Kraft Heinz recently sued Aetna, claiming that the insurer is not providing all of Kraft Heinz’s medical claims data. More lawsuits of this sort are likely to come, experts warned.
“What the law says is that employers cannot enter into an agreement with a third party service provider or network carrier that would limit [the employer’s] access to their [own] de-identified claims data,” said Chris Deacon, founder of VerSan Consulting, in an interview.
“What it does is it inherently recognizes that the claims data is the employer’s and it says you can’t contract with a party that limits your access to that data. The onus is really on the employer to make sure that they’re not party to such agreements. The implication there is very direct that the employer has an obligation and responsibility to be looking at that data … to make sure that they’re spending their plan assets prudently.”