(a)As used in this Code section, the term "state health plan" means:
(1)Medical assistance program provided pursuant to Article 7 of Chapter 4 of Title 49;
(2)PeachCare for Kids Program provided pursuant to Article 13 of Chapter 5 of Title 49;
(3)The state employees' health insurance plan established pursuant to Article 1 of Chapter 18 of Title 45;
(4)The health insurance plan for public school teachers established pursuant to Subpart 2 of Part 6 of Article 17 of Chapter 2 of Title 20; and (5) The health insurance plan for public school employees established pursuant to Subpart 3 of Part 6 of Article 17 of Chapter 2 of Title 20.
(b)On and after July 1, 2022, the department shall post in a prominent location on the department website a statistical report or reports containing data rel
Free access — add to your briefcase to read the full text and ask questions with AI
(a) As used in this Code section, the term "state health plan" means: (1) Medical assistance program provided pursuant to Article 7 of Chapter 4 of Title 49; (2) PeachCare for Kids Program provided pursuant to Article 13 of Chapter 5 of Title 49; (3) The state employees' health insurance plan established pursuant to Article 1 of Chapter 18 of Title 45; (4) The health insurance plan for public school teachers established pursuant to Subpart 2 of Part 6 of Article 17 of Chapter 2 of Title 20; and (5) The health insurance plan for public school employees established pursuant to Subpart 3 of Part 6 of Article 17 of Chapter 2 of Title 20. (b) On and after July 1, 2022, the department shall post in a prominent location on the department website a statistical report or reports containing data relating to the state health plans administered by the department. Such reports shall be updated and posted no less than biannually and shall contain, but shall not be limited to, the following metrics: (1) The number of, type of, and changes in enrolled providers; (2) County-level data on primary care providers enrolled per 1,000 people and indicating which counties fall below defined benchmarks; (3) Data on hospital utilization and costs, including but not limited to, the number of inpatient admissions, average length of stay, readmission rate, emergency department utilization information, including diagnosis and non-emergent utilization, and amounts paid per facility, including plan paid amounts or net payment per admission; (4) Membership or beneficiary enrollment data including demographic and population based reporting on common disease states; (5) Data on prescription drug spending, including data on aggregate payment amounts for the ten most frequently prescribed medications and the ten most costly medications, as well as historical data related to the volume and cost of such medications, whether brand name drug or generic brand drug utilization, and costs; (6) Financial results by aid category or plan group, as applicable, including per-member per-month cost figures for low-income Medicaid, PeachCare for Kids, and fee-for-service program categories; and (7) Long-term care data, including waiver services participation and net payments by category of service. (c) Nothing in this Code section shall be construed to require the inclusion in the report or reports posted pursuant to subsection (b) of this Code section of any information which would violate the federal Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, or which is exempt from disclosure under the provisions of Article 4 of Chapter 18 of Title 50, relating to open records. Pursuant to Code Section 28-9-5 , in 2022, this Code section enacted as Code Section 31-2-17 was redesignated as Code Section 31-2-18.