(a) Payors must submit complete and accurate data files
for all applicable plans as required by this subchapter and consistent
with the Texas APCD CDL v1.09, released May 20, 2022. The Texas APCD
CDL is available on the Center's website and:
(1) is modeled on the "All-Payer Claims Database Common
Data Layout" published by the National Association of Health Data
Organizations and used with permission;
(2) identifies which data elements payors are required
to submit in each data file and which data elements are optional,
consistent with Insurance Code §38.404(c), concerning Establishment
and Administration of Database; and
(3) identifies the record specifications, definitions,
code tables, and threshold levels for each required data element.
(b) The Center may issue technical guidance that provides
flexibility regarding the existing requirements contained in the Texas
APCD CDL, such as removing required data elements, clarifying specifications,
increasing the maximum length, or decreasing the minimum threshold.
However, such guidance may not modify statutory requirements, impose
more stringent requirements, or increase the scope of the data being
collected.
(c) The Center will establish, evaluate, and update
data collection procedures within a submission guide, consistent with
Insurance Code §38.404(f), concerning Establishment and Administration
of Database. Notwithstanding subsection (b) of this section, in the
event of an inconsistency between this subchapter and the submission
guide, this subchapter controls.
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