32.1-276.5:1 - Disclosures of contractual arrangements to be made publicly available.
§ 32.1-276.5:1. Disclosures of contractual arrangements to be made publiclyavailable.
A. In order to advance transparency in health care and provide patients andfamilies with better information on which to judge value among theirtreatment options, the Commissioner shall negotiate and contract with anonprofit organization authorized under § 32.1-276.4 for an annual survey ofcarriers offering private group health insurance policies, which are subjectto HEDIS reporting, to determine the reimbursement that is paid for a minimumof 25 most frequently reported health care services which may includeinpatient and outpatient diagnostic services, surgical services or thetreatment of certain conditions or diseases. Each carrier shall report theaverage reimbursement paid for a specific service from all providers andprovider types, to include hospitals, outpatient or ambulatory surgerycenters and physician offices. The survey shall also include, when available,the average reimbursement rates for the same services provided forreimbursement by fee-for-service Medicare and Medicaid. The survey shall bemanaged by the Commissioner to insure that when such information is reportedit will provide the aggregate information so that readers will be able todetermine the average amount of reimbursement paid for specific healthcareservices. No provider, facility or carrier specific reimbursement informationshall be included in the public survey reports. Such specific informationshall be deemed proprietary and shall not be disclosed to the public; onlythe Commissioner will have access to the underlying survey data. The publicsurvey reports shall be made available to the public through an InternetWebsite operated by the contracting organization.
The Commissioner, in conjunction with stakeholders working through thenon-profit organization, shall work to (i) incorporate existing servicequality data and guidance to the price information to further assist informedconsumer choice to the extent it is practical and consistent with generallyaccepted national guidelines, and (ii) seek over time to display price andquality information for episodes of care in a manner which is consistent withgenerally accepted national guidelines.
B. The information acquired in the survey and provided to the Commissionershall be confidential and shall be excluded from the Virginia Freedom ofInformation Act (§ 2.2-3700 et seq.) pursuant to subdivision 21 of §2.2-3705.6.
(2008, cc. 71, 102.)