New York expands Medical and Indemnity Data call reporting

March 8, 2023 / 8 min read

On February 16, 2023, the Board of Governors of the New York Compensation Insurance Rating Board (“Rating Board”) approved a proposal requiring all member carrier groups, regardless of premium market share in New York State, to report data in response to the Medical Data Call (“MDC”) and Indemnity Data Call (“IDC”). The Rating Board announced this change via bulletin dated February 27, 2023.

Significantly, as noted, New York is expanding MDC and IDC reporting “regardless of premium market share.”^[1] Currently, New York’s MDC and IDC data calls apply to member groups with premium market share in New York exceeding 0.5% in any of the most recent three calendar years.^[2] This expansion becomes effective starting either January 1, 2024, or January 1, 2025, depending on a member carrier group’s current reporting status as outlined more fully below.

Ny-expands-medical

The following provides key details about New York’s upcoming data call extensions, claims impact, and how Verisk can help:

New York’s MDC and IDC data calls - background

New York began collecting medical transactional data via the MDC in 2011 and detailed indemnity data via the IDC in 2020.^[3] The Rating Board notes that these data calls help them “(i) validate data elements utilized in ratemaking, (ii) research and study the complex workers’ compensation system in New York, (iii) track trends and reforms, (iv) support the public actuary in legislative analysis efforts, as well as (v) provide understanding and context to periodic changes in various pricing values.”^[4]

Upon adopting the MDC and IDC, the Rating Board established that “member carrier groups with premium market share in New York State exceeding 0.5% in any of the most recent three calendar years are required to report MDC and IDC data.”^[5]As noted above, the Rating Board is now expanding MDC and IDC reporting regardless of premium market share per the timelines outlined in the next section.

Implementation and timelines

The Rating Board will implement its plan to expand MDC and IDC reporting in two phases as follows:

Phase 1: Member Carrier Groups Reporting MDC and IDC in Other Jurisdictions (transactions on and after January 1, 2024) -- These groups will be required to report MDC and IDC data to the Rating Board reflecting transactions occurring on and after January 1, 2024, with the first data submission due on June 30, 2024.^[6]

Phase 2: Member Carrier Groups Not Reporting MDC and IDC in Any Jurisdiction (transactions on or after January 1, 2025) -- The Rating Board is giving these groups additional time to prepare for this expansion. On this point, the Rating Board states that it “recognizes that member carrier groups who do not currently report MDC and IDC data in other jurisdictions have likely not yet developed the infrastructure to effect reporting in the near term, and that the requisite information technology development effort may be time intensive.”^[7]As such, the Rating Board notes that these groups will be required to report MDC and IDC data to the Rating Board reflecting transactions on and after January 1, 2025, with the first data submission due on June 30, 2025.^[8] Further, the Rating Board notes that it will be contacting these group in March of 2023 to discuss the implementation timeline for each member carrier group.^[9]

Regarding the above timelines, the Rating Board notes that it “will work with member carrier groups who are unable to satisfy the timelines listed above to find a mutually agreeable implementation timeline.”^[10] Likewise, the Rating Board indicates that it will work with new carrier groups entering the New York marketplace in the future “to find a mutually agreeable implementation timeline.”^[11]

Data call expansion – rationale

In support of extending MDC and IDC reporting, the Rating Board states, in part, that “[r]equiring that all member carrier groups participate in the MDC and IDC, regardless of New York premium market share, promotes equal treatment of all member carrier groups and benefits the marketplace in a variety of ways."^[12]

As examples, the Rating Board references the following four bases for this expansion:

First, the Rating Board notes that “member carrier groups expend resources submitting MDC and IDC data to the Rating Board, and that obligation should be applied equally across all member carrier groups.”^[13]

Second, the Rating Board views the MDC and IDC data as “provid[ing] significant value to the Rating Board and broader workers’ compensation community, and increasing participation will enhance data credibility as well as ensure that the data is representative of the entire marketplace.”^[14] On this point, the Rating Board further comments: “For example, member carrier groups who do not currently submit MDC and IDC data may focus on a particular segment of the insured market with unique exposure or claims experience. Collecting detailed data from such carrier groups will provide insight into market segments that are not sufficiently reflected in the data collected at present. Maintaining a database that reflects the entire marketplace will enhance the Rating Board’s research studies and analyses.”^[15]

Third, the Rating Board notes that it uses MDC and IDC data “to support data validation efforts” and “[c]ollecting data from the entire marketplace – member carrier groups large and small – will enable the Rating Board to perform additional data validation, resulting in more accurate data, research, services, and products.”^[16]

Finally, the Rating Board notes that, in some situations, “a member carrier group’s market share exceeds the current fixed 0.5% reporting threshold in one year and falls short of this threshold in other years … [and that] [s]uch volatility may result in member carrier groups reporting MDC and IDC data intermittently, causing data collection and data validation challenges.”^[17]

Penalty

Member groups who refuse to participate in the MDC and IDC will be penalized. On this point, the Rating Board states: “A member carrier group’s refusal to participate in the MDC and IDC will result in a financial penalty in an amount to be determined by the Rating Board, and such penalty shall continue and compound with interest until such member carrier group comes into compliance with the Rating Board’s data reporting requirements.”^[18]

Time to get ready – how Verisk can help!

New York’s forthcoming expansion of the MDC and IDC data calls is significant in that reporting will be required regardless of premium market share. In the bigger picture, it will be interesting to monitor if New York’s expansion will lead other Data Collection Organizations to follow suit.

Now is the time for insurers to start preparing for these new requirements. If you are currently reporting IDC and/or MDC via our wcPrism solution, we can help you comply with this new requirement. Please let me know if you would like to set-up a call to further discuss this update and how we can help you easily and efficiently stay compliant with New York’s expanded reporting requirements. If you are not currently reporting through wcPrism, we would certainly look forward to setting up a call to discuss how our wcPrism solution can help you with all of your state workers’ compensation reporting!

Please contact the author at nicholas.guarda@verisk.com or 732.887.7556 for questions or to set up a call to discuss these forthcoming updates.

[1] Bulletin from Jeremy Attie, President and CEO, New York Compensation Insurance Rating Board to “Members of the Rating Board,” dated February 27, 2023 (R.C. 2577), p. 1. On this point, the first paragraph of the bulletin states: “I write to inform you that on February 16, 2023, the Board of Governors of the New York Compensation Insurance Rating Board (“Rating Board”) approved a proposal requiring all member carrier groups, regardless of premium market share in New York State, to report data in response to the Medical Data Call (“MDC”) and Indemnity Data Call (“IDC”). The rationale and details related to this new requirement are set forth below.” Id.

[2] Bulletin from Jeremy Attie, President and CEO, New York Compensation Insurance Rating Board to “Members of the Rating Board,” dated February 27, 2023 (R.C. 2577), p. 1.

[3] Id.

[4] Id.

[5] Id.

[6] Bulletin from Jeremy Attie, President and CEO, New York Compensation Insurance Rating Board to “Members of the Rating Board,” dated February 27, 2023 (R.C. 2577), p. 2.

[7] Id.

[8] Id.

[9] Id.

[10] Id.

[11] Id.

[12] Bulletin from Jeremy Attie, President and CEO, New York Compensation Insurance Rating Board to “Members of the Rating Board,” dated February 27, 2023 (R.C. 2577), p. 1.

[13] Id.

[14] Bulletin from Jeremy Attie, President and CEO, New York Compensation Insurance Rating Board to “Members of the Rating Board,” dated February 27, 2023 (R.C. 2577), p. 1.

[15] Bulletin from Jeremy Attie, President and CEO, New York Compensation Insurance Rating Board to “Members of the Rating Board,” dated February 27, 2023 (R.C. 2577), p. 1 and 2.

[16] Bulletin from Jeremy Attie, President and CEO, New York Compensation Insurance Rating Board to “Members of the Rating Board,” dated February 27, 2023 (R.C. 2577), p. 2.

[17] Id.

[18] Bulletin from Jeremy Attie, President and CEO, New York Compensation Insurance Rating Board to “Members of the Rating Board,” dated February 27, 2023 (R.C. 2577), p. 3.