All-Payer Claims Database Project - Coming Soon

 APCD2

The Department of Health and Human Services (DHHS), Division of Health Care Financing and Policy (DHCFP) is preparing to launch an All-Payer Claims Database (APCD). 

In support of existing law related to the quality, accessibility, and affordability of health care needs of the residents of this state, Senate Bill 40 was passed in the 81st (2021) Session of the Nevada Legislature and signed into law on June 7, 2021. The Bill includes the implementation of an APCD containing information relating to health insurance claims for benefits provided in this State.

An APCD will allow Nevada to collect data in effort to improve healthcare transparency by permitting the examination of costs, quality, and utilization. Access to APCD data will assist the state to assess the impact of programs, demonstrations, and initiatives as well as assist with health policy decisions that support healthcare and payment reform initiatives.
 
In accordance with NRS 439B.800 through 439B.875, an APCD is a large database that includes medical claims, pharmacy claims, dental claims, eligibility, and provider files collected from private and public payers. Insurers will report data directly to the APCD. 

Goals

  • Promote healthcare price transparency, particularly for prescription drugs.
  • Promote consumer engagement and informed decision making.
  • Understand regional cost variation and the driving factors.   
  • Quality improvement. 
  • Facilitate data driven policy decision and legislative actions. 

Data Submission Guide

As the Department prepares for the upcoming project and begins onboarding the vendor, we understand the importance of the APCD Data Submission Guide (DSG) to stakeholders. We will work closely with the vendor on this and encourage input from data submitters by conducting public workshop sessions for those who will be utilizing this guide, as they will be required to submit health data in accordance with the DSG. The DSG will establish file requirements for developing data files for submission. Data submitters/stakeholders will be notified once these sessions are scheduled.

Timeline/Events

Event       Date/Status
Vendor Contract Start Date        January 4, 2024 
Onboard Vendor and Project Kick-Off        Jan.-Feb. 2024   
Revise Proposed Regulations Resubmission        April 30, 2024/In Progress

Please continue to check this page for important updates