Mobile Health Record Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 1390 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 FEBRUARY 27, 2019 Mrs. BROOKS of Indiana (for herself and Ms. CLARKE of New York) intro- duced 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, prescrip- tions, tests, and diagnoses, through a mobile health record application of the individual’s choosing, and for other purposes. VerDate Sep 11 2014 00:29 Mar 08, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H1390.IH H1390 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 1390 IH Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Mobile Health Record 4 Act of 2019’’. 5 SEC. 2. FINDINGS; SENSE OF CONGRESS. 6 (a) FINDINGS.—Congress finds the following: 7 (1) The Centers for Medicare & Medicaid Serv- 8 ices’ (CMS) Blue Button 2.0 Program was an- 9 nounced in April 2018 to build upon CMS’s Blue 10 Button Program. 11 (2) The Blue Button 2.0 Program provides 4 12 years of Medicare part A, B, and D data for 53 mil- 13 lion Medicare beneficiaries through an Application 14 Programming Interface (API). The data contains a 15 variety of information including, but not limited to, 16 a list of a patient’s providers, prescriptions, tests, 17 and diagnoses. The Blue Button 2.0 Program re- 18 quires the use of CMS-approved applications to 19 allow beneficiaries to download coded data. 20 (3) Mobile applications currently exist that have 21 the power to decode the Medicare Blue Button data 22 and present it in a user-friendly, easy-to-read and 23 understand format. Prior to Blue Button 2.0, the 24 Blue Button Program allowed beneficiaries to 25 VerDate Sep 11 2014 00:29 Mar 08, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1390.IH H1390 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 1390 IH download such data, but the information was not de- 1 coded into the easy-to-read and understand format 2 that a mobile application provides. 3 (4) The Blue Button 2.0 Program was created 4 to empower patients with the use of these applica- 5 tions, but additional steps need to be taken in order 6 to ensure the program reaches its intended purpose 7 of providing patients with their personal medical 8 claim information to prevent harmful medical errors 9 and reducing redundant spending. 10 (5) According to a study published by Johns 11 Hopkins University in 2016, more than 250,000 12 deaths per year are due to medical error, making it 13 the third leading cause of death in the United 14 States. Further, millions of dollars are wasted on 15 duplicative or unnecessary tests and procedures. 16 (b) SENSE OF CONGRESS.—It is the sense of Con- 17 gress that the Centers for Medicare & Medicaid Services’ 18 Blue Button 2.0 Program has the potential to positively 19 influence patient behavior, improve patient safety and 20 health outcomes, and help reduce unnecessary health care 21 expenditures, but action needs to be taken to help the ini- 22 tiative meet the program’s goals. 23 VerDate Sep 11 2014 00:29 Mar 08, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1390.IH H1390 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 1390 IH SEC. 3. PROMOTING PATIENT ACCESS TO PERSONAL MED- 1 ICAL CLAIM INFORMATION, INCLUDING A PA- 2 TIENT’S PROVIDERS, PRESCRIPTIONS, TESTS, 3 AND DIAGNOSES, THROUGH THE USE OF MO- 4 BILE HEALTH RECORD APPLICATIONS. 5 (a) MEDICARE.—Title XVIII of the Social Security 6 Act (42 U.S.C. 1395 et seq.) is amended by adding at 7 the end the following new section: 8 ‘‘SEC. 1899C. MOBILE ACCESS TO PERSONAL MEDICAL IN- 9 FORMATION PROGRAM. 10 ‘‘(a) ESTABLISHMENT.— 11 ‘‘(1) IN GENERAL.—Not later than January 1, 12 2020, the Secretary shall establish a program to be 13 known as the ‘Mobile Access to Personal Medical In- 14 formation Program’ (in this section referred to as 15 the ‘Program’) for purposes of creating a developer- 16 friendly, standards-based API that enables individ- 17 uals entitled to benefits under part A or enrolled 18 under part B to connect their claims data to the ap- 19 plications, services, and research programs they 20 trust while allowing such individuals to retain full 21 control over how the copy of the data they receive 22 can be used and by whom. The Program shall pro- 23 vide such an individual access to the personal med- 24 ical claim information of the individual through a 25 mobile health record application of the individual’s 26 VerDate Sep 11 2014 00:29 Mar 08, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1390.IH H1390 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 1390 IH choice approved by the Secretary under subsection 1 (b). Such information shall be made available 2 through such application in a manner similar to how 3 such information is made available under the Blue 4 Button 2.0 program (or a successor program). 5 ‘‘(2) ENCOURAGING USE OF PROGRAM.—In car- 6 rying out the Program, the Secretary shall consider 7 establishing methods for encouraging individuals de- 8 scribed in paragraph (1) to access their personal 9 medical claim information under the Program. Such 10 methods may include— 11 ‘‘(A) providing individuals described in 12 paragraph (1) access to a one-time financial in- 13 centive to download for free or at a discounted 14 price a CMS-approved mobile health record ap- 15 plication of their choice that can be used to ac- 16 cess their personal medical claim information 17 under the Program; 18 ‘‘(B) paying a reasonable fee per download 19 to the application developer to be capped at a 20 fair market value; or 21 ‘‘(C) other methods determined appro- 22 priate by the Secretary. 23 For purposes of the previous sentence, the Secretary 24 shall consult with application developers, insurers, 25 VerDate Sep 11 2014 00:29 Mar 08, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1390.IH H1390 pamtmann on DSKBFK8HB2PROD with BILLS 6 •HR 1390 IH and other appropriate entities determined by the 1 Secretary, to establish appropriate methods of finan- 2 cial incentive payment for applications approved to 3 participate in the program. 4 ‘‘(b) MOBILE HEALTH RECORD APPLICATIONS.— 5 ‘‘(1) APPROVAL.—The Secretary shall establish 6 a process under which the Secretary, in consultation 7 with staff with appropriate technical expertise, ap- 8 proves mobile health record applications for use 9 under the Program. Such process shall include re- 10 quirements providing that such application— 11 ‘‘(A) demonstrates the capacity to provide 12 the personal medical claim information of an in- 13 dividual described in subsection (a) to such in- 14 dividual in an easily accessible format; 15 ‘‘(B) utilizes a machine-readable, struc- 16 tured, coded format conforming to a data con- 17 tent standard approved by the Secretary; 18 ‘‘(C) has the ability to aggregate data from 19 multiple sources; 20 ‘‘(D) is encrypted (or contains other data 21 security safeguards determined appropriate by 22 the Secretary) and conforms to other cybersecu- 23 rity standards and best practices determined 24 appropriate by the Secretary; 25 VerDate Sep 11 2014 00:29 Mar 08, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1390.IH H1390 pamtmann on DSKBFK8HB2PROD with BILLS 7 •HR 1390 IH ‘‘(E) provides for a mechanism through 1 which the Secretary may track the number of 2 times and frequency with which such individual 3 accesses the personal medical claim information 4 of such individual; 5 ‘‘(F) does not use a third-party service for 6 ad revenue or for any other means; and 7 ‘‘(G) meets such other requirements as 8 may be specified by the Secretary. 9 ‘‘(2) ANNUAL REVIEW OF APPROVAL.—The 10 Secretary shall, not less than annually and in con- 11 sultation with staff with appropriate technical exper- 12 tise, review each mobile health record application ap- 13 proved under paragraph (1) to determine whether 14 such application continues to meet the requirements 15 specified in such paragraph. The Secretary shall re- 16 voke the approval of any such application that fails 17 to meet such requirements. 18 ‘‘(c) INFORMATION ON PROGRAM.—The Secretary 19 shall, through the public website of the Centers for Medi- 20 care & Medicaid Services, mailed notices, through a notice 21 at the time of enrollment of an individual in part A or 22 part B, public awareness campaigns, the notice described 23 in section 1804(a), the provision of personalized preven- 24 tion plan services (as defined in section 1861(hhh)), or 25 VerDate Sep 11 2014 00:29 Mar 08, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1390.IH H1390 pamtmann on DSKBFK8HB2PROD with BILLS 8 •HR 1390 IH otherwise (as determined appropriate by the Secretary), 1 ensure that individuals described in subsection (a) receive 2 information not less than twice each year regarding the 3 Program, including a list of mobile health record applica- 4 tions approved under subsection (b)(1). 5 ‘‘(d) CYBERSECURITY AND DATA PRIVACY.— 6 ‘‘(1) CONSULTATION.—In carrying out the Pro- 7 gram, the Secretary shall consult with the National 8 Coordinator for Health Information Technology and 9 other Federal agencies determined appropriate by 10 the Secretary to ensure the compliance of entities 11 participating in the Program with all applicable pro- 12 visions of the regulations promulgated by the Sec- 13 retary under part C of title XI and section 264 of 14 the Health Insurance Portability and Accountability 15 Act of 1996. 16 ‘‘(2) ADDITIONAL CYBERSECURITY PROTEC- 17 TIONS.—In carrying out the Program, the Secretary 18 shall consult with appropriate Federal agencies, in- 19 cluding the National Institute for Standards and 20 Technology, and appropriate public-private partner- 21 ships (such as the Sector Coordinating Councils), in- 22 cluding the Healthcare and Public Health Sector Co- 23 ordinating Council, to ensure that relevant and ap- 24 plicable cybersecurity guidelines are followed when 25 VerDate Sep 11 2014 00:29 Mar 08, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1390.IH H1390 pamtmann on DSKBFK8HB2PROD with BILLS 9 •HR 1390 IH establishing the Program (including when estab- 1 lishing standards and best practices under sub- 2 section (b)(1)(D) and standards and criteria under 3 subsection (e)(1)(C)). 4 ‘‘(e) DEFINITIONS.—In this section: 5 ‘‘(1) MOBILE HEALTH RECORD APPLICATION.— 6 The term ‘mobile health record application’ means a 7 software application that— 8 ‘‘(A) runs on a mobile device (such as a 9 mobile phone or handheld computing platform); 10 ‘‘(B) allows an individual to access the in- 11 dividual’s personal medical claim information; 12 and 13 ‘‘(C) meets such cybersecurity and data se- 14 curity standards and criteria as the Secretary 15 may specify, which may be similar to such 16 standards and criteria used under the Blue 17 Button 2.0 program (or a successor program). 18 ‘‘(2) PERSONAL MEDICAL CLAIM INFORMA- 19 TION.—The term ‘personal medical claim informa- 20 tion’ means, with respect to an individual— 21 ‘‘(A) a list of claims for items and services 22 furnished to such individual payable under part 23 A or part B, including any prescriptions or 24 tests; 25 VerDate Sep 11 2014 00:29 Mar 08, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1390.IH H1390 pamtmann on DSKBFK8HB2PROD with BILLS 10 •HR 1390 IH ‘‘(B) a list of providers and suppliers who 1 furnished such items and services; 2 ‘‘(C) any diagnoses made by such providers 3 and suppliers; 4 ‘‘(D) Medicare Advantage encounter data 5 from an MA or MA–PD plan under part C; and 6 ‘‘(E) prescription drug event data.’’. 7 (b) MEDICAID.—Section 1903 of the Social Security 8 Act (42 U.S.C. 1396b) is amended by adding at the end 9 the following new subsection: 10 ‘‘(aa) PAYMENTS FOR MOBILE ACCESS TO PERSONAL 11 MEDICAL CLAIM INFORMATION.— 12 ‘‘(1) PAYMENTS.—In addition to payments oth- 13 erwise provided under subsection (a), in the case of 14 a State that elects to develop, or purchase from a 15 private entity, a mobile health record application 16 through which an individual enrolled under the State 17 plan (or a waiver of such plan) may access the per- 18 sonal medical claim information of such individual, 19 the Secretary shall pay to such State, for each quar- 20 ter beginning on or after the date of the enactment 21 of the Mobile Health Record Act of 2019, an 22 amount equal to 90 percent of so much of the sums 23 expended during such quarter as are attributable to 24 VerDate Sep 11 2014 00:29 Mar 08, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H1390.IH H1390 pamtmann on DSKBFK8HB2PROD with BILLS 11 •HR 1390 IH the development, or purchase, of such mobile health 1 record application. 2 ‘‘(2) DEFINITIONS.—In this subsection: 3 ‘‘(A) MOBILE HEALTH RECORD APPLICA- 4 TION.—The term ‘mobile health record applica- 5 tion’ has the meaning given such term in sec- 6 tion 1899C(e). 7 ‘‘(B) PERSONAL MEDICAL CLAIM INFORMA- 8 TION.—The term ‘personal medical claim infor- 9 mation’ means, with respect to a State and an 10 individual enrolled under the State plan (or a 11 waiver of such plan)— 12 ‘‘(i) a list of claims for items and 13 services furnished to such individual under 14 the State plan (or waiver), including any 15 prescriptions or tests; 16 ‘‘(ii) a list of providers and suppliers 17 who furnished such items and services; and 18 ‘‘(iii) any diagnoses made by such 19 providers and suppliers.’’. 20 Æ VerDate Sep 11 2014 00:29 Mar 08, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\H1390.IH H1390 pamtmann on DSKBFK8HB2PROD with BILLS