SB 1062 Summary

• Requires insurers offering provider quality and cost efficiency comparison programs to hire independent health care quality organizations to review their methodologies against national standards

• Establishes 18 mandatory criteria for provider comparison programs, including disclosure of measures and methodologies, consumer and provider input opportunities, complaint resolution processes, and quality/cost data transparency

• Mandates all quality measures be endorsed by the National Quality Forum (NQF) or successor organizations, with fallback options including measures from NCQA, Ambulatory Care Quality Alliance, or Joint Commission (HEDIS)

• Requires any person distributing health care quality and cost efficiency data in comparative format to identify the measure source and evidence-based science, with exemption for peer-reviewed academic journal articles not funded by insurers or government

• Assigns enforcement authority to the Department of Insurance for health insurer violations and to the Department of Health and Senior Services for other entities, with penalties up to $1,000 for violations