Access to Claims Data Act

This bill tells the U.S. Department of Health and Human Services to set up, by January 1, 2026, a simple way for certain doctor-led data groups to request health insurance “claims” records. These records are the billing details from Medicare, and possibly Medicaid and the Children’s Health Insurance Program if the department decides to include them. The goal is to help measure care quality, improve patient safety, and support research. Any research that’s shared can use combined data without personal information.

The groups can link billing records with patient outcome information to find what works best. They don’t need a separate, special certification to get this data under this program. The data can be focused on specific providers, specialties, states, or the whole country. There will be a reasonable fee that only covers the cost to provide the data.

• Who is affected: Doctor-led clinical data registries; health care providers; Medicare patients, and possibly Medicaid/CHIP if included.
• What changes: Easier access to claims records to study care quality, link to outcomes, and share de-identified results. No extra certification is required for these registries.
• When: The access process must be in place by January 1, 2026.