BILL ANALYSIS Ó SB 1196 Page 1 Date of Hearing: August 8, 2012 ASSEMBLY COMMITTEE ON APPROPRIATIONS Felipe Fuentes, Chair SB 1196 (Hernández) - As Amended: June 28, 2012 Policy Committee: HealthVote:19-0 Urgency: No State Mandated Local Program: Yes Reimbursable: No SUMMARY This bill prohibits contracts between a health plan or insurer, and a provider or supplier, from prohibiting, conditioning, or restricting the disclosure of health care claims data to a qualified entity that is certified by the federal Health and Human Services Secretary to use the data to evaluate performance on a range of quality and efficiency measures. FISCAL EFFECT Negligible state fiscal effect. COMMENTS 1)Rationale . The author indicates that key reforms in the federal Patient Protection and Affordable Care Act (ACA) intend to promote transparency in price and quality measurements, and that reimbursement reforms and other trends in the health care marketplace demand such transparency. Despite this, the author contends, some providers have prevented price and quality information from being disclosed. The author believes this bill will help ensure successful implementation of data transparency requirements in California by removing barriers to data access. 2)Background . The ACA requires Medicare fee-for-service claims data to be made available to qualified entities for the evaluation of the performance of providers and suppliers. Qualified entities may use the data to evaluate the performance of providers and suppliers, and to generate public reports regarding such performance. Qualified entities are also required to combine claims data from sources other than SB 1196 Page 2 Medicare with the Medicare data when evaluating the performance of providers and suppliers. This bill would ensure that no contractual prohibitions would prevent Medicare and other health care claims data from being transmitted to qualified entities for purposes described above. 3)Related Legislation . SB 751 (Gaines), Chapter 244, Statutes of 2011 prohibited contracts between plans or insurers, and hospitals or hospital-owned facilities, from including provisions that restrict the ability of the plans or insurer to furnish information to enrollees or policyholders concerning the cost and quality of services performed by the hospital or facility. Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081