Health care price transparency tool -- Transparency tool requirements.

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  5. Health care price transparency tool -- Transparency tool requirements.

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Affected by 63I-1-267 on 7/1/2024

Effective 3/17/2021
67-3-11. Health care price transparency tool -- Transparency tool requirements.
  • (1) The state auditor shall create a health care price transparency tool:
    • (a) subject to appropriations from the Legislature and any available funding from third-party sources;
    • (b) with technical support from the Public Employees' Benefit and Insurance Program created in Section 49-20-103, the Department of Health, and the Insurance Department; and
    • (c) in accordance with the requirements in Subsection (2).
  • (2) A health care price transparency tool created by the state auditor under this section shall:
    • (a) present health care price information for consumers in a manner that is clear and accurate;
    • (b) be available to the public in a user-friendly manner;
    • (c) incorporate existing data collected under Section 26-33a-106.1;
    • (d) incorporate data collected under Section 26-61a-106, regarding fees for qualified medical providers recommending medical cannabis, as those terms are defined in Section 26-61a-102;
    • (e) group billing codes for common health care procedures;
    • (f) be updated on a regular basis; and
    • (g) be created and operated in accordance with all applicable state and federal laws.
  • (3) The state auditor may make the health care pricing data from the health care price transparency tool available to the public through an application program interface format if the data meets state and federal data privacy requirements.
  • (4)
    • (a) Before making a health care price transparency tool available to the public, the state auditor shall:
      • (i) seek input from the Health Data Committee created in Section 26-1-7 on the overall accuracy and effectiveness of the reports provided by the health care price transparency tool; and
      • (ii) establish procedures to give data providers a 30-day period to review pricing information before the state auditor publishes the information on the health care price transparency tool.
    • (b) If the state auditor complies with the requirements of Subsection (4)(a), the health care price transparency tool is not subject to the requirements of Section 26-33a-107.
  • (5) Each year in which a health care price transparency tool is operational, the state auditor shall report to the Health and Human Services Interim Committee before November 1 of that year:
    • (a) the utilization of the health care price transparency tool; and
    • (b) policy options for improving access to health care price transparency data.




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