II 111th CONGRESS 1st Session S. 974 IN THE SENATE OF THE UNITED STATES May 5, 2009 Mr. Martinez introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XIX of the Social Security Act to require the Secretary of Health and Human Services to make certain de-identified information collected under the Medicaid Statistical Information System publicly available on the Internet.

1.

Short title

This Act may be cited as the Medicaid Accountability through Transparency Act of 2009.

2.

Medicaid Internet-based transparency program

(a)

In general

Title XIX of the Social Security Act, as amended by section 203(d) of the Children's Health Insurance Program Reauthorization Act of 2009 (Public Law 111–3), is amended by adding at the end the following new section:

1943.

Internet-based transparency program

(a)

In General

Not later than one year after the date of the enactment of this section, the Secretary shall implement a program under which the Secretary shall make available through the public Internet website of the Department of Health and Human Services non-aggregated information on individuals collected under the Medicaid Statistical Information System described in section 1903(r)(1)(F) insofar as such information has been de-identified in accordance with regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996. In implementing such program, the Secretary shall ensure that— (1)the information made so available is in a format that is easily accessible, useable, and understandable to the public, including individuals interested in improving the quality of care provided to individuals eligible for items and services under this title, researchers, health care providers, and individuals interested in reducing the prevalence of waste and fraud under this title; (2)the information made so available is as current as deemed practical by the Secretary and shall be updated at least once per calendar quarter; (3)to the extent feasible— (A)all hospitals, nursing homes, clinics, and large physician practices included in such information that are identifiable by name to individuals who access the information through such program; and (B)all individual health care providers not described in subparagraph (A), including physicians and dentists, are identifiable by unique identifier numbers that are disclosed only to appropriate officials within the Department of Health and Human Services and the State involved; and (4)the Secretary periodically solicits comments from a sampling of individuals who access the information through such program on how to best improve the utility of the program. (b)

Use of Contractor

For purposes of implementing the program under subsection (a) and ensuring the information made available through such program is periodically updated, the Secretary may select and enter into a contract with a public or private entity meeting such criteria and qualifications as the Secretary determines appropriate. (c)

Annual reports

Not later than 2 years after the date of the enactment of this section and annually thereafter, the Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Finance of the Senate a report on the progress of the program under subsection (a), including on the extent to which information made available through the program is accessed and the extent to which comments received under subsection (a)(4) were used during the year involved to improve the utility of the program. (d)

Incentives for Compliance with Existing State Requirements

If the Secretary determines that one of the 50 States or the District of Columbia has not fully and properly complied with section 1903(r)(1)(F), including any encounter data requirements, for any period beginning after the date that is one year after the date of the enactment of this section, the Secretary shall reduce the amount paid to the State or the District of Columbia, respectively, under section 1903(a) by $25,000 for each such day. Such reduction shall be made unless— (1)the State or the District of Columbia, respectively, demonstrates to the Secretary’s satisfaction that the State made a good faith effort to comply; (2)not later than 60 days after the date of a finding that the State or the District of Columbia, respectively, has not fully and properly complied with section 1903(r)(1)(F), the State or the District of Columbia, respectively, submits to the Secretary (and the Secretary approves) a corrective action plan to implement such a program; and (3)not later than 12 months after the date of such submission (and approval), the State or the District of Columbia, respectively, fulfills the terms of such corrective action plan. The Secretary shall transfer the amount of any reduction under this subsection to the fund established under subsection (e).(e)

Funding

(1)

Medicaid Internet-based Transparency Fund

The Secretary shall establish a fund to be known as the Medicaid Internet-based Transparency Fund, consisting of such amounts as may be transferred to such Fund under subsection (d) and such amounts as may be appropriated to such Fund under paragraph (3). (2)

Expenditures from Fund

Amounts in the Medicaid Internet-based Transparency Fund shall be available to the Secretary only for purposes of carrying out this section. (3)

Authorization of appropriations

There is authorized to be appropriated to the Medicaid Internet-based Transparency Fund $10,000,000 for fiscal year 2009, to remain available until expended.

. (b)

Feasibility report on including SCHIP information in Internet-based transparency program

Not later than 2 years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to the Committee on Energy and Commerce of the House of Representative and the Committee on Finance of the Senate a report on the feasibility, potential costs, and potential benefits of making publicly available through an Internet-based program de-identified payment and patient encounter information for items and services furnished under title XXI of the Social Security Act which would not otherwise be included in the information collected under the Medicaid Statistical Information System described in section 1903(r)(1)(F) of such Act and made available under section 1943 of such Act, as added by subsection (a).