1     
HEALTH INFORMATION EXCHANGE AMENDMENTS

2     
2019 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Brad M. Daw

5     
Senate Sponsor: Allen M. Christensen

6     

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:
15          None
16     Other Special Clauses:
17          None
18     Utah Code Sections Affected:
19     AMENDS:
20          26-1-37, as last amended by Laws of Utah 2013, Chapter 167
21     

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
29     organization.

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
68     31A-22-614.5.
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)(e), a health care provider or third party
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. Sec. 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, or a qualified network is a
85     disclosure for treatment, payment, or health care operations if it complies with Subsection

86     (3)(a) or (c) and is for treatment, payment, or health care operations, as those terms are defined
87     in 45 C.F.R. Parts 160, 162, and 164.     
88          (e) A health care provider or third party payer is not required to use the standards
89     adopted by the department under the provisions of Subsection (2) if the health care provider or
90     third party payer engage in the electronic exchange of clinical health information within a
91     particular health care system.
92          (4) Nothing in this section shall limit the number of networks eligible to engage in the
93     electronic data interchange of clinical health information using the standards adopted by the
94     department under Subsection (2)(a)(ii).
95          (5) (a) The department, a local health department, a health care provider, a third party
96     payer, or a qualified network is not subject to civil liability for a disclosure of clinical health
97     information if the disclosure is in accordance [both] with:
98          (i) Subsection (3)(a); and [with]
99          (ii) Subsection (3)(b), [(3)(c), or (3)(d)] (c), or (d).
100          (b) The department, a local health department, a health care provider, a third party
101     payer, or a qualified network that accesses or reviews clinical health information from or
102     through the electronic exchange in accordance with the requirements in this section is not
103     subject to civil liability for the access or review.
104          (6) Within a qualified network, information generated or disclosed in the electronic
105     exchange of clinical health information is not subject to discovery, use, or receipt in evidence
106     in any legal proceeding of any kind or character.