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State nears detailed information on health charges

Thursday, June 20, 2019   (0 Comments)
Posted by: DCMS
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The News Service of Florida
By NSF Staff


Florida health care regulators now say that a much-promised website to help residents shop for health care will have specific information about what individual facilities charge by this fall.

The site has had limited value because state officials have had trouble getting claims data. But that has changed, and Agency for Health Care Administration spokesman Patrick Manderfield said the state expects to have needed claims data by the end of June. That means, he said, the state should have a website with county level facility-specific cost information by this fall. That’s about three years after a bill took effect that gave the state the green light to collect the data and establish the website.

The Legislature approved the creation of what is known as an all-payer claims database in 2016, requiring companies that write coverage in the state employees’ health-insurance program or participate in the Medicaid managed-care program to submit claims data to the state’s vendor, Health Care Cost Institute. 

In addition to creating the database, lawmakers agreed to spend millions of dollars on it. But the state was slow to implement the rules needed to carry out the program.

Moreover, Florida-based companies, including Florida Blue, had concerns over the privacy of sensitive information and ownership of the data. The concerns stemmed, in part, from the fact that Health Care Cost Institute, known as HCCI, was founded by three insurance companies, Humana, Aetna and UnitedHealthcare.

The privacy and ownership issues were resolved, Florida Blue spokeswoman Toni Woods said, when AHCA “clarified that issuers remain owners of their own submitted data.”

HCCI, which has been paid $4.3 million, refused to comment and referred all questions to the Agency for Health Care Administration. Even without the detailed data, Manderfield said there have been more than 64,000 hits on the Florida Health Price Finder website.