AHCA Extends Deadline On Database Rule

Jan 5, 2018

The Agency for Health Care Administration agreed Thursday to extend by one week the deadline for health-insurance companies and HMOs to submit comments to the state on a proposed rule for a new all-payers claims database.

Testifying at a rule hearing, Florida Association of Health Plans Vice President and General Counsel Wences Troncoso asked the state to extend a Friday deadline for written comment by 20 days to give health plans and insurance companies additional time to review the proposed rule and a 93-page submission guideline manual that accompanies it.

“We want to make sure we thoroughly review the submission draft guidelines to make sure that we come out with a product that is acceptable to everyone,” Troncoso says.

Troncoso also testified that health plans were concerned with a requirement that HMOs and insurance companies submit to the statewide database health claims from 2014, 2015 and 2016. A law establishing the database didn't take effect until July 1, 2016, which makes the requirement retroactive, he said.

Tallahassee attorney Bruce Platt also testified at the hearing, telling regulators the 93-page manual includes information on submitting Medicare Advantage claims, even though the law establishing the database specifically excluded the claims.

Gov. Rick Scott championed increased health-care transparency in 2016, a year after a bruising legislative battle over expanding Medicaid access to uninsured, childless adults.

In lieu of expanding Medicaid access, Scott said he would help uninsured Floridians by working to lower the costs of health care. In response, the Legislature passed a bill authorizing an all-payers claims database and agreed to spend more than $4 million to get it up and running.

AHCA hopes to finalize the proposed rule and have health plans and insurance companies start submitting the claims to the statewide database this spring. AHCA has an agreement with Health Care Cost Institute, which will analyze the data and post it to a state website. AHCA Secretary Justin Senior said the goal is to post the average costs paid to every hospital and ambulatory surgical in the state for nearly 300 health-care services.