The Health DATA Act would require group health plans to be allowed to audit de-identified claims and encounter data held by service providers. Contracts could not unreasonably restrict audits, access to pricing details, or disclosure of overpayments. The bill also sets privacy rules for shared data and makes plan fiduciaries responsible for data they control. It would prohibit employers, plan sponsors, administrators, and fiduciaries from discriminating against participants or beneficiaries based on plan data. Violations could lead to civil penalties.
If you are covered by a group health plan, the bill would add protections against discrimination based on certain plan data. It would also give plans broader rights to review data and service provider payments, subject to privacy requirements. The bill would allow certain participants and beneficiaries to seek relief in court without first using the plan’s administrative process.
The bill does not provide a cost estimate or specify government spending. It authorizes civil penalties, including $10,000 per day for certain service-provider violations and $100 per day for each affected participant or beneficiary in cases of discrimination.
No publicly available information.
No publicly available information.