Bill Text: FL S1258 | 2013 | Regular Session | Comm Sub
Bill Title: Comprehensive Health Information System
Spectrum: Bipartisan Bill
Status: (Engrossed - Dead) 2013-05-03 - Died on Calendar [S1258 Detail]
Download: Florida-2013-S1258-Comm_Sub.html
Florida Senate - 2013 CS for SB 1258 By the Committee on Appropriations; and Senator Grimsley 576-03540-13 20131258c1 1 A bill to be entitled 2 An act relating to a comprehensive health information 3 system; amending s. 408.05, F.S.; renaming the Florida 4 Center for Health Information and Policy Analysis as 5 the Florida Health Information Transparency 6 Initiative; providing a statement of purpose for the 7 initiative; providing the duties of the Agency for 8 Health Care Administration; revising the data and 9 information required to be included in the health 10 information system; revising the functions that the 11 agency must perform in order to collect and 12 disseminate health information and statistics; 13 deleting provisions that require the center to provide 14 technical assistance to persons and organizations 15 engaged in health planning activities; deleting 16 provisions that require the center to provide 17 widespread dissemination of data; requiring the agency 18 to implement the transparency initiative in a manner 19 that recognizes state-collected data as an asset and 20 rewards taxpayer investment in information collection 21 and management; authorizing the agency to apply for, 22 receive, and accept grants, gifts, and other payments, 23 including property and services, from a governmental 24 or other public or private entity or person; requiring 25 the agency to ensure that certain vendors do not 26 inhibit or impede consumer access to state-collected 27 health data and information; abolishing the State 28 Consumer Health Information and Policy Advisory 29 Council; amending ss. 381.026, 395.301, 465.0244, 30 627.6499, and 641.54, F.S.; conforming provisions to 31 changes made by the act; providing an effective date. 32 33 Be It Enacted by the Legislature of the State of Florida: 34 35 Section 1. Section 408.05, Florida Statutes, is amended to 36 read: 37 408.05 FloridaCenter forHealth Information Transparency 38 Initiativeand Policy Analysis.— 39 (1) PURPOSEESTABLISHMENT.—The agency shall coordinate 40establish a Florida Center for Health Information and Policy41Analysis. The center shall establisha comprehensive health 42 information system to promote accessibility, transparency, and 43 utility of state-collected data and information about health 44 providers, facilities, services, and payment sourcesprovide for45the collection, compilation, coordination, analysis, indexing,46dissemination, and utilization of both purposefully collected47and extant health-related data and statistics. The agencycenter48 shall be responsible for making data available in a manner that 49 allows for and encourages multiple and innovative uses of data 50 sets collected under the auspices of the state. Subject to the 51 General Appropriations Act, the agency shall contract with one 52 or more vendors to develop new methods of dissemination and to 53 convert data into easily usable electronic formatsstaffed with54public health experts, biostatisticians, information system55analysts, health policy experts, economists, and other staff56necessary to carry out its functions. 57 (2) HEALTH-RELATED DATA.—The comprehensive health 58 information systemoperated by the Florida Center for Health59Information and Policy Analysisshall include the following data 60 and informationidentify the best available data sources and61coordinate the compilation of extant health-related data and62statistics and purposefully collect data on: 63(a) The extent and nature of illness and disability of the64state population, including life expectancy, the incidence of65various acute and chronic illnesses, and infant and maternal66morbidity and mortality.67(b) The impact of illness and disability of the state68population on the state economy and on other aspects of the69well-being of the people in this state.70(c) Environmental, social, and other health hazards.71(d) Health knowledge and practices of the people in this72state and determinants of health and nutritional practices and73status.74 (a)(e)Health resources, including licensedphysicians,75dentists, nurses, and otherhealth professionals, licensedby76specialty and type of practice and acute, long-term care and77other institutional care facility supplies and specific services78provided by hospitals, nursing homes, home health agencies, and79otherhealth care facilities, managed care organizations, and 80 other health services regulated or funded by the state. 81 (b)(f)Utilization of health resourcescare by type of82provider. 83 (c)(g)Health care costs and financing, including Medicaid 84 claims and encounter data and data from other public and private 85 payorstrends in health care prices and costs, thesources of86payment for health care services,and federal, state, and local87expenditures for health care. 88(h) Family formation, growth, and dissolution.89 (d)(i)The extent, source, and type of public and private 90 health insurance coverage in this state. 91 (e)(j)The data necessary for measuring value and quality 92 of care provided by various health care providers, including 93 applicable credentials, accreditation status, utilization, 94 revenues and expenses, outcomes, site visits, and other 95 regulatory reports, and the results of administrative and civil 96 litigation. 97 (3) COORDINATIONCOMPREHENSIVE HEALTH INFORMATION SYSTEM. 98 In order to collect and disseminate comprehensiveproduce99comparable and uniformhealth information and statistics for the 100 public as well as for the development of policy recommendations, 101 the agency shall perform the following functions: 102 (a) Collect and compile data from all state agencies and 103 programs involved in providing, regulating, and paying for 104 health servicesCoordinate the activities of state agencies105involved in the design and implementation of the comprehensive106health information system. 107 (b) Promote data sharing through theUndertakeresearch,108 development, dissemination, and evaluation of state-collected 109 health data and by making such data available, transferable, and 110 readily usablerespecting the comprehensive health information111system. 112(c) Review the statistical activities of state agencies to113ensure that they are consistent with the comprehensive health114information system.115 (c)(d)Develop written agreements with local, state, and 116 federal agencies for the sharing of health-care-related data or 117 using the facilities and services of such agencies. State 118 agencies, local health councils, and other agencies under state 119 contract shall assist the agencycenterin obtaining, compiling, 120 and transferring health-care-related data maintained by state 121 and local agencies.Written agreements must specify the types,122methods, and periodicity of data exchanges and specify the types123of data that will be transferred to the center.124 (d)(e)Enable and facilitate the sharing and use of all 125 state-collected health data to the maximum extent allowed by law 126Establish by rule the types of data collected, compiled,127processed, used, or shared.Decisions regarding center data sets128should be made based on consultation with the State Consumer129Health Information and Policy Advisory Council and other public130and private users regarding the types of data which should be131collected and their uses. The center shall establish132standardized means for collecting health information and133statistics under laws and rules administered by the agency.134(f) Establish minimum health-care-related data sets which135are necessary on a continuing basis to fulfill the collection136requirements of the center and which shall be used by state137agencies in collecting and compiling health-care-related data.138The agency shall periodically review ongoing health care data139collections of the Department of Health and other state agencies140to determine if the collections are being conducted in141accordance with the established minimum sets of data.142(g) Establish advisory standards to ensure the quality of143health statistical and epidemiological data collection,144processing, and analysis by local, state, and private145organizations.146 (e)(h)Monitor data collection procedures, test data 147 quality, and take such corrective actions as may be necessary to 148 ensure that data and information disseminated under the 149 initiative are accurate, valid, reliable, and completePrescribe150standards for the publication of health-care-related data151reported pursuant to this section which ensure the reporting of152accurate, valid, reliable, complete, and comparable data. Such153standards should include advisory warnings to users of the data154regarding the status and quality of any data reported by or155available from the center. 156 (f)(i)Initiate and maintain activities necessary to 157 collect, edit, verify, archive, and retrievePrescribe standards158for the maintenance and preservation of the center’s data. This159should include methods forarchivingdata, retrieval of archived160data,anddata compiled pursuant to this sectionediting and161verification. 162(j) Ensure that strict quality control measures are163maintained for the dissemination of data through publications,164studies, or user requests.165(k) Develop, in conjunction with the State Consumer Health166Information and Policy Advisory Council, and implement a long167range plan for making available health care quality measures and168financial data that will allow consumers to compare health care169services. The health care quality measures and financial data170the agency must make available shall include, but is not limited171to, pharmaceuticals, physicians, health care facilities, and172health plans and managed care entities. The agency shall update173the plan and report on the status of its implementation174annually. The agency shall also make the plan and status report175available to the public on its Internet website. As part of the176plan, the agency shall identify the process and timeframes for177implementation, any barriers to implementation, and178recommendations of changes in the law that may be enacted by the179Legislature to eliminate the barriers. As preliminary elements180of the plan, the agency shall:1811. Make available patient-safety indicators, inpatient182quality indicators, and performance outcome and patient charge183data collected from health care facilities pursuant to s.184408.061(1)(a) and (2). The terms “patient-safety indicators” and185“inpatient quality indicators” shall be as defined by the186Centers for Medicare and Medicaid Services, the National Quality187Forum, the Joint Commission on Accreditation of Healthcare188Organizations, the Agency for Healthcare Research and Quality,189the Centers for Disease Control and Prevention, or a similar190national entity that establishes standards to measure the191performance of health care providers, or by other states. The192agency shall determine which conditions, procedures, health care193quality measures, and patient charge data to disclose based upon194input from the council. When determining which conditions and195procedures are to be disclosed, the council and the agency shall196consider variation in costs, variation in outcomes, and197magnitude of variations and other relevant information. When198determining which health care quality measures to disclose, the199agency:200a. Shall consider such factors as volume of cases; average201patient charges; average length of stay; complication rates;202mortality rates; and infection rates, among others, which shall203be adjusted for case mix and severity, if applicable.204b. May consider such additional measures that are adopted205by the Centers for Medicare and Medicaid Studies, National206Quality Forum, the Joint Commission on Accreditation of207Healthcare Organizations, the Agency for Healthcare Research and208Quality, Centers for Disease Control and Prevention, or a209similar national entity that establishes standards to measure210the performance of health care providers, or by other states.211 212When determining which patient charge data to disclose, the213agency shall include such measures as the average of214undiscounted charges on frequently performed procedures and215preventive diagnostic procedures, the range of procedure charges216from highest to lowest, average net revenue per adjusted patient217day, average cost per adjusted patient day, and average cost per218admission, among others.2192. Make available performance measures, benefit design, and220premium cost data from health plans licensed pursuant to chapter221627 or chapter 641. The agency shall determine which health care222quality measures and member and subscriber cost data to223disclose, based upon input from the council. When determining224which data to disclose, the agency shall consider information225that may be required by either individual or group purchasers to226assess the value of the product, which may include membership227satisfaction, quality of care, current enrollment or membership,228coverage areas, accreditation status, premium costs, plan costs,229premium increases, range of benefits, copayments and230deductibles, accuracy and speed of claims payment, credentials231of physicians, number of providers, names of network providers,232and hospitals in the network. Health plans shall make available233to the agency any such data or information that is not currently234reported to the agency or the office.2353. Determine the method and format for publicdisclosureof236data reported pursuant to this paragraph. The agency shall make237its determination based upon input from the State Consumer238Health Information and Policy Advisory Council. At a minimum,239the data shall be made available on the agency’s Internet240website in a manner that allows consumers to conduct an241interactive search that allows them to view and compare the242information for specific providers. The website must include243such additional information as is determined necessary to ensure244that the website enhances informed decisionmaking among245consumers and health care purchasers, which shall include, at a246minimum, appropriate guidance on how to use the data and an247explanation of why the data may vary from provider to provider.2484. Publish on its website undiscounted charges for no fewer249than 150 of the most commonly performed adult and pediatric250procedures, including outpatient, inpatient, diagnostic, and251preventative procedures.252(4) TECHNICAL ASSISTANCE.—253(a) The center shall provide technical assistance to254persons or organizations engaged in health planning activities255in the effective use of statistics collected and compiled by the256center. The center shall also provide the following additional257technical assistance services:2581. Establish procedures identifying the circumstances under259which, the places at which, the persons from whom, and the260methods by which a person may secure data from the center,261including procedures governing requests, the ordering of262requests, timeframes for handling requests, and other procedures263necessary to facilitate the use of the center’s data. To the264extent possible, the center should provide current data timely265in response to requests from public or private agencies.2662. Provide assistance to data sources and users in the267areas of database design, survey design, sampling procedures,268statistical interpretation, and data access to promote improved269health-care-related data sets.2703. Identify health care data gaps and provide technical271assistance to other public or private organizations for meeting272documented health care data needs.2734. Assist other organizations in developing statistical274abstracts of their data sets that could be used by the center.2755. Provide statistical support to state agencies with276regard to the use of databases maintained by the center.2776. To the extent possible, respond to multiple requests for278information not currently collected by the center or available279from other sources by initiating data collection.2807. Maintain detailed information on data maintained by281other local, state, federal, and private agencies in order to282advise those who use the center of potential sources of data283which are requested but which are not available from the center.2848. Respond to requests for data which are not available in285published form by initiating special computer runs on data sets286available to the center.2879. Monitor innovations in health information technology,288informatics, and the exchange of health information and maintain289a repository of technical resources to support the development290of a health information network.291(b) The agency shall administer, manage, and monitor grants292to not-for-profit organizations, regional health information293organizations, public health departments, or state agencies that294submit proposals for planning, implementation, or training295projects to advance the development of a health information296network. Any grant contract shall be evaluated to ensure the297effective outcome of the health information project.298(c) The agency shall initiate, oversee, manage, and299evaluate the integration of health care data from each state300agency that collects, stores, and reports on health care issues301and make that data available to any health care practitioner302through a state health information network.303(5) PUBLICATIONS; REPORTS; SPECIAL STUDIES.—The center304shall provide for the widespread dissemination of data which it305collects and analyzes. The center shall have the following306publication, reporting, and special study functions:307(a) The center shall publish and make available308periodically to agencies and individuals health statistics309publications of general interest, including health plan consumer310reports and health maintenance organization member satisfaction311surveys; publications providing health statistics on topical312health policy issues; publications that provide health status313profiles of the people in this state; and other topical health314statistics publications.315(b) The center shall publish, make available, and316disseminate, promptly and as widely as practicable, the results317of special health surveys, health care research, and health care318evaluations conducted or supported under this section. Any319publication by the center must include a statement of the320limitations on the quality, accuracy, and completeness of the321data.322(c) The center shall provide indexing, abstracting,323translation, publication, and other services leading to a more324effective and timely dissemination of health care statistics.325(d) The center shall be responsible for publishing and326disseminating an annual report on the center’s activities.327(e) The center shall be responsible, to the extent328resources are available, for conducting a variety of special329studies and surveys to expand the health care information and330statistics available for health policy analyses, particularly331for the review of public policy issues. The center shall develop332a process by which users of the center’s data are periodically333surveyed regarding critical data needs and the results of the334survey considered in determining which special surveys or335studies will be conducted. The center shall select problems in336health care for research, policy analyses, or special data337collections on the basis of their local, regional, or state338importance; the unique potential for definitive research on the339problem; and opportunities for application of the study340findings.341 (4)(6)PROVIDER DATA REPORTING.—This section does not 342 confer on the agency the power to demand or require that a 343 health care provider or professional furnish information, 344 records of interviews, written reports, statements, notes, 345 memoranda, or data other than as expressly required by law. 346 (5)(7)HEALTH INFORMATION ENTERPRISEBUDGET; FEES.— 347 (a) The agency shall implement the transparency initiative 348 in a manner that recognizes state-collected data as an asset and 349 rewards taxpayer investment in information collection and 350 managementLegislature intends that funding for the Florida351Center for Health Information and Policy Analysis be352appropriated from the General Revenue Fund. 353 (b) The agencyFlorida Center for Health Information and354Policy Analysismay apply for,andreceive, and accept grants, 355 gifts, and other payments, including property and services, from 356 aanygovernmental or other public or private entity or person 357 and make arrangements foras tothe use of such fundssame, 358 including the undertaking of special studies and other projects 359 relating to health-care-related topics.Funds obtained pursuant360to this paragraph may not be used to offset annual361appropriations from the General Revenue Fund.362 (c) The agency shall ensure that a vendor who enters into a 363 contract with the state under this section does not inhibit or 364 impede consumer access to state-collected health data and 365 informationcenter may charge such reasonable fees for services366as the agency prescribes by rule.The established fees may not367exceed the reasonable cost for such services. Fees collected may368not be used to offset annual appropriations from the General369Revenue Fund.370(8) STATE CONSUMER HEALTH INFORMATION AND POLICY ADVISORY371COUNCIL.—372(a) There is established in the agency the State Consumer373Health Information and Policy Advisory Council to assist the374center in reviewing the comprehensive health information system,375including the identification, collection, standardization,376sharing, and coordination of health-related data, fraud and377abuse data, and professional and facility licensing data among378federal, state, local, and private entities and to recommend379improvements for purposes of public health, policy analysis, and380transparency of consumer health care information. The council381shall consist of the following members:3821. An employee of the Executive Office of the Governor, to383be appointed by the Governor.3842. An employee of the Office of Insurance Regulation, to be385appointed by the director of the office.3863. An employee of the Department of Education, to be387appointed by the Commissioner of Education.3884. Ten persons, to be appointed by the Secretary of Health389Care Administration, representing other state and local390agencies, state universities, business and health coalitions,391local health councils, professional health-care-related392associations, consumers, and purchasers.393(b) Each member of the council shall be appointed to serve394for a term of 2 years following the date of appointment, except395the term of appointment shall end 3 years following the date of396appointment for members appointed in 2003, 2004, and 2005. A397vacancy shall be filled by appointment for the remainder of the398term, and each appointing authority retains the right to399reappoint members whose terms of appointment have expired.400(c) The council may meet at the call of its chair, at the401request of the agency, or at the request of a majority of its402membership, but the council must meet at least quarterly.403(d) Members shall elect a chair and vice chair annually.404(e) A majority of the members constitutes a quorum, and the405affirmative vote of a majority of a quorum is necessary to take406action.407(f) The council shall maintain minutes of each meeting and408shall make such minutes available to any person.409(g) Members of the council shall serve without compensation410but shall be entitled to receive reimbursement for per diem and411travel expenses as provided in s.112.061.412(h) The council’s duties and responsibilities include, but413are not limited to, the following:4141. To develop a mission statement, goals, and a plan of415action for the identification, collection, standardization,416sharing, and coordination of health-related data across federal,417state, and local government and private sector entities.4182. To develop a review process to ensure cooperative419planning among agencies that collect or maintain health-related420data.4213. To create ad hoc issue-oriented technical workgroups on422an as-needed basis to make recommendations to the council.423(9) APPLICATION TO OTHER AGENCIES.—Nothing in this section424shall limit, restrict, affect, or control the collection,425analysis, release, or publication of data by any state agency426pursuant to its statutory authority, duties, or427responsibilities.428 Section 2. Paragraph (c) of subsection (4) of section 429 381.026, Florida Statutes, is amended to read: 430 381.026 Florida Patient’s Bill of Rights and 431 Responsibilities.— 432 (4) RIGHTS OF PATIENTS.—Each health care facility or 433 provider shall observe the following standards: 434 (c) Financial information and disclosure.— 435 1. A patient has the right to be given, upon request, by 436 the responsible provider, his or her designee, or a 437 representative of the health care facility full information and 438 necessary counseling on the availability of known financial 439 resources for the patient’s health care. 440 2. A health care provider or a health care facility shall, 441 upon request, disclose to each patient who is eligible for 442 Medicare, before treatment, whether the health care provider or 443 the health care facility in which the patient is receiving 444 medical services accepts assignment under Medicare reimbursement 445 as payment in full for medical services and treatment rendered 446 in the health care provider’s office or health care facility. 447 3. A primary care provider may publish a schedule of 448 charges for the medical services that the provider offers to 449 patients. The schedule must include the prices charged to an 450 uninsured person paying for such services by cash, check, credit 451 card, or debit card. The schedule must be posted in a 452 conspicuous place in the reception area of the provider’s office 453 and must include, but is not limited to, the 50 services most 454 frequently provided by the primary care provider. The schedule 455 may group services by three price levels, listing services in 456 each price level. The posting must be at least 15 square feet in 457 size. A primary care provider who publishes and maintains a 458 schedule of charges for medical services is exempt from the 459 license fee requirements for a single period of renewal of a 460 professional license under chapter 456 for that licensure term 461 and is exempt from the continuing education requirements of 462 chapter 456 and the rules implementing those requirements for a 463 single 2-year period. 464 4. If a primary care provider publishes a schedule of 465 charges pursuant to subparagraph 3., he or she must continually 466 post it at all times for the duration of active licensure in 467 this state when primary care services are provided to patients. 468 If a primary care provider fails to post the schedule of charges 469 in accordance with this subparagraph, the provider mustshall be470required topay any license fee and comply withanycontinuing 471 education requirements for which an exemption was received. 472 5. A health care provider or a health care facility shall, 473 upon request, furnish a person, before the provision of medical 474 services, a reasonable estimate of charges for such services. 475 The health care provider or the health care facility shall 476 provide an uninsured person, before the provision of a planned 477 nonemergency medical service, a reasonable estimate of charges 478 for such service and information regarding the provider’s or 479 facility’s discount or charity policies for which the uninsured 480 person may be eligible. Such estimates by a primary care 481 provider must be consistent with the schedule posted under 482 subparagraph 3. To the extent possible, estimates shall, to the483extent possible,be written in language comprehensible to an 484 ordinary layperson. Such reasonable estimate does not preclude 485 the health care provider or health care facility from exceeding 486 the estimate or making additional charges based on changes in 487 the patient’s condition or treatment needs. 488 6. Each licensed facility not operated by the state shall 489 make available to the public on its Internet website or by other 490 electronic means a description of and a link to the performance 491 outcome and financial data that is published by the agency 492pursuant to s.408.05(3)(k). The facility shall place a notice 493 in the reception area that such information is available 494 electronically and the website address. The licensed facility 495 may indicate that the pricing information is based on a 496 compilation of charges for the average patient and that each 497 patient’s bill may vary from the average depending upon the 498 severity of illness and individual resources consumed. The 499 licensed facility may also indicate that the price of service is 500 negotiable for eligible patients based upon the patient’s 501 ability to pay. 502 7. A patient has the right to receive a copy of an itemized 503 bill upon request. A patient has a right to be given an 504 explanation of charges upon request. 505 Section 3. Subsection (11) of section 395.301, Florida 506 Statutes, is amended to read: 507 395.301 Itemized patient bill; form and content prescribed 508 by the agency.— 509 (11) Each licensed facility shall make available on its 510 Internet website a link to the performance outcome and financial 511 data that is published by the Agency for Health Care 512 Administrationpursuant to s.408.05(3)(k). The facility shall 513 place a notice in the reception area that the information is 514 available electronically and the facility’s Internet website 515 address. 516 Section 4. Section 465.0244, Florida Statutes, is amended 517 to read: 518 465.0244 Information disclosure.—Every pharmacy shall make 519 available on its Internet website a link to the performance 520 outcome and financial data that is published by the Agency for 521 Health Care Administrationpursuant to s.408.05(3)(k)and shall 522 place in the area where customers receive filled prescriptions 523 notice that such information is available electronically and the 524 address of its Internet website. 525 Section 5. Subsection (2) of section 627.6499, Florida 526 Statutes, is amended to read: 527 627.6499 Reporting by insurers and third-party 528 administrators.— 529 (2) Each health insurance issuer shall make available on 530 its Internet website a link to the performance outcome and 531 financial data that is published by the Agency for Health Care 532 Administrationpursuant to s.408.05(3)(k)and shall include in 533 every policy delivered or issued for delivery to any person in 534 the state oranymaterials provided as required by s. 627.64725 535 notice that such information is available electronically and the 536 address of its Internet website. 537 Section 6. Subsection (7) of section 641.54, Florida 538 Statutes, is amended to read: 539 641.54 Information disclosure.— 540 (7) Each health maintenance organization shall make 541 available on its Internet website a link to the performance 542 outcome and financial data that is published by the Agency for 543 Health Care Administrationpursuant to s.408.05(3)(k)and shall 544 include in every policy delivered or issued for delivery to any 545 person in the state oranymaterials provided as required by s. 546 627.64725 notice that such information is available 547 electronically and the address of its Internet website. 548 Section 7. This act shall take effect July 1, 2013.