Health Care Transparency Amendments

The deadline for the division to establish and maintain the Medicaid data dashboard was moved from July 1, 2026, to December 31, 2026.

The requirement for the dashboard to include historical data was extended to cover the period from January 1, 2023, through September 30, 2026, instead of ending on July 1, 2026.

A new exception was added allowing the department to withhold publishing reports on improper payments if doing so would interfere with an ongoing investigation by the Office of Inspector General or the Medicaid Fraud Control Unit.

Removed the requirement for risk contractors and subcontractors to conduct annual independent audits of their financial statements and internal controls.

Changed the data reporting mechanism from a 'database' maintained by managed care organizations to a 'dashboard' established and maintained by the Division of Integrated Healthcare.

Modified data granularity requirements; the new dashboard requires data by 'type' (e.g., billing code type, provider type) rather than specific identifiers like 'billing code' or 'national drug code identifier'.

Removed the prohibition on the department engaging actuaries who have provided services to risk contractors within the preceding 12 months.

Removed the requirement for managed care organizations to submit CMS data to the division within 30 days.

Simplified the improper payment reporting section by removing the requirement for managed care organizations to submit CMS data and the specific rules regarding subcontractor data collection.

Deleted a long list of specific legal definitions (e.g., 'Agent', 'Affiliated person', 'Claim', 'Conflict of interest', 'Control', 'Covered service', 'HIPAA', 'Immediate family member', 'Improper payment', 'Inspector general', 'Key employee', 'Managed care organization', 'Managed care plan', 'Managing employee', 'Medicaid provider', 'National drug code identifier', 'Ownership interest', 'Parent organization', 'Pass through payment', 'Protected health information', 'Related party', 'Risk contractor', 'State directed payment', 'Subcontractor', 'Value add benefits', 'Value-based purchasing model').

Added a specific deadline for the division to establish the dashboard by July 1, 2026, and a requirement to include historical data from 2023 through July 2026.

Changed the database mandate from requiring the division to 'establish' a new system to 'maintain' a relational database, allowing the use of existing databases to fulfill the requirement.

Added a new requirement for risk contractors to conduct quarterly root cause analyses on improper payments and submit detailed reports to the division.

Narrowed the definition of 'risk contractor' by removing references to 'health insuring organizations' and specific 'dual eligible special needs plans' that were previously included.

Strengthened conflict-of-interest rules for actuaries by shortening the exclusion period from three years to 12 months and adding restrictions on ownership interests and compensation arrangements.

Moved the bill's effective date forward from May 6, 2026, to April 24, 2026.