All-Payer Claims Database (APCD)

 APCD2

Questions?

Email APCD@dhcfp.nv.gov

 

The All-Payer Claims Database (APCD) will collect and analyze healthcare claims data from all payers, including Medicaid, Medicare, and other public and private payers. This database will help the state to monitor healthcare utilization, cost, quality and evaluate the impact of programs, demonstrations, and initiatives. It will also support health policy decisions related to healthcare and payment initiatives, to foster a more efficient healthcare system.

PURPOSE: To enhance transparency, improve healthcare quality, and reduce costs by providing comprehensive data on healthcare utilization, costs, and outcomes.

WHO IS IMPACTED: According to NRS Chapter 439B, an APCD is a database that includes medical claims, pharmacy claims, dental claims, eligibility information, and provider files collected from Nevada's healthcare payers. They will be reporting data directly to the APCD.

TRAINING: Training and other notifications will be sent over the APCD email list. Sign up for notifications here.

HISTORY: Existing law and regulatory authorities Senate Bill 40 passed during the 81st (2021) Session of the Nevada Legislature and was signed into law on June 7, 2021. It included the establishment and the implementation of an APCD to collect, manage, and analyze healthcare claims data from all payers in Nevada.

 

Goals

  • Increase transparency in healthcare pricing, with a focus on prescription drug costs.
  • Enhance consumer engagement and support informed decision making.
  • Analyze regional cost variations and identify contributing factors.
  • Promote quality improvements in healthcare services.
  • Support data driven policy development and legislative initiatives.

Data Submission Guide

As the Department prepares for the implementation of the APCD, we understand the importance of the APCD Data Submission Guide (DSG) to data submitters. Several training sessions will be hosted in collaboration with our vendor and data submitters throughout the process. The DSG is a data submission formatting guide aligned with the APCD Common Data Layout (APCD-CDL). The Department and the vendor will notify data submitters when these training sessions are scheduled.

Timeline

Vendor contract start        Jan. 4, 2024 
Onboard vendor and project kick-off        Jan.-Feb. 2024   
Revise proposed regulations resubmission (LCB)        Aug. 2024
Public Hearing: APCD Notice of Intent to Adopt        Oct. 1, 2024     
Final adoption/approval from Legislative Commission Board         Nov. 15, 2024
Launch of APCD Data Submission Portal        Dec. 9, 2024
Webinar: Intro to Submitter Registration        Dec. 17, 2024
Registration deadline         Feb. 1, 2025 
Trainings and one-on-one onboarding        Jan.-Mar. 2025
Test file submission due to Onpoint        Mar. 2025
Three (3) yrs of historical data & quarterly submissions due        July 2025

Notifications will be sent over the APCD email list.
Sign up for notifications
here.


Please continue to check this page for important updates.

Questions?

Email APCD@dhcfp.nv.gov