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Access to medical claims data

Published (4/29/2010)
By Nick Busse
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Health plan sponsors, including some employers, would have access to employees’ medical claims data, under a bill sponsored by Rep. Jim Abeler (R-Anoka).

HF3396 would require health plan companies and managers of preferred provider networks to annually submit medical claims data to health plan sponsors. For example, a union health care plan would have access to information on union members’ medical claims.

The House Commerce and Labor Committee held an informational hearing on the bill April 27. No action was taken. There is no Senate companion.

Supporters say access to this data is an important tool that will help health plan sponsors monitor and improve the quality of their members’ health and wellness plans.

“Without access to our data, we are at a disadvantage, and we as a health plan are unable to perform its due diligence in evaluating the effectiveness of its wellness programs,” said Martha LaFave, health fund coordinator for International Union of Operating Engineers Local 49.

LaFave said access to claims data would allow the health plan to reach out to union members with certain conditions, help them select a quality health care provider and identify diseases early. It would also help plan sponsors figure out what changes are needed to best serve members’ needs.

Some committee members are concerned the bill raises data privacy issues, however. Rep. Tim Sanders (R-Blaine) said some employees may be getting tested for conditions they don’t want their employer to know about.

Rep. Sarah Anderson (R-Plymouth) raised similar doubts, asking whether an employee who is pregnant and doesn’t want her employer to know would be forced into disclosing that information.

“I think we’re going down a slippery slope that will cause more problems than it will solve,” Anderson said.

Committee Chairman Rep. Joe Atkins (DFL-Inver Grove Heights) said the committee would not act on the bill this year, but he thought it worthwhile to “tee the issue up” in anticipation of future debates.

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