7 LONG TITLE
8 General Description:
9 This bill amends provisions relating to the electronic exchange of clinical information.
10 Highlighted Provisions:
11 This bill:
12 ▸ exempts certain persons from civil liability relating to the access or review of
13 certain clinical health information.
14 Money Appropriated in this Bill:
16 Other Special Clauses:
18 Utah Code Sections Affected:
20 26-1-37, as last amended by Laws of Utah 2013, Chapter 167
22 Be it enacted by the Legislature of the state of Utah:
23 Section 1. Section 26-1-37 is amended to read:
24 26-1-37. Duty to establish standards for the electronic exchange of clinical health
25 information -- Immunity.
26 (1) For purposes of this section:
27 (a) "Affiliate" means an organization that directly or indirectly through one or more
28 intermediaries controls, is controlled by, or is under common control with another
30 (b) "Clinical health information" shall be defined by the department by administrative
31 rule adopted in accordance with Subsection (2).
32 (c) "Electronic exchange":
33 (i) includes:
34 (A) the electronic transmission of clinical health data via Internet or extranet; and
35 (B) physically moving clinical health information from one location to another using
36 magnetic tape, disk, or compact disc media; and
37 (ii) does not include exchange of information by telephone or fax.
38 (d) "Health care provider" means a licensing classification that is either:
39 (i) licensed under Title 58, Occupations and Professions, to provide health care; or
40 (ii) licensed under Chapter 21, Health Care Facility Licensing and Inspection Act.
41 (e) "Health care system" shall include:
42 (i) affiliated health care providers;
43 (ii) affiliated third party payers; and
44 (iii) other arrangement between organizations or providers as described by the
45 department by administrative rule.
46 (f) "Qualified network" means an entity that:
47 (i) is a non-profit organization;
48 (ii) is accredited by the Electronic Healthcare Network Accreditation Commission, or
49 another national accrediting organization recognized by the department; and
50 (iii) performs the electronic exchange of clinical health information among multiple
51 health care providers not under common control, multiple third party payers not under common
52 control, the department, and local health departments.
53 (g) "Third party payer" means:
54 (i) all insurers offering health insurance who are subject to Section 31A-22-614.5; and
55 (ii) the state Medicaid program.
56 (2) (a) In addition to the duties listed in Section 26-1-30, the department shall, in
57 accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act:
58 (i) define:
59 (A) "clinical health information" subject to this section; and
60 (B) "health system arrangements between providers or organizations" as described in
61 Subsection (1)(e)(iii); and
62 (ii) adopt standards for the electronic exchange of clinical health information between
63 health care providers and third party payers that are for treatment, payment, health care
64 operations, or public health reporting, as provided for in 45 C.F.R. Parts 160, 162, and 164,
65 Health Insurance Reform: Security Standards.
66 (b) The department shall coordinate its rule making authority under the provisions of
67 this section with the rule making authority of the Insurance Department under Section
69 (c) The department shall establish procedures for developing the rules adopted under
70 this section, which ensure that the Insurance Department is given the opportunity to comment
71 on proposed rules.
72 (3) (a) Except as provided in Subsection (3)[
73 payer in Utah is required to use the standards adopted by the department under the provisions
74 of Subsection (2) if the health care provider or third party payer elects to engage in an
75 electronic exchange of clinical health information with another health care provider or third
76 party payer.
77 (b) A health care provider or third party payer may disclose information to the
78 department or a local health department, by electronic exchange of clinical health information,
79 as permitted by Subsection 45 C.F.R. 164.512(b).
80 (c) When functioning in its capacity as a health care provider or payer, the department
81 or a local health department may disclose clinical health information by electronic exchange to
82 another health care provider or third party payer.
83 (d) An electronic exchange of clinical health information by a health care provider, a
84 third party payer, the department, or a local health department is a disclosure for treatment,
85 payment, or health care operations if it complies with Subsection (3)(a) or (c) and is for
86 treatment, payment, or health care operations, as those terms are defined in 45 C.F.R. Parts
87 160, 162, and 164.
88 (e) The department, a local health department, a health care provider, or a third party
89 payer may access or review clinical health information from the electronic exchange if the
90 access or review is:
91 (i) for treatment, payment, or health care operations as those terms are defined in 45
92 C.F.R. Sec. 160.103; and
93 (ii) in accordance with 45 C.F.R. Parts 160, 162, and 164.
95 adopted by the department under the provisions of Subsection (2) if the health care provider or
96 third party payer engage in the electronic exchange of clinical health information within a
97 particular health care system.
98 (4) Nothing in this section shall limit the number of networks eligible to engage in the
99 electronic data interchange of clinical health information using the standards adopted by the
100 department under Subsection (2)(a)(ii).
101 (5) The department, a local health department, a health care provider, a third party
102 payer, or a qualified network is not subject to civil liability for [
103 disclosure of clinical health information if the access, review, or disclosure is in accordance
105 (a) Subsection (3)(a); and [
106 (b) Subsection (3)(b), [
107 (6) Within a qualified network, information generated or disclosed in the electronic
108 exchange of clinical health information is not subject to discovery, use, or receipt in evidence
109 in any legal proceeding of any kind or character.