The Department of Health Care Access and Information (HCAI) June HPD Program Quarterly Newsletter is designed to keep stakeholders informed on programmatic updates and ongoing stakeholder engagement.
Proposed Revisions to CMS Data Release Policies
The Centers for Medicare and Medicaid Services (CMS) has announced its intent to revise its policies for accessing its CMS Research Identifiable File (RIF) data, proposing such access only be fulfilled within the Chronic Conditions Warehouse Virtual Research Data Center, among other changes.
While there will be an exemption for state entities to continue to receive this data, and HCAI does not expect this change to impact the HPD Program, many in HCAI’s community of researchers have expressed concern with the new apparent direction. Notwithstanding such concerns, it is validating to HCAI that CMS is proposing to take an approach of maximizing personal privacy protections using a secure research enclave, emulating California’s “enclave-first” model.
With CMS revising its data access policies, there may be an opportunity for California to open discussions about CMS allowing HCAI to re-release Medicare Fee-for-Service data through its own secure research enclave – a request many HPD stakeholders have voiced.
HPD Program Updates
Public Reporting
HCAI anticipates releasing a public report on prescription drug costs in the near future. This will be followed by updated versions of the HPD Snapshot and HPD Measures reports, which will be scheduled for release in Quarter 3 of 2024.
Program Regulations
HCAI has been preparing the following regulations packages for the HPD Program.
- HPD Program Data Release Regulations. The HPD Data Use, Access, and Release regulations proposal has undergone three periods of public comment and is under final review by the Office of Administrative Law for adoption.
- The proposed revisions were made to effectuate the intent of the law by clarifying requirements that are necessary to allow the public and other state agencies to access and use HPD data for the benefit of Californians while protecting patient privacy. The proposed revisions will also improve compliance with data application requirements, as well as improve overall program efficiency.
- Please refer to the HCAI Laws & Regulations website to review all rulemaking documents.
- HPD Program Non-Claims Payment Data Collection Regulations. HCAI is developing regulations to collect non-claims payment data from health plans and submitters. Non-claims payments are identified as information that submitters must provide to HPD as described in Health and Safety Code section 127673. HCAI anticipates the non-claims payment regulations to be released for public comment by summer 2024, with an anticipated completion date by early 2025. The Non-Claims Payment Data Fact Sheet, updated April 19, 2024, provides additional information on non-claims payment data collection efforts, including a timeline of the regulation development process and a frequently asked questions section for health plans and submitters.
HPD Dental Plan Data Collection
Dental plans and submitters must be registered with the HPD Program through the Onpoint Health Data Claims Data Manager (CDM). Below are important dates for dental plans and submitters to be aware of regarding dental data collection:
- Dental data testing period ends on July 31, 2024.
- Historical dental data files for the period from June 29, 2017, through December 2021 must be submitted by October 31, 2024.
- All remaining dental data for the period beginning January 2022 through October 2024 must be submitted by February 1, 2025.
- Dental plans will follow the Monthly Production Submission Schedule and submit November 2024 data by January 1, 2025.
- Please refer to California Code of Regulations Sections 97340, 97348, 97351, and 97352 for more information.
HPD System Monthly Data File Submissions
The HPD Program continues to process ongoing monthly data file submissions from health plans and insurers and requests data submitters to submit earlier in the month whenever possible. Data submitters are encouraged to reach out to the HCAI team if there are any concerns with meeting the reporting deadline. HCAI greatly appreciates the efforts of all data submitters in their timely submissions and those that have adjusted their submission schedules accordingly to meet HCAI’s request.
HCAI continues to conduct ongoing and regular evaluation of data quality and completeness to support both public reporting and the release of non-public data. HCAI has begun building annual plan reports and began plan engagement in May 2024. HPD program staff will reach out to additional plans in summer 2024 to schedule a walk-through of the reports. The reports include an executive summary, data visuals, and questions tailored to each plan and submitter. The annual plan reports will include a feedback loop for plans to share their experiences, provide an opportunity for plans to validate their data, inform HCAI about best practices across the commercial sector, and provide additional insight for public reporting of HPD data.
Participation in National Workgroups
HCAI continues to participate in the APCD Council’s APCD-CDL™ Data Maintenance Request (DMR) workgroup. NAHDO published the newly developed NCP Data LayoutTM in April 2024, which is now available on the NAHDO website. The APCD Council developed this layout to support states interested in efficient and accurate NCP data collection. The NCP Data LayoutTM is free to access to help healthcare data programs use this guidance.
NAHDO will be hosting an interactive discussion to learn more about the NCP Data LayoutTM on Tuesday, June 25, 2024, from 10:00 a.m. to 11:00 a.m. PDT. Please register for the event or reach out to info@nahdo.org for more information.
Ertug Misirli, a Research Data Specialist at HCAI, was recently awarded the Rising Star Award by NAHDO. Ertug has been a crucial member in his role supporting the HPD Program by leveraging his expertise in health care payments data to focus on data collection, analysis, and interpretation to improve the delivery and quality of healthcare for the public. Congratulations on the recognition, Ertug!
HPD Stakeholder Engagement
Voluntary Self-Funded Outreach
Many health benefit programs 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 self-funded employers and other purchasers, which are not mandatory 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 purchase goals and the HPD Program goals, including transparency, informed policy decisions, improved health care, and equitable access to affordable and high-quality care. The HPD Program Voluntary Submitters webpage provides additional information on requesting assistance.
On March 1, 2024, HCAI submitted to the California State Legislature the 2024 HPD Program Legislative Report, which includes findings and next steps for increasing voluntary data from private self-funded employers and other purchasers to increase the comprehensiveness of the HPD. Based on recommendations made in the 2024 HPD Program Legislative Report, HCAI has been conducting outreach efforts, including engaging with employer groups and purchasers. HCAI will provide updates and discuss voluntary self-funded outreach during the July HPD Program Advisory Committee.
HPD Program Advisory Committee
The HPD Program Advisory Committee is comprised of health care stakeholders and experts to assist and advise the HCAI Director in formulating program policies about data collection, data management, data use, data access, and the development of public information to meet the goals of the HPD Program. The HPD Program Advisory Committee convenes quarterly.
Upcoming July Meeting
HCAI is hosting the next HPD Program Advisory Committee meeting on July 25, 2024, from 9:00 a.m. to 12:30 p.m. The July meeting will be held in a hybrid format where committee members and members of the public can attend in person at the Sacramento office or online via Microsoft Teams. Meeting topics include program updates on milestones for data collection including non-claims data collection and voluntary data collection. The agenda and all other meeting materials will be posted on the HPD Program Advisory Committee webpage prior to the meeting.
Past Meetings
HCAI hosted a meeting on April 25, 2024, which focused on data release and pricing. Because the Committee did not complete their discussion around pricing reductions, HCAI hosted a follow-up meeting on May 13, 2024. The meeting was a continuation of the discussion on data access pricing and price reductions and provided an update on the status of the Data Release Committee (DRC).
HPD Data Release Committee
The HPD Data Release Committee (DRC) is integral in supporting the implementation and administration of the HPD Program and advises HCAI on the release of HPD data. The HPD DRC convenes monthly, unless otherwise stated. Below is information on the most recent and upcoming meetings.
Upcoming June Meeting
HCAI is hosting the next HPD DRC meeting on June 19, 2024, from 1:00 p.m. to 4:00 p.m. The meeting will be held in a hybrid format where committee members attend in person at the Sacramento or Los Angeles offices, while members of the public can join in person or online via Microsoft Teams. Meeting topics include introductions to resources created to assist the DRC in conducting reviews of data requests and a continuation of the use case discussion started at the March 20, 2024, meeting. The agenda and all other meeting materials will be posted on the HPD DRC webpage prior to the meeting.
Past Meetings
During the meeting on March 20, 2024, the DRC formally adopted the HPD Data Release Committee Manual, Version 1.0. The Committee also had a robust discussion around use cases, where committee members had an opportunity to consider the types of questions that may arise when reviewing requests for non-public data. Previous DRC meeting materials are available on the HPD DRC webpage under the “Meetings Archive” section.
HPD Submitter Group
The HPD Program Submitter Group provides a forum for HPD Data Submitters to receive the latest information on submission requirements, troubleshoot data submissions, and address other technical issues related to data submission. These meetings are intended for entities required to submit or are supporting the submission of data to the HPD System. The HPD Submitter Group convenes quarterly.
Upcoming July Meeting
The third HPD Submitter Group meeting will be held on July 11, 2024.Please register to attend the virtual meeting. Anticipated meeting topics include the status of production file submissions, a review of data quality assurance and improvement, and an update on non-claims payments. The agenda and all other meeting materials will be posted on the HPD Program Submitters Group webpage prior to the meeting.
Past Meetings
The most recent HPD Program Submitter Group meeting was held on April 11, 2024, and focused on the status of production file submissions, a review of reporting manual changes, and an update to non-claims payments. Presentation materials are available on the HPD Submitter Group webpage.
HPD Program Submitter Resources
The HPD Program Submitters webpage offers submitter training materials under the Submitter Resources Section. The training materials are provided by Onpoint Health Data to help HPD Program Submitters with registering and submitting files through the CDM. The Frequently Asked Questions Section also provides information on registration and data submission. Please contact Onpoint Health Data at hpd-support@onpointhealthdata.org to view the training videos.
About the HPD Program
Assembly Bill 80 (Chapter 12, Statutes of 2020) provides HCAI the authority to establish the HPD Program. The HPD System is California’s All-Payer Claims Database, or APCD, and is intended to support greater health care cost transparency, inform policy decisions supporting quality health care, and reduce health care costs and disparities.
Watch the video below to learn more about the HPD Program. Also visit HCAI’s HPD Program webpage or email hpd@hcai.ca.gov for any questions. Subscribe to “Healthcare Payments Database News” to receive future newsletters if this newsletter was forwarded to you.
How does the HPD Collect and Report Data?
Watch this video and share it with your colleagues!
HPD Program Careers
Are you interested in joining the HCAI Team? Click below to watch for job opportunities coming soon to support the HPD Program:
