Health DATA Act of 2026
- Bill Number
- H.R. 9486
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Status
- Introduced
- Latest Action
- 2026-06-25: Referred to the House Committee on Education and Workforce.
- Last Updated
- 2026-07-06T13:38:28Z
AI-Generated Summary
Purpose This legislation amends the Employee Retirement Income Security Act of 1974 (ERISA) to enhance transparency in group health plan data, strengthen audit rights, expand fiduciary responsibilities over data, and prohibit discrimination based on such data.
Key Provisions
- Audit Rights and Transparency: Requires contracts between group health plans and service providers (including providers, networks, third-party administrators, and pharmacy benefit managers) to grant plans the ability to audit de-identified claims and encounter data. Contracts may not impose unreasonable limits on audits, data access, disclosure of pricing terms in value-based or capitated arrangements, overpayment recovery, or auditor selection.
- Privacy Protections: Mandates that data sharing comply with HIPAA privacy rules and related regulations, restricting use and disclosure of protected health information.
- Civil Penalties: Authorizes the Secretary of Labor to impose penalties of $10,000 per day for violations of data access rules and $100 per day per affected participant for discrimination violations.
- Gag Clause Attestations: Requires the Secretary to collect attestations related to data transparency and ensures no conflicts of interest in submissions.
- Fiduciary Duty Expansion: Broadens the definition of a fiduciary to include authority over the use, management, or safeguarding of plan-generated data.
- Anti-Discrimination Rules: Prohibits employers, plan sponsors, administrators, and fiduciaries from discriminating against participants or beneficiaries based on plan data, with enforcement through ERISA remedies and equitable relief.
Significant Changes to Existing Law
- Introduces new contractual requirements for data access under ERISA Section 408(b)(2).
- Adds Section 524 to ERISA for data-based discrimination protections.
- Updates fiduciary definitions in Section 3(21) and enforcement provisions in Section 502.
- Modifies Section 506 to centralize collection of attestations.
Potential Impacts
- Government Agencies: Increases oversight duties for the Department of Labor in collecting attestations, enforcing penalties, and monitoring compliance.
- Citizens/Participants: Provides greater access to plan data for verification of costs and compliance, along with protections against data-driven discrimination.
- International Relations: No direct effects identified.
Main Stakeholders Affected
- Group health plans and their participants or beneficiaries.
- Employers, plan sponsors, administrators, and fiduciaries.
- Service providers, including health care providers, networks, third-party administrators, and pharmacy benefit managers.
Notable Legal, Constitutional, or Political Implications
- Strengthens ERISA's fiduciary and anti-discrimination frameworks while explicitly preserving existing federal and state privacy and civil rights laws, such as HIPAA, GINA, the ADA, and civil rights statutes.
- Introduces new civil enforcement mechanisms without altering constitutional structures.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Recent Actions
- 2026-06-25: Referred to the House Committee on Education and Workforce.
- 2026-06-25: Introduced in House
- 2026-06-25: Introduced in House
Bill Versions
- Health Data Access, Transparency, and Affordability Act of 2026 — issued 2026-06-25 — PDF (11 pages)