East PDX Today

WASHINGTON, D.C. – The House Committee on Education and the Workforce voted to advance H.R. 4527, the Health Data Access, Transparency, and Affordability (DATA) Act. The bipartisan proposal, introduced by Reps. Lori Chavez-DeRemer (OR-05) and Mark Takano (CA-39) and cosponsored by Rep. Kathy Manning (NC-06), seeks to close loopholes by improving transparency in the health insurance marketplace – streamlining employers’ ability to compare plans and provide their workers with high quality and affordable health benefits.

“Small business owners have enough on their plate – they shouldn’t have to play games with PBMs and TPAs to fully understand the cost of the health plans they’re offering employees. Our bipartisan Health DATA Act is a commonsense solution that will make it easier for employers to choose more affordable health care options. I’m glad our bill passed committee and will continue pushing to get it signed into law,” Chavez-DeRemer said.

"I'm pleased that the Health DATA Act, legislation I co-led with Reps. Chavez-DeRemer and Manning to hold PBMs and third-party administrators accountable and create a more patient-centered and efficient healthcare system, passed out of the Education and the Workforce Committee markup. By cracking down on the methods by which these PBMs and TPAs evade their legal obligations, we are fostering transparency and accountability within the healthcare system, ultimately leading to improved cost management and better quality of care for plan participants," Takano said.

“Increasing transparency in the health care system is critical to lowering costs. I’m proud to lead the Health Data Act with Representatives Chavez-DeRemer and Takano to hold PBMs and third-party administrators accountable, creating a more efficient health care system that offers better quality care for patients,” said Manning. “I’m pleased that members on both sides of the aisle recognized the importance of increased transparency and passed the commonsense Health Data Act through the Education and Workforce Committee. I’ll continue working to ensure that this legislation is passed through the U.S. House.”

Some pharmacy benefit managers (PBMs) and third party administrators (TPAs) are using loopholes to circumvent current law by limiting the number of claims an employer can audit, limiting the number of audits an employer can conduct, demanding the audit be conducted by their own company, hiding indirect compensation received by the service provider for its role administering a plan, and demanding that the audit take place on the service providers’ premises.

The Health DATA Access Act would close these loopholes by ensuring that a contract or arrangement entered by an employer sponsored health plan and the service provider may not:

• Restrict a plan fiduciary from auditing, reviewing, or otherwise accessing de-identified claims data;  
• Restrict the plan fiduciary from choosing who will conduct any audits of claims; or 
• Limit the number of claims that the plan fiduciary may audit in a given time period.

Full text of the bill is available HERE.

Original source can be found here.