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Insurance department backs law to standardize machine‑readable healthcare price files; carriers ask for dialogue on format
Summary
The Insurance Department proposed legislation to standardize carrier machine‑readable price files by giving the commissioner authority to require a single format so carriers’ federally required files (in‑network negotiated rates, out‑of‑network allowed/paid amounts and prescription‑drug prices) can be aggregated and used for analysis and consumer tools.
The New Hampshire Insurance Department proposed a bill to codify the federal “transparency and coverage” machine‑readable file requirements and to give the commissioner authority to require a single, standard format for carriers to post price data. The department said the federal rule obliges carriers to post three large machine‑readable files (in‑network negotiated rates, out‑of‑network allowed/paid amounts and prescription‑drug negotiated rates/historical net prices) but allows carriers to publish the data in multiple formats; that heterogeneity makes the federal postings difficult to use for statewide analysis or for third‑party tools.
Alex Feldwegle and Jason Aziz of the Insurance Department told the committee the department’s grant‑funded work last year confirmed the federal files are being posted but in inconsistent formats. The department asked for authority to standardize the presentation — via rule — so that the data can be easily aggregated, analyzed and turned into consumer tools. Feldwegle said the bill would largely mirror the federal specification but add an ability for the commissioner to set consumer‑useful formatting so researchers, state analysts and tool developers can combine carrier files into a usable dataset.
Carriers told the committee they are already producing the federally required files and cautioned that creating a separate state format could be costly and time‑consuming. Anthem, Centene and AHIP said implementation burden and IT costs could be significant if carriers must reformat large monthly files to a state‑specific spec, and Anthem asked that the prescription‑drug file language wait until federal rules are final. Industry witnesses asked the department to move the format work forward by consensus and by rulemaking rather than immediate statute that mandates a particular format.
Insurance department staff suggested a middle path: keep the federal content requirements in statute and use rulemaking to design a common, machine‑readable format for all carriers to submit specifically to the department. The department said that approach would preserve federal compliance while enabling the state to compile comparable datasets for policy analysis and consumer tools and would limit duplication if done by collaborative rulemaking with carriers.
Committee members asked whether the department has authority now to request the files; department witnesses said carriers must host the federal files publicly but the state lacks authority to require a uniform format across carriers. The committee closed the hearing and sent the bill to subcommittee, with members asking the department to continue stakeholder conversations and to produce a proposed format and cost estimate for carriers.
