MHCC Receives $2.9 Million Grant to Improve Insurance Rate Reviews

BALTIMORE (September 26, 2013)- The Maryland Health Care Commission (MHCC) has been awarded a nearly $2.9 million grant to enhance Maryland’s All Payer Claims Database (APCD), which contains health insurance claim information from private insurers, Medicare, and Medicaid. MHCC will develop new systems to more quickly collect claim information and, working with the Maryland Insurance Administration, will develop tools that allow the Insurance Administration to better assess whether proposed premium increases are justified.

“In Maryland, we are committed to constantly enhancing the way we use data to make government more efficient, effective and transparent and to improve the lives of our residents,” Governor Martin O’Malley said. “These resources will allow us to better use the data we already have as we continue to give all Marylanders access to quality, affordable healthcare.”

Integrating the claims data into the rate review process will allow the Maryland Insurance Administration to review requested rate increases in the context of a carrier’s actual claims experience, as well as State and local trends. MHCC will also create a web-based tool to allow easy access to health prices and insurance rates. The state plans to make some of the summarized information accessible to consumers.

“This grant will allow us to use data more effectively for oversight of insurance rates, which will mean lower prices for Marylanders,” said Dr. Joshua M. Sharfstein, Secretary of the Department of Health and Mental Hygiene.

The grant is from the Center for Consumer Information & Insurance Oversight (CCIIO), the organization in the Centers for Medicare and Medicaid Services (CMS) charged with overseeing the implementation of the provisions ACA related to private health insurance.

“Maryland has been ahead of the national curve on implementing the very reforms that will lower prices for patients while increasing the quality and efficiency of health care. This federal investment recognizes the inherent fairness of Maryland’s All-Payer Claims System and uses the latest technology to help it work better for all of us,” Senator Ben Cardin said.

“Maryland is an innovation state, and I am committed to ensuring we are at the forefront of putting health care reform into action,” Senator Barbara A. Mikulski said. “These funds in the federal checkbook will help strengthen Maryland’s claims system to provide more accurate and timely claims. That’s an important part of implementing health care reform and meeting Maryland’s health care needs.”

The APCD, also called the Medical Care Data Base, was established by the Maryland General Assembly to collect information on health care services provided to Maryland residents by hospitals, health care professionals, and pharmacies. All private insurance carriers with more than $1 million in premiums are required to submit data to the APCD.

The CCIIO Rate Review Grant program makes $250 million available to States over five years to transform the review of health insurance premium increases. The grant program is currently releasing the third cycle of funding. The Maryland Insurance Administration received $1.0 million in 2010 and $3.9 million in 2011 to enhance the rate review process. This latest round of funding will allow rate reviews to incorporate experience and market trends.

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