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2017 Session

Budget Amendments - SB900 (Member Request)

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Chief Patron: Carrico
APCD and Payment Reform Participation (language only)

Item 4-5.04 #1s

Item 4-5.04 #1s

Special Conditions and Restrictions on Expenditures
Goods and Services

Language

Page 561, after line 23, insert:

"m. MEDICAL SERVICES: Any entity that contracts with the Commonwealth or any department, agency or subdivision thereof to provide individual or group accident and sickness insurance policies or third party administration services to adjust or settle healthcare claims shall participate fully in otherwise voluntary health care data collection and payment reform initiatives designed to support health care value improvement in the Conunonwealth, including: (a) execution of a standard data submission and use agreement with the nonprofit organization maintaining the All-Payer Claims Database (APCD), as well as timely and complete submission of standard data elements on a par with other participating data suppliers to the APCD; and (b) joining with providers and other public and private payers in multi-stakeholder initiatives developing and testing common payment reform metrics and methodologies that reward value improvement, such as the CMS Comprehensive Primary Care Plus initiative."



Explanation

(This amendment requires providers contracting with the Commonwealth for health insurance or processing of health care claims to participate in health care data collection and payment reform initiatives designed to support health care value improvement.)