Bill Text: FL S1258 | 2013 | Regular Session | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Comprehensive Health Information System
Spectrum: Bipartisan Bill
Status: (Engrossed - Dead) 2013-05-03 - Died on Calendar [S1258 Detail]
Download: Florida-2013-S1258-Introduced.html
Bill Title: Comprehensive Health Information System
Spectrum: Bipartisan Bill
Status: (Engrossed - Dead) 2013-05-03 - Died on Calendar [S1258 Detail]
Download: Florida-2013-S1258-Introduced.html
Florida Senate - 2013 SB 1258 By Senator Grimsley 21-01321B-13 20131258__ 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 useable 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, but may not be 60 limited to, the following data and informationidentify the best61available data sources and coordinate the compilation of extant62health-related data and statistics and purposefully collect data63on: 64(a) The extent and nature of illness and disability of the65state population, including life expectancy, the incidence of66various acute and chronic illnesses, and infant and maternal67morbidity and mortality.68(b) The impact of illness and disability of the state69population on the state economy and on other aspects of the70well-being of the people in this state.71(c) Environmental, social, and other health hazards.72(d) Health knowledge and practices of the people in this73state and determinants of health and nutritional practices and74status.75 (a)(e)Health resources, including licensedphysicians,76dentists, nurses, and otherhealth professionals, licensedby77specialty and type of practice and acute, long-term care and78other institutional care facility supplies and specific services79provided by hospitals, nursing homes, home health agencies, and80otherhealth care facilities, managed care organizations, and 81 other health services regulated or funded by the state. 82 (b)(f)Utilization of health resourcescare by type of83provider. 84 (c)(g)Health care costs and financing, including Medicaid 85 claims and encounter data and data from other public and private 86 payorstrends in health care prices and costs, thesources of87payment for health care services,and federal, state, and local88expenditures for health care. 89(h) Family formation, growth, and dissolution.90 (d)(i)The extent, source, and type of public and private 91 health insurance coverage in this state. 92 (e)(j)The data necessary for measuring value and quality 93 of care provided by various health care providers, including 94 applicable credentials, accreditation status, utilization, 95 revenues and expenses, outcomes, site visits, and other 96 regulatory reports, and the results of administrative and civil 97 litigation. 98 (3) COORDINATIONCOMPREHENSIVE HEALTH INFORMATION SYSTEM. 99 In order to collect and disseminate comprehensiveproduce100comparable and uniformhealth information and statistics for the 101 public as well as for development of policy recommendations, the 102 agency shall perform the following functions: 103 (a) Collect and compile data from all state agencies and 104 programs involved in providing, regulating, and paying for 105 health servicesCoordinate the activities of state agencies106involved in the design and implementation of the comprehensive107health information system. 108 (b) Promote data sharing through theUndertakeresearch,109 development, dissemination, and evaluation of state-collected 110 health data and by making such data available, transferable, and 111 readily useablerespecting the comprehensive health information112system. 113(c) Review the statistical activities of state agencies to114ensure that they are consistent with the comprehensive health115information system.116 (c)(d)Develop written agreements with local, state, and 117 federal agencies for the sharing of health-care-related data or 118 using the facilities and services of such agencies. State 119 agencies, local health councils, and other agencies under state 120 contract shall assist the agencycenterin obtaining, compiling, 121 and transferring health-care-related data maintained by state 122 and local agencies.Written agreements must specify the types,123methods, and periodicity of data exchanges and specify the types124of data that will be transferred to the center.125 (d)(e)Enable and facilitate the sharing and use of all 126 state-collected health data to the maximum extent allowed by law 127Establish by rule the types of data collected, compiled,128processed, used, or shared.Decisions regarding center data sets129should be made based on consultation with the State Consumer130Health Information and Policy Advisory Council and other public131and private users regarding the types of data which should be132collected and their uses. The center shall establish133standardized means for collecting health information and134statistics under laws and rules administered by the agency.135(f) Establish minimum health-care-related data sets which136are necessary on a continuing basis to fulfill the collection137requirements of the center and which shall be used by state138agencies in collecting and compiling health-care-related data.139The agency shall periodically review ongoing health care data140collections of the Department of Health and other state agencies141to determine if the collections are being conducted in142accordance with the established minimum sets of data.143(g) Establish advisory standards to ensure the quality of144health statistical and epidemiological data collection,145processing, and analysis by local, state, and private146organizations.147 (e)(h)Monitor data collection procedures, test data 148 quality, and take such corrective actions as may be necessary to 149 ensure that data and information disseminated under the 150 initiative are accurate, valid, reliable, and completePrescribe151standards for the publication of health-care-related data152reported pursuant to this section which ensure the reporting of153accurate, valid, reliable, complete, and comparable data. Such154standards should include advisory warnings to users of the data155regarding the status and quality of any data reported by or156available from the center. 157 (f)(i)Initiate and maintain activities necessary to 158 collect, edit, verify, archive, and retrievePrescribe standards159for the maintenance and preservation of the center’s data. This160should include methods forarchivingdata, retrieval of archived161data,anddata compiled pursuant to this sectionediting and162verification. 163(j) Ensure that strict quality control measures are164maintained for the dissemination of data through publications,165studies, or user requests.166(k) Develop, in conjunction with the State Consumer Health167Information and Policy Advisory Council, and implement a long168range plan for making available health care quality measures and169financial data that will allow consumers to compare health care170services. The health care quality measures and financial data171the agency must make available shall include, but is not limited172to, pharmaceuticals, physicians, health care facilities, and173health plans and managed care entities. The agency shall update174the plan and report on the status of its implementation175annually. The agency shall also make the plan and status report176available to the public on its Internet website. As part of the177plan, the agency shall identify the process and timeframes for178implementation, any barriers to implementation, and179recommendations of changes in the law that may be enacted by the180Legislature to eliminate the barriers. As preliminary elements181of the plan, the agency shall:1821. Make available patient-safety indicators, inpatient183quality indicators, and performance outcome and patient charge184data collected from health care facilities pursuant to s.185408.061(1)(a) and (2). The terms “patient-safety indicators” and186“inpatient quality indicators” shall be as defined by the187Centers for Medicare and Medicaid Services, the National Quality188Forum, the Joint Commission on Accreditation of Healthcare189Organizations, the Agency for Healthcare Research and Quality,190the Centers for Disease Control and Prevention, or a similar191national entity that establishes standards to measure the192performance of health care providers, or by other states. The193agency shall determine which conditions, procedures, health care194quality measures, and patient charge data to disclose based upon195input from the council. When determining which conditions and196procedures are to be disclosed, the council and the agency shall197consider variation in costs, variation in outcomes, and198magnitude of variations and other relevant information. When199determining which health care quality measures to disclose, the200agency:201a. Shall consider such factors as volume of cases; average202patient charges; average length of stay; complication rates;203mortality rates; and infection rates, among others, which shall204be adjusted for case mix and severity, if applicable.205b. May consider such additional measures that are adopted206by the Centers for Medicare and Medicaid Studies, National207Quality Forum, the Joint Commission on Accreditation of208Healthcare Organizations, the Agency for Healthcare Research and209Quality, Centers for Disease Control and Prevention, or a210similar national entity that establishes standards to measure211the performance of health care providers, or by other states.212 213When determining which patient charge data to disclose, the214agency shall include such measures as the average of215undiscounted charges on frequently performed procedures and216preventive diagnostic procedures, the range of procedure charges217from highest to lowest, average net revenue per adjusted patient218day, average cost per adjusted patient day, and average cost per219admission, among others.2202. Make available performance measures, benefit design, and221premium cost data from health plans licensed pursuant to chapter222627 or chapter 641. The agency shall determine which health care223quality measures and member and subscriber cost data to224disclose, based upon input from the council. When determining225which data to disclose, the agency shall consider information226that may be required by either individual or group purchasers to227assess the value of the product, which may include membership228satisfaction, quality of care, current enrollment or membership,229coverage areas, accreditation status, premium costs, plan costs,230premium increases, range of benefits, copayments and231deductibles, accuracy and speed of claims payment, credentials232of physicians, number of providers, names of network providers,233and hospitals in the network. Health plans shall make available234to the agency any such data or information that is not currently235reported to the agency or the office.2363. Determine the method and format for public disclosure of237data reported pursuant to this paragraph. The agency shall make238its determination based upon input from the State Consumer239Health Information and Policy Advisory Council. At a minimum,240the data shall be made available on the agency’s Internet241website in a manner that allows consumers to conduct an242interactive search that allows them to view and compare the243information for specific providers. The website must include244such additional information as is determined necessary to ensure245that the website enhances informed decisionmaking among246consumers and health care purchasers, which shall include, at a247minimum, appropriate guidance on how to use the data and an248explanation of why the data may vary from provider to provider.2494. Publish on its website undiscounted charges for no fewer250than 150 of the most commonly performed adult and pediatric251procedures, including outpatient, inpatient, diagnostic, and252preventative procedures.253(4) TECHNICAL ASSISTANCE.—254(a) The center shall provide technical assistance to255persons or organizations engaged in health planning activities256in the effective use of statistics collected and compiled by the257center. The center shall also provide the following additional258technical assistance services:2591. Establish procedures identifying the circumstances under260which, the places at which, the persons from whom, and the261methods by which a person may secure data from the center,262including procedures governing requests, the ordering of263requests, timeframes for handling requests, and other procedures264necessary to facilitate the use of the center’s data. To the265extent possible, the center should provide current data timely266in response to requests from public or private agencies.2672. Provide assistance to data sources and users in the268areas of database design, survey design, sampling procedures,269statistical interpretation, and data access to promote improved270health-care-related data sets.2713. Identify health care data gaps and provide technical272assistance to other public or private organizations for meeting273documented health care data needs.2744. Assist other organizations in developing statistical275abstracts of their data sets that could be used by the center.2765. Provide statistical support to state agencies with277regard to the use of databases maintained by the center.2786. To the extent possible, respond to multiple requests for279information not currently collected by the center or available280from other sources by initiating data collection.2817. Maintain detailed information on data maintained by282other local, state, federal, and private agencies in order to283advise those who use the center of potential sources of data284which are requested but which are not available from the center.2858. Respond to requests for data which are not available in286published form by initiating special computer runs on data sets287available to the center.2889. Monitor innovations in health information technology,289informatics, and the exchange of health information and maintain290a repository of technical resources to support the development291of a health information network.292(b) The agency shall administer, manage, and monitor grants293to not-for-profit organizations, regional health information294organizations, public health departments, or state agencies that295submit proposals for planning, implementation, or training296projects to advance the development of a health information297network. Any grant contract shall be evaluated to ensure the298effective outcome of the health information project.299(c) The agency shall initiate, oversee, manage, and300evaluate the integration of health care data from each state301agency that collects, stores, and reports on health care issues302and make that data available to any health care practitioner303through a state health information network.304(5) PUBLICATIONS; REPORTS; SPECIAL STUDIES.—The center305shall provide for the widespread dissemination of data which it306collects and analyzes. The center shall have the following307publication, reporting, and special study functions:308(a) The center shall publish and make available309periodically to agencies and individuals health statistics310publications of general interest, including health plan consumer311reports and health maintenance organization member satisfaction312surveys; publications providing health statistics on topical313health policy issues; publications that provide health status314profiles of the people in this state; and other topical health315statistics publications.316(b) The center shall publish, make available, and317disseminate, promptly and as widely as practicable, the results318of special health surveys, health care research, and health care319evaluations conducted or supported under this section. Any320publication by the center must include a statement of the321limitations on the quality, accuracy, and completeness of the322data.323(c) The center shall provide indexing, abstracting,324translation, publication, and other services leading to a more325effective and timely dissemination of health care statistics.326(d) The center shall be responsible for publishing and327disseminating an annual report on the center’s activities.328(e) The center shall be responsible, to the extent329resources are available, for conducting a variety of special330studies and surveys to expand the health care information and331statistics available for health policy analyses, particularly332for the review of public policy issues. The center shall develop333a process by which users of the center’s data are periodically334surveyed regarding critical data needs and the results of the335survey considered in determining which special surveys or336studies will be conducted. The center shall select problems in337health care for research, policy analyses, or special data338collections on the basis of their local, regional, or state339importance; the unique potential for definitive research on the340problem; and opportunities for application of the study341findings.342 (4)(6)PROVIDER DATA REPORTING.—This section does not 343 confer on the agency the power to demand or require that a 344 health care provider or professional furnish information, 345 records of interviews, written reports, statements, notes, 346 memoranda, or data other than as expressly required by law. 347 (5)(7)HEALTH INFORMATION ENTERPRISEBUDGET; FEES.— 348 (a) The agency shall implement the transparency initiative 349 in a manner that recognizes state-collected data as an asset and 350 rewards taxpayer investment in information collection and 351 managementLegislature intends that funding for the Florida352Center for Health Information and Policy Analysis be353appropriated from the General Revenue Fund. 354 (b) The agencyFlorida Center for Health Information and355Policy Analysismay apply for,andreceive, and accept grants, 356 gifts, and other payments, including property and services, from 357 aanygovernmental or other public or private entity or person 358 and make arrangements foras tothe use of such fundssame, 359 including the undertaking of special studies and other projects 360 relating to health-care-related topics.Funds obtained pursuant361to this paragraph may not be used to offset annual362appropriations from the General Revenue Fund.363 (c) The agency shall ensure that a vendor who enters into a 364 contract with the state under this section does not inhibit or 365 impede consumer access to state-collected health data and 366 informationcenter may charge such reasonable fees for services367as the agency prescribes by rule.The established fees may not368exceed the reasonable cost for such services. Fees collected may369not be used to offset annual appropriations from the General370Revenue Fund.371(8) STATE CONSUMER HEALTH INFORMATION AND POLICY ADVISORY372COUNCIL.—373(a) There is established in the agency the State Consumer374Health Information and Policy Advisory Council to assist the375center in reviewing the comprehensive health information system,376including the identification, collection, standardization,377sharing, and coordination of health-related data, fraud and378abuse data, and professional and facility licensing data among379federal, state, local, and private entities and to recommend380improvements for purposes of public health, policy analysis, and381transparency of consumer health care information. The council382shall consist of the following members:3831. An employee of the Executive Office of the Governor, to384be appointed by the Governor.3852. An employee of the Office of Insurance Regulation, to be386appointed by the director of the office.3873. An employee of the Department of Education, to be388appointed by the Commissioner of Education.3894. Ten persons, to be appointed by the Secretary of Health390Care Administration, representing other state and local391agencies, state universities, business and health coalitions,392local health councils, professional health-care-related393associations, consumers, and purchasers.394(b) Each member of the council shall be appointed to serve395for a term of 2 years following the date of appointment, except396the term of appointment shall end 3 years following the date of397appointment for members appointed in 2003, 2004, and 2005. A398vacancy shall be filled by appointment for the remainder of the399term, and each appointing authority retains the right to400reappoint members whose terms of appointment have expired.401(c) The council may meet at the call of its chair, at the402request of the agency, or at the request of a majority of its403membership, but the council must meet at least quarterly.404(d) Members shall elect a chair and vice chair annually.405(e) A majority of the members constitutes a quorum, and the406affirmative vote of a majority of a quorum is necessary to take407action.408(f) The council shall maintain minutes of each meeting and409shall make such minutes available to any person.410(g) Members of the council shall serve without compensation411but shall be entitled to receive reimbursement for per diem and412travel expenses as provided in s.112.061.413(h) The council’s duties and responsibilities include, but414are not limited to, the following:4151. To develop a mission statement, goals, and a plan of416action for the identification, collection, standardization,417sharing, and coordination of health-related data across federal,418state, and local government and private sector entities.4192. To develop a review process to ensure cooperative420planning among agencies that collect or maintain health-related421data.4223. To create ad hoc issue-oriented technical workgroups on423an as-needed basis to make recommendations to the council.424(9) APPLICATION TO OTHER AGENCIES.—Nothing in this section425shall limit, restrict, affect, or control the collection,426analysis, release, or publication of data by any state agency427pursuant to its statutory authority, duties, or428responsibilities.429 Section 2. Paragraph (c) of subsection (4) of section 430 381.026, Florida Statutes, is amended to read: 431 381.026 Florida Patient’s Bill of Rights and 432 Responsibilities.— 433 (4) RIGHTS OF PATIENTS.—Each health care facility or 434 provider shall observe the following standards: 435 (c) Financial information and disclosure.— 436 1. A patient has the right to be given, upon request, by 437 the responsible provider, his or her designee, or a 438 representative of the health care facility full information and 439 necessary counseling on the availability of known financial 440 resources for the patient’s health care. 441 2. A health care provider or a health care facility shall, 442 upon request, disclose to each patient who is eligible for 443 Medicare, before treatment, whether the health care provider or 444 the health care facility in which the patient is receiving 445 medical services accepts assignment under Medicare reimbursement 446 as payment in full for medical services and treatment rendered 447 in the health care provider’s office or health care facility. 448 3. A primary care provider may publish a schedule of 449 charges for the medical services that the provider offers to 450 patients. The schedule must include the prices charged to an 451 uninsured person paying for such services by cash, check, credit 452 card, or debit card. The schedule must be posted in a 453 conspicuous place in the reception area of the provider’s office 454 and must include, but is not limited to, the 50 services most 455 frequently provided by the primary care provider. The schedule 456 may group services by three price levels, listing services in 457 each price level. The posting must be at least 15 square feet in 458 size. A primary care provider who publishes and maintains a 459 schedule of charges for medical services is exempt from the 460 license fee requirements for a single period of renewal of a 461 professional license under chapter 456 for that licensure term 462 and is exempt from the continuing education requirements of 463 chapter 456 and the rules implementing those requirements for a 464 single 2-year period. 465 4. If a primary care provider publishes a schedule of 466 charges pursuant to subparagraph 3., he or she must continually 467 post it at all times for the duration of active licensure in 468 this state when primary care services are provided to patients. 469 If a primary care provider fails to post the schedule of charges 470 in accordance with this subparagraph, the provider mustshall be471required topay any license fee and comply withanycontinuing 472 education requirements for which an exemption was received. 473 5. A health care provider or a health care facility shall, 474 upon request, furnish a person, before the provision of medical 475 services, a reasonable estimate of charges for such services. 476 The health care provider or the health care facility shall 477 provide an uninsured person, before the provision of a planned 478 nonemergency medical service, a reasonable estimate of charges 479 for such service and information regarding the provider’s or 480 facility’s discount or charity policies for which the uninsured 481 person may be eligible. Such estimates by a primary care 482 provider must be consistent with the schedule posted under 483 subparagraph 3. To the extent possible, estimates shall, to the484extent possible,be written in language comprehensible to an 485 ordinary layperson. Such reasonable estimate does not preclude 486 the health care provider or health care facility from exceeding 487 the estimate or making additional charges based on changes in 488 the patient’s condition or treatment needs. 489 6. Each licensed facility not operated by the state shall 490 make available to the public on its Internet website or by other 491 electronic means a description of and a link to the performance 492 outcome and financial data that is published by the agency 493pursuant to s.408.05(3)(k). The facility shall place a notice 494 in the reception area that such information is available 495 electronically and the website address. The licensed facility 496 may indicate that the pricing information is based on a 497 compilation of charges for the average patient and that each 498 patient’s bill may vary from the average depending upon the 499 severity of illness and individual resources consumed. The 500 licensed facility may also indicate that the price of service is 501 negotiable for eligible patients based upon the patient’s 502 ability to pay. 503 7. A patient has the right to receive a copy of an itemized 504 bill upon request. A patient has a right to be given an 505 explanation of charges upon request. 506 Section 3. Subsection (11) of section 395.301, Florida 507 Statutes, is amended to read: 508 395.301 Itemized patient bill; form and content prescribed 509 by the agency.— 510 (11) Each licensed facility shall make available on its 511 Internet website a link to the performance outcome and financial 512 data that is published by the Agency for Health Care 513 Administrationpursuant to s.408.05(3)(k). The facility shall 514 place a notice in the reception area that the information is 515 available electronically and the facility’s Internet website 516 address. 517 Section 4. Section 465.0244, Florida Statutes, is amended 518 to read: 519 465.0244 Information disclosure.—Every pharmacy shall make 520 available on its Internet website a link to the performance 521 outcome and financial data that is published by the Agency for 522 Health Care Administrationpursuant to s.408.05(3)(k)and shall 523 place in the area where customers receive filled prescriptions 524 notice that such information is available electronically and the 525 address of its Internet website. 526 Section 5. Subsection (2) of section 627.6499, Florida 527 Statutes, is amended to read: 528 627.6499 Reporting by insurers and third-party 529 administrators.— 530 (2) Each health insurance issuer shall make available on 531 its Internet website a link to the performance outcome and 532 financial data that is published by the Agency for Health Care 533 Administrationpursuant to s.408.05(3)(k)and shall include in 534 every policy delivered or issued for delivery to any person in 535 the state oranymaterials provided as required by s. 627.64725 536 notice that such information is available electronically and the 537 address of its Internet website. 538 Section 6. Subsection (7) of section 641.54, Florida 539 Statutes, is amended to read: 540 641.54 Information disclosure.— 541 (7) Each health maintenance organization shall make 542 available on its Internet website a link to the performance 543 outcome and financial data that is published by the Agency for 544 Health Care Administrationpursuant to s.408.05(3)(k)and shall 545 include in every policy delivered or issued for delivery to any 546 person in the state oranymaterials provided as required by s. 547 627.64725 notice that such information is available 548 electronically and the address of its Internet website. 549 Section 7. This act shall take effect July 1, 2013.