[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7272 Introduced in House (IH)]

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115th CONGRESS
  2d Session
                                H. R. 7272

To amend titles XVIII and XIX of the Social Security Act to promote the 
 ability of individuals entitled to benefits under part A or enrolled 
 under part B of the Medicare program and individuals enrolled under a 
State plan under the Medicaid program to access their personal medical 
   claim data, including their providers, prescriptions, tests, and 
     diagnoses, through a mobile health record application of the 
             individual's choosing, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           December 12, 2018

    Mrs. Brooks of Indiana (for herself and Ms. Clarke of New York) 
 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 amend titles XVIII and XIX of the Social Security Act to promote the 
 ability of individuals entitled to benefits under part A or enrolled 
 under part B of the Medicare program and individuals enrolled under a 
State plan under the Medicaid program to access their personal medical 
   claim data, including their providers, prescriptions, tests, and 
     diagnoses, through a mobile health record application of the 
             individual's choosing, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Mobile Health Record Act of 2018''.

SEC. 2. FINDINGS; SENSE OF CONGRESS.

    (a) Findings.--Congress finds the following:
            (1) The Centers for Medicare & Medicaid Services' (CMS) 
        Blue Button 2.0 Program was announced in April 2018 to build 
        upon CMS's Blue Button Program.
            (2) The Blue Button 2.0 Program provides 4 years of 
        Medicare part A, B, and D data for 53 million Medicare 
        beneficiaries through an Application Programming Interface 
        (API). The data contains a variety of information including, 
        but not limited to, a list of a patient's providers, 
        prescriptions, tests, and diagnoses. The Blue Button 2.0 
        Program requires the use of CMS-approved applications to allow 
        beneficiaries to download coded data.
            (3) Mobile applications currently exist that have the power 
        to decode the Medicare Blue Button data and present it in a 
        user-friendly, easy-to-read and understand format. Prior to 
        Blue Button 2.0, the Blue Button Program allowed beneficiaries 
        to download such data, but the information was not decoded into 
        the easy-to-read and understand format that a mobile 
        application provides.
            (4) The Blue Button 2.0 Program was created to empower 
        patients with the use of these applications, but additional 
        steps need to be taken in order to ensure the program reaches 
        its intended purpose of providing patients with their personal 
        medical claim information to prevent harmful medical errors and 
        reducing redundant spending.
            (5) According to a study published by Johns Hopkins 
        University in 2016, more than 250,000 deaths per year are due 
        to medical error, making it the 3rd leading cause of death in 
        the United States. Further, millions of dollars are wasted on 
        duplicative or unnecessary tests and procedures.
    (b) Sense of Congress.--It is the sense of Congress that the 
Centers for Medicare & Medicaid Services' Blue Button 2.0 Program has 
the potential to positively influence patient behavior, improve patient 
safety and health outcomes, and help reduce unnecessary health care 
expenditures, but action needs to be taken to help the initiative meet 
the program's goals.

SEC. 3. PROMOTING PATIENT ACCESS TO PERSONAL MEDICAL CLAIM INFORMATION, 
              INCLUDING A PATIENT'S PROVIDERS, PRESCRIPTIONS, TESTS, 
              AND DIAGNOSES, THROUGH THE USE OF MOBILE HEALTH RECORD 
              APPLICATIONS.

    (a) Medicare.--Title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.) is amended by adding at the end the following new 
section:

``SEC. 1899C. MOBILE ACCESS TO PERSONAL MEDICAL INFORMATION PROGRAM.

    ``(a) Establishment.--
            ``(1) In general.--Not later than January 1, 2020, the 
        Secretary shall establish a program to be known as the `Mobile 
        Access to Personal Medical Information Program' (in this 
        section referred to as the `Program') for purposes of creating 
        a developer-friendly, standards-based API that enables 
        individuals entitled to benefits under part A or enrolled under 
        part B to connect their claims data to the applications, 
        services, and research programs they trust while allowing such 
        individuals to retain full control over how the copy of the 
        data they receive can be used and by whom. The Program shall 
        provide such an individual access to the personal medical claim 
        information of the individual through a mobile health record 
        application of the individual's choice approved by the 
        Secretary under subsection (b). Such information shall be made 
        available through such application in a manner similar to how 
        such information is made available under the Blue Button 2.0 
        program (or a successor program).
            ``(2) Encouraging use of program.--In carrying out the 
        Program, the Secretary shall consider establishing methods for 
        encouraging individuals described in paragraph (1) to access 
        their personal medical claim information under the Program. 
        Such methods may include--
                    ``(A) providing individuals described in paragraph 
                (1) access to a one-time financial incentive to 
                download for free or at a discounted price a CMS-
                approved mobile health record application of their 
                choice that can be used to access their personal 
                medical claim information under the Program;
                    ``(B) paying a reasonable fee per download to the 
                application developer to be capped at a fair market 
                value; or
                    ``(C) other methods determined appropriate by the 
                Secretary.
        For purposes of the previous sentence, the Secretary shall 
        consult with application developers, insurers, and other 
        appropriate entities determined by the Secretary, to establish 
        appropriate methods of financial incentive payment for 
        applications approved to participate in the program.
    ``(b) Mobile Health Record Applications.--
            ``(1) Approval.--The Secretary shall establish a process 
        under which the Secretary, in consultation with staff with 
        appropriate technical expertise, approves mobile health record 
        applications for use under the Program. Such process shall 
        include requirements providing that such application--
                    ``(A) demonstrates the capacity to provide the 
                personal medical claim information of an individual 
                described in subsection (a) to such individual in an 
                easily accessible format;
                    ``(B) utilizes a machine-readable, structured, 
                coded format conforming to a data content standard 
                approved by the Secretary;
                    ``(C) has the ability to aggregate data from 
                multiple sources;
                    ``(D) is encrypted (or contains other data security 
                safeguards determined appropriate by the Secretary) and 
                conforms to other cybersecurity standards and best 
                practices determined appropriate by the Secretary;
                    ``(E) provides for a mechanism through which the 
                Secretary may track the number of times and frequency 
                with which such individual accesses the personal 
                medical claim information of such individual;
                    ``(F) does not use a third-party service for ad 
                revenue or for any other means; and
                    ``(G) meets such other requirements as may be 
                specified by the Secretary.
            ``(2) Annual review of approval.--The Secretary shall, not 
        less than annually and in consultation with staff with 
        appropriate technical expertise, review each mobile health 
        record application approved under paragraph (1) to determine 
        whether such application continues to meet the requirements 
        specified in such paragraph. The Secretary shall revoke the 
        approval of any such application that fails to meet such 
        requirements.
    ``(c) Information on Program.--The Secretary shall, through the 
public website of the Centers for Medicare & Medicaid Services, mailed 
notices, through a notice at the time of enrollment of an individual in 
part A or part B, public awareness campaigns, the notice described in 
section 1804(a), the provision of personalized prevention plan services 
(as defined in section 1861(hhh)), or otherwise (as determined 
appropriate by the Secretary), ensure that individuals described in 
subsection (a) receive information not less than twice each year 
regarding the Program, including a list of mobile health record 
applications approved under subsection (b)(1).
    ``(d) Cybersecurity and Data Privacy.--
            ``(1) Consultation.--In carrying out the Program, the 
        Secretary shall consult with the National Coordinator for 
        Health Information Technology and other Federal agencies 
        determined appropriate by the Secretary to ensure the 
        compliance of entities participating in the Program with all 
        applicable provisions of the regulations promulgated by the 
        Secretary under part C of title XI and section 264 of the 
        Health Insurance Portability and Accountability Act of 1996.
            ``(2) Additional cybersecurity protections.--In carrying 
        out the Program, the Secretary shall consult with appropriate 
        Federal agencies, including the National Institute for 
        Standards and Technology, and appropriate public-private 
        partnerships (such as the Sector Coordinating Councils), 
        including the Healthcare and Public Health Sector Coordinating 
        Council, to ensure that relevant and applicable cybersecurity 
        guidelines are followed when establishing the Program 
        (including when establishing standards and best practices under 
        subsection (b)(1)(D) and standards and criteria under 
        subsection (e)(1)(C)).
    ``(e) Definitions.--In this section:
            ``(1) Mobile health record application.--The term `mobile 
        health record application' means a software application that--
                    ``(A) runs on a mobile device (such as a mobile 
                phone or handheld computing platform);
                    ``(B) allows an individual to access the 
                individual's personal medical claim information; and
                    ``(C) meets such cybersecurity and data security 
                standards and criteria as the Secretary may specify, 
                which may be similar to such standards and criteria 
                used under the Blue Button 2.0 program (or a successor 
                program).
            ``(2) Personal medical claim information.--The term 
        `personal medical claim information' means, with respect to an 
        individual--
                    ``(A) a list of claims for items and services 
                furnished to such individual payable under part A or 
                part B, including any prescriptions or tests;
                    ``(B) a list of providers and suppliers who 
                furnished such items and services;
                    ``(C) any diagnoses made by such providers and 
                suppliers;
                    ``(D) Medicare Advantage encounter data from an MA 
                or MA-PD plan under part C; and
                    ``(E) prescription drug event data.''.
    (b) Medicaid.--Section 1903 of the Social Security Act (42 U.S.C. 
1396b) is amended by adding at the end the following new subsection:
    ``(aa) Payments for Mobile Access to Personal Medical Claim 
Information.--
            ``(1) Payments.--In addition to payments otherwise provided 
        under subsection (a), in the case of a State that elects to 
        develop, or purchase from a private entity, a mobile health 
        record application through which an individual enrolled under 
        the State plan (or a waiver of such plan) may access the 
        personal medical claim information of such individual, the 
        Secretary shall pay to such State, for each quarter beginning 
        on or after the date of the enactment of the Mobile Health 
        Record Act of 2018, an amount equal to 90 percent of so much of 
        the sums expended during such quarter as are attributable to 
        the development, or purchase, of such mobile health record 
        application.
            ``(2) Definitions.--In this subsection:
                    ``(A) Mobile health record application.--The term 
                `mobile health record application' has the meaning 
                given such term in section 1899C(e).
                    ``(B) Personal medical claim information.--The term 
                `personal medical claim information' means, with 
                respect to a State and an individual enrolled under the 
                State plan (or a waiver of such plan)--
                            ``(i) a list of claims for items and 
                        services furnished to such individual under the 
                        State plan (or waiver), including any 
                        prescriptions or tests;
                            ``(ii) a list of providers and suppliers 
                        who furnished such items and services; and
                            ``(iii) any diagnoses made by such 
                        providers and suppliers.''.
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