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Insurance department seeks to give self‑funded employers de‑identified CHIS data to encourage opt‑in
Summary
An amendment would allow self‑insured employers that opt into New Hampshire’s all‑payer claims database (CHIS) to receive de‑identified, aggregated claims information to help them shop third‑party administrators and manage risk; the department said privacy safeguards and a Supreme Court precedent limit mandatory reporting.
The New Hampshire Insurance Department asked a House committee to advance an amendment that would incentivize self‑funded employee health plans to opt into the state’s All‑Payer Claims Database (CHIS) by providing participating employers with de‑identified, aggregated claims data.
Michelle Heaton, director of life and health at the New Hampshire Insurance Department, told the committee that commercial insurers and the state health plan already must report claims to CHIS and that the department uses the data to analyze health‑care costs and trends. Because of a court ruling, the department cannot require self‑funded plans to report; it can only offer a voluntary opt‑in.
Why it matters: staff said aggregate CHIS data could help employers benchmark spending, compare third‑party administrators and better manage risk. The department proposed text that would allow the agency to disclose limited, de‑identified data back to an employer that agreed to opt in.
Privacy protections and legal limits: Heaton and Jennifer Smith, legislative director for the insurance department, said any employer disclosure would be de‑identified and aggregated so that “individual employees can’t be singled out,” as Smith put it during the hearing. The department cited a controlling Supreme Court case (transcript reference: Gobet) that bars requiring self‑funded plans to report claims data to the state; the amendment therefore offers an incentive rather than a mandate.
Background and process: Tyler Brennan was credited by staff as the officer who originally began building the all‑payer system. Heaton said the database was created to provide a single source for total medical costs and to illuminate price issues such as balance billing and disparate provider charges. The committee took a straw vote to advance the amendment.
Next steps: staff said they would continue coordination with stakeholders and finalize drafting before any floor action.
