As used in this article, the term: “Administrator” means the administrator of the GAPCD. “Advisory committee” means the GAPCD Advisory Committee established pursuant to Code Section 31-53-41. “Claims data” means information included in an institutional, professional, or pharmacy claim or equivalent information transaction for a covered individual, including the amount paid to a provider of […]
There is established the GAPCD Advisory Committee for the purpose of making recommendations regarding the creation of the framework and implementation plan for the GAPCD to facilitate the reporting of health care and health quality data resulting in transparent and public reporting of safety, quality, cost, and efficiency information at all levels of health care. […]
The advisory committee shall make initial recommendations to the director no later than March 1, 2021, regarding the creation and operation of a state all-payer claims database, to be known as the GAPCD, that: Include specific strategies to measure and collect data related to health care safety and quality, utilization, health outcomes, and cost; Focus […]
The director shall seek funding for the creation of the all-payer health claims database and develop a plan for the financial stability of the GAPCD. No later than March 15, 2021, the director shall report to the Governor and the General Assembly on the status of the funding effort and on the status of the […]
The objectives of the GAPCD shall be to facilitate data-driven, evidence-based improvements in access, quality, and cost of health care and to promote and improve public health through the understanding of health care expenditure patterns and operation and performance of the health care system. Specific uses of the GAPCD include, but are not limited to: […]
The administrator of the GAPCD shall be the Center for Health Analytics and Informatics of the Georgia Institute of Technology. The administrator, in consultation with the advisory committee, shall: Determine the data to be collected from submitting entities and the method of collection, including mandatory and voluntary reporting of health care and health quality data; […]
The advisory committee and the administrator should consider the following design criteria: Allowing the use of federal Health Insurance Portability and Accountability Act of 1996 compliant, government level secured cloud computing resources to save funding; Ensuring all inbound data is converted to a common standard and ensuring that data quality checks are done on inbound […]
Beginning in January, 2023, and every month thereafter, all submitting entities shall submit claims data for state residents to the GAPCD in accordance with this article and rules and regulations promulgated pursuant to this article. Submitting entities shall submit 95 percent of data within 60 days from the day that the adjudicated claims were paid, […]
The GAPCD shall be designed to: Provide access to the public through a public portal, contingent on funding, in a form and manner that ensures the privacy and security of personal health information as required by state and federal law, as a resource to insurers, consumers, employers, providers, purchasers of health care, and state agencies […]
The administrator shall prepare an annual report to include: Any policies established or revised pursuant to state and federal medical privacy laws, including the federal Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended; The number of requests for data and reports from the GAPCD, whether the request was submitted by a […]
Except as otherwise provided in this Code section, any submitting entity that fails to submit claims data in accordance with this article shall be subject to penalty. The office shall adopt a schedule of penalties not to exceed $1,000.00 per day of violation, determined by the severity of the violation. A penalty imposed under this […]
The office shall promulgate rules and regulations necessary to implement the provisions of this article. History. Code 1981, § 31-53-51 , enacted by Ga. L. 2020, p. 743, § 1/SB 482.
If at any time it is determined that there is not sufficient funding to finance the ongoing operations of the GAPCD, the GAPCD shall cease operating and the advisory committee and administrator shall no longer have the duty to carry out the functions required pursuant to this article. If the GAPCD ceases to operate, any […]
Nothing in this article shall be construed to impose any reporting obligation on any self-funded employer or plan sponsor, or to impose any requirement with respect to the manner in which any such self-funded plan is administered. Nothing in this article shall prevent an insurer or third-party administrator from communicating its views to an employer […]
