Health Care Payments Data (HPD)

Public Reporting#

HCAI is required to produce publicly available information from the database, including data products and analytic reports, to support the goals of the program. The HPD Advisory Committee is responsible for advising HCAI on principles and priorities for public reporting.

HCAI anticipates continuing to advance the accessibility and usefulness of HPD public reports as the database becomes more comprehensive and complete and HCAI builds its capacity over time.

Stakeholder Engagement#

HPD Program Advisory Committee#

HCAI is required to convene an HPD Program Advisory Committee comprised of health care stakeholders and experts to assist and advise the HCAI Director in formulating program policies regarding data collection, management, use, access, and development of public information to meet the goals of the HPD Program. The committee does not have decision-making authority related to the administration of the database but will serve as a forum for stakeholder and public engagement on policy decisions, while fostering accountability and transparency.

HPD Data Release Committee#

HCAI is required to convene a Data Release Committee (DRC) to advise on requests for access to non-public data.

The DRC is an integral part of the HPD Program and will be supporting HCAI to:

• Lay the foundation for HPD data access and release and contribute to the launch of an effective and credible Data Release Program
• Advise HCAI on relevant policies and processes
• Participate in thoughtful deliberation to weigh broad use of HPD data and public benefit to Californians with protection of patient privacy  
• Review and make recommendations to HCAI on access to and release of non-public HPD data

The DRC is made up of subject matter experts representing key stakeholder groups including: consumers, labor, providers (both at clinician and hospital levels), payers, purchasers, suppliers, and researchers.

HPD Program Data Submitters#

The enabling legislation identifies the following entities as mandatory submitters to the HPD:  

• Health care service plans, including a specialized health care service plan. 
• Insurers licensed to provide health insurance, as defined in Section 106 of the Insurance Code. 
• Self-insured plans subject to Section 1349.2, or a state entity, city, county, or other political subdivision of the state, or a public joint labor management trust that offers self-insured or multiemployer-insured plans that pay for or reimburse any part of the cost of health care services. 
• The State Department of Health Care Services, for those enrolled in Medi-Cal and other insurance affordability programs, whether enrolled in Medi-Cal managed care, fee-for-service Medi-Cal, or any other payment arrangement. 
• The legislation also specifies additional voluntary submitters, who can opt-in to submit their data to the HPD System.

HPD Program Voluntary Submitters#

Many health benefit programs are increasingly concerned about the continued escalation of health care costs and are interested in more effective use of data and transparency to drive the development of solutions. An estimated 4-5 million Californians are covered by ERISA self-funded employers and other purchasers, which are not mandatory submitters under the HPD Program. These purchasers may choose to contribute their data to the HPD. The more comprehensive the HPD is in reflecting the entire population of California, the more accurate the analytic findings will be and the greater the likelihood of achieving both purchaser goals and HPD program goals – including transparency, informed policy decisions, improved health care, and equitable access to affordable and high-quality care.

Laws and Regulations#

AB 80 (Chapter 12, Statutes of 2020) provides HCAI the authority to establish the Health Care Payments Data (HPD) Program. This enabling legislation expands the mandate provided by AB 1810 (Chapter 34, Statutes of 2018), which included a one-time appropriation for HCAI to develop and administer the program and required HCAI to convene a Review Committee of stakeholders and experts to advise the department on the establishment, implementation, sustainability, and ongoing administration of the HPD Program. The Review Committee’s recommendations were included in a report submitted to the California Legislature on March 9, 2020.

Health and Safety Code, Division 107, Part 2, Section 8.5 provides HCAI the authority to implement the HPD Program to collect health care data from health care plans, health insurers, government agencies and others (Health and Safety Code Section 127671.1). 

Data Collection Regulations #

See the California Code of Regulations Title 22, Division 7, Chapter 11, Articles 1 to 7 to view a simple text version of the documents linked in this section.

Sections 97300, 97305, 97310, 97314, 97318, 97330, 97331, 97332, 97334, 97340, 97342, 97344, 97346, 97348, 97349, 97350, 97351, 97352, 97360, 97362, and 97370 of the California Code of Regulations, Title 22, Division 7, Chapter 11, Articles 1 to 7: Health Care Payments Data Program. Filed with the Secretary of State and effective on November 17, 2023.

Non-Claims Payment Data Collection Regulations#

The final rulemaking action for the HPD Non-Claims Payment (NCP) Data Collection Regulations was approved by the Office of Administrative Law, and the regulations are in effect as of March 25, 2025. The final rulemaking action adopts regulations to collect NCP data as part of the required HPD data collection efforts under the Health and Safety Code Section 127673(b).

See the California Code of Regulations Title 22, Division 7, Chapter 11, Articles 1 to 7 to view a simple text version of the documents linked in this section.

Sections 97300, 97305, 97340, 97341, 97344, 97350, 97351, 97352, and 97353 of the California Code of Regulations, Title 22, Division 7, Chapter 11, Articles 1 to 7: Health Care Payments Data Program. Filed with the Secretary of State and effective on March 25, 2025.

Data Use, Access and Release Regulations#

See the California Code of Regulations Title 22, Division 7, Chapter 11, Article 8 to view a simple text version of the documents linked in this section.

Sections 97380, 97382, 97384, 97386, 97388, 97390, 97392, 97394, 97396, 97398, 97400, 97402, 97404, 97406, 97408, 97410, 97412, 97414, 97416 of the California Code of Regulations, Title 22, Division 7, Chapter 11, Article 8: Health Care Payments Data Program. Click to view the Final Statement of Reasons. Filed with the Secretary of State and effective on November 25, 2024.

Contact#

Contact HPD at hpd@hcai.ca.gov with any questions.