Feds Ready National Claims Database
The federal government plans to build a national database of health care claims data covering tens of millions of individuals covered, or soon to be covered, under three government health plans.
The federal government plans to build a national database of health care claims data covering tens of millions of individuals covered, or soon to be covered, under three government health plans.
In a notice published Oct. 5 in the Federal Register, the U.S. Office of Personnel Management said "this action will be effective without further notice on November 15, 2010, unless comments are received that would result in a contrary determination."
The Health Claims Data Warehouse will contain a wide array of information on individuals covered under the existing Federal Employee Health Benefit Program and two programs created under the health reform law: The National Pre-Existing Condition Insurance Program and the Multi-State Option Plan that will provide a range of coverage nationwide.
The Office of Personnel Management will analyze collected data to assess the best value for enrollees and taxpayers. "OPM will collect, manage and analyze health services data on an ongoing basis by establishing regular data feeds for each of three programs," according to the notice. "In many instances, the data will be de-identified for specific analyses that provide flexible queries of the data set for general demographic queries, risk-adjusted profiles, and comparison of chronically ill patients and other useful analytics; and engage in econometric modeling of, among other things, health trends, risk adjustment methodologies, pharmacy pricing and negotiation."
Data in the national warehouse could include name, Social Security number, date of birth, gender, phone number, address, spouse and dependent names and addresses, and information on employment, providers, coverage, procedures and diagnoses, along with related provider charges and reimbursement.
Further, the data will be shared with other entities for law enforcement purposes, congressional inquiries when individuals request assistance from their congressional office, judicial and administrative proceedings, national archives and records administration, within the Office of Personnel Management for statistical/analytical studies, and for litigation in which the office is authorized to appear.
The warehouse will maintain records for seven years before destroying them by electronic erasure. Individuals will have the right to find out if the warehouse contains information about them and to request amendment of records.
To access the Federal Register notice, click here.
--Joseph Goedert
In a notice published Oct. 5 in the Federal Register, the U.S. Office of Personnel Management said "this action will be effective without further notice on November 15, 2010, unless comments are received that would result in a contrary determination."
The Health Claims Data Warehouse will contain a wide array of information on individuals covered under the existing Federal Employee Health Benefit Program and two programs created under the health reform law: The National Pre-Existing Condition Insurance Program and the Multi-State Option Plan that will provide a range of coverage nationwide.
The Office of Personnel Management will analyze collected data to assess the best value for enrollees and taxpayers. "OPM will collect, manage and analyze health services data on an ongoing basis by establishing regular data feeds for each of three programs," according to the notice. "In many instances, the data will be de-identified for specific analyses that provide flexible queries of the data set for general demographic queries, risk-adjusted profiles, and comparison of chronically ill patients and other useful analytics; and engage in econometric modeling of, among other things, health trends, risk adjustment methodologies, pharmacy pricing and negotiation."
Data in the national warehouse could include name, Social Security number, date of birth, gender, phone number, address, spouse and dependent names and addresses, and information on employment, providers, coverage, procedures and diagnoses, along with related provider charges and reimbursement.
Further, the data will be shared with other entities for law enforcement purposes, congressional inquiries when individuals request assistance from their congressional office, judicial and administrative proceedings, national archives and records administration, within the Office of Personnel Management for statistical/analytical studies, and for litigation in which the office is authorized to appear.
The warehouse will maintain records for seven years before destroying them by electronic erasure. Individuals will have the right to find out if the warehouse contains information about them and to request amendment of records.
To access the Federal Register notice, click here.
--Joseph Goedert
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