Delaware Senate Bill 238 (Prior Session Legislation)

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Completed Legislative Action
Spectrum: Moderate Partisan Bill (Democrat 8-2)
Status: Passed on July 21 2016 - 100% progression
Action: 2016-07-21 - Signed by Governor
Text: Latest bill text (Engrossed) [HTML]

This Act establishes a Delaware Health Care Claims Database to be administered and operated within the existing framework of the Delaware Health Information Network. Sixteen states have enacted legislation to create health care claims databases which are generally referred to as an “All Payer Claims Database” or a “Multi Payer Claims Database”. In short, this Act will help Delaware answer the following questions: (1) How much does Delaware spend on health care? (2) How much does a service cost at a specific facility? (3) How have health care prices changed over time? (4) Are Delaware’s efforts to establish value-based alternatives to the traditional “fee for service” health care system effective? The Delaware Health Care Claims Database will help advance the ongoing work to transform the State’s health care system from a fee-for-service system to a value-based system that rewards health care providers for quality and efficiency of care. To complete that transformation, health care providers and other health care entities accepting financial risk for a population must have an appropriate level of access to health care claims data—particularly data that provides some transparency into health care pricing. Centralized and standardized access to claims data is also critical to maximizing population health initiatives, including the study of occurrences of injury or illness across the continuum of care in Delaware or in specific neighborhoods. This Act sets forth the basic structure and parameters of the Health Care Claims Database, subject to further guidance to be set forth in rules and regulations to be promulgated by the DHIN, in continued consultation with the Department of Health and Social Services, the Health Care Commission, and stakeholders in the health care community. Specific Requirements for Claims Data Reporting This Act requires certain types of claims data defined as “required claims data” to be reported by the entities specified as “mandatory reporting entities” in the Act. The Act only mandates reporting of claims data for the Medicaid Program, the State Group Health Insurance Program, and any qualified health plan in the Delaware Health Insurance Marketplace for plan year 2017 and any subsequent plan year. This Act also authorizes health insurers and providers who are not required to participate in the Health Care Claims Database to voluntarily report “claims data” pursuant to appropriate data submission and use agreements between the voluntary reporting entity and the DHIN. In both mandatory and voluntary claims data reporting, the Delaware Health Care Claims Database will maintain the privacy and confidentiality of individually identifiable health information in accordance with all federal and state privacy and security laws, including compliance with guidance found in Statement 6 of the Department of Justice and Federal Trade Commission Enforcement Policy regarding the exchange of price and cost information, and with appropriate limits on the disclosure of potentially proprietary contracted unit price information. In order to comply with a recent decision of the United States Supreme Court, the mandatory reporting requirements of this Act do not apply to self-insured commercial health plans that are regulated pursuant to the Employee Retirement Income Security Act of 1974 (ERISA). The Delaware Health Care Claims Database will be administered and operated by the DHIN Board of Directors, whose membership consists of a broad coalition of health care stakeholder representatives, including representatives of hospitals, physicians, providers, insurers, the business community, and government officials. This Act authorizes the DHIN Board, or a subcommittee established by the DHIN Board to administer the APCD, to review a request for claims data to determine if the requesting party or entity should have access to the requested claims data for a legitimate purpose in accordance with the goals of the statute. The determination by the DHIN Board shall be made in accordance with its bylaws, including those pertaining to conflict of interest recusal, and is not subject to appeal or to any other private right of action. This Act is revenue-neutral; it will be funded with grant money and other independent funding sources to be identified by the DHIN, in accordance with the DHIN’s existing statutory authority.

An Act To Amend Title 16 Of The Delaware Code Relating To The Delaware Health Information Network.

Sen. Bethany Hall-Long [D]	Rep. Melanie Smith [D]	Sen. Gregory Lavelle [R]	Sen. Ernesto Lopez [R]
Rep. Earl Jaques [D]	Rep. James Johnson [D]	Rep. Quinton Johnson [D]	Rep. Bryon Short [D]
Rep. David Bentz [D]	Rep. Debra Heffernan [D]

2016-06-30 - House - House Third Reading (Y: 39 N: 0 NV: 0 Abs: 2) [PASS]

Date	Chamber	Action
2016-07-21	Senate	Signed by Governor
2016-06-30	House	Passed by House of Representatives. Votes: Passed 39 YES 0 NO 0 NOT VOTING 2 ABSENT 0 VACANT
2016-06-15	House	Reported Out of Committee (HEALTH & HUMAN DEVELOPMENT) in House with 1 Favorable, 12 On Its Merits
2016-06-10	House	Introduced and Assigned to Health & Human Development Committee in House
2016-06-09	Senate	Passed by Senate. Votes: Passed 21 YES 0 NO 0 NOT VOTING 0 ABSENT 0 VACANT
2016-06-09	Senate	Amendment SA 1 - Passed by Senate. Votes: Passed 21 YES 0 NO 0 NOT VOTING 0 ABSENT 0 VACANT
2016-06-09	Senate	Amendment SA 1 - Introduced in Senate
2016-05-18	Senate	Reported Out of Committee (HEALTH & SOCIAL SERVICES) in Senate with 1 Favorable, 4 On Its Merits
2016-05-13	Senate	Assigned to Health & Social Services Committee in Senate

Type	Source
Summary	http://legis.delaware.gov/LIS/lis148.nsf/2bede841c6272c888025698400433a04/9769e86011716c9085257fb000496291?OpenDocument
Text	http://legis.delaware.gov/LIS/lis148.nsf/vwLegislation/SB+238/$file/legis.html?open
Text	http://legis.delaware.gov/LIS/lis148.nsf/EngrossmentsforLookup/SB+238/$file/Engross.html?open
Roll Call	http://legis.delaware.gov/LIS/lis148.nsf/7712cf7cc0e9227a852568470077336f/b85d23c45238db3d85257fe300002dbf?OpenDocument