Access to Claims Data Act

Summary#

The Access to Claims Data Act would require the HHS Secretary to set up a process by January 1, 2026 that lets certain clinical data registries request claims data. Registries may receive Medicare claims data and, if the Secretary allows, Medicaid and CHIP claims. The data can be linked with clinical outcomes to support quality assessments, risk-adjusted analyses, and research. Registries would not have to be "qualified entities" to access the data. The bill allows publishing deidentified combined claims and clinical outcomes data and permits HHS to charge a reasonable fee equal to the cost of providing the data.

What it means for you#

• If you run or work with a qualified clinical data registry or a clinician-led registry, this bill would create a path to request claims data to link with clinical records for quality work and research.
• If you are a provider or supplier, registries could analyze and report quality assessments about care given to providers and suppliers.
• If you are a patient, the bill allows registries to publish deidentified combined claims and clinical outcome data; the bill text does not provide additional public details about patient consent or other privacy protections beyond deidentification.

Expenses#

The bill says data must be provided for a reasonable fee equal to the cost of making the data available. Any fee collected would be deposited into the Centers for Medicare & Medicaid Services Program Management Account. No publicly available information on specific fee amounts or total program costs is provided in the bill text.

Proponents' View#

The bill states its purpose is to facilitate research and quality improvement by allowing registries to link claims data with clinical outcomes, run scientifically valid, risk-adjusted analyses, report results to providers and suppliers, and publish deidentified research and quality improvement analyses.

Opponents' View#

No publicly available information.