Access to Claims Data Act

The Access to Claims Data Act would require the Secretary of Health and Human Services to create a formal process, by January 1, 2026, that allows certain clinical data registries to request federal claims data for research and quality improvement. Specifically, qualified clinical data registries (QCDRs) and clinician-led clinical data registries could request Medicare claims data, and, if deemed appropriate by the Secretary, Medicaid and CHIP data as well. The data would be used to link claims with clinical outcomes, conduct quality assessments and improvement activities, report results to providers and suppliers, perform risk-adjusted analyses, and publish research and quality-improvement findings (which may include deidentified, combined claims and outcomes data). Access would be provided at a reasonable, cost-based fee to CMS, with fees deposited into the CMS Program Management Account. Importantly, registries would not be required to be “qualified” or “quasi-qualified” entities to access the data.