Download Zipped Amended WordPerfect HB0009.ZIP
[Introduced][Status][Bill Documents][Fiscal Note][Bills Directory]

H.B. 9

This document includes Senate Committee Amendments incorporated into the bill on Mon, Jan 22, 2007 at 5:23 PM by rday. -->              1     

HEALTH CARE COST AND QUALITY DATA

             2     
2007 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Michael T. Morley

             5     
Senate Sponsor: Michael G. Waddoups

             6     
             7      LONG TITLE
             8      General Description:
             9          This bill amends the Health Data Authority Act to authorize the Health Data
             10      Committee, as funding is available, to collect data on the costs of episodes of health
             11      care, and, as funding is available, authorizes the Department of Health to develop a plan
             12      to measure and compare costs of episodes of care.
             13      Highlighted Provisions:
             14          This bill:
             15          .    amends the powers and duties of the Health Data Committee;
             16          .    authorizes the Health Data Committee to develop and adopt a plan for the collection
             17      and use of health care data related to cost of episodes of health care; and
             18          .    makes implementation of the plan contingent on funding.
             19      Monies Appropriated in this Bill:
             20          None
             21      Other Special Clauses:
             22          None
             23      Utah Code Sections Affected:
             24      AMENDS:
             25          26-33a-104, as last amended by Chapter 201, Laws of Utah 1996
             26      ENACTS:
             27          26A-33a-106.1, Utah Code Annotated 1953



             28     
             29      Be it enacted by the Legislature of the state of Utah:
             30          Section 1. Section 26-33a-104 is amended to read:
             31           26-33a-104. Purpose, powers, and duties of the committee.
             32          (1) The purpose of the committee is to direct a statewide effort to collect, analyze, and
             33      distribute health care data to facilitate the promotion and accessibility of quality and
             34      cost-effective health care and also to facilitate interaction among those with concern for health
             35      care issues.
             36          (2) The committee shall:
             37          (a) develop and adopt by rule, following public hearing and comment, a health data
             38      plan that shall among its elements:
             39          (i) identify the key health care issues, questions, and problems amenable to resolution
             40      or improvement through better data, more extensive or careful analysis, or improved
             41      dissemination of health data;
             42          (ii) document existing health data activities in the state to collect, organize, or make
             43      available types of data pertinent to the needs identified in Subsection (2)(a)(i);
             44          (iii) describe and prioritize the actions suitable for the committee to take in response to
             45      the needs identified in Subsection (2)(a)(i) in order to obtain or to facilitate the obtaining of
             46      needed data, and to encourage improvements in existing data collection, interpretation, and
             47      reporting activities, and indicate how those actions relate to the activities identified under
             48      Subsection (2)(a)(ii);
             49          (iv) detail the types of data needed for the committee's work, the intended data
             50      suppliers, and the form in which such data are to be supplied, noting the consideration given to
             51      the potential alternative sources and forms of such data and to the estimated cost to the
             52      individual suppliers as well as to the department of acquiring these data in the proposed
             53      manner; the plan shall reasonably demonstrate that the committee has attempted to maximize
             54      cost-effectiveness in the data acquisition approaches selected;
             55          (v) describe the types and methods of validation to be performed to assure data validity
             56      and reliability;
             57          (vi) explain the intended uses of and expected benefits to be derived from the data
             58      specified in Subsection (2)(a)(iv), including the contemplated tabulation formats and analysis


             59      methods; the benefits described must demonstrably relate to one or more of the following:
             60      promoting quality health care, managing health care costs, or improving access to health care
             61      services;
             62          (vii) describe the expected processes for interpretation and analysis of the data flowing
             63      to the committee; noting specifically the types of expertise and participation to be sought in
             64      those processes; and
             65          (viii) describe the types of reports to be made available by the committee and the
             66      intended audiences and uses;
             67          (b) have the authority to collect, validate, analyze, and present health data in
             68      accordance with the plan while protecting individual privacy through the use of a control
             69      number as the health data identifier;
             70          (c) evaluate existing identification coding methods and, if necessary, require by rule
             71      that health data suppliers use a uniform system for identification of patients, health care
             72      facilities, and health care providers on health data they submit under this chapter;
             73          (d) report biennially to the governor and the Legislature on how the committee is
             74      meeting its responsibilities under this chapter; and
             75          (e) advise, consult, contract, and cooperate with any corporation, association, or other
             76      entity for the collection, analysis, processing, or reporting of health data identified by control
             77      number only in accordance with the plan.
             78          (3) The committee may adopt rules to carry out the provisions of this chapter in
             79      accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking Act.
             80          (4) Except for data collection, analysis, and validation functions described in this
             81      section, nothing in this chapter shall be construed to authorize or permit the committee to
             82      perform regulatory functions which are delegated by law to other agencies of the state or
             83      federal governments or to perform quality assurance or medical record audit functions that
             84      health care facilities, health care providers, or [third-party] third party payors are required to
             85      conduct to comply with federal or state law. The committee shall not recommend or determine
             86      whether a health care provider, health care facility, [third-party] third party payor, or
             87      self-funded employer is in compliance with federal or state laws including but not limited to
             88      federal or state licensure, insurance, reimbursement, tax, malpractice, or quality assurance
             89      statutes or common law.


             90          (5) Nothing in this chapter shall be construed to require a data supplier to supply health
             91      data identifying a patient by name or describing detail on a patient beyond that needed to
             92      achieve the approved purposes included in the plan.
             93          (6) No request for health data shall be made of health care providers and other data
             94      suppliers until a plan for the use of such health data has been adopted.
             95          (7) If a proposed request for health data imposes unreasonable costs on a data supplier,
             96      due consideration shall be given by the committee to altering the request. If the request is not
             97      altered, the committee shall pay the costs incurred by the data supplier associated with
             98      satisfying the request that are demonstrated by the data supplier to be unreasonable.
             99          (8) [The] After a plan is adopted as provided in Section 26A-33a-106.1 , the committee
             100      [does not have the authority to] may require any data supplier to submit fee schedules,
             101      maximum allowable costs, area prevailing costs, terms of contracts, discounts, fixed
             102      reimbursement arrangements, capitations, or other specific arrangements for reimbursement to
             103      a health care provider.
             104          (9) S. [ [ ] The [ ] ] [ Except as permitted in Subsection (10), the ] .S committee shall not
             104a      publish any
             105      health data collected under Subsection (8) which would disclose [any of the information
             106      described in Subsection (8)] specific terms of contracts, discounts, or fixed reimbursement
             107      arrangements, or other specific reimbursement arrangements between an individual provider
             108      and a specific payer.
             109          (10) Nothing in Subsection (8) shall prevent the committee from requiring the
             110      submission of health data on the reimbursements actually made to health care providers from
             111      any source of payment, including consumers.
             112          Section 2. Section 26A-33a-106.1 is enacted to read:
             113          26A-33a-106.1. Health care cost and reimbursement data.
             114          (1) (a) The committee shall, as funding is available, establish an advisory panel to
             115      advise the committee on the development of a plan for the collection and use of health care
             116      data pursuant to Subsection 26-33a-104 (6) and this section.
             117          (b) The advisory panel shall include:
             118          (i) the chairman of the Utah Hospital Association;
             119          (ii) a representative of a rural hospital as designated by the Utah Hospital Association;
             120          (iii) a representative of the Utah Medical Association;



             121          (iv) a physician from a small group practice as designated by the Utah Medical
             122      Association;
             123          (v) two representatives from the Utah Health Insurance Association;
             124          (vi) a representative from the Department of Health as designated by the executive
             125      director of the department;
             126          (vii) a representative from the committee;
             127          (viii) a consumer advocate appointed by the committee;
             128          (ix) a member of the House of Representatives appointed by the speaker of the House;
             129      and
             130          (x) a member of the Senate appointed by the president of the Senate.
             131          (c) The advisory panel shall elect a chair from among its members, and shall be staffed
             132      by the committee.
             133          (2) (a) The committee shall, as funding is available, establish a plan for collecting data
             134      from data suppliers, as defined in Section 26-33a-102 , to determine measurements of cost and
             135      reimbursements for risk adjusted episodes of health care.
             136          (b) The plan adopted under this Subsection (2) shall include:
             137          (i) the type of data that will be collected;
             138          (ii) how the data will be evaluated;
             139          (iii) how the data will be used;
             140          (iv) the extent to which, and how the data will be protected; and
             141          (v) who will have access to the data.




Legislative Review Note
    as of 11-15-06 4:46 PM


Office of Legislative Research and General Counsel

Interim Committee Note
    as of 12-12-06 10:02 AM


The Health and Human Services Interim Committee recommended this bill.

Interim Committee Note
    as of 12-12-06 10:02 AM


The Retirement and Independent Entities Interim Committee recommended this bill.


[Bill Documents][Bills Directory]