SENATE BILL 403

51st legislature - STATE OF NEW MEXICO - first session, 2013

INTRODUCED BY

Linda M. Lopez

AN ACT

RELATING TO HEALTH CARE; ESTABLISHING THE ALL-PAYER CLAIMS DATABASE TASK FORCE; MAKING AN APPROPRIATION.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

      SECTION 1. ALL-PAYER CLAIMS DATABASE TASK FORCE--DUTIES--MEMBERSHIP--REPORTING.--

          A. By August 1, 2013, the general services department shall contract with an entity with expertise in the field of health care cost and quality analysis and charge that entity with convening an all-payer claims database task force to identify the following:

                (1) the sources among public and private entities for health care claims data in the state and the manner in which the database may receive data from these entities;

                (2) sources of funding for the establishment and operation of an all-payer claims database, including fees for the use of data;

                (3) the possibilities afforded in state and other applicable law for a governance structure and operational entity that will provide for:

                     (a) the safe collection, management, storage and sharing of health care claims data;

                     (b) a public-private partnership to manage the database's duties; and

                     (c) accountability to the public and state government;

                (4) criteria for deeming persons eligible to receive data from the database and protocols for applying for the use of data;

                (5) applications for the data in the database that will achieve the goal of high-quality health care while cutting health care costs; and

                (6) entities with which the database may partner to achieve improvements in the quality and cost of health care services in the state.

          B. The entity that convenes the all-payer claims database task force pursuant to Subsection A of this section shall invite, at a minimum, representatives of the following:

                (1) the medical assistance division of the human services department;

                (2) the office of health care reform of the human services department;

                (3) the interagency behavioral health purchasing collaborative;

                (4) the public health division of the department of health;

                (5) the developmental disabilities supports division of the department of health;

                (6) the corrections department;

                (7) the New Mexico interagency benefits advisory committee;

                (8) an entity with experience in the establishment or operation of a statewide electronic medical records system;

                (9) the university of New Mexico;

                (10) New Mexico state university;

                (11) each private insurer that offers insurance in the state, including representatives from both major medical insurers and limited insurers;

                (12) self-insured private employers;

                (13) the New Mexico primary care association;

                (14) the New Mexico hospital association;

                (15) the New Mexico medical society;

                (16) the New Mexico osteopathic medical association;

                (17) the New Mexico nurses association; and

                (18) a health care consumer advocacy organization.

          C. By November 1, 2014, the task force shall compile its findings and develop recommendations pursuant to those findings and report its findings and recommendations to:

                (1) the governor;

                (2) the legislative health and human services committee; and

                (3) the legislative finance committee.

          D. As used in this section:

                (1) "limited insurer" means a person authorized pursuant to the New Mexico Insurance Code to offer only a limited-benefit policy intended to supplement major medical coverage, including medicare supplement, vision, dental, disease-specific, accident-only or hospital indemnity-only insurance policies, or that only issues policies for long-term care or disability income; and

                (2) "major medical insurer" means a person authorized pursuant to the New Mexico Insurance Code as a health insurer, nonprofit health service provider, health maintenance organization, managed care organization, fraternal benefit society or provider service organization to offer a hospital and medical expense-incurred policy, plan or contract in the state.

     SECTION 2. APPROPRIATION.--Twenty thousand dollars ($20,000) is appropriated from the general fund to the general services department for expenditure in fiscal year 2014 to contract with an entity, located in a class A county with a population of at least six hundred thousand individuals as of the last decennial census, with expertise in health care quality and cost analysis to convene and operate an all-payer claims database task force pursuant to Section 1 of this act. Any unexpended or unencumbered balance remaining at the end of fiscal year 2014 shall revert to the general fund.

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