Title 29LaborRelease 119-73

§1191d Standardized reporting format

Title 29 › Chapter CHAPTER 18— - EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM › Subchapter SUBCHAPTER I— - PROTECTION OF EMPLOYEE BENEFIT RIGHTS › Subtitle Subtitle B— - Regulatory Provisions › Part part 7— - group health plan requirements › Subpart Subpart C— - General Provisions › § 1191d

Last updated Apr 6, 2026|Official source

Summary

The Secretary must create and update a single, standard file format within 1 year after December 27, 2020, so group health plans can voluntarily report medical, pharmacy, and dental claims plus eligibility and provider information to State All-Payer Claims Databases. The Secretary must also give States directions on how to collect that data in the standard format. Within 90 days after December 27, 2020, the Secretary must set up a 15-member advisory committee to help design the format and guidance. The committee includes certain federal health officials and other members appointed by the Secretary and the Comptroller General, such as representatives of employers, employee organizations, researchers, consumer advocates, and a State All-Payer Claims Database. Members serve staggered 3-year terms and vacancies must be filled within 3 months. The committee must send a report with recommendations to the Secretary and certain Congressional committees within 180 days after December 27, 2020. Up to $5,000,000 is authorized for fiscal year 2021 to carry out this work, available until spent or until the committee’s report is submitted. Once the report is filed, the committee requirement ends.

Full Legal Text

Title 29, §1191d

Labor — Source: USLM XML via OLRC

(a)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)(1)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)(A)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)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)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)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)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)Beginning on the date on which the report is submitted under subsection (b)(3), subsection (b) shall have no force or effect.

Legislative History

Notes & Related Subsidiaries

Statutory Notes and Related Subsidiaries

Change of Name

Committee on Education and Labor of House of Representatives changed to Committee on Education and the Workforce of House of Representatives by House Resolution No. 5, One Hundred Eighteenth Congress, Jan. 9, 2023.

Reference

Citations & Metadata

Citation

29 U.S.C. § 1191d

Title 29Labor

Last Updated

Apr 6, 2026

Release point: 119-73