NY A08507

Requires the department to collect and analyze health care claims data from the Empire Plan or its successor by December 1st each year to develop a publicly available hospital pricing report.

Report must exclude optional benefit plan claims and Medicare primary individual claims, and include comparative analysis of in-network and out-of-network allowed amounts for each New York hospital identified by name and CMS certification number.

Report shall cover four service categories: inpatient hospital, outpatient hospital, emergency room services, and physician services provided during inpatient admissions, outpatient visits, or emergency room services.

Report must include top twenty services by volume within each service category per hospital facility and analyze trends using prior two years of pricing data, including all-plan aggregated yearly spending by hospital.

Report shall be delivered to legislative fiscal committees, health care committee chairs, and relevant oversight committees by December 31st each year and posted on the department website by January 1st, with confidential proprietary pricing information protected.