Sec. 10. (a) The advisory board may make recommendations to the executive director and administrator regarding the data base that:

(1) include specific strategies to measure and collect data related to health care safety and quality, utilization, health outcomes, and cost;

Terms Used In Indiana Code 27-1-44.6-10

  • administrator: has the meaning in Indiana Code 27-1-44.6-1
  • advisory board: refers to the all payer claims data base advisory board established under section 5 of this chapter. See Indiana Code 27-1-44.6-2
  • Commissioner: means the "insurance commissioner" of this state. See Indiana Code 27-1-2-3
  • data base: refers to the all payer claims data base established under Indiana Code 27-1-44.6-3
  • executive director: has the meaning in Indiana Code 27-1-44.6-4
  • Insurance: means a contract of insurance or an agreement by which one (1) party, for a consideration, promises to pay money or its equivalent or to do an act valuable to the insured upon the destruction, loss or injury of something in which the other party has a pecuniary interest, or in consideration of a price paid, adequate to the risk, becomes security to the other against loss by certain specified risks; to grant indemnity or security against loss for a consideration. See Indiana Code 27-1-2-3
  • Oversight: Committee review of the activities of a Federal agency or program.
  • premium: means money or any other thing of value paid or given in consideration to an insurer, insurance producer, or solicitor on account of or in connection with a contract of insurance and shall include as a part but not in limitation of the above, policy fees, admission fees, membership fees and regular or special assessments and payments made on account of annuities. See Indiana Code 27-1-2-3
  • Year: means a calendar year, unless otherwise expressed. See Indiana Code 1-1-4-5
(2) focus on data elements that foster quality improvement and peer group comparisons;

(3) facilitate value based, cost effective purchasing of health care services by public and private purchasers and consumers;

(4) result in usable and comparable information that allows public and private health care purchasers, consumers, and data analysts to identify and compare health plans, health insurers, health care facilities, and health care providers regarding the provision of safe, cost effective, high quality health care services;

(5) use and build upon existing data collection standards and methods to establish and maintain the data base in a cost effective and efficient manner;

(6) are designed to measure the following performance domains:

(A) safety;

(B) timeliness;

(C) effectiveness;

(D) efficiency;

(E) equity; and

(F) patient centeredness;

(7) incorporate and utilize claims, eligibility, and other publicly available data to the extent it is the most cost effective method of collecting data to minimize the cost and administrative burden on data sources;

(8) include recommendations about whether to include data on the uninsured;

(9) discuss the harmonization of the data base with other state, regional, and federal efforts concerning all payer claims data bases;

(10) discuss the harmonization of the data base with federal legislation concerning all payer claims data bases;

(11) discuss a limit on the number of times the executive director and administrator may require submission of the required data elements;

(12) discuss a limit on the number of times the executive director and administrator may change the required data elements for submission in a calendar year considering administrative costs, resources, and time required to fulfill the requests;

(13) discuss compliance with the federal Health Insurance Portability and Accountability Act (42 U.S.C. § 201 et seq.), as amended, and other proprietary information related to collection and release of data;

(14) discuss comparing Indiana’s health insurance premium rates, Medicaid reimbursement rates, and Medicare reimbursement rates with all other states; and

(15) discuss auditing and comparing Indiana’s health insurance reimbursement claim denials with all other states.

     (b) The advisory board shall make recommendations to the executive director regarding how the ongoing oversight of the operations of the data base should function, including where the data base should be housed.

     (c) Any recommendations or actions by the advisory board are subject to the approval of the commissioner.

As added by P.L.195-2021, SEC.12. Amended by P.L.203-2023, SEC.20.

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