Bill > HB1739

This bill establishes an All Payor Claims Database (APCD) in Pennsylvania to collect, analyze, and report comprehensive healthcare cost and quality data. The database will require various healthcare payors (including government and private insurers), providers, and facilities to submit detailed claims data covering medical, mental health, dental, pharmaceutical, and emergency services. The Health Care Cost Containment Council will oversee the database, with the goal of promoting healthcare transparency, helping consumers compare healthcare costs and quality, supporting regulatory oversight, and enabling research into healthcare spending trends. The bill mandates that data submitted must include information like patient demographics, episode of care details, diagnostic codes, pricing and payment information, and service frequency. Data suppliers who fail to submit or correct data can face significant administrative penalties of up to $1,000 per day. The database will create public reports and interactive tools to help consumers understand healthcare costs, with strict confidentiality protections for personal health information. The council will develop user-friendly, accessible reports in multiple languages and digital formats, with the first public reports to be issued by September 1, 2026. Enforcement of the database's requirements will involve multiple state agencies, with potential penalties including fines up to $250,000 per day, license suspensions, and other disciplinary actions for non-compliance.

Health and Social Services

https://www.legis.state.pa.us/cfdocs/billinfo/bill_history.cfm?syear=2025&sind=0&body=H&type=B&bn=1739