The Office of Cost and Accountability (OCA) presented a proposed enforcement framework for payer data submissions that combines per-member penalties for failures to submit, flat untimely fines for late files, and progressive increases for repeat noncompliance. Staff described a two-part untimely penalty, a separate per-member failure-to-submit charge and the option to pursue administrative orders if entities do not comply.

Key components presented by staff: Assistant Deputy Director CJ Howard said the office's proposal includes an initial untimely data-submission penalty of $10,000 and an additional $10,000 if data are still not submitted by Nov. 1; a failure-to-submit penalty tied to membership of $5 per member in the first year that would double in each subsequent noncompliant year; and a five-day correction window for submitters after OCA identifies technical deficiencies. CJ Howard said the $5-per-member penalty "on average ... equates to approximately 0.07% of the plan's annual revenue" and that the per-member figure ranges across plans from about 0.01% to 0.14% depending on plan size and revenue.

Deadlines, extensions and technical assistance: Staff reiterated the Sept. 1 statutory data-submission due date and said submitters may request two optional 15-day extensions. If an entity misses the final extension, progressive enforcement steps would begin; those steps include technical assistance, optional public testimony, a required data-submission plan if files remain missing 30 days after Nov. 1, and potential administrative orders and public disclosure of assessed penalties.

Board reaction and requested changes: Board members and staff urged stronger escalation and clarified enforcement mechanics. Dr. Richard Pan asked whether the office would apply a Consumer Price Index adjustment on top of the doubling schedule; CJ Howard said CPI could be used to preserve penalty relevance over time. Several board members said the current dollar figures were too small to deter intentional noncompliance. Ian Lewis said some entities may view the proposed penalties "as a cost of doing business," and recommended a steeper, time-based escalation (for example, additional per-member charges or monthly penalties after a deadline). Elizabeth Mitchell and other board members urged accelerating monthly penalties after December and prioritizing enforcement against larger market actors or those whose noncompliance most affects access and affordability.

Data-submission status and technical outreach: Deputy Director Vishal Pagani reported the office's outreach: 51 plans registered to submit data, staff held five all-plan workgroup meetings, OCA conducted 38 one-on-one technical-assistance meetings during July and August, 21 plans had submitted test files to OCA's portal and six plans had already submitted production files for the 2023'24 data set. Staff said OCA will continue technical assistance while pursuing enforcement steps for chronic or intentional noncompliance.

Public comment: Beth Capelle of Health Access noted legal standards referenced in statute and urged stronger penalties, calling $5 per member "nothing" compared to premium dollars at stake. Capelle said the legal standard for enforcement involves whether an entity "knowingly" failed to provide information and urged OCA to publish progress and noncompliance earlier in the process so oversight is transparent. Labor and consumer groups emphasized that modest fines would not deter avoidance when carriers or hospitals could gain far more by missing reporting obligations.

Next steps: Staff said they would revise the proposal to consider board feedback, including steeper or more frequent time-based escalation, and present updated enforcement mechanics and notice/transparency approaches at upcoming meetings. The proposal as presented is informational; no formal enforcement rules were adopted at the meeting.

Ending note: Board members emphasized the office's statutory obligation to collect timely, complete data and asked staff to balance flexibility for entities acting in good faith with stronger remedies for repeated or deliberate noncompliance.