This bill amends the current law regarding the provision of claims experience data by the State Health Benefits Program (SHBP) and the School Employees Health Benefits Program (SEHBP) to public employers. It changes the frequency of data requests from once every 24 months to once per calendar year and allows the majority representative of the employees of the public employer to request the data if the employer has made a request. The bill mandates that the claims experience data provided must include a comprehensive list of specific information, such as medical claims summaries, prescription utilization reports, and detailed reports on high-cost medical claims.

Additionally, the bill reinforces privacy protections by ensuring that the claims experience data is released in compliance with the federal Health Insurance Portability and Accountability Act (HIPAA) and prohibits the release of information that could identify individuals or adversely affect personal privacy rights. These provisions aim to enhance transparency for public employers while safeguarding the privacy of individuals involved in the health benefits programs. The same requirements for data provision and privacy protections will apply to both the SHBP and SEHBP.

Statutes affected:
Introduced: 52:14-17.37