S. 5520: Standardizing Cancer Recommendations for Earlier Evaluation and Navigation of Screenings Act

This bill would direct federal health officials to create a standardized, machine-readable framework for cancer screening recommendations. In plain terms, it would turn cancer screening guidance from organizations like the U.S. Preventive Services Task Force and the National Cancer Institute into a format that health software can read and use automatically.

What the framework would do

Within one year of enactment, the National Coordinator for Health Information Technology would have to create this framework in consultation with federal public health and cancer experts. The framework would use factors such as age, sex, and high-risk conditions to help determine what cancer screenings a person should get. It would be updated every year.

The recommendations would have to be available in a machine-readable form so electronic health systems can use them to build patient-facing tools. The bill says this format must work with common data standards used in health IT, including mCODE or USCDI.

Privacy requirements

The bill says the federal government must follow existing privacy laws, including HIPAA rules, when carrying out these activities. It also states that nothing in the bill would allow unauthorized use, disclosure, or re-identification of personal health information.

Changes to health IT certification

Within five years, the Secretary of Health and Human Services would have to require certified health information technology to include functions that apply the new cancer screening framework. This would let software determine whether an individual has completed recommended cancer screenings.

The bill also adds privacy-related requirements for that functionality. It would need to:

• Use only the minimum necessary patient data, such as age, sex, and high-risk factors;
• Give patients clear information about how their data is used to generate screening recommendations; and
• Allow patients to access, review, and request changes to their health information, consistent with privacy laws.

Guidance for health plans

Within two years, the Secretary of Health and Human Services would have to issue guidance encouraging certain health plans to use technology that applies the cancer screening framework. This guidance would apply to:

• Medicaid managed care organizations and certain related entities;
• Medicare Advantage plans; and
• Qualified health plans sold through Affordable Care Act exchanges.

The guidance would also encourage health plans to let consumers opt in to certified electronic health record technology that includes the new cancer screening functionality.

Research and pilot projects

The bill would also let the Patient-Centered Outcomes Research Institute support research, pilot projects, implementation work, and dissemination efforts related to interoperable health technology. These efforts could include computable clinical guidelines, decision support tools, patient-facing decision aids, and systems that help identify people who may be eligible for preventive services or clinical research.

Relevant Companies

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