HB4331, the Access to Claims Data Act, would require the Secretary of Health and Human Services to create a process by January 1, 2026, allowing certain clinical data registries to request federal claims data for research and quality-improvement purposes. The bill is aimed at qualified clinical data registries and clinician-led clinical data registries, which could use the data to link claims information with clinical outcomes, assess provider performance, conduct scientifically valid analyses, and publish deidentified research and quality-improvement findings.
The bill primarily focuses on Medicare claims data, but it also gives HHS discretion to include Medicaid and CHIP claims data if appropriate. It specifies that the data request process may cover provider-specific, specialty-specific, state-specific, or nationwide claims data. The legislation also states that these registries do not need to be qualified entities or quasi-qualified entities to access the data under this new process, and it requires payment of a reasonable fee equal to the cost of making the data available, with fees deposited into the CMS Program Management Account.
Impact
If enacted, the bill would amend federal health data access practices by directing HHS to open a formal pathway for certain registries to obtain claims data from Medicare, and potentially Medicaid and CHIP, for research and quality improvement. It would not directly change benefit coverage or payment rules, but it would expand the use of federal claims data for clinical benchmarking, patient safety work, and outcomes research, while also creating a fee structure for data access and administration.
Sentiment
The bill appears to have a generally supportive, bipartisan-leaning policy purpose based on its sponsors and subject matter, with an emphasis on improving research, quality measurement, and patient safety through better data access. No committee transcript or vote record is available in the provided materials, so there is no recorded floor or committee sentiment beyond the bill’s stated intent and sponsorship.
Contention
The main policy tension in the bill is between expanding access to sensitive federal claims data for research and quality improvement and preserving privacy, data stewardship, and administrative control over those datasets. Another possible point of contention is the scope of access—particularly whether Medicaid and CHIP data should be included, which is left to HHS discretion—and whether allowing registries to bypass the usual qualified-entity or quasi-qualified-entity requirements could raise concerns about oversight, data security, or competitive fairness among data users.
Data on fully denied claims required to be submitted to the all-payer claims database, fee schedule for expanded access to data in the all-payer claims database established, and money appropriated.