Standards and protocols to improve patient matching

(a) In general Subtitle C of title XXX of the Public Health Service Act (42 U.S.C. 300jj–51 et seq.) is amended by adding at the end the following new section: 3023. Standards and protocols to improve patient matching (a) Establishing a uniform definition for patient match rate (1) In general Not later than 180 days after the date of enactment of this section, the Secretary shall, in consultation with health care providers, vendors of electronic health records and health information technology, patient groups, and other relevant stakeholders, develop a definition and standards for accurate and precise patient matching to track patient match rates and document improvements of patient matching over time. The Secretary shall ensure that such definition and standards for patient match rate account for— (A) duplicate records; (B) overlaid records; (C) instances of multiple matches found; and (D) mismatch rates within the same healthcare organizations and provider systems. (2) Review and update In consultation with health care providers, vendors of electronic health records and health information technology, patient groups, and other relevant stakeholders, the Secretary shall review and update the definition and standards developed under paragraph (1), as appropriate, not less frequently than once every 3 years to ensure that such definition and standards are consistent with updates and improvements in technologies and processes. (b) Development of a standard data set To improve patient matching (1) In general Not later than 180 days after the date of enactment of this section, subject to paragraph (2), the National Coordinator shall review the current data set in the United States Core Data for Interoperability and identify, define, and adopt the minimum data set needed to support the adoption of patient matching by entities, including health care providers, developers of health care information technology or certified health IT, or health information networks of exchange, at a rate of 99.9 percent. The National Coordinator shall include such minimum data set in the United States Core Data for Interoperability. (2) Development of data standards in United States core data for interoperability For purposes of improving interoperable health exchange, not later than 1 year after defining the minimum data set described in paragraph (1), the National Coordinator shall create, update, or adopt data standards for the data elements identified in the minimum data set and incorporate such standards into the United States Core Data for Interoperability. (3) Consultation required In identifying and defining the minimum data set described in paragraph (1) and creating, updating, or adopting data standards described in paragraph (2), the National Coordinator shall consult with— (A) health care providers; (B) vendors of electronic health records; (C) vendors of health information technology; (D) patient groups; (E) Federal agencies, including the National Institute of Standards and Technology, the Centers for Disease Control and Prevention, the Department of Defense, the National Institutes of Health, the Department of Veterans Affairs, the Social Security Administration, the Indian Health Service, and the Office for Civil Rights; (F) public health authorities within State, local, territorial, and Tribal; and (G) any other stakeholders the Secretary determines appropriate. (4) Rule of construction Nothing in this subsection shall be construed to require an entity to meet a minimum patient match rate of 99.9 percent.. (b) Incorporating the minimum data set for patient matching into certification requirements Section 3004(b) of subtitle B of title XXX of the Public Health Service Act (42 U.S.C. 300jj–14(b)) is amended by adding at the end the following new subparagraph: (4) Special rule (A) Incorporation of minimum data set into health it certification requirements Notwithstanding paragraph (3), the Secretary shall incorporate and adopt the minimum data set for patient matching established under section 3023 into the certification criteria adopted under this section not later than 180 days after such data set is finalized. (B) Incorporation of minimum data set into Medicare interoperability program requirements Not later than 24 months after the incorporation of the minimum data set for patient matching into the certification criteria as required in subparagraph (A), the Secretary shall incorporate and adopt such minimum data set for patient matching established under section 3023 into program requirements to promote the interoperability of certified EHR technology for entities participating in the Medicare program under title XVIII of the Social Security Act.. (c) Additional incentives To promote interoperability (1) In general Not later than 24 months after the incorporation and adoption of the minimum data set for patient matching into the program requirements to promote the interoperability of certified EHR technology for entities participating under the Medicare program under title XVIII of the Social Security Act as required in subparagraph (B) of section 3004(b)(4) of title XXX of the Public Health Service Act (42 U.S.C. 300jj–14(b)), the Administrator of the Centers for Medicare and Medicaid Services shall, through rulemaking, establish a voluntary bonus measure within the Medicare Promoting Interoperability Program for eligible providers who meet an accurate patient match rate (as defined under section 3023 of subtitle C of title XXX of the Public Health Service Act) of at least 90 percent or the rate determined under paragraph (4) to voluntary attest to and receive a payment adjustment for meeting such measure. (2) Special rule In establishing the voluntary bonus measure described in paragraph (1), the Administrator shall— (A) ensure that the total score for incentive payments or status as an eligible provider will not be negatively impacted if the eligible provider does not attest to an accurate patient match rate; and (B) ensure that the voluntary attestations regarding patient matching rates shall not be publicly disclosed. (3) Voluntary reporting program The National Coordinator, along with the Centers for Medicare and Medicaid Services and other Federal agencies determined appropriate by the Secretary, shall develop a voluntary reporting program for eligible providers to anonymously submit patient matching accuracy data to the Department of Health and Human Services. (4) Annual review of patient match rate (A) In general Utilizing the patient matching accuracy data described in paragraph (2) and any additional data sources available, the Administrator of the Centers of Medicare and Medicaid Services shall review and evaluate the patient match attestation rates annually to determine if such rate should be adjusted. (B) Adjustment The Administrator may adjust the patient match rate described in paragraph (1) if the Administrator determines that the patient match attestation rate should be adjusted to further incentivize the voluntary reporting of accurate patient match rates.