H.B. 47

1

STANDARDS FOR EXCHANGE OF
2 ELECTRONIC HEALTH INFORMATION
3 2008 GENERAL SESSION
4 STATE OF UTAH
5 Chief Sponsor: Ronda Rudd Menlove
6 Senate Sponsor: ____________
7
8 LONG TITLE
9 Committee Note:
10 The Health and Human Services Interim Committee recommended this bill.
11 General Description:
12 This bill adds to the duties of the Department of Health.
13 Highlighted Provisions:
14 This bill:
15 . authorizes the Department of Health to adopt standards for the secure exchange of
16 electronic health information;
17 . defines terms;
18 . authorizes the department to require individuals who elect to participate in the
19 exchange of electronic health information to use the standards adopted by the
20 department;
21 . requires the department to report to the Legislature's Health and Human Services
22 Interim Committee concerning the adoption of the standards for the secure
23 exchange of electronic health information; and
24 . coordinates rulemaking authority between the Department of Health and the
25 Insurance Department.
26 Monies Appropriated in this Bill:
27 None

28 Other Special Clauses:
29 None
30 Utah Code Sections Affected:
31 AMENDS:
32 31A-22-614.5, as enacted by Laws of Utah 1993, Chapter 255
33 ENACTS:
34 26-1-37, Utah Code Annotated 1953
35
36 Be it enacted by the Legislature of the state of Utah:
37 Section 1. Section 26-1-37 is enacted to read:
38 26-1-37. Duty to establish standards for the exchange of electronic health
39 information exchange.
40 (1) For purposes of this section:
41 (a) "Affiliate" means an organization that directly or indirectly through one or more
42 intermediaries controls, is controlled by, or is under common control with another
43 organization.
44 (b) "Clinical health care information" shall be defined by the department by
45 administrative rule adopted in accordance with Subsection (2).
46 (c) "Health care provider" means a licensing classification that:
47 (i) is either:
48 (A) licensed under Title 58, Occupations and Professions, to provide health care; or
49 (B) licensed under Chapter 21, Health Care Facility Licensing and Inspection Act; and
50 (ii) is listed by the department as eligible to participate in the secure exchange of
51 electronic health information by administrative rule adopted by the department in accordance
52 with Subsection (2).
53 (d) "Health care system" shall be defined by the department by administrative rule
54 adopted in accordance with Subsection (2), and shall include:
55 (i) affiliated health care providers;
56 (ii) affiliated third party payers; and
57 (iii) other arrangement between organizations or providers as described by the
58 department by administrative rule.

59 (e) "Third party payer" means:
60 (i) all insurers offering health insurance who are subject to Section 31A-22-614.5 ; and
61 (ii) the state Medicaid program.
62 (2) (a) In addition to the duties listed in Section 26-1-30 , the department shall, in
63 accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking Act:
64 (i) define "clinical health information" subject to this section;
65 (ii) define "health care system";
66 (iii) designate the health care providers who are eligible to participate in the shared
67 standards for the secure exchange of electronic health information; and
68 (iv) adopt standards for the secure exchange of electronic health information between
69 one health care system and another health care system.
70 (b) The department shall coordinate its rule making authority under the provisions of
71 this section with the rule making authority of the Department of Insurance under Section
72 31A-22-614.5 . The department shall establish procedures for developing the rules adopted
73 under this section, which ensure that the Department of Insurance is given the opportunity to
74 comment on proposed rules.
75 (3) (a) A health care provider or third party payer is required to use the standards
76 adopted by the department under the provisions of Subsection (2) if the health care provider or
77 third party payer elects to engage in the exchange of electronic health information between one
78 health care system and another health care system.
79 (b) A health care provider or third party payer is not required to use the standards
80 adopted by the department under the provisions of Subsection (2) if the health care provider or
81 third party payer engages in the exchange of electronic health information within a particular
82 health care system.
83 (4) The department shall report on the use of the standards for the secure exchange of
84 electronic health information to the legislative Health and Human Services Interim Committee
85 no later than October 15, 2008 and no later than every October 15th thereafter. The report shall
86 include publicly available information concerning the costs and savings for the department,
87 third party payers, and health care providers associated with the standards for the secure
88 exchange of electronic health records.
89 Section 2. Section 31A-22-614.5 is amended to read:

90 31A-22-614.5. Uniform claims processing.
91 (1) Beginning July 1, 1993, all insurers offering health insurance shall use a uniform
92 claim form and uniform billing and claim codes.
93 (2) The uniform claim forms and billing codes shall be adopted and approved by the
94 commissioner in accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking Act.
95 The commissioner shall consult with the director of the Division of Health Care Financing, the
96 National Uniform Claim Form Task Force, and the National Uniform Billing Committee when
97 adopting the uniform claims and billing codes.
98 (3) (a) (i) Beginning July 1, 1995, all insurers shall offer compatible systems of
99 electronic billing approved by the commissioner in accordance with Title 63, Chapter 46a,
100 Utah Administrative Rulemaking Act.
101 (ii) The systems approved by the commissioner may include monitoring and
102 disseminating information concerning eligibility and coverage of individuals.
103 (iii) The commissioner shall coordinate the administrative rules adopted under the
104 provisions of this section with the administrative rules adopted by the Department of Health for
105 the implementation of the community health information exchange under Section 26-1-37 .
106 The department shall establish procedures for developing the rules adopted under this section,
107 which ensure that the Department of Health is given the opportunity to comment on proposed
108 rules.
109 (b) The commissioner shall regulate any fees charged by insurers to the providers for:
110 (i) uniform claim forms [or];
111 (ii) electronic billing[.]; or
112 (iii) the secure exchange of electronic health information permitted by Section 26-1-37 .




Legislative Review Note
as of 11-14-07 2:20 PM

Office of Legislative Research and General Counsel