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Health DATA Act of 2026
Introduced Jun 25, 2026 · Last action Jun 25, 2026 — Referred to the House Committee on Education and Workforce.
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Summary
This legislation is called the Health DATA Act of 2026. Referred to the House Committee on Education and Workforce.
Full bill text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9486 Introduced in House (IH)]
<DOC>
119th CONGRESS
2d Session
H. R. 9486
To amend the Employee Retirement Income Security Act of 1974 to
increase transparency of group health plan data, prevent
discrimination, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 25, 2026
Mr. Takano introduced the following bill; which was referred to the
Committee on Education and Workforce
_______________________________________________________________________
A BILL
To amend the Employee Retirement Income Security Act of 1974 to
increase transparency of group health plan data, prevent
discrimination, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Health Data Access, Transparency,
and Affordability Act of 2026'' or ``Health DATA Act of 2026''.
SEC. 2. INCREASING TRANSPARENCY OF GROUP HEALTH PLAN DATA.
(a) Group Health Plan Audit Rights.--
(1) In general.--Section 408(b)(2) of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1108(b)(2))
is amended by inserting after subparagraph (C) the following:
``(D) No contract or arrangement for services, and
no extension or renewal of such a contract or
arrangement, between a group health plan (as defined in
section 733(a)) and any other entity, including a
health care provider (including a health care
facility), network or association of providers, service
provider offering access to a network of providers,
third-party administrator, or entity providing pharmacy
benefit management services, is reasonable within the
meaning of this paragraph unless such contract or
arrangement--
``(i) allows the group health plan to audit
all de-identified claims and encounter
information or data described in section
724(a)(1)(B), provided that such information or
data has been deidentified in accordance with
section 164.514 of title 45, Code of Federal
Regulations (or successor regulations), to--
``(I) ensure that such entity
complies with the terms of the plan,
the terms of the contract or
arrangement for services, and the
requirements of this title; and
``(II) determine the reasonableness
of compensation received by such
entity; and
``(ii) does not--
``(I) unreasonably limit the number
of audits permitted during a given
period of time;
``(II) limit the number of de-
identified claims and encounter
information or data that the group
health plan may access during an audit;
``(III) limit the disclosure of
pricing terms for value-based payment
arrangements or capitated payment
arrangements, including--
``(aa) payment calculations
and formulas;
``(bb) quality measures;
``(cc) contract terms;
``(dd) payment amounts;
``(ee) measurement periods
for all incentives; and
``(ff) other payment
methodologies used by an
entity, including a health care
provider (including a health
care facility), network or
association of providers,
service provider offering
access to a network of
providers, third-party
administrator, or entity
providing pharmacy benefit
management services;
``(IV) limit the disclosure of
overpayments and overpayment recovery
terms;
``(V) limit the right of the group
health plan to select an auditor;
``(VI) otherwise limit or unduly
delay by greater than 60 calendar days
after the date of request the group
health plan from auditing any such de-
identified claims and encounter
information or data; or
``(VII) permit the entity to charge
a fee beyond the reasonable direct
costs to provide the required
information and otherwise comply and
assist with an audit request.''.
(2) Privacy requirements.--
(A) In general.--Section 408(b)(2) of the Employee
Retirement Income Security Act of 1974 (29 U.S.C.
1108(b)(2)), as amended by paragraph (1), is further
amended by adding at the end the following:
``(E) Privacy requirements.--
``(i) In general.--An entity shall--
``(I) provide data or information
under subparagraph (D) in a manner
consistent with--
``(aa) the privacy
regulations promulgated under
section 13402(a) of the Health
Information Technology for
Clinical Health Act (42 U.S.C.
17932(a)); and
``(bb) the privacy
regulations promulgated under
the Health Insurance
Portability and Accountability
Act of 1996 in part 160 and
subparts A and E of part 164 of
title 45, Code of Federal
Regulations (or successor
regulations); and
``(II) to the extent such data or
information constitutes protected
health information, restrict the use
and disclosure of such information for
purposes of such privacy regulations.
``(ii) Restriction.--A group health plan
shall comply with section 164.504(f) of title
45, Code of Federal Regulations (or a successor
regulation), and a plan sponsor shall act in
accordance with the terms of the agreement
described in such section.''.
(b) Civil Enforcement.--
(1) In general.--Subsection (c) of section 502 of such Act
(29 U.S.C. 1132) is amended by adding at the end the following:
``(14) In the case of an agreement between a group health
plan and a health care provider (including a health care
facility), network or association of providers, service
provider offering access to a network of providers, third-party
administrator, entity providing pharmacy benefit management
services, or other service provider that violates the
provisions of section 724, the Secretary may assess a civil
penalty against such provider, network or association of
providers, service provider offering access to a network of
providers, third-party administrator, entity providing pharmacy
benefit management services, or other service provider in the
amount of $10,000 for each day during which such violation
continues. Such penalty shall be in addition to other penalties
as may be prescribed by law.''.
(2) Penalty collection.--Paragraph (6) of section 502(a) of
such Act, is amended to read as follows:
``(6) by the Secretary to collect any civil penalty that
the Secretary has imposed or assessed pursuant to this
title;''.
(c) Improving Collection of Gag Clause Attestations.--
(1) In general.--Section 506 of such Act (29 U.S.C. 1136)
is amended by adding at the end the following:
``(d) Attestations Relating to Group Health Plan Data.--
Notwithstanding subsection (a) of this section, the Secretary shall
collect the attestations required to be submitted under section
724(a)(3). The Secretary shall ensure that any service provider
submitting such an attestation on behalf of a group health plan does
not have any conflicts of interest with regard to such attestation.''.
(2) Conforming amendment.--Section 506(a) of such Act (29
U.S.C. 1136(a)) is amended by striking ``In order'' and
inserting ``Subject to subsection (d), in order''.
SEC. 3. FIDUCIARY DUTY WITH RESPECT TO PLAN DATA.
Section 3(21)(A)(iii) of the Employee Retirement Income Security
Act (29 U.S.C. 1002(21)(A)(iii)) is amended by striking ``such plan.''
and inserting the following: ``such plan, including any authority over
the use, management, disposition, or safeguarding of data generated,
used, or maintained by the plan or a service provider to the plan in
connection with the administration of benefits or management of plan
assets.''.
SEC. 4. PREVENTING DISCRIMINATION BASED ON PLAN DATA.
(a) In General.--Part 5 of subtitle B of title I of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1131 et seq.) is
amended by adding at the end the following:
``SEC. 524. PREVENTING DISCRIMINATION BASED ON PLAN DATA.
``(a) In General.--It shall be unlawful for a person specified in
subsection (c) to discharge, fine, suspend, expel, discipline, or
discriminate against, including by failing to meet the requirements of
subsection (a) or (b) of section 702 (related to discrimination in
eligibility and premiums for participation in group health plans), a
participant or beneficiary on the basis of information or data
described in section 724.
``(b) Enforcement.--
``(1) In general.--The provisions of section 502 shall be
applicable in the enforcement of this section, except that in
any action brought under subsection (a)(1)(B) of such section
in relation to data or information described in section 724, a
participant or beneficiary may not be required to exhaust
administrative remedies prior to bringing such action.
``(2) Equitable relief.--In applying section 502 for the
purposes of this section, the term `equitable relief' shall
include any relief necessary to restore a participant or
beneficiary to the position they would have occupied but for a
violation of subsection (a).
``(3) Civil monetary penalty.--
``(A) In general.--In the case of a violation of
subsection (a) by a person, the Secretary may assess a
civil monetary penalty against such person.
``(B) Amount.--The amount of the civil monetary
penalty imposed by subparagraph (A) shall be $100 for
each day in the noncompliance period with respect to
each participant or beneficiary to whom such violation
of subsection (a) relates.
``(C) Noncompliance period.--For the purposes of
this subparagraph, the term `noncompliance period'
means, with respect to any violation of subsection (a),
the period--
``(i) beginning on the date such violation
occurs; and
``(ii) ending on the date such violation is
corrected.
``(c) Specified Person.--A person specified in this subsection is
any of the following:
``(1) An employer.
``(2) A plan sponsor.
``(3) A plan administrator.
``(4) A plan fiduciary.''.
(b) Rule of Construction.--Nothing in this Act, or the amendments
made by this Act, shall be construed to limit the application of any
Federal or State privacy or civil rights law, including the HIPAA
privacy regulations, the Genetic Information Nondiscrimination Act of
2008 (Public Law 110-233) (including the amendments made by such Act),
the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.),
section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), section
1557 of the Patient Protection and Affordable Care Act (42 U.S.C.
18116), title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d), and
title VII of the Civil Rights Act of 1964 (42 U.S.C. 2000e).
(c) Clerical Amendment.--The table of contents in section 1 of the
Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et
seq.) is amended by inserting after the item relating to section 523
the following:
``Sec. 524. Preventing discrimination based on plan data.''.
<all>Official legislative text sourced from the public record (cached on CivicsHQ).
Official source
View the original bill, actions, and full legislative record on Congress.gov.
Status
In Committee
- 1Introduced
- 2Committee
- 3Floor
- 4Passed
- 5Signed
Timeline reflects current normalized status only. Full action history is not yet stored in the API.
Sponsors
- Rep. Takano, Mark [D-CA-39]DHouseCA
Cosponsors
No cosponsors on record.
Votes
Voting records are not yet available for this bill.