HB 5327

Abstract

Creates the All Payer Claims Database Act. Provides that the Department of Insurance shall establish an All Payer Claims database for sharing limited use health care data. Provides that the All Payer Claims database shall not include or disclose any data that contains direct, primary, or obvious personal identifiers, and that the Department shall develop criteria and procedures to ensure that limited use health care data complies with the requirements of Health Insurance Portability and Accountability Act of 1996. Provides that the Department shall make available to the public on its website a public limited use health care data set for purposes of facilitating transparency in health care costs; that the public limited use health care data set shall be publicly accessible, publicly searchable, contain current information, and have easy to use online tools; and that the Department shall publish the data set in a standardized, consumer-friendly format. Provides that in presenting limited use health care data for public access, the Department shall make comparative considerations regarding geography, demographics, general economic factors, and institutional size. Provides that all health care payers shall annually submit health insurance claims information as claims data without personally identifying information to the Department. Provides that the Department shall adopt rules as may be necessary to provide for the release of health care data from the database. Defines terms. Amends the Hospital Licensing Act. Provides that before providing any nonemergency medical services, each licensed hospital shall provide in writing or by electronic means a good faith estimate of reasonably anticipated charges by the hospital for the treatment of the patient's specific condition. Provides that the hospital shall provide the estimate to the patient within 7 business days after recommending a specific course of treatment or set of services. Provides that a hospital may not charge the patient more than 110% of the estimate. Provides that a hospital that fails to provide the estimate within the timeframe required shall be liable for a daily fine of $1,000 until the estimate is provided to the patient and that the total fine may not exceed $10,000. Amends the University of Illinois Hospital Act to make similar changes.