Access to Federal Health Plan Claims Data Act Does

This bill creates a new way for medical research organizations called "clinician-led clinical data registries" to get access to Medicare and health insurance claims data. Think of these registries as specialized databases that doctors and researchers use to track how different treatments work and whether patients are getting better care. Right now, these organizations say they can't get the data they need easily enough, so this bill aims to fix that problem.

Here's what changes: The government would set up a streamlined process where these medical registries can request claims data—information about what treatments patients received, what they cost, and what happened to patients afterward. Instead of going through complicated existing programs that take a long time, registries would get a decision on their request within 60 days. Once approved, they'd have access to this data for at least five years before needing to reapply. The data would be delivered within 30 days of a request, and registries could ask for specific information like data about particular doctors, medical specialties, states, or the whole country.

The bill also lets these registries use the data they receive to publish public reports about how well doctors and hospitals are performing, and they can sell access to this information to researchers and other authorized users—though they can't use it for marketing. All of this comes with strict privacy protections and rules about how the data can be used. If someone misuses the data, they could face penalties up to $100 per patient affected. Additionally, the bill includes a separate provision allowing Medicare to cover newer medical treatments while data is being collected to prove whether they actually work, as long as the evidence collection happens through approved registries and takes no more than five years.

Meaningful Access to Federal Health Plan Claims Data Act of 2021

Bucshon, Larry

Meaningful Access to Federal Health Plan Claims Data Act of 2021 This bill requires the Centers for Medicare &amp; 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.