New Mexico Register / Volume XXXI, Issue
22 / November 24, 2020
NOTICE OF PUBLIC HEARING
The New
Mexico Department of Health will hold a public hearing on the proposed adoption of rule, 7.1.31 NMAC, “Statewide Health Care Claims Database.” The public hearing will be held on January 6,
2021 at 9:30 am via Cisco Webex online, via telephone,
and, comments will be received via email through the day of the hearing until
5:00 pm. The hearing is being held via
internet, email and telephonic means due to the concerns surrounding
Coronavirus and in accord with Governor Michelle Lujan Grisham’s Executive
Order 2020-004, Declaration of a Public Health Emergency, and any subsequent
executive orders, and the March 12, 2020 Public Health Emergency Order to Limit
Mass Gatherings Due to COVID-19. This
hearing will be conducted to receive public comment regarding the adoption of the proposed rule, 7.1.31 NMAC, concerning the creation and
maintenance of a repository of healthcare claims data to be used to increase
the quality and effectiveness of health care delivered in New Mexico. The adoption
of the proposed rule will assist in making health care costs more
transparent to the public; fulfilling the DOH’s legislative obligations in
24-14A-3, NMSA 1978, as part of the overall “Health Information System”,
“created for the purpose of assisting the department, legislature and other
agencies and organizations in the state's efforts in collecting, analyzing and
disseminating health information to assist: in the performance of health
planning and policymaking functions, including identifying personnel, facility,
education and other resource needs and allocating financial, personnel and
other resources where appropriate; consumers in making informed decisions
regarding health care; and in administering, monitoring and evaluating a
statewide health plan.
By
adopting this rule the Department proposes to establish a statewide all-payer
claims database (“APCD”) to support transparent public reporting of health care
information. An APCD is a repository of
healthcare claims data that combines data from multiple payers, including
Medicare, Medicaid, private insurers, dental insurers, children’s health
insurance, self-insured employer plans, and pharmacy
plans. An APCD for New Mexico would
provide the opportunity to aggregate health care data including outpatient
visit, pharmacy, cost, and other data, for dissemination to the public,
researchers, and others for the purposes of improving health care planning,
quality, and consumer choice. The database should improve transparency to:
assist patients, providers, and hospitals to make informed choices about care;
enable providers, hospitals, and communities to improve by benchmarking their
performance against that of others by focusing on best practices, enable
purchasers to identify value, build expectations into their purchasing
strategy, and reward improvements over time; and promote competition based on
quality and cost. The database will
systematically collect all medical claims for covered medical services,
pharmacy claims, dental claims, member eligibility and enrollment data, and
provider data with necessary identifiers from
private and public payers, with data from all settings of care that permit the
systematic analysis of health care delivery.
The legal
authority authorizing the proposed amendment of the rule by the Department is
at Subsection E of Section 9-7-6, NMSA 1978 and the Health Information System
Act, 24-14A-1 et seq. NMSA 1978. A free
copy of the full text of the proposed rule can be obtained from the
Department’s website at https://nmhealth.org/publication/regulation/.
Any
interested member of the public may attend the hearing and offer public comments
on the proposed rule during the hearing. To access the hearing by telephone: please
call 1-408-418-9388. Your telephone
comments will be recorded. To access the
hearing via internet: please go to Webex.com; click the “Join” button; click
the “Join a meeting” button; enter the following meeting number and password
where indicated on screen—Meeting number (access code): 146 647 3114# Meeting password: aJNBXEPt674; click
the “OK” button. You may also provide
comment via Chat during the live streaming.
Written
public comments may also be submitted to the mailing address shown below. Please submit any written comments regarding
the proposed rule to the attention of:
Kenneth Geter, Bureau Chief
Community & Health Systems Epidemiology Bureau
Epidemiology and Response Division
New Mexico Department of Health
1190 S St. Francis Dr., Ste
N1320
Santa Fe, NM 87505
(505) 827-2694
Mailed
written comments must be received by 5 pm MST on January 6, 2021. Written
comments may also be submitted to the email address shown above through 5:00 pm
MST on the date of the hearing. All
written comments will be published on the agency website at https://nmhealth.org/publication/regulation/ within 3 days of receipt,
and will be available at the New Mexico Department of Health Office of General
Counsel for public inspection.
If you are
an individual with a disability who is in need of special assistance or
accommodations to attend or participate in the hearing, please contact Sheila
Apodaca by telephone at (505) 827-2997. The
Department requests at least ten (10) days advance notice to provide requested
special accommodations