2020 West Virginia Code
Chapter 33. Insurance
Article 4A. All-Payer Claims Database
§33-4A-4. Data Subject to This Article
(a) All health care payers shall submit data to the secretary, or an entity designated by the secretary, at such times and in a form specified in rule. Any health care payer that the secretary or commissioner determines paid or administered the payment of health insurance claims in this state for policies on fewer than 500 covered lives in the previous calendar year is exempt from the requirements of this article.
(b) Data submitted in accordance with this article shall be considered confidential by law and privileged, are exempt from disclosure pursuant to 29B-1-1 et seq. of this code, are not open to public inspection, are not subject to subpoena, are not subject to discovery or admissible in evidence in any criminal, private, civil, or administrative action, are not subject to production pursuant to court order, and shall only be used and disclosed pursuant to law and legislative rules promulgated pursuant to this article.
(c)(1) Data submitted to and retained by the all-payer claims database (APCD) shall be available as a resource for the secretary and commissioner to conduct public health analyses, conduct program analyses, review health care utilization, expenditures, and performance in West Virginia, conduct academic research, and to enhance the ability of consumers to make informed and cost-effective health care decisions.
(2) Data submitted to and retained by the APCD may, in accordance with this article and the legislative rules promulgated pursuant to this article, also be available as a resource for insurers, researchers, employers, providers, purchasers of health care, consumers, and state agencies. Any such use shall be limited to public health, research, consumer reporting, and program evaluation purposes.
(d) Notwithstanding any other provision of law to the contrary, the APCD may not disclose any data that contain personal identifiers. The secretary, in accordance with procedures and standards set forth in legislative rule, may approve access to data elements not prohibited from disclosure by the APCD, as well as synthetic or created unique identifiers, for use by researchers, including government agencies, with established protocols for safeguarding confidential or privileged information. Use of the data by the secretary and commissioner shall not constitute a disclosure.
