Data Submission Program
All health carriers operating in Washington state must submit claims to the WA-APCD, as well as state Medicaid plans, public-employee benefits plans, third-party administrators paying claims on behalf of health plans, and the Washington State Labor and Industries program (RCW 43.371.030). Self-funded employer-sponsored plans and Taft-Hartley trust health plans may submit claims data on a voluntary basis. Submitters are organized into two reporting groups, Group 1 and Group 2.
Group 1 data submitters
Group 1 submitters include commercial health insurers, Medicaid managed care organizations (MCOs), Medicare Advantage plans, and Medicare Part D drug plans for Medicare Advantage enrollees. Data will also be supplied for persons covered under the Health Care Authority Public Employees Benefits Board (PEBB) and Medicaid fee-for-service programs.
Milestones with due dates
Waiver Documents Publicly Available
1/6/17
Data Submission Guide Comments Due from Data Submitters
1/9/17
Final Data Submission Guide Release
1/16/17
Waiver Requests Due
3/15/17
WA-APCD Ready to Accept Data
3/15/17
Historical Data Intake (2013-6)
3/15/17-5/15/17
First Quarterly Data Intake (1QTR 2017 and 2QTR 2017)
7/31/17
Group 2 data submitters
Group 2 submitters include stand-alone dental insurers, the Washington State Labor and Industries program (workers’ compensation), voluntary submitters (self-funded and others), and commercial insurers not included in Group 1.
Milestones with due dates
Group 2 Initial Data Supplier Registration
5/22/17-6/21/17
WA-APCD Ready to Accept Group 2 Data
11/15/17
Data Exemption (Exception) Applications Due
11/30/17
Intake of Historical Data
11/15/17-1/14/18
Data Exemption (Waiver) Applications for First Quarterly Submissions Due
3/1/18
Data Exemption (Extension) Applications for First Quarterly Submissions Due
3/31/18
First Quarterly Data Intake (1QTR-4QTR 2017 and 1QTR 2018)
4/30/18
Additional data submission information
Data suppliers can log into the Onpoint Claims Data Manager to access submission documentation and details.