Texas Insurance Code
§ 38.404 — ESTABLISHMENT AND ADMINISTRATION OF DATABASE
IN § 38.404Title 2. TEXAS DEPARTMENT OF INSURANCE · Part A. ADMINISTRATION OF THE TEXAS DEPARTMENT OF INSURANCE · Ch. 38. DATA COLLECTION AND REPORTS · Art. I. TEXAS ALL PAYOR CLAIMS DATABASE
Statute text
View on source(a)The department shall collaborate with the center under this subchapter to aid in the center's establishment of the database. The center shall leverage the existing resources and infrastructure of the center to establish the database to collect, process, analyze, and store data relating to medical, dental, pharmaceutical, and other relevant health care claims and encounters, enrollment, and benefit information for the purposes of increasing transparency of health care costs, utilization, and access and improving the affordability, availability, and quality of health care in this state, including by improving population health in this state.
(b)The center shall serve as the administrator of the database, design, build, and secure the database infrastructure, and determine the accuracy of the data submitted for inclusion in the database.
(c)In determining the information a payor is required to submit to the center under this subchapter, the center must consider requiring inclusion of information useful to health policy makers, employers, and consumers for purposes of improving health care quality and outcomes, improving population health, and controlling health care costs. The required information at a minimum must include the following information as it relates to all health care services, supplies, and devices paid or otherwise adjudicated by the payor:
(1)the name and National Provider Identifier, as described in 45 C.F.R. Section 162.410, of each health care provider paid by the payor;
(2)the claim line detail that documents the health care services, supplies, or devices provided by the health care provider;
(3)the amount of charges billed by the health care provider and the payor's:
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Legislative history
Acts 2023, 88th Leg., R.S., Ch. 603 (H.B. 3414), Sec. 3, eff. June 11, 2023.