The Department of Health Care Access and Information (HCAI) is releasing the December Health Care Payments Data (HPD) Quarterly Newsletter. The newsletter is designed to keep stakeholders informed on programmatic updates including information about the upcoming Advisory Committee and Submitter Group Meetings, relevant federal updates impacting All Payer Claims Databases (APCD), and HPD careers.
HPD Programmatic Updates
Save the date for HPD’s Submitter Group Meeting:
The first quarter of 2023 HPD Submitter Group meeting will be held on January 12, 2023. Please use this link to register for the HPD Submitter Group to have the meeting added to your calendar. The agenda and instructions to register is posted to the HPD Program Submitters website.
October Submitter Group Question and Results of Submitter Poll:
We received excellent engagement at the October submitter group meeting on October 13, 2022. Below is a particularly important question raised by the group and HCAI’s response:
Question: For monthly data submissions, does “submitted” mean a file must be in pass status or just the initial submission of a file to CDM?
Answer: The submission date is the date in which a submitter provides data to the HPD System through the Claims Data Manager (CDM). When files are submitted, they need to be “acceptable” which means in compliance with all data file requirements per the California Code of Regulations (CCR), APCD-CDL version 2.1 errata, and the HPD Data Submissions Guide (DSG). HCAI acceptance (pass status) or rejection (not pass status) may take up to three business days. HCAI recommends submitters consider submitting files early so that the file(s) have adequate time to be accepted (i.e. in “Pass” status) prior to the deadline. Please refer to CCR Sections 97344, 97346, 97360 regarding monthly data file submission and data acceptance, and the HPD DSG page 4.
For the first time, we also polled submitter group participants to gain insights about what topics to share during the 2023 submitter group meeting series, and how often and how long meetings should be held. Below are the submitter group poll results:
- What topics would you like to see covered during either the January or April 2023 HPD Submitter Group meeting?
Majority Response: Monthly Data Submission FAQs (85%)
- What topics would you like to see covered during either the July or December 2023 HPD Submitter Group meeting?
Majority Response: Data Access and Release (57%)
- If we were to have a presentation on HPD regulations, what sub-topics would you find the most useful?
Majority Response: FAQs from submitters (71%)
- How often should the HPD submitter group meetings be held?
Majority Response: Keep the same- Four times a year (quarterly) (81%)
- How long should HPD submitter group meetings last?
Majority Response: Flexible- Depends on the topics being covered (65%)
Annual Plan and Submitter Registration:
HPD’s annual plan and submitter registration period is just around the corner! Per California Code of Regulations Section 97334, health plans and submitters are required to review and update or confirm all registration information annually by the last calendar day of February. The 2023 annual registration period will open for plans on January 2, 2023, and plans are encouraged to complete registration prior to the opening of registration for
submitters, which will be occur on February 1, 2023. This staggered approach to registration assists with mapping plan to submitter relationships appropriately. Onpoint Health Data, supporting the HPD Platform, will hold informational webinars about the registration process specific for plans and submitters. Below are dates for the plan and submitter registration webinars:
Plan registration webinar
Thursday, January 5, 2023, from 10:00 a.m. -11:00 a.m. (PST).
To register for the webinar, please go to this link.
Submitter registration webinar
Wednesday, January 25, 2023, from 10:00 a.m. -11:00 a.m. (PST)
To register for this webinar, please go to this link.
A separate save the date message will be sent with more details on registering to attend one or both webinars.
Initiation of Monthly Data File Reporting and Ongoing Monthly Data Submissions:
Registered submitters have until February 1, 2023 to submit all data files for the reporting months between January 2022 and October 2022. Starting with the November 2022 reporting month, registered submitters are required to begin ongoing monthly data submission. The November 2022 reporting month is due to HCAI by January 2, 2023, due to the New Year’s Day holiday. Regulatory provisions regarding ongoing monthly data submission are cited in California Code of Regulations Sections 97340 and 97352. You may also refer to the HPD Reporting Manual page 12 for an outline of reporting period and corresponding submission due dates. Please contact the HPD program at hpd@hcai.ca.gov regarding questions or concerns with meeting this regulatory requirement.
HPD System Data Collection: The HPD System has collected and processed over 14 billion records of production data from CMS, the Department of Health Care Services, and commercial data submitters!
HCAI greatly appreciates the efforts of all data submitters, including those already submitting 2022 data to the System. HCAI will be conducting ongoing regular evaluation of data quality and completeness.
Data Release Regulations and Certification of HPD Emergency Regulations:
Data release regulations are currently under development and will be noticed for public comment early next year. HCAI is also preparing to certify HPD’s emergency regulations, which took effect on December 20, 2021. These regulations will also be noticed for public comment early next year. HCAI has until December 20, 2023, to complete the HPD emergency regulations certification process.
Participation in National Workgroups:
HCAI and the HPD Program continue to participate in the APCD Council’s All-Payer Claims Database Common Data Layout (APCD-CDL™) Data Maintenance Request (DMR) workgroup. The APCD-CDL™ version 3.0 is expected to be released in mid-January 2023. The APCD-CDL™ version 2.0 will continue to be the file format used for HPD’s data collection through 2023. HCAI will monitor the release in order to update HPD regulations. HCAI and the HPD Program also continue to participate in the Non-Claims-Based Payments workgroup, in an effort to develop a national standard for collecting Alternative Payment Model data from payer and provider organizations.
HPD Advisory Committee
HCAI is hosting the next HPD Program Advisory Committee Meeting on January 26, 2023. The meeting will be held from 9:00 a.m. to 12:30 p.m. (PST).
As of July 1, 2022, the Bagley Keene Open Meeting Act provisions have been revised for the next fiscal year, to allow for meetings to be held virtually. The January HPD Meeting will be held in a hybrid format allowing members of the public and committee members to attend in person or via Microsoft Teams.
January 2023 Advisory Committee Anticipated Topics:
The January meeting will focus on supplemental data collection, including capitation and alternate payment methodologies (APM), and include an overview of state APCD approaches to APM data collection and reporting.
The agenda and all other meeting materials will be posted on the HPD Advisory Committee website prior to the meeting.
HPD Data Release Committee
Pursuant to Health and Safety Code section 127671, et seq. HCAI is required to convene a Data Release Committee (DRC) to support the implementation and administration of the Health Care Payments Data Program. The DRC will be an integral part of the HPD Program, advising HCAI on the release of HPD data. HCAI hosted the first DRC meeting on December 6, 2022. The December meeting topics included the swearing in of DRC members, an orientation of members to the HPD Program and System, their roles and responsibilities as committee members, and an initial discussion on how to define ‘benefit to California’ when weighing recommendations around the release of non-public HPD data. The next DRC meeting will be held on January 10, 2023, from 9:00 a.m. to 12:30 p.m. (PST). The agenda and meeting materials will be posted on the HCAI website in advance of the meeting. Additional information can be found on the Health Care Payments Database Program (HPD) Data Release Committee page.
Are you interested in joining the HPD Team?
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About the HPD Program
Assembly Bill 80 (Chapter 12, Statutes of 2020) provides HCAI the authority to establish the Health Care Payments Data Program (HPD), often referred to as an All Payer Claims Database or APCD, which is intended to support greater health care cost transparency, inform policy decisions supporting quality health care, and to reduce health care costs and disparities.
To find out more please visit HCAI’s HPD Webpage or email hpd@hcai.ca.gov. If this newsletter was forwarded to you, and you would like to receive future ones please subscribe to “Healthcare Payments Database News” here.