2019 Session

Budget Amendments - HB1700 (Member Request)

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Chief Patron: Garrett
Funding for Mandatory All Payer Claims Database

Item 293 #2h

Item 293 #2h

First Year - FY2019 Second Year - FY2020
Health and Human Resources
Department of Health FY2019 $0 FY2020 $1,150,000 GF

Page 306, line 1, strike "$21,239,583" and insert "$22,389,583".

Page 309, line 17, strike "$25,000" and insert "$1,175,000".


(This amendment provides $1.2 million from the general fund the second year to provide state funding for the Virginia All Payer Claims Database (APCD). The APCD's purpose is to facilitate data-driven, evidence-based improvements in access, quality, and cost of health care. The APCD is also intended to promote and improve public health through the understanding of health care expenditure patterns and operation and performance of the health care system. Proposed legislation would convert Virginia's voluntary APCD to a mandatory APCD requiring the submission of data from all non-self funded ERISA plans and providing a process for self-funded ERISA plans to opt-in to the APCD. Across the nation there are 18 statewide APCDs. Most are fully funded by the state, especially those states operating a mandatory APCD. Virginia's is the largest to date to be fully implemented. APCD data includes paid health care claims from commercial health insurance companies, and government programs such as Medicare and Medicaid. Claims cover care provided to Virginians regardless of venue such as physician office, pharmacy, hospital inpatient care, surgical centers and other treatment sites. The APCD was designed and is now supporting a variety of Virginia Department of Health (VDH) population health programs including asthma, antibiotic uses and Clostridium Difficile infections. There are 77 users of the APCD within VDH. VHI provides training and technical assistance to these users. The Department of Medical Assistance Services (DMAS) also uses the APCD to submit data and analyze claims of Medicaid recipients. A companion amendment provides funding for the DMAS portion of the APCD, because it is entitled to a federal match.)