Establishes a health care disparities data collection system

Section 1. Subsections (d) and (e) of section 210 of the insurance law, subsection (d) as amended by chapter 455 of the laws of 2018 and subsection (e) as added by chapter 579 of the laws of 1998, are amended to read as follows:

(d) Beginning no later than September first of the year following the effective date of the rules and regulations establishing the health care disparities data collection system, pursuant to title three-A of article two of the public health law, and on September first of the preceding year if practicable, in addition to the information required in subsections (a), (b) and (c) of this section, the superintendent shall include in such guide and selection of the data applicable to each insurer or entity from the health care disparities data collection system. Such data shall include data collected or compiled in regard to health care quality and health outcomes pursuant to section two thousand nine hundred ninety-five-c of the public health law or other data that is generally recognized as authoritative and reliable.

(e) Health insurers and entities certified pursuant to article fortyfour of the public health law shall provide annually to the superintendent and the commissioner of health, and the commissioner of health shall provide to the superintendent, all of the information necessary for the superintendent to produce the annual consumer guide, including the mental health and substance use disorder parity report, provided that this requirement shall not apply to information provided for in subsection (d) of this section if the superintendent already possesses such information as part of the data collection system provided for in

EXPLANATION--Matter in italics (underscored) is new; matter in brackets

[ ] is old law to be omitted.

LBD04708-02-9

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title three-A of article two of the public health law. In compiling the guide, the superintendent shall make every effort to ensure that the information is presented in a clear, understandable fashion which facilitates comparisons among individual insurers and entities, and in a format which lends itself to the widest possible distribution to consumers. The superintendent shall either include the information from the annual consumer guide in the consumer shopping guide required by subsection (a) of section four thousand three hundred twenty-three of this chapter or combine the two guides as long as consumers in the individual market are provided with the information required by subsection (a) of section four thousand three hundred twenty-three of this chapter.

[(e)] (f) The superintendent shall contract with a national organization for the purposes of drafting and designing the guide, including the preparation of relevant explanatory material. Such organization shall have actual experience in preparing a similar guide for at least one other state. The superintendent, in consultation with the commissioner of health, may also contract with one or more national organizations to assist such commissioner in the collection of data and the analysis and auditing of the clinical measurers. Such organizations shall consult periodically with associations representing health insurers and health maintenance organizations as well as with consumer representatives in New York in preparing the consumer guide. In regard to information added to the consumer guide or guides pursuant to subsection (d) of this section, the data selected as well as the format shall be determined by the superintendent in consultation with the commissioner of health, with consideration given to the views expressed by stakeholders in the review and comment process held pursuant to subdivision eleven of section two hundred forty-seven of the public health law.

§ 2. Subsection (a) of section 4323 of the insurance law, as amended by chapter 1 of the laws of 1999, is amended to read as follows:

(a) All health maintenance organizations issued a certificate of authority under article forty-four of the public health law or licensed under this article shall prepare, in conjunction with the superintendent, and shall participate in and share the cost of the publication and dissemination of a consumer's shopping guide for standardized individual health plans issued pursuant to sections four thousand three hundred twenty-one and four thousand three hundred twenty-two of this article and a separate consumer shopping guide for standardized qualifying individual health insurance contracts and standardized qualifying group health insurance contracts issued pursuant to section four thousand three hundred twenty-six of this article. The consumer's shopping guides shall be published annually and shall include the names, addresses and telephone numbers of all health maintenance organizations offering such coverage as well as a description of the plan design and premiums in such a manner that facilitates consumer comparison. Such consumer guides shall also contain, in a manner that facilitates consumer comparison, a selection of the data applicable to each such health maintenance organization from the health care disparities data collection system established under title three-A of article two of the public health law. The data selected as well as the format shall be determined by the superintendent in consultation with the commissioner of health, with consideration given to the views expressed by stakeholders in the review and comment process held pursuant to subdivision eleven of section two hundred forty-seven of the public health law.

§ 3. Subdivision 1 of section 206 of the public health law is amended by adding a new paragraph (w) to read as follows:

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(w) establish, administer and enforce the health care disparities data collection system established under title three-A of this article.

§ 4. Article 2 of the public health law is amended by adding a new title 3-A to read as follows:

TITLE III-A

HEALTH CARE DISPARITIES DATA COLLECTION SYSTEM Section 245. Legislative intent.

246. Definitions.

247. Establishment of health care disparities data collection

system.

248. Dissemination of health care disparities data to the

public.

249. Enforcement.

§ 245. Legislative intent. The legislature finds and declares that substantial disparities exist as to health care outcomes based on race, ethnicity, sex, primary language, disability status, and sexual orientation in this state and in the nation. The intent of this title is to establish a uniform data health care disparities data collection system in this state which will enable health care consumers to be fully informed as to the record of health plans and health care institutions in addressing disparities based on these factors in order to make informed health care choices and for state policymakers to address disparities. The data collection system established under this title shall incorporate the disparities data collected under the patient protection and affordable care act, existing state and federal laws and regulations, and the additional requirements established under this title. It is further the intent of this title that the department assemble health disparities data from all state and federal agencies that presently collect such data or that will be required to collect it in the future and compile this data in a format that is easily accessible and available to the public at no charge.

§ 246. Definitions. The following words and phrases, as used in this title, shall have the following meanings: 1. "Article twenty-eight facility" means any entity regulated under article twenty-eight of this chapter, including a hospital, nursing home, or residential health care facility.

2. "Data provider" means an article twenty-eight facility defined pursuant to subdivision one of this section or a health insurer defined pursuant to subdivision four of this section.

3. "Health care disparities data collection system" or "data collection system" means the collection of information in the form established in this title.

4. "Health insurer" means a health maintenance organization issued a certificate of authority under article forty-four of this chapter, an entity licensed under article forty-three or forty-four of the insurance law, or a person, firm or corporation providing health insurance policies under article thirty-two of the insurance law. Such term shall include a public insurance program.

5. "Patient protection and affordable care act" or "affordable care act" means public law 111-148 and public law 111-152, as such laws may from time to time be amended.

6. "Public insurance program" includes an approved organization pursuant to title one-A of article twenty-five of this chapter and a participant in the program created by section four thousand three hundred twenty-six of the insurance law. Such term shall also include medical

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assistance for needy persons pursuant to title eleven of article five of the social services law.

7. "Race and ethnicity" means all racial categories compiled by the United States census, provided that the "Asian" racial category shall be broken down further into the subcategories designated by the census, including "Asian Indian," "Chinese," "Filipino," "Japanese," "Korean," "Vietnamese," and "other Asian."

8. "Retention rate" means the percentage of those enrolled in a public insurance program that are asked to renew or recertify and do renew or recertify as of two months after the expiration of their previous health insurance coverage.

9. "Take up rate" means the percentage of those eligible for a public insurance program that enroll in the program.

§ 247. Establishment of health care disparities data collection system. 1. The department shall establish by rulemaking a health care disparities data collection system. Once established, the data included in such system shall be made available to the public under the terms established in this title.

2. All data providers shall be required to furnish the data mandated to be submitted under subdivision three of this section and any other data which the department shall prescribe, and otherwise participate in the health care disparities collection system established under this title.

3. The data collection system shall include at least the following data sets disaggregated by race and ethnicity, sex, primary language, disability status, and sexual orientation:

a. in the case of health insurers, the number of subscribers, covered persons (including spouses and children in the case of family coverage), and applicants;

b. in the case of article twenty-eight facilities, the number of patients and data concerning health care quality and health outcomes collected and/or disseminated pursuant to section two thousand nine hundred ninety-five-b of this chapter, and/or any other data in regard to health care quality and health outcomes selected by the department that is generally recognized as authoritative and reliable;

c. in the case of public insurance programs, take up rates and retention rates;

d. data collected or compiled pursuant to section two thousand nine hundred ninety-five-c of this chapter;

e. any data in addition to the data referred to in paragraphs b, c and d of this subdivision in regard to health care quality and outcomes which is required to be disclosed or furnished to any state agency by any provision of law, that is already disaggregated by race and/or ethnicity, sex, primary language, disability status, and/or sexual orientation, or for which it is practicable to disaggregate such data by such factors;

f. any data that is required to be reported in regard to applicants, recipients or participants under title one of the patient protection and affordable care act (42 U.S.C. 300k) and its implementing regulations, as such regulations may from time to time be amended; and

g. any other data or data methodology that the department determines would meet the goals of this title, including data produced or collected by the federal government.

4. Unless the context clearly indicates otherwise, for the purposes of paragraph f of subdivision three of this section, the terms "applicant," "recipient" or "participant" shall have the same meaning as such terms

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are given in the affordable care act and its implementing regulations, as such act and regulations shall from time to time be amended.

5. The department shall require data providers to update at least annually any data that is furnished under subdivision three of this section. Notwithstanding the preceding sentence, for any data collected pursuant to any other provision of law which requires updating more frequently than annually, the frequency provided for in such provision shall apply.

6. Any state agency, including any health benefit exchange or exchanges created in the state under the affordable care act which obtains or possesses data which is subject to this title shall be required to furnish such data to the department upon request, in the format and manner requested by the department. Such agency or entity shall also be required to cooperate with the department in the establishment and maintenance of the data collection system.