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H0148.................................................by HEALTH AND WELFARE HEALTH CARE DATA - Adds to and amends existing law relating to collection and analysis of health care data to adopt an Idaho Health Care Data Act; to define terms; to establish a Bureau of Health Care Statistics; to proscribe disclosure of reimbursement contracts, to proscribe health care provider comparisons; to prohibit disclosure of identifiable health data; to provide a Health Data Plan Advisory Committee; and to exempt disclosure of health care data submitted to the Bureau of Health Care Statistics. 02/09 House intro - 1st rdg - to printing 02/10 Rpt prt - to Health/Wel
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]] Fifty-eighth Legislature First Regular Session - 2005 IN THE HOUSE OF REPRESENTATIVES HOUSE BILL NO. 148 BY HEALTH AND WELFARE COMMITTEE 1 AN ACT 2 RELATING TO COLLECTION AND ANALYSIS OF HEALTH CARE DATA; AMENDING TITLE 56, 3 IDAHO CODE, BY THE ADDITION OF A NEW CHAPTER 14, TITLE 56, IDAHO CODE, TO 4 ADOPT AN IDAHO HEALTH CARE DATA ACT, TO PROVIDE A SHORT TITLE, TO DEFINE 5 TERMS, TO ESTABLISH A BUREAU OF HEALTH CARE STATISTICS, TO PROSCRIBE DIS- 6 CLOSURE OF REIMBURSEMENT CONTRACTS, TO PROSCRIBE HEALTH CARE PROVIDER COM- 7 PARISONS, TO PROHIBIT DISCLOSURE OF IDENTIFIABLE HEALTH DATA AND TO PRO- 8 VIDE A HEALTH DATA PLAN ADVISORY COMMITTEE; AND AMENDING SECTION 9-340C, 9 IDAHO CODE, TO EXEMPT DISCLOSURE OF HEALTH CARE DATA SUBMITTED TO THE 10 BUREAU OF HEALTH CARE STATISTICS. 11 Be It Enacted by the Legislature of the State of Idaho: 12 SECTION 1. That Title 56, Idaho Code, be, and the same is hereby amended 13 by the addition thereto of a NEW CHAPTER, to be known and designated as Chap- 14 ter 14, Title 56, Idaho Code, and to read as follows: 15 CHAPTER 14 16 HEALTH DATA ACT 17 56-1401. SHORT TITLE. This act may be cited as the "Idaho Health Data 18 Act." 19 56-1402. DEFINITIONS. For the purposes of this chapter, the following 20 terms have the meanings set forth: 21 (1) "Bureau" means the bureau of health care statistics created in the 22 department of health and welfare. 23 (2) "Data supplier" means a health care facility, health care provider, 24 self-funded employer, third-party payer, health maintenance organization, or 25 government department which could reasonably be expected to provide health 26 data under this chapter. 27 (3) "Director" means the director of the department of health and wel- 28 fare. 29 (4) "Disclosure" means the communication or release of health care data 30 to any individual or organization outside the committee, its staff and con- 31 tracting agencies. 32 (5) "Health care facility" means an organization delivering service or 33 supplies for patient care. This includes hospitals, outpatient facilities, 34 surgery centers, nursing homes, rehabilitation centers, mental health clinics, 35 or other organized entities charging for and delivering health care. 36 (6) "Health care provider" means any professional person delivering and 37 charging for health care services or supplies. 38 (7) "Health data" means information relating to the health status of 39 individuals, health services delivered, the availability of health manpower 40 and facilities, and the use and cost of resources and services to the con- 41 sumer, except "vital records." 2 1 (8) "Identifiable health data" means any item, collection or grouping of 2 health data that makes the individual described or providing the data identi- 3 fiable. 4 (9) "Individual" means a natural person. 5 (10) "Plan" means the plan developed by the bureau pursuant to this chap- 6 ter. 7 (11) "Research and analysis" means activities using health data including: 8 (a) Describing the group characteristics of individuals or organizations; 9 (b) Analyzing variance and noncompliance among individuals and organiza- 10 tions; 11 (c) Conducting statistical procedures to improve the quality of health 12 data; 13 (d) Designing surveys and selecting samples of individuals and organiza- 14 tions; 15 (e) Preparing and publishing reports describing these matters. 16 (12) "Self-funded employer" means an employer who provides for the payment 17 of health care services directly from employer funds thereby assuming the 18 financial risks rather than passing them on to an outside insurer through pre- 19 mium payments. 20 (13) "Third party payer" means an insurer offering health insurance, man- 21 aged care plan, or any program funded or administered by the state of Idaho 22 for the provision of health care services, including medicaid or other medical 23 assistance, any other similar corporation, organization, association, entity 24 or person. 25 56-1403. BUREAU OF HEALTH CARE STATISTICS. The director is authorized to 26 establish the bureau of health care statistics within the division of public 27 health services. The purpose of the bureau is to perform collection, valida- 28 tion, analysis, display and dissemination of health and related data to facil- 29 itate the promotion and accessibility of quality and cost-effective health 30 care. 31 The bureau shall: 32 (1) Develop by rule, following public hearing and comment, a health data 33 plan that shall: 34 (a) Identify the key health care issues, questions, and problems amenable 35 to resolution or improvement through better data, more extensive or care- 36 ful analysis or imparted dissemination of health data; 37 (b) Document existing health data activities in the state pertinent to 38 paragraph (a) of this subsection; 39 (c) Describe and prioritize actions to be taken by the department of 40 health and welfare or the legislature in response to the needs identified; 41 (d) Detail the types of data needed for the bureau's work, the intended 42 data suppliers and the form in which the data is to be supplied; 43 (e) Describe the types and methods of validation to be performed to 44 assure validity and accuracy; 45 (f) Explain the intended uses and expected benefits. These benefits must 46 relate to promoting health care quality, managing health care costs, or 47 improving access to health care services; 48 (g) Describe the processes for interpretation and analysis, noting the 49 expertise and participation in the process; 50 (h) Describe the types of reports to be made available and their intended 51 audiences and uses. 52 (2) Have the authority to collect, validate, analyze and present health 53 data in accordance with the plan. 54 (3) Evaluate existing identification coding methods and, if necessary, 3 1 require by rule that health data suppliers use a uniform system for identifi- 2 cation of individuals, facilities and providers. 3 (4) Report annually to the governor and the legislature on how the bureau 4 is exercising its responsibilities under this chapter. 5 The bureau may promulgate rules pursuant to chapter 52, title 67, Idaho 6 Code, to implement the provisions of this chapter. 7 Except for data collection, analysis and validation functions described in 8 this section, nothing shall be construed to authorize or permit the bureau to 9 perform regulatory functions delegated by law to other agencies of the state 10 or federal government, or to perform quality assurance or medical record audit 11 functions that health care facilities, providers or third party payers are 12 required to perform. 13 Nothing in this chapter shall be construed to require a data supplier to 14 supply health data identifying a patient by name or describing detail about a 15 patient beyond that needed to achieve the approved purposes included in the 16 plan. 17 No request for health data shall be made until a plan for the use of the 18 data is approved. 19 56-1404. NONDISCLOSURE OF REIMBURSEMENT CONTRACTS. The bureau does not 20 have the authority to require any data supplier to submit fee schedules, maxi- 21 mum allowable costs, area prevailing costs, terms of contracts, discounts, 22 fixed reimbursement arrangements, capitations or other specific arrangements 23 for reimbursements to a health care provider. 24 The bureau shall not publish any health care data that would disclose any 25 of the information acquired as provided in this section. 26 Nothing shall prevent the bureau from requiring the submission of health 27 data on the reimbursements actually made to health care providers from any 28 source of payment, including consumers. 29 56-1405. HEALTH CARE PROVIDER COMPARISONS. The bureau shall not release 30 reports that compare or identify health care providers or data submitters 31 unless: 32 (1) The comparisons are validated by a private, independent analyst; 33 (2) The data submitter or health care provider is allowed to verify the 34 accuracy and submit corrections and comments; 35 (3) The bureau corrects data found to be in error; 36 (4) The bureau allows the data supplier a reasonable amount of time to 37 review the report and prepare a response. 38 56-1406. DISCLOSURE OF IDENTIFIABLE HEALTH DATA PROHIBITED. All informa- 39 tion, reports, statements, memoranda or other data received by the bureau is 40 privileged and confidential, and shall not be directly or indirectly subject 41 to subpoena or discovery proceedings or be admitted as evidence, nor shall 42 testimony relating thereto be admitted as evidence, or in any action of any 43 kind in any court or before any administrative body, agency or person for any 44 purpose whatsoever. Any release or publication shall be done in such a way 45 that no person is identifiable. The bureau may disclose information if the 46 individual identified has agreed to the disclosure. 47 The penalty for disclosure in violation of this section is a misdemeanor. 48 56-1407. HEALTH DATA PLAN ADVISORY COMMITTEE. The bureau shall develop a 49 health data plan advisory committee, the members of which shall be appointed 50 by the director and shall include at least one (1) licensed physician, one (1) 51 licensed pharmacist, a hospital executive, a health plan executive, a county 4 1 commissioner, and a lay person. There shall be no less than seven (7) nor more 2 than eleven (11) members on the committee. These members should, as much as 3 possible, be knowledgeable in health data issues and represent the diversity 4 of data suppliers and the geographic diversity of the state. The purpose of 5 this advisory committee is to provide input into the effectiveness of the plan 6 and the bureau, and the effect of data collections and reports on the practi- 7 tioners and patients. 8 SECTION 2. That Section 9-340C, Idaho Code, be, and the same is hereby 9 amended to read as follows: 10 9-340C. RECORDS EXEMPT FROM DISCLOSURE -- PERSONNEL RECORDS, PERSONAL 11 INFORMATION, HEALTH RECORDS, PROFESSIONAL DISCIPLINE. The following records 12 are exempt from disclosure: 13 (1) Except as provided in this subsection, all personnel records of a 14 current or former public official other than the public official's public ser- 15 vice or employment history, classification, pay grade and step, longevity, 16 gross salary and salary history, status, workplace and employing agency. All 17 other personnel information relating to a public employee or applicant includ- 18 ing, but not limited to, information regarding sex, race, marital status, 19 birth date, home address and telephone number, applications, testing and 20 scoring materials, grievances, correspondence and performance evaluations, 21 shall not be disclosed to the public without the employee's or applicant's 22 written consent. A public official or authorized representative may inspect 23 and copy his personnel records, except for material used to screen and test 24 for employment. 25 (2) Retired employees' and retired public officials' home addresses, home 26 telephone numbers and other financial and nonfinancial membership records; 27 active and inactive member financial and membership records and mortgage port- 28 folio loan documents maintained by the public employee retirement system. 29 Financial statements prepared by retirement system staff, funding agents and 30 custodians concerning the investment of assets of the public employee retire- 31 ment system of Idaho are not considered confidential under this chapter. 32 (3) Information and records submitted to the Idaho state lottery for the 33 performance of background investigations of employees, lottery retailers and 34 major procurement contractors; audit records of lottery retailers, vendors and 35 major procurement contractors submitted to or performed by the Idaho state 36 lottery; validation and security tests of the state lottery for lottery games; 37 business records and information submitted pursuant to sections 67-7412(8) and 38 (9) and 67-7421(8) and (9), Idaho Code, and such documents and information 39 obtained and held for the purposes of lottery security and investigative 40 action as determined by lottery rules unless the public interest in disclosure 41 substantially outweighs the private need for protection from public disclo- 42 sure. 43 (4) Records of a personal nature as follows: 44 (a) Records of personal debt filed with a public agency or independent 45 public body corporate and politic pursuant to law; 46 (b) Personal bank records compiled by a public depositor for the purpose 47 of public funds transactions conducted pursuant to law; 48 (c) Records of ownership of financial obligations and instruments of a 49 public agency or independent public body corporate and politic, such as 50 bonds, compiled by the public agency or independent public body corporate 51 and politic pursuant to law; 52 (d) Records, with regard to the ownership of, or security interests in, 53 registered public obligations; 5 1 (e) Vital statistics records; and 2 (f) Military records as described in and pursuant to section 65-301, 3 Idaho Code. 4 (5) Information in an income or other tax return measured by items of 5 income or sales, which is gathered by a public agency for the purpose of 6 administering the tax, except such information to the extent disclosed in a 7 written decision of the tax commission pursuant to a taxpayer protest of a 8 deficiency determination by the tax commission, under the provisions of sec- 9 tion 63-3045B, Idaho Code. 10 (6) Records of a personal nature related directly or indirectly to the 11 application for and provision of statutory services rendered to persons apply- 12 ing for public care for the elderly, indigent, or mentally or physically hand- 13 icapped, or participation in an environmental or a public health study, pro- 14 vided the provisions of this subsection making records exempt from disclosure 15 shall not apply to the extent that such records or information contained in 16 those records are necessary for a background check on an individual that is 17 required by federal law regulating the sale of firearms, guns or ammunition. 18 (7) Employment security information and unemployment insurance benefit 19 information, except that all interested parties may agree to waive the exemp- 20 tion. 21 (8) Any personal records, other than names, business addresses and busi- 22 ness phone numbers, such as parentage, race, religion, sex, height, weight, 23 tax identification and social security numbers, financial worth or medical 24 condition submitted to any public agency or independent public body corporate 25 and politic pursuant to a statutory requirement for licensing, certification, 26 permit or bonding. 27 (9) Unless otherwise provided by agency rule, information obtained as 28 part of an inquiry into a person's fitness to be granted or retain a license, 29 certificate, permit, privilege, commission or position, private association 30 peer review committee records authorized in title 54, Idaho Code. Any agency 31 which has records exempt from disclosure under the provisions of this subsec- 32 tion shall annually make available a statistical summary of the number and 33 types of matters considered and their disposition. 34 (10) The records, findings, determinations and decisions of any prelitiga- 35 tion screening panel formed under chapters 10 and 23, title 6, Idaho Code. 36 (11) Complaints received by the board of medicine and investigations and 37 informal proceedings, including informal proceedings of any committee of the 38 board of medicine, pursuant to chapter 18, title 54, Idaho Code, and rules 39 adopted thereunder. 40 (12) Records of the department of health and welfare or a public health 41 district that identify a person infected with a reportable disease. 42 (13) Records of hospital care, medical records, including prescriptions, 43 drug orders, records or any other prescription information that specifically 44 identifies an individual patient, prescription records maintained by the board 45 of pharmacy under section 37-2730A, Idaho Code, records of psychiatric care or 46 treatment and professional counseling records relating to an individual's con- 47 dition, diagnosis, care or treatment, provided the provisions of this subsec- 48 tion making records exempt from disclosure shall not apply to the extent that 49 such records or information contained in those records are necessary for a 50 background check on an individual that is required by federal law regulating 51 the sale of firearms, guns or ammunition. 52 (14) Information collected pursuant to the directory of new hires act, 53 chapter 16, title 72, Idaho Code. 54 (15) Personal information contained in motor vehicle and driver records 55 that is exempt from disclosure under the provisions of chapter 2, title 49, 6 1 Idaho Code. 2 (16) Records of the financial status of prisoners pursuant to subsection 3 (2) of section 20-607, Idaho Code. 4 (17) Records of the Idaho state police or department of correction 5 received or maintained pursuant to section 19-5514, Idaho Code, relating to 6 DNA databases and databanks. 7 (18) Records of the department of health and welfare relating to a survey, 8 resurvey or complaint investigation of a licensed nursing facility shall be 9 exempt from disclosure. Such records shall, however, be subject to disclosure 10 as public records as soon as the facility in question has received the report, 11 and no later than the fourteenth day following the date that department of 12 health and welfare representatives officially exit the facility pursuant to 13 federal regulations. Provided however, that for purposes of confidentiality, 14 no record shall be released under this section which specifically identifies 15 any nursing facility resident. 16 (19) Records and information contained in the registry of immunizations 17 against childhood diseases maintained in the department of health and welfare, 18 including information disseminated to others from the registry by the depart- 19 ment of health and welfare. 20 (20) Records of the Idaho housing and finance association (IHFA) relating 21 to the following: 22 (a) Records containing personal financial, family, health or similar per- 23 sonal information submitted to or otherwise obtained by the IHFA; 24 (b) Records submitted to or otherwise obtained by the IHFA with regard to 25 obtaining and servicing mortgage loans and all records relating to the 26 review, approval or rejection by the IHFA of said loans; 27 (c) Mortgage portfolio loan documents; 28 (d) Records of a current or former employee other than the employee's 29 duration of employment with the association, position held and location of 30 employment. This exemption from disclosure does not include the contracts 31 of employment or any remuneration, including reimbursement of expenses, of 32 the executive director, executive officers or commissioners of the associ- 33 ation. All other personnel information relating to an association employee 34 or applicant including, but not limited to, information regarding sex, 35 race, marital status, birth date, home address and telephone number, 36 applications, testing and scoring materials, grievances, correspondence, 37 retirement plan information and performance evaluations, shall not be dis- 38 closed to the public without the employee's or applicant's written con- 39 sent. An employee or authorized representative may inspect and copy that 40 employee's personnel records, except for material used to screen and test 41 for employment or material not subject to disclosure elsewhere in the 42 Idaho public records act. 43 (21) Records of the department of health and welfare related to child sup- 44 port services in cases in which there is reasonable evidence of domestic vio- 45 lence, as defined in chapter 63, title 39, Idaho Code, that can be used to 46 locate any individuals in the child support case except in response to a court 47 order. 48 (22) Records of the Idaho state bar lawyer's assistance program pursuant 49 to chapter 49, title 54, Idaho Code, unless a participant in the program 50 authorizes the release pursuant to subsection (4) of section 54-4901, Idaho 51 Code. 52 (23) Records and information contained in the trauma registry created by 53 chapter 20, title 57, Idaho Code, together with any reports, analyses and com- 54 pilations created from such information and records. 55 (24) Records contained in the court files, or other records prepared as 7 1 part of proceedings for judicial authorization of sterilization procedures 2 pursuant to chapter 39, title 39, Idaho Code. 3 (25) The physical voter registration card on file in the county clerk's 4 office; however, a redacted copy of said card shall be made available consis- 5 tent with the requirements of this section. Information from the voter regis- 6 tration card maintained in the statewide voter registration database, includ- 7 ing age, will be made available except for the voter's driver's license num- 8 ber, date of birth and, upon showing of good cause by the voter to the county 9 clerk in consultation with the county prosecuting attorney, the physical resi- 10 dence address of the voter. For the purposes of this subsection good cause 11 shall include the protection of life and property and protection of victims of 12 domestic violence and similar crimes. 13 (26) All reports, statements, memoranda or other data received by the 14 bureau of health care data pursuant to chapter 14, title 56, Idaho Code.
STATEMENT OF PURPOSE RS 14774 This bill will establish a Bureau, parallel to the Bureau of Vital Statistics, in the Department of Health. The Health Data Bureau will, with the advice of the committee of those submitting data, develop a plan to acquire, analyze and report the needed data. It also authorizes changes required in the existing law to protect the individual's identity and health care history. FISCAL NOTE $200,000 is anticipated for the first year of operation. There are grants available for the development of a state health database (AHPR/NIH)for one source. Operations can be supported through contracts with CMS and others needing reports on state healthcare usage. Currently, Utah covers about 3/4 of the operations cost with such revenue. The savings to the State and the citizens are difficult to estimate, but as the cost of Idaho healthcare paid by Medicaid, Medicare and the BlueCross BlueShield plans is over 4 billion dollars, one improved policy decision would probably pay for the program. Contact Name: Rep. John Rusche Phone: 208-750-6048 STATEMENT OF PURPOSE/FISCAL NOTE H 148