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29 U.S.C. § 1191d — Standardized reporting format

Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1191d — Standardized reporting format

**(a) In general** Not later than 1 year after December 27, 2020, the Secretary shall establish (and periodically update) a standardized reporting format for the voluntary reporting, by group health plans to State All Payer Claims Databases, of medical claims, pharmacy claims, dental claims, and eligibility and provider files that are collected from private and public payers, and shall provide guidance to States on the process by which States may collect such data from such plans in the standardized reporting format. **(b) Consultation** (1) **Advisory Committee** — Not later than 90 days after December 27, 2020, the Secretary shall convene an Advisory Committee (referred to in this section as the “Committee”), consisting of 15 members to advise the Secretary regarding the format and guidance described in paragraph (1).11 So in original. Probably should be “subsection (a).” (2) **Membership** (A) *Appointment* — In accordance with subparagraph (B), not later than 90 days after December 27, 2020, the Secretary, in coordination with the Secretary of Health and Human Services, shall appoint under subparagraph (B)(iii), and the Comptroller General of the United States shall appoint under subparagraph (B)(iv), members who have distinguished themselves in the fields of health services research, health economics, health informatics, data privacy and security, or the governance of State All Payer Claims Databases, or who represent organizations likely to submit data to or use the database, including patients, employers, or employee organizations that sponsor group health plans, health care providers, health insurance issuers, or third-party administrators of group health plans. Such members shall serve 3-year terms on a staggered basis. Vacancies on the Committee shall be

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Stable record: federal_law:legal_authorities:record_usc_0557425c938334ed77e52115
Source file: Laws/federal/codes/united-states-code/title-29/section-1191d-standardized-reporting-format--efa50bcbdc.md
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Source location: Title 29, Chapter 18, § 1191d; chapter-018-employee-retirement-income-security-program.md

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**(a) In general** Not later than 1 year after December 27, 2020, the Secretary shall establish (and periodically update) a standardized reporting format for the voluntary reporting, by group health plans to State All Payer Claims Databases, of medical claims, pharmacy claims, dental claims, and eligibility and provider files that are collected from private and public payers, and shall provide guidance to States on the process by which States may collect such data from such plans in the standardized reporting format. **(b) Consultation** (1) **Advisory Committee** — Not later than 90 days after December 27, 2020, the Secretary shall convene an Advisory Committee (referred to in this section as the “Committee”), consisting of 15 members to advise the Secretary regarding the format and guidance described in paragraph (1).11 So in original. Probably should be “subsection (a).” (2) **Membership** (A) *Appointment* — In accordance with subparagraph (B), not later than 90 days after December 27, 2020, the Secretary, in coordination with the Secretary of Health and Human Services, shall appoint under subparagraph (B)(iii), and the Comptroller General of the United States shall appoint under subparagraph (B)(iv), members who have distinguished themselves in the fields of health services research, health economics, health informatics, data privacy and security, or the governance of State All Payer Claims Databases, or who represent organizations likely to submit data to or use the database, including patients, employers, or employee organizations that sponsor group health plans, health care providers, health insurance issuers, or third-party administrators of group health plans. Such members shall serve 3-year terms on a staggered basis. Vacancies on the Committee shall be filled by appointment consistent with this paragraph not later than 3 months after the vacancy arises. (B) *Composition* — The Committee shall be comprised of— (i) the Assistant Secretary of Employee Benefits and Security Administration of the Department of Labor, or a designee of such Assistant Secretary; (ii) the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services, or a designee of such Assistant Secretary; (iii) members appointed by the Secretary, in coordination with the Secretary of Health and Human Services, including— (I) 1 member to serve as the chair of the Committee; (II) 1 representative of the Centers for Medicare & Medicaid Services; (III) 1 representative of the Agency for Healthcare Research and Quality; (IV) 1 representative of the Office for Civil Rights of the Department of Health and Human Services with expertise in data privacy and security; (V) 1 representative of the National Center for Health Statistics; (VI) 1 representative of the Office of the National Coordinator for Health Information Technology; and (VII) 1 representative of a State All-Payer 22 So in original. Definition in subsec. (c) does not contain hyphen in “All Payer”. Claims Database; (iv) members appointed by the Comptroller General of the United States, including— (I) 1 representative of an employer that sponsors a group health plan; (II) 1 representative of an employee organization that sponsors a group health plan; (III) 1 academic researcher with expertise in health economics or health services research; (IV) 1 consumer advocate; and (V) 2 additional members. (3) **Report** — Not later than 180 days after December 27, 2020, the Committee shall report to the Secretary, the Committee on Health, Education, Labor, and Pensions of the Senate, and the Committee on Energy and Commerce and the Committee on Education and Labor of the House of Representatives. Such report shall include recommendations on the establishment of the format and guidance described in subsection (a). **(c) State All Payer Claims Database** In this section, the term “State All Payer Claims Database” means, with respect to a State, a database that may include medical claims, pharmacy claims, dental claims, and eligibility and provider files, which are collected from private and public payers. **(d) Authorization of appropriations** To carry out this section, there are authorized to be appropriated $5,000,000 for fiscal year 2021, to remain available until expended or, if sooner, until the date described in subsection (e). **(e) Sunset** Beginning on the date on which the report is submitted under subsection (b)(3), subsection (b) shall have no force or effect.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 247d–11 — State All Payer Claims Databases

**(a) In general** The Secretary shall make one-time grants to eligible States for the purposes described in subsection (b). **(b) Uses** A State may use a grant received under subsection (a) for one of the following purposes: (1) To establish a State All Payer Claims Database. (2) To improve an 11 So in original. existing State All Payer Claims Databases.1 **(c) Eligibility** To be eligible to receive a grant under subsection (a), a State shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary specifies, including, with respect to a State All Payer Claims Database, at least specifics on how the State will ensure uniform data collection and the privacy and security of such data. **(d) Grant period and amount** Grants awarded under this section shall be for a period of 3-years,22 So in original. Probably should be “3 years,”. and in an amount of $2,500,000, of which $1,000,000 shall be made available to the State for each of the first 2 years of the grant period, and $500,000 shall be made available to the State for the third year of the grant period. **(e) Authorized users** (1) **Application** — An entity desiring authorization for access to a State All Payer Claims Database that has received a grant under this section shall submit to the State All Payer Claims Database an application for such access, which shall include— (A) in the case of an entity requesting access for research purposes— (i) a description of the uses and methodologies for evaluating health system performance using such data; and (ii) documentation of approval of the research by an institutional review board, if applicable for a particular plan of research; or (B) in the case of an entity such as an employer, h

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Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1191d — Standardized reporting format

Page 615 TITLE 29—LABOR § 1191d 1 So in original. Probably should be ‘‘subsection (a).’’ 2 So in original. Definition in subsec. (c) does not contain hy- phen in ‘‘All Payer’’. 18001(b)(3) of Pub. L. 114–255, set out as a note under section 1167 of this title. EFFECTIVE DATE OF 2008 AMENDMENT Amendment by Pub. L. 110–233 applicable with re- spect to group health plans for plan years beginning after the date that is one year after May 21, 2008, see section 101(f)(2) of Pub. L. 110–233, set out as a note under section 1132 of this title. EFFECTIVE DATE Section applicable with respect to group health plans for plan years beginning after June 30, 1997, except as otherwise provided, see section 101(g) of Pub. L. 104–191, set out as a note under section 1181 of this title. § 1191c. Regulations The Secretary, consistent with section 104 of the Health Care Portability and Accountability Act of 1996, may promulgate such regulations as may be necessary or appropriate to carry out the provisions of this part. The Secretary may promulgate any interim final rules as the Sec- retary determines are appropriate to carry out this part. (Pub. L. 93–406, title I, § 734, formerly § 707, as added Pub. L. 104–191, title I, § 101(a), Aug. 21, 1996, 110 Stat. 1951; renumbered § 734, Pub. L. 104–204, title VI, § 603(a)(3), Sept. 26, 1996, 110 Stat. 2935.) Editorial Notes REFERENCES IN TEXT Section 104 of the Health Care Portability and Ac- countability Act of 1996, referred to in text, probably means section 104 of the Health Insurance Portability and Accountability Act of 1996, Pub. L. 104–191, which is set out as a note under section 300gg–92 of Title 42, The Public Health and Welfare. Statutory Notes and Related Subsidiaries EFFECTIVE DATE Section applicable

Source: Supplied 2024 U.S. Code historical extraction · 29 U.S.C. § 1191d

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