NY S04097

Department must collect and analyze health care claims data by December 1 each year to develop a publicly available New York State health benefit plan hospital pricing report.

Report must include comparative analysis of in-network negotiated rates and out-of-network allowed amounts by hospital facility (identified by name and CMS certification number) across four service categories: inpatient hospital, outpatient hospital, emergency room, and physician services.

Report shall detail the top twenty services by volume within each service category, compare rates to Medicare reimbursement under title eighteen of the Social Security Act, and analyze five-year pricing trends.

Report must include all-plan aggregated yearly spending by hospital facility and be delivered to legislative fiscal committees, health care committee chairs, and relevant civil service and governmental employee committee chairs by December 31 each year, then posted on the department website by January 1.

Department shall maintain individual insurers' and health plans' confidential proprietary pricing information as confidential to the extent permitted by law.