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7 LONG TITLE
8 General Description:
9 This bill modifies provisions related to the Department of Health and Human Services'
10 health data authority.
11 Highlighted Provisions:
12 This bill:
13 ▸ modifies the membership of the Health Data Committee;
14 ▸ transfers duties from the Health Data Committee to the Department of Health and
15 Human Services;
16 ▸ modifies requirements related to obtaining health data;
17 ▸ extends the sunset date related to the Department of Health and Human Services'
18 health data authority; and
19 ▸ makes technical changes.
20 Money Appropriated in this Bill:
21 None
22 Other Special Clauses:
23 This bill provides a special effective date.
24 Utah Code Sections Affected:
25 AMENDS:
26 26B-1-413, as renumbered and amended by Laws of Utah 2023, Chapter 305
27 26B-4-106 (Superseded 07/01/24), as renumbered and amended by Laws of Utah
28 2023, Chapter 307
29 26B-8-501, as renumbered and amended by Laws of Utah 2023, Chapter 306
30 26B-8-502, as renumbered and amended by Laws of Utah 2023, Chapter 306
31 26B-8-503, as renumbered and amended by Laws of Utah 2023, Chapter 306
32 26B-8-504, as renumbered and amended by Laws of Utah 2023, Chapter 306
33 26B-8-505, as renumbered and amended by Laws of Utah 2023, Chapter 306
34 26B-8-506, as renumbered and amended by Laws of Utah 2023, Chapter 306
35 26B-8-507, as renumbered and amended by Laws of Utah 2023, Chapter 306
36 26B-8-508, as renumbered and amended by Laws of Utah 2023, Chapter 306
37 53-2d-203 (Effective 07/01/24), as renumbered and amended by Laws of Utah 2023,
38 Chapters 307, 310
39 63A-13-301, as last amended by Laws of Utah 2023, Chapter 329
40 63I-1-226 (Superseded 07/01/24), as last amended by Laws of Utah 2023, Chapters
41 249, 269, 270, 275, 332, 335, 420, and 495 and repealed and reenacted by Laws of
42 Utah 2023, Chapter 329
43 63I-1-226 (Effective 07/01/24), as last amended by Laws of Utah 2023, Chapters 249,
44 269, 270, 275, 310, 332, 335, 420, and 495 and repealed and reenacted by Laws of
45 Utah 2023, Chapter 329 and last amended by Coordination Clause, Laws of Utah
46 2023, Chapters 329, 332
47 ENACTS:
48 26B-8-501.1, Utah Code Annotated 1953
49
50 Be it enacted by the Legislature of the state of Utah:
51 Section 1. Section 26B-1-413 is amended to read:
52 26B-1-413. Health Data Committee -- Purpose, powers, and duties of the
53 committee -- Membership -- Terms -- Chair -- Compensation.
54 (1) The definitions in Section 26B-8-501 apply to this section.
55 (2) [
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60 (3) The committee shall advise and consult with the department related to the
61 department's duties under Chapter 5, Part 8, Utah Health Data Authority.
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142 (i) the commissioner of the Utah Insurance Department[
143 designee who shall have knowledge regarding the health care system and characteristics and
144 use of health data[
145 (ii) two legislators jointly appointed by the speaker of the House of Representatives
146 and the president of the Senate;
147 (iii) one advocate for data privacy jointly appointed by the speaker of the House of
148 Representatives and the president of the Senate; and
149 (iv) one member of the public with knowledge regarding data privacy jointly appointed
150 by the speaker of the House of Representatives and the president of the Senate.
151 (b) [
152 consent of the Senate in accordance with Subsection [
153 63G, Chapter 24, Part 2, Vacancies.
154 [
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156 [
157 shall:
158 (a) be knowledgeable regarding the health care system and the characteristics and use
159 of health data;
160 (b) be selected so that the committee at all times includes individuals who provide
161 care;
162 (c) include one person employed by or otherwise associated with a general acute
163 hospital as defined in Section 26B-2-201, who is knowledgeable about the collection, analysis,
164 and use of health care data;
165 (d) include two physicians, as defined in Section 58-67-102:
166 (i) who are licensed to practice in this state;
167 (ii) who actively practice medicine in this state;
168 (iii) who are trained in or have experience with the collection, analysis, and use of
169 health care data; and
170 (iv) one of whom is selected by the Utah Medical Association;
171 (e) include three persons:
172 (i) who are:
173 (A) employed by or otherwise associated with a business that supplies health care
174 insurance to the business's employees; and
175 (B) knowledgeable about the collection and use of health care data; and
176 (ii) at least one of whom represents an employer employing 50 or fewer employees;
177 (f) include three persons representing health insurers:
178 (i) at least one of whom is employed by or associated with a third-party payor that is
179 not licensed under Title 31A, Chapter 8, Health Maintenance Organizations and Limited
180 Health Plans;
181 (ii) at least one of whom is employed by or associated with a third party that is licensed
182 under Title 31A, Chapter 8, Health Maintenance Organizations and Limited Health Plans; and
183 (iii) who are trained in, or experienced with the collection, analysis, and use of health
184 care data;
185 (g) include two consumer representatives:
186 (i) from organized consumer or employee associations; and
187 (ii) knowledgeable about the collection and use of health care data;
188 (h) include one person:
189 (i) representative of a neutral, non-biased entity that can demonstrate that the entity has
190 the broad support of health care payers and health care providers; and
191 (ii) who is knowledgeable about the collection, analysis, and use of health care data;
192 and
193 (i) include two persons representing public health who are trained in or experienced
194 with the collection, use, and analysis of health care data.
195 [
196 committee members expire, the governor shall appoint each new member or reappointed
197 member to a four-year term.
198 (b) Notwithstanding the requirements of Subsection [
199 at the time of appointment or reappointment, adjust the length of terms to ensure that the terms
200 of committee members are staggered so that approximately half of the committee is appointed
201 every two years.
202 (c) Members may serve after the members' terms expire until replaced.
203 [
204 shall be appointed for the unexpired term.
205 [
206 among the committee's membership. The chair shall report to the executive director.
207 [
208 Meeting dates shall be set by the chair upon 10 working days' notice to the other members, or
209 upon written request by at least four committee members with at least 10 working days' notice
210 to other committee members.
211 (b) [
212 business. Action may not be taken except upon the affirmative vote of a majority of a quorum
213 of the committee.
214 (c) All meetings of the committee shall be open to the public, except that the
215 committee may hold a closed meeting if the requirements of Sections 52-4-204, 52-4-205, and
216 52-4-206 are met.
217 [
218 (a) may not receive compensation or benefits for the member's service, but may receive
219 per diem and travel expenses in accordance with:
220 (i) Section 63A-3-106;
221 (ii) Section 63A-3-107; and
222 (iii) rules made by the Division of Finance pursuant to Sections 63A-3-106 and
223 63A-3-107; and
224 (b) shall comply with the conflict of interest provisions described in Title 63G, Chapter
225 24, Part 3, Conflicts of Interest.
226 Section 2. Section 26B-4-106 (Superseded 07/01/24) is amended to read:
227 26B-4-106 (Superseded 07/01/24). Data collection.
228 (1) The committee shall specify the information that shall be collected for the
229 emergency medical services data system established pursuant to Subsection (2).
230 (2) (a) The department shall establish an emergency medical services data system,
231 which shall provide for the collection of information, as defined by the committee, relating to
232 the treatment and care of patients who use or have used the emergency medical services
233 system.
234 (b) The committee shall coordinate with the [
235
236 [
237 (i) appropriate analytical methods;
238 (ii) the total amount of air ambulance flight charges in the state for a one-year period;
239 and
240 (iii) of the total number of flights in a one-year period under Subsection (2)(b)(ii):
241 (A) the number of flights for which a patient had no personal responsibility for paying
242 part of the flight charges;
243 (B) the number of flights for which a patient had personal responsibility to pay all or
244 part of the flight charges;
245 (C) the range of flight charges for which patients had personal responsibility under
246 Subsection (2)(b)(iii)(B), including the median amount for paid patient personal responsibility;
247 and
248 (D) the name of any air ambulance provider that received a median paid amount for
249 patient responsibility in excess of the median amount for all paid patient personal responsibility
250 during the reporting year.
251 (c) The department may share, with the Department of Public Safety, information from
252 the emergency medical services data system that:
253 (i) relates to traffic incidents;
254 (ii) is for the improvement of traffic safety;
255 (iii) may not be used for the prosecution of criminal matters; and
256 (iv) may not include any personally identifiable information.
257 (3) (a) On or before October 1, the department shall make the information in
258 Subsection (2)(b) public and send the information in Subsection (2)(b) to public safety
259 dispatchers and first responders in the state.
260 (b) Before making the information in Subsection (2)(b) public, the committee shall
261 provide the air ambulance providers named in the report with the opportunity to respond to the
262 accuracy of the information in the report under Section 26B-8-506.
263 (4) Persons providing emergency medical services:
264 (a) shall provide information to the department for the emergency medical services
265 data system established pursuant to Subsection (2)(a);
266 (b) are not required to provide information to the department under Subsection (2)(b);
267 and
268 (c) may provide information to the department under Subsection (2)(b) or (3)(b).
269 Section 3. Section 26B-8-501 is amended to read:
270 26B-8-501. Definitions.
271 As used in this part:
272 (1) "Committee" means the Health Data Committee created in Section 26B-1-413.
273 (2) "Control number" means [
274
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276 (a) is assigned by the department to an individual's health data;
277 (b) is consistent with the best practices of data privacy; and
278 (c) is used to ensure health data is not able to be readily associated with an individual
279 when the health data is provided for research or statistical analysis.
280 (3) "Data supplier" means a health care facility, health care provider, self-funded
281 employer, third-party payor, health maintenance organization, or government department which
282 could reasonably be expected to provide health data under this part.
283 (4) "Disclosure" or "disclose" means the communication of health care data to any
284 individual or organization outside the [
285 agencies.
286 (5) (a) "Health care facility" means a facility that is licensed by the department under
287 Chapter 2, Part 2, Health Care Facility Licensing and Inspection.
288 (b) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
289 [
290 committee, may by rule add, delete, or modify the list of facilities that come within this
291 definition for purposes of this part.
292 (6) "Health care provider" means the same as that term is defined in Section
293 78B-3-403.
294 (7) "Health data" means information relating to the health status of individuals, health
295 services delivered, the availability of health manpower and facilities, and the use and costs of
296 resources and services to the consumer, except vital records as defined in Section 26B-8-101
297 shall be excluded.
298 (8) "Health maintenance organization" means the same as that term is defined in
299 Section 31A-8-101.
300 (9) "Identifiable health data" means any item, collection, or grouping of health data that
301 makes the individual supplying or described in the health data identifiable.
302 (10) "Organization" means any corporation, association, partnership, agency,
303 department, unit, or other legally constituted institution or entity, or part thereof.
304 (11) "Research and statistical analysis" means activities using health data analysis
305 including:
306 (a) describing the group characteristics of individuals or organizations;
307 (b) analyzing the noncompliance among the various characteristics of individuals or
308 organizations;
309 (c) conducting statistical procedures or studies to improve the quality of health data;
310 (d) designing sample surveys and selecting samples of individuals or organizations;
311 and
312 (e) preparing and publishing reports describing these matters.
313 (12) "Self-funded employer" means an employer who provides for the payment of
314 health care services for employees directly from the employer's funds, thereby assuming the
315 financial risks rather than passing them on to an outside insurer through premium payments.
316 (13) "Plan" means the plan developed and adopted by the [
317 department under [
318 (14) "Third party payor" means:
319 (a) an insurer offering a health benefit plan, as defined by Section 31A-1-301, to at
320 least 2,500 enrollees in the state;
321 (b) a nonprofit health service insurance corporation licensed under Title 31A, Chapter
322 7, Nonprofit Health Service Insurance Corporations;
323 (c) a program funded or administered by Utah for the provision of health care services,
324 including the Medicaid and medical assistance programs described in Chapter 3, Part 1, Health
325 Care Assistance; and
326 (d) a corporation, organization, association, entity, or person:
327 (i) which administers or offers a health benefit plan to at least 2,500 enrollees in the
328 state; and
329 (ii) which is required by administrative rule adopted by the department in accordance
330 with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to supply health data to the
331 [
332 Section 4. Section 26B-8-501.1 is enacted to read:
333 26B-8-501.1. Health data authority duties.
334 (1) The department shall:
335 (a) in consultation with the committee and in accordance with Title 63G, Chapter 3,
336 Utah Administrative Rulemaking Act, develop and adopt by rule, following public hearing and
337 comment, a health data plan that shall among its elements:
338 (i) identify the key health care issues, questions, and problems amenable to resolution
339 or improvement through better data, more extensive or careful analysis, or improved
340 dissemination of health data;
341 (ii) document existing health data activities in the state to collect, organize, or make
342 available types of data pertinent to the needs identified in Subsection (1)(a)(i);
343 (iii) describe and prioritize the actions suitable for the department to take in response to
344 the needs identified in Subsection (1)(a)(i) in order to obtain or to facilitate the obtaining of
345 needed data, and to encourage improvements in existing data collection, interpretation, and
346 reporting activities, and indicate how those actions relate to the activities identified under
347 Subsection (1)(a)(ii);
348 (iv) detail the types of data needed for the department's work, the intended data
349 suppliers, and the form in which such data are to be supplied, noting the consideration given to
350 the potential alternative sources and forms of such data and to the estimated cost to the
351 individual suppliers as well as to the department of acquiring the data in the proposed manner
352 and reasonably demonstrate that the department has attempted to maximize cost-effectiveness
353 in the data acquisition approaches selected;
354 (v) describe the types and methods of validation to be performed to assure data validity
355 and reliability;
356 (vi) explain the intended uses of and expected benefits to be derived from the data
357 specified in Subsection (1)(a)(iv), including the contemplated tabulation formats and analysis
358 methods; the benefits described shall demonstrably relate to one or more of the following:
359 (A) promoting quality health care;
360 (B) managing health care costs; or
361 (C) improving access to health care services;
362 (vii) describe the expected processes for interpretation and analysis of the data flowing
363 to the department, noting specifically the types of expertise and participation to be sought in
364 those processes; and
365 (viii) describe the types of reports to be made available by the department and the
366 intended audiences and uses;
367 (b) have the authority to collect, validate, analyze, and present health data in
368 accordance with the plan while protecting individual privacy through the use of the best
369 practices of data privacy;
370 (c) evaluate existing identification coding methods and, if necessary, require by rule
371 adopted in accordance with Subsection (2), that health data suppliers use a uniform system for
372 identification of patients, health care facilities, and health care providers on health data they
373 submit under this section and Chapter 8, Part 5, Utah Health Data Authority; and
374 (d) advise, consult, contract, and cooperate with any corporation, association, or other
375 entity for the collection, analysis, processing, or reporting of health data.
376 (2) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
377 department, in consultation with the committee, may adopt rules to carry out the provisions of
378 this section and Chapter 8, Part 5, Utah Health Data Authority.
379 (3) (a) Except for data collection, analysis, and validation functions described in this
380 section, nothing in this part shall be construed to authorize or permit the department to perform
381 regulatory functions which are delegated by law to other agencies of the state or federal
382 governments or to perform quality assurance or medical record audit functions that health care
383 facilities, health care providers, or third party payors are required to conduct to comply with
384 federal or state law.
385 (b) The department may not recommend or determine whether a health care provider,
386 health care facility, third party payor, or self-funded employer is in compliance with federal or
387 state laws including federal or state licensure, insurance, reimbursement, tax, malpractice, or
388 quality assurance statutes or common law.
389 (4) Nothing in this part, shall be construed to require a data supplier to supply health
390 data identifying a patient by name or describing detail on a patient beyond that needed to
391 achieve the approved purposes included in the plan.
392 (5) No request for health data shall be made of health care providers and other data
393 suppliers until a plan for the use of such health data has been adopted.
394 (6) (a) If a proposed request for health data imposes unreasonable costs on a data
395 supplier, due consideration shall be given by the department to altering the request.
396 (b) If the request is not altered, the department shall pay the costs incurred by the data
397 supplier associated with satisfying the request that are demonstrated by the data supplier to be
398 unreasonable.
399 (7) After a plan is adopted as provided in Section 26B-8-504, the department may
400 require any data supplier to submit fee schedules, maximum allowable costs, area prevailing
401 costs, terms of contracts, discounts, fixed reimbursement arrangements, capitations, or other
402 specific arrangements for reimbursement to a health care provider.
403 (8) (a) The department may not publish any health data collected under Subsection (7)
404 that would disclose specific terms of contracts, discounts, or fixed reimbursement
405 arrangements, or other specific reimbursement arrangements between an individual provider
406 and a specific payer.
407 (b) Nothing in Subsection (7) shall prevent the department from requiring the
408 submission of health data on the reimbursements actually made to health care providers from
409 any source of payment, including consumers.
410 (9) Any data collected by the department shall be done in accordance with state and
411 federal data privacy laws.
412 (10) (a) The department shall:
413 (i) create an opt-out system where an individual may choose to have an individual's
414 identifiable health data suppressed or restricted from being accessible for department duties
415 described under this part;
416 (ii) maintain a list of people who have opted out for use in accordance with Subsection
417 (10)(b); and
418 (iii) provide instructions for the opt-out system described in Subsection (10)(a)(i) in a
419 conspicuous location on the department's website.
420 (b) For an individual who opts out under Subsection (10)(a), the department may not
421 share, analyze, or use any identifiable health data from the health data obtained under this part
422 for the individual, including data previously obtained under this part.
423 (11) (a) For identifiable health data, the department shall:
424 (i) use the minimum necessary data to accomplish the duties described in this part; and
425 (ii) only use personally identifiable information for:
426 (A) quality assurance;
427 (B) referential integrity; or
428 (C) complying with breach notification requirements.
429 (b) If the department receives an individual's social security number with data obtained
430 under this part, the department may not share any part of the social security number with any
431 person.
432 (12) The department shall annually report to the Health and Human Services Interim
433 Committee regarding privacy practices and efforts the department is undertaking to enhance
434 data privacy.
435 (13) (a) Before October 1, 2024, the department shall review all state statutory
436 mandates related to the collection of any form of health data and provide a written report to the
437 Health and Human Services Interim Committee outlining the mandates that are older than 10
438 years old with:
439 (i) a description regarding how the data is used; and
440 (ii) a recommendation regarding whether the department should continue collecting the
441 data.
442 (b) The department may request assistance from the Office of Legislative Research and
443 General Counsel to determine when statutory mandates were enacted.
444 Section 5. Section 26B-8-502 is amended to read:
445 26B-8-502. Executive secretary -- Appointment -- Powers.
446 (1) An executive secretary shall be appointed by the executive director, [
447
448 direction of the executive director.
449 (2) The executive secretary shall:
450 (a) employ full-time employees necessary to carry out this part;
451 (b) supervise the development of a draft health data plan for the [
452 department's review, modification, and approval; and
453 (c) supervise and conduct the staff functions of the committee in order to assist the
454 committee in meeting its responsibilities under this part.
455 Section 6. Section 26B-8-503 is amended to read:
456 26B-8-503. Limitations on use of health data.
457 The [
458 payors, health care providers, or health care facilities to make recommendations with regard to
459 a single health care provider or health care facility, or a group of health care providers or health
460 care facilities.
461 Section 7. Section 26B-8-504 is amended to read:
462 26B-8-504. Health care cost and reimbursement data.
463 (1) The [
464 (a) establish a plan for collecting data from data suppliers to determine measurements
465 of cost and reimbursements for risk-adjusted episodes of health care;
466 (b) share data regarding insurance claims and an individual's and small employer
467 group's health risk factor and characteristics of insurance arrangements that affect claims and
468 usage with the Insurance Department, only to the extent necessary for:
469 (i) risk adjusting; and
470 (ii) the review and analysis of health insurers' premiums and rate filings; and
471 (c) assist the Legislature and the public with awareness of, and the promotion of,
472 transparency in the health care market by reporting on:
473 (i) geographic variances in medical care and costs as demonstrated by data available to
474 the [
475 (ii) rate and price increases by health care providers:
476 (A) that exceed the Consumer Price Index - Medical as provided by the United States
477 Bureau of Labor Statistics;
478 (B) as calculated yearly from June to June; and
479 (C) as demonstrated by data available to the [
480 (d) provide on at least a monthly basis, enrollment data collected by the [
481 department to a not-for-profit, broad-based coalition of state health care insurers and health
482 care providers that are involved in the standardized electronic exchange of health data as
483 described in Section 31A-22-614.5, to the extent necessary:
484 (i) for the department or the Medicaid Office of the Inspector General to determine
485 insurance enrollment of an individual for the purpose of determining Medicaid third party
486 liability;
487 (ii) for an insurer that is a data supplier, to determine insurance enrollment of an
488 individual for the purpose of coordination of health care benefits; and
489 (iii) for a health care provider, to determine insurance enrollment for a patient for the
490 purpose of claims submission by the health care provider;
491 (e) coordinate with the State Emergency Medical Services Committee to publish data
492 regarding air ambulance charges under Section 26B-4-106;
493 (f) share data collected under this part with the state auditor for use in the health care
494 price transparency tool described in Section 67-3-11; and
495 (g) publish annually a report on primary care spending within Utah.
496 (2) A data supplier is not liable for a breach of or unlawful disclosure of the data
497 caused by an entity that obtains data in accordance with Subsection (1).
498 (3) The plan adopted under Subsection (1) shall include:
499 (a) the type of data that will be collected;
500 (b) how the data will be evaluated;
501 (c) how the data will be used;
502 (d) the extent to which, and how the data will be protected; and
503 (e) who will have access to the data.
504 Section 8. Section 26B-8-505 is amended to read:
505 26B-8-505. Comparative analyses.
506 (1) The [
507 identify health care providers or data suppliers from the data it collects under this part or from
508 any other source.
509 (2) (a) Except as provided in Subsection (7)(c), the [
510 publish compilations or reports from the data it collects under this part or from any other
511 source which:
512 (i) contain the information described in Subsection (2)(b); and
513 (ii) compare and identify by name at least a majority of the health care facilities, health
514 care plans, and institutions in the state.
515 (b) Except as provided in Subsection (7)(c), the report required by this Subsection (2)
516 shall:
517 (i) be published at least annually;
518 (ii) list, as determined by the [
519 least the top 50 medical procedures performed in the state by volume;
520 (iii) describe the methodology approved by the [
521 the amounts described in Subsection (2)(b)(ii); and
522 (iv) contain comparisons based on at least the following factors:
523 (A) nationally or other generally recognized quality standards;
524 (B) charges; and
525 (C) nationally recognized patient safety standards.
526 (3) (a) The [
527 evaluate the standard comparative reports of the [
528 compare, or rank the performance of data suppliers by name.
529 (b) The evaluation described in this Subsection (3) shall include a validation of
530 statistical methodologies, limitations, appropriateness of use, and comparisons using standard
531 health services research practice.
532 (c) The independent analyst described in Subsection (3)(a) shall be experienced in
533 analyzing large databases from multiple data suppliers and in evaluating health care issues of
534 cost, quality, and access.
535 (d) The results of the analyst's evaluation shall be released to the public before the
536 standard comparative analysis upon which it is based may be published by the [
537 department.
538 (4) The [
539 consultation with the committee shall make rules in accordance with Title 63G, Chapter 3,
540 Utah Administrative Rulemaking Act, to adopt a timetable for the collection and analysis of
541 data from multiple types of data suppliers.
542 (5) The comparative analysis required under Subsection (2) shall be available free of
543 charge and easily accessible to the public.
544 (6) (a) The department shall include in the report required by Subsection (2)(b), or
545 include in a separate report, comparative information on commonly recognized or generally
546 agreed upon measures of cost and quality identified in accordance with Subsection (7), for:
547 (i) routine and preventive care; and
548 (ii) the treatment of diabetes, heart disease, and other illnesses or conditions as
549 determined by the [
550 (b) The comparative information required by Subsection (6)(a) shall be based on data
551 collected under Subsection (2) and clinical data that may be available to the [
552 department, and shall compare:
553 (i) results for health care facilities or institutions;
554 (ii) results for health care providers by geographic regions of the state;
555 (iii) a clinic's aggregate results for a physician who practices at a clinic with five or
556 more physicians; and
557 (iv) a geographic region's aggregate results for a physician who practices at a clinic
558 with less than five physicians, unless the physician requests physician-level data to be
559 published on a clinic level.
560 (c) The department:
561 (i) may publish information required by this Subsection (6) directly or through one or
562 more nonprofit, community-based health data organizations; and
563 (ii) may use a private, independent analyst under Subsection (3)(a) in preparing the
564 report required by this section.
565 (d) A report published by the department under this Subsection (6):
566 (i) is subject to the requirements of Section 26B-8-506; and
567 (ii) shall, prior to being published by the department, be submitted to a neutral,
568 non-biased entity with a broad base of support from health care payers and health care
569 providers in accordance with Subsection (7) for the purpose of validating the report.
570 (7) (a) [
571 of Subsection (6)(a), use the quality measures that are developed and agreed upon by a neutral,
572 non-biased entity with a broad base of support from health care payers and health care
573 providers.
574 (b) If the entity described in Subsection (7)(a) does not submit the quality measures,
575 the department may select the appropriate number of quality measures for purposes of the
576 report required by Subsection (6).
577 (c) (i) For purposes of the reports published on or after July 1, 2014, the department
578 may not compare individual facilities or clinics as described in Subsections (6)(b)(i) through
579 (iv) if the department determines that the data available to the department can not be
580 appropriately validated, does not represent nationally recognized measures, does not reflect the
581 mix of cases seen at a clinic or facility, or is not sufficient for the purposes of comparing
582 providers.
583 (ii) The department shall report to the [
584 Interim Committee prior to making a determination not to publish a report under Subsection
585 (7)(c)(i).
586 Section 9. Section 26B-8-506 is amended to read:
587 26B-8-506. Limitations on release of reports.
588 The [
589 identifies health care providers or data suppliers unless it:
590 (1) allows the data supplier and the health care provider to verify the accuracy of the
591 information submitted to the [
592 department any corrections of errors with supporting evidence and comments within a
593 reasonable period of time to be established by rule, with the concurrence of the department,
594 made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act;
595 (2) corrects data found to be in error; and
596 (3) allows the data supplier a reasonable amount of time prior to publication to review
597 the [
598 Section 10. Section 26B-8-507 is amended to read:
599 26B-8-507. Disclosure of identifiable health data prohibited.
600 (1) (a) All information, reports, statements, memoranda, or other data received by the
601 [
602 (b) Any use, release, or publication of the information shall be done in such a way that
603 no person is identifiable except as provided in Sections 26B-8-506 and 26B-8-508.
604 (2) No member of the [
605 having released or published reports or compilations of data supplied to the [
606 department, so long as the publication or release is in accordance with the requirements of
607 Subsection (1).
608 (3) No person, corporation, or entity may be held civilly liable for having provided data
609 to the [
610 Section 11. Section 26B-8-508 is amended to read:
611 26B-8-508. Exceptions to prohibition on disclosure of identifiable health data.
612 (1) The [
613 (a) the individual has authorized the disclosure;
614 (b) the disclosure is to the department or a public health authority in accordance with
615 Subsection (2); or
616 (c) the disclosure complies with the provisions of:
617 (i) Subsection (3);
618 (ii) insurance enrollment and coordination of benefits under Subsection
619 26B-8-504(1)(d); or
620 (iii) risk adjusting under Subsection 26B-8-504(1)(b).
621 (2) The [
622 or a public health authority under Subsection (1)(b) if:
623 (a) the department or the public health authority has clear statutory authority to possess
624 the identifiable health data; and
625 (b) the disclosure is solely for use:
626 (i) in the Utah Statewide Immunization Information System operated by the
627 department;
628 (ii) in the Utah Cancer Registry operated by the University of Utah, in collaboration
629 with the department; or
630 (iii) by the medical examiner, as defined in Section 26B-8-201, or the medical
631 examiner's designee.
632 (3) The [
633 request for disclosure of information that may include identifiable health data:
634 (a) whether the request comes from a person after that person has received approval to
635 do the specific research or statistical work from an institutional review board; and
636 (b) whether the requesting entity complies with the provisions of Subsection (4).
637 (4) A request for disclosure of information that may include identifiable health data
638 shall:
639 (a) be for a specified period; or
640 (b) be solely for bona fide research or statistical purposes as determined in accordance
641 with administrative rules adopted by the department in accordance with Title 63G, Chapter 3,
642 Utah Administrative Rulemaking Act, which shall require:
643 (i) the requesting entity to demonstrate to the department that the data is required for
644 the research or statistical purposes proposed by the requesting entity; and
645 (ii) the requesting entity to enter into a written agreement satisfactory to the department
646 to protect the data in accordance with this part or other applicable law.
647 (5) A person accessing identifiable health data pursuant to Subsection (4) may not
648 further disclose the identifiable health data:
649 (a) without prior approval of the department; and
650 (b) unless the identifiable health data is disclosed or identified by control number only.
651 (6) Identifiable health data that has been designated by a data supplier as being subject
652 to regulation under 42 C.F.R. Part 2, Confidentiality of Substance Use Disorder Patient
653 Records, may only be used or disclosed in accordance with applicable federal regulations.
654 Section 12. Section 53-2d-203 (Effective 07/01/24) is amended to read:
655 53-2d-203 (Effective 07/01/24). Data collection.
656 (1) The committee shall specify the information that shall be collected for the
657 emergency medical services data system established pursuant to Subsection (2).
658 (2) (a) The bureau shall establish an emergency medical services data system, which
659 shall provide for the collection of information, as defined by the committee, relating to the
660 treatment and care of patients who use or have used the emergency medical services system.
661 (b) The committee shall coordinate with the [
662
663 Services, to create a report of data collected by the [
664 Health and Human Services under Section 26B-8-504 regarding:
665 (i) appropriate analytical methods;
666 (ii) the total amount of air ambulance flight charges in the state for a one-year period;
667 and
668 (iii) of the total number of flights in a one-year period under Subsection (2)(b)(ii):
669 (A) the number of flights for which a patient had no personal responsibility for paying
670 part of the flight charges;
671 (B) the number of flights for which a patient had personal responsibility to pay all or
672 part of the flight charges;
673 (C) the range of flight charges for which patients had personal responsibility under
674 Subsection (2)(b)(iii)(B), including the median amount for paid patient personal responsibility;
675 and
676 (D) the name of any air ambulance provider that received a median paid amount for
677 patient responsibility in excess of the median amount for all paid patient personal responsibility
678 during the reporting year.
679 (c) The bureau may share, with the department, information from the emergency
680 medical services data system that:
681 (i) relates to traffic incidents; and
682 (ii) is for the improvement of traffic safety.
683 (d) Information shared under Subsection (2)(c) may not:
684 (i) be used for the prosecution of criminal matters; or
685 (ii) include any personally identifiable information.
686 (3) (a) On or before October 1, the department shall make the information in
687 Subsection (2)(b) public and send the information in Subsection (2)(b) to public safety
688 dispatchers and first responders in the state.
689 (b) Before making the information in Subsection (2)(b) public, the committee shall
690 provide the air ambulance providers named in the report with the opportunity to respond to the
691 accuracy of the information in the report under Section 26B-8-506.
692 (4) Persons providing emergency medical services:
693 (a) shall provide information to the department for the emergency medical services
694 data system established pursuant to Subsection (2)(a);
695 (b) are not required to provide information to the department under Subsection (2)(b);
696 and
697 (c) may provide information to the department under Subsection (2)(b) or (3)(b).
698 Section 13. Section 63A-13-301 is amended to read:
699 63A-13-301. Access to records -- Retention of designation under Government
700 Records Access and Management Act.
701 (1) In order to fulfill the duties described in Section 63A-13-202, and in the manner
702 provided in Subsection (4), the office shall have unrestricted access to all records of state
703 executive branch entities, all local government entities, and all providers relating, directly or
704 indirectly, to:
705 (a) the state Medicaid program;
706 (b) state or federal Medicaid funds;
707 (c) the provision of Medicaid related services;
708 (d) the regulation or management of any aspect of the state Medicaid program;
709 (e) the use or expenditure of state or federal Medicaid funds;
710 (f) suspected or proven fraud, waste, or abuse of state or federal Medicaid funds;
711 (g) Medicaid program policies, practices, and procedures;
712 (h) monitoring of Medicaid services or funds; or
713 (i) a fatality review of a person who received Medicaid funded services.
714 (2) The office shall have access to information in any database maintained by the state
715 or a local government to verify identity, income, employment status, or other factors that affect
716 eligibility for Medicaid services.
717 (3) The records described in Subsections (1) and (2) include records held or maintained
718 by the department, the division, the Department of Health and Human Services, the
719 Department of Workforce Services, a local health department, a local mental health authority,
720 or a school district. The records described in Subsection (1) include records held or maintained
721 by a provider. When conducting an audit of a provider, the office shall, to the extent possible,
722 limit the records accessed to the scope of the audit.
723 (4) A record, described in Subsection (1) or (2), that is accessed or copied by the
724 office:
725 (a) may be reviewed or copied by the office during normal business hours, unless
726 otherwise requested by the provider or health care professional under Subsection (4)(b);
727 (b) unless there is a credible allegation of fraud, shall be accessed, reviewed, and
728 copied in a manner, on a day, and at a time that is minimally disruptive to the health care
729 professional's or provider's care of patients, as requested by the health care professional or
730 provider;
731 (c) may be submitted electronically;
732 (d) may be submitted together with other records for multiple claims; and
733 (e) if it is a government record, shall retain the classification made by the entity
734 responsible for the record, under Title 63G, Chapter 2, Government Records Access and
735 Management Act.
736 (5) Except as provided in Subsection (7), notwithstanding any provision of state law to
737 the contrary, the office shall have the same access to all records, information, and databases to
738 which the department or the division has access.
739 (6) The office shall comply with the requirements of federal law, including the Health
740 Insurance Portability and Accountability Act of 1996 and 42 C.F.R., Part 2, relating to the
741 office's:
742 (a) access, review, retention, and use of records; and
743 (b) use of information included in, or derived from, records.
744 (7) The office's access to data held by the [
745 Health and Human Services under Title 26B, Chapter 8, Part 5, Utah Health Data Authority:
746 (a) is not subject to this section; and
747 (b) is subject to Title 26B, Chapter 8, Part 5, Utah Health Data Authority.
748 Section 14. Section 63I-1-226 (Superseded 07/01/24) is amended to read:
749 63I-1-226 (Superseded 07/01/24). Repeal dates: Titles 26A through 26B.
750 (1) Subsection 26B-1-204(2)(i), related to the Primary Care Grant Committee, is
751 repealed July 1, 2025.
752 (2) Section 26B-1-315, which creates the Medicaid Expansion Fund, is repealed July 1,
753 2024.
754 (3) Section 26B-1-319, which creates the Neuro-Rehabilitation Fund, is repealed
755 January 1, 2025.
756 (4) Section 26B-1-320, which creates the Pediatric Neuro-Rehabilitation Fund, is
757 repealed January 1, 2025.
758 (5) Subsection 26B-1-324(4), the language that states "the Behavioral Health Crisis
759 Response Commission, as defined in Section 63C-18-202," is repealed December 31, 2026.
760 (6) Subsection 26B-1-329(6), related to the Behavioral Health Crisis Response
761 Commission, is repealed December 31, 2026.
762 (7) Section 26B-1-402, related to the Rare Disease Advisory Council Grant Program, is
763 repealed July 1, 2026.
764 (8) Section 26B-1-409, which creates the Utah Digital Health Service Commission, is
765 repealed July 1, 2025.
766 (9) Section 26B-1-410, which creates the Primary Care Grant Committee, is repealed
767 July 1, 2025.
768 (10) Section 26B-1-416, which creates the Utah Children's Health Insurance Program
769 Advisory Council, is repealed July 1, 2025.
770 (11) Section 26B-1-417, which creates the Brain Injury Advisory Committee, is
771 repealed July 1, 2025.
772 (12) Section 26B-1-418, which creates the Neuro-Rehabilitation Fund and Pediatric
773 Neuro-Rehabilitation Fund Advisory Committee, is repealed January 1, 2025.
774 (13) Section 26B-1-422, which creates the Early Childhood Utah Advisory Council, is
775 repealed July 1, 2029.
776 (14) Section 26B-1-428, which creates the Youth Electronic Cigarette, Marijuana, and
777 Other Drug Prevention Program, is repealed July 1, 2025.
778 (15) Section 26B-1-430, which creates the Coordinating Council for Persons with
779 Disabilities, is repealed July 1, 2027.
780 (16) Section 26B-1-431, which creates the Forensic Mental Health Coordinating
781 Council, is repealed July 1, 2023.
782 (17) Section 26B-1-432, which creates the Newborn Hearing Screening Committee, is
783 repealed July 1, 2026.
784 (18) Section 26B-1-434, regarding the Correctional Postnatal and Early Childhood
785 Advisory Board, is repealed July 1, 2026.
786 (19) Section 26B-2-407, related to drinking water quality in child care centers, is
787 repealed July 1, 2027.
788 (20) Subsection 26B-3-107(9), which addresses reimbursement for dental hygienists, is
789 repealed July 1, 2028.
790 (21) Section 26B-3-136, which creates the Children's Health Care Coverage Program,
791 is repealed July 1, 2025.
792 (22) Section 26B-3-137, related to reimbursement for the National Diabetes Prevention
793 Program, is repealed June 30, 2027.
794 (23) Subsection 26B-3-213(2), the language that states "and the Behavioral Health
795 Crisis Response Commission created in Section 63C-18-202" is repealed December 31, 2026.
796 (24) Sections 26B-3-302 through 26B-3-309, regarding the Drug Utilization Review
797 Board, are repealed July 1, 2027.
798 (25) Title 26B, Chapter 3, Part 5, Inpatient Hospital Assessment, is repealed July 1,
799 2024.
800 (26) Title 26B, Chapter 3, Part 6, Medicaid Expansion Hospital Assessment, is
801 repealed July 1, 2024.
802 (27) Title 26B, Chapter 3, Part 7, Hospital Provider Assessment, is repealed July 1,
803 2028.
804 (28) Section 26B-3-910, regarding alternative eligibility, is repealed July 1, 2028.
805 (29) Section 26B-4-136, related to the Volunteer Emergency Medical Service
806 Personnel Health Insurance Program, is repealed July 1, 2027.
807 (30) Section 26B-4-710, related to rural residency training programs, is repealed July 1,
808 2025.
809 (31) Subsections 26B-5-112(1) and (5), the language that states "In consultation with
810 the Behavioral Health Crisis Response Commission, established in Section 63C-18-202," is
811 repealed December 31, 2026.
812 (32) Section 26B-5-112.5 is repealed December 31, 2026.
813 (33) Section 26B-5-114, related to the Behavioral Health Receiving Center Grant
814 Program, is repealed December 31, 2026.
815 (34) Section 26B-5-118, related to collaborative care grant programs, is repealed
816 December 31, 2024.
817 (35) Section 26B-5-120 is repealed December 31, 2026.
818 (36) In relation to the Utah Assertive Community Treatment Act, on July 1, 2024:
819 (a) Subsection 26B-5-606(2)(a)(i), the language that states "and" is repealed; and
820 (b) Subsections 26B-5-606(2)(a)(ii), 26B-5-606(2)(b), and 26B-5-606(2)(c) are
821 repealed.
822 (37) In relation to the Behavioral Health Crisis Response Commission, on December
823 31, 2026:
824 (a) Subsection 26B-5-609(1)(a) is repealed;
825 (b) Subsection 26B-5-609(3)(a), the language that states "With recommendations from
826 the commission," is repealed;
827 (c) Subsection 26B-5-610(1)(b) is repealed;
828 (d) Subsection 26B-5-610(2)(b), the language that states "and in consultation with the
829 commission," is repealed; and
830 (e) Subsection 26B-5-610(4), the language that states "In consultation with the
831 commission," is repealed.
832 (38) Subsections 26B-5-611(1)(a) and (10), in relation to the Utah Substance Use and
833 Mental Health Advisory Council, are repealed January 1, 2033.
834 (39) Section 26B-5-612, related to integrated behavioral health care grant programs, is
835 repealed December 31, 2025.
836 (40) Subsection 26B-7-119(5), related to reports to the Legislature on the outcomes of
837 the Hepatitis C Outreach Pilot Program, is repealed July 1, 2028.
838 (41) Section 26B-7-224, related to reports to the Legislature on violent incidents and
839 fatalities involving substance abuse, is repealed December 31, 2027.
840 (42) Title 26B, Chapter 8, Part 5, Utah Health Data Authority, is repealed July 1,
841 [
842 (43) Section 26B-8-513, related to identifying overuse of non-evidence-based health
843 care, is repealed December 31, 2023.
844 Section 15. Section 63I-1-226 (Effective 07/01/24) is amended to read:
845 63I-1-226 (Effective 07/01/24). Repeal dates: Titles 26A through 26B.
846 (1) Subsection 26B-1-204(2)(i), related to the Primary Care Grant Committee, is
847 repealed July 1, 2025.
848 (2) Section 26B-1-315, which creates the Medicaid Expansion Fund, is repealed July 1,
849 2024.
850 (3) Section 26B-1-319, which creates the Neuro-Rehabilitation Fund, is repealed
851 January 1, 2025.
852 (4) Section 26B-1-320, which creates the Pediatric Neuro-Rehabilitation Fund, is
853 repealed January 1, 2025.
854 (5) Subsection 26B-1-324(4), the language that states "the Behavioral Health Crisis
855 Response Commission, as defined in Section 63C-18-202," is repealed December 31, 2026.
856 (6) Subsection 26B-1-329(6), related to the Behavioral Health Crisis Response
857 Commission, is repealed December 31, 2026.
858 (7) Section 26B-1-402, related to the Rare Disease Advisory Council Grant Program, is
859 repealed July 1, 2026.
860 (8) Section 26B-1-409, which creates the Utah Digital Health Service Commission, is
861 repealed July 1, 2025.
862 (9) Section 26B-1-410, which creates the Primary Care Grant Committee, is repealed
863 July 1, 2025.
864 (10) Section 26B-1-416, which creates the Utah Children's Health Insurance Program
865 Advisory Council, is repealed July 1, 2025.
866 (11) Section 26B-1-417, which creates the Brain Injury Advisory Committee, is
867 repealed July 1, 2025.
868 (12) Section 26B-1-418, which creates the Neuro-Rehabilitation Fund and Pediatric
869 Neuro-Rehabilitation Fund Advisory Committee, is repealed January 1, 2025.
870 (13) Section 26B-1-422, which creates the Early Childhood Utah Advisory Council, is
871 repealed July 1, 2029.
872 (14) Section 26B-1-428, which creates the Youth Electronic Cigarette, Marijuana, and
873 Other Drug Prevention Program, is repealed July 1, 2025.
874 (15) Section 26B-1-430, which creates the Coordinating Council for Persons with
875 Disabilities, is repealed July 1, 2027.
876 (16) Section 26B-1-431, which creates the Forensic Mental Health Coordinating
877 Council, is repealed July 1, 2023.
878 (17) Section 26B-1-432, which creates the Newborn Hearing Screening Committee, is
879 repealed July 1, 2026.
880 (18) Section 26B-1-434, regarding the Correctional Postnatal and Early Childhood
881 Advisory Board, is repealed July 1, 2026.
882 (19) Section 26B-2-407, related to drinking water quality in child care centers, is
883 repealed July 1, 2027.
884 (20) Subsection 26B-3-107(9), which addresses reimbursement for dental hygienists, is
885 repealed July 1, 2028.
886 (21) Section 26B-3-136, which creates the Children's Health Care Coverage Program,
887 is repealed July 1, 2025.
888 (22) Section 26B-3-137, related to reimbursement for the National Diabetes Prevention
889 Program, is repealed June 30, 2027.
890 (23) Subsection 26B-3-213(2), the language that states "and the Behavioral Health
891 Crisis Response Commission created in Section 63C-18-202" is repealed December 31, 2026.
892 (24) Sections 26B-3-302 through 26B-3-309, regarding the Drug Utilization Review
893 Board, are repealed July 1, 2027.
894 (25) Title 26B, Chapter 3, Part 5, Inpatient Hospital Assessment, is repealed July 1,
895 2024.
896 (26) Title 26B, Chapter 3, Part 6, Medicaid Expansion Hospital Assessment, is
897 repealed July 1, 2024.
898 (27) Title 26B, Chapter 3, Part 7, Hospital Provider Assessment, is repealed July 1,
899 2028.
900 (28) Section 26B-3-910, regarding alternative eligibility, is repealed July 1, 2028.
901 (29) Section 26B-4-710, related to rural residency training programs, is repealed July 1,
902 2025.
903 (30) Subsections 26B-5-112(1) and (5), the language that states "In consultation with
904 the Behavioral Health Crisis Response Commission, established in Section 63C-18-202," is
905 repealed December 31, 2026.
906 (31) Section 26B-5-112.5 is repealed December 31, 2026.
907 (32) Section 26B-5-114, related to the Behavioral Health Receiving Center Grant
908 Program, is repealed December 31, 2026.
909 (33) Section 26B-5-118, related to collaborative care grant programs, is repealed
910 December 31, 2024.
911 (34) Section 26B-5-120 is repealed December 31, 2026.
912 (35) In relation to the Utah Assertive Community Treatment Act, on July 1, 2024:
913 (a) Subsection 26B-5-606(2)(a)(i), the language that states "and" is repealed; and
914 (b) Subsections 26B-5-606(2)(a)(ii), 26B-5-606(2)(b), and 26B-5-606(2)(c) are
915 repealed.
916 (36) In relation to the Behavioral Health Crisis Response Commission, on December
917 31, 2026:
918 (a) Subsection 26B-5-609(1)(a) is repealed;
919 (b) Subsection 26B-5-609(3)(a), the language that states "With recommendations from
920 the commission," is repealed;
921 (c) Subsection 26B-5-610(1)(b) is repealed;
922 (d) Subsection 26B-5-610(2)(b), the language that states "and in consultation with the
923 commission," is repealed; and
924 (e) Subsection 26B-5-610(4), the language that states "In consultation with the
925 commission," is repealed.
926 (37) Subsections 26B-5-611(1)(a) and (10), in relation to the Utah Substance Use and
927 Mental Health Advisory Council, are repealed January 1, 2033.
928 (38) Section 26B-5-612, related to integrated behavioral health care grant programs, is
929 repealed December 31, 2025.
930 (39) Subsection 26B-7-119(5), related to reports to the Legislature on the outcomes of
931 the Hepatitis C Outreach Pilot Program, is repealed July 1, 2028.
932 (40) Section 26B-7-224, related to reports to the Legislature on violent incidents and
933 fatalities involving substance abuse, is repealed December 31, 2027.
934 (41) Title 26B, Chapter 8, Part 5, Utah Health Data Authority, is repealed July 1,
935 [
936 (42) Section 26B-8-513, related to identifying overuse of non-evidence-based health
937 care, is repealed December 31, 2023.
938 Section 16. Effective date.
939 (1) Except as provided in Subsection (2), this bill takes effect on May 1, 2024.
940 (2) The actions affecting Section 63I-1-226 (Effective 07/01/24) and Section
941 53-2d-203 (Effective 07/01/24) take effect on July 1, 2024.