Amendment SSA1-SB44

SB44-SSA1,828,6 153.21 (1) The department shall prepare and submit to the governor and to the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2) an annual guide to assist consumers in selecting health care providers other than hospitals and ambulatory surgery centers and health care plans. The guide shall be written in language that is understandable to lay persons laypersons. The department shall widely publicize and distribute the guide to consumers.

SB44-SSA1, s. 2094m Section 2094m. 153.21 (2) of the statutes is created to read:

SB44-SSA1,828,15 153.21 (2) The entity under contract under s. 153.05 (2m) (a) shall prepare and submit to the governor and to the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2) an annual guide to assist consumers in selecting hospitals and ambulatory surgery centers. The guide shall be written in language that is understandable to laypersons and shall include data derived from the annual survey of hospitals conducted by the American Hospital Association and the annual hospital fiscal survey. The entity shall widely publicize and distribute the guide to consumers.

SB44-SSA1, s. 2094n Section 2094n. 153.22 of the statutes is created to read:

SB44-SSA1,828,22 153.22 Patient-level data utilization, charge, and quality report. (1) The entity under contract under s. 153.05 (2m) (a) shall prepare and submit to the governor and to the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2), an annual report that summarizes utilization, charge, and quality data on patients treated by hospitals and ambulatory surgery centers during the most recent calendar year.

SB44-SSA1, s. 2094q Section 2094q. 153.45 (title) of the statutes is amended to read:

SB44-SSA1,828,24 153.45 (title) Release of data by department.

SB44-SSA1, s. 2094r Section 2094r. 153.45 (1) (b) 1. of the statutes is renumbered 153.46 (1) (b) and amended to read:

SB44-SSA1,829,8 153.46 (1) (b) For information that is submitted by hospitals or ambulatory surgery centers, public use data files that do not permit the identification of specific patients, employers, or health care providers, as defined by rules promulgated by the department. The identification of patients, employers, or health care providers shall be protected by all necessary means, including the deletion of patient identifiers and the use of calculated variables and aggregated variables.

SB44-SSA1, s. 2094s Section 2094s. 153.45 (1) (b) 2. of the statutes is renumbered 153.45 (1) (b), and 153.45 (1) (b) (intro.), as renumbered, is amended to read:

SB44-SSA1,829,22 153.45 (1) (b) (intro.) For information that is submitted by health care providers other than hospitals or ambulatory surgery centers, public use data files that do not permit the identification of specific patients, employers , or health care providers, as defined by rules promulgated by the department. The identification of patients, employers, or health care providers shall be protected by all necessary means, including the deletion of patient identifiers; the use of calculated variables and aggregated variables; the specification of counties as to residence, rather than zip codes; the use of 5-year categories for age, rather than exact age; not releasing information concerning a patient's race or, ethnicity, or dates of admission, discharge, procedures, or visits; and masking sensitive diagnoses and procedures by use of larger diagnostic and procedure categories. Public use data files under this subdivision paragraph may include only the following:

SB44-SSA1, s. 2094t Section 2094t. 153.45 (1) (c) (intro.) of the statutes is amended to read:

SB44-SSA1,830,10 153.45 (1) (c) (intro.) Custom-designed reports containing portions of the data under par. (b). Of information submitted by health care providers that are not hospitals or ambulatory surgery centers, requests under this paragraph for data elements other than those available for public use data files under par. (b) 2., including the patient's month and year of birth, require review and approval by the independent review board before the data elements may be released. Information that contains the name of a health care provider that is not a hospital or ambulatory surgery center may be released only if the independent review board first reviews and approves the release or if the department promulgates rules that specify circumstances under which the independent review board need not review and approve the release. Reports under this paragraph may include the patient's zip code only if at least one of the following applies:

SB44-SSA1, s. 2094u Section 2094u. 153.45 (2) of the statutes is amended to read:

SB44-SSA1,830,15 153.45 (2) The department shall provide to other entities agencies or to organizations the data necessary to fulfill their statutory mandates for epidemiological purposes or to minimize the duplicate collection of similar data elements.

SB44-SSA1, s. 2094v Section 2094v. 153.45 (3) of the statutes is amended to read:

SB44-SSA1,830,21 153.45 (3) The department may, but is not required to, release health care provider-specific and employer-specific data that relates to health care providers other than hospitals and ambulatory surgery centers, except in public use data files as specified under sub. (1) (b), in a manner that is specified in rules promulgated by the department.

SB44-SSA1, s. 2094w Section 2094w. 153.45 (5) of the statutes is amended to read:

SB44-SSA1,831,3 153.45 (5) The department may not release any health care information that is subject to rules promulgated under s. 153.75 (1) (b) until the verification, comment and review procedures required under those rules have been complied with. Nothing in this subsection prohibits release of health care provider-specific information to the a health care provider that is not a hospital or ambulatory surgery center, to whom the information relates is specific.

SB44-SSA1, s. 2094x Section 2094x. 153.46 of the statutes is created to read:

SB44-SSA1,831,7 153.46 Release of data by entity. (1) After completion of data verification, comment, and review procedures, the entity under contract under s. 153.05 (2m) (a) shall release data, together with comments, if any, in the following forms:

SB44-SSA1,831,8 (a) Standard reports.

SB44-SSA1,831,11 (c) Custom-designed reports containing portions of the data under par. (b). Reports under this paragraph may include the patient's zip code only if at least one of the following applies:

SB44-SSA1,831,12 1. Other potentially identifying data elements are not released.

SB44-SSA1,831,13 2. Population density is sufficient to mask patient identity.

SB44-SSA1,831,15 3. Other potentially identifying data elements are grouped to provide population density sufficient to protect identity.

SB44-SSA1,831,16 4. Multiple years of data elements are added to protect identity.

SB44-SSA1,831,19 (1m) After completion of data verification and review procedures specified under s. 153.01 (4j), the entity may, but is not required to, release special data compilations.

SB44-SSA1,831,23 (2) The entity under contract under s. 153.05 (2m) (a) shall provide to the department and to any other organization or agency the data necessary to fulfill the department's, organization's, or agency's statutory mandates for epidemiological purposes.

SB44-SSA1,832,2 (3) The entity under contract under s. 153.05 (2m) (a) may, but is not required to, release hospital-specific, ambulatory surgery center-specific, and hospital or ambulatory surgery center employer-specific data, except in public use data files as specified under sub. (1) (b).

SB44-SSA1,832,5 (4) The entity under contract under s. 153.05 (2m) (a) shall, as limited by this section and s. 153.50, provide equal access to the data collected and reports generated by the entity to all requesters that pay the fees under s. 153.65 (2).

SB44-SSA1,832,8 (5) The entity under contract under s. 153.05 (2m) (a) shall provide to the department, without charge, claims and provider survey information that is requested by or required to be provided to the department.

SB44-SSA1,832,11 (6) No person who purchases a data compilation or report under s. 153.65 (2) may release or sell the data sets so purchased, except that the department may release data and information as part of reports created by the department.

SB44-SSA1, s. 2094y Section 2094y. 153.50 (3) (intro.) of the statutes is amended to read:

SB44-SSA1,832,17 153.50 (3) Departmental measures Measures to ensure protection of patient identity. (intro.) To ensure that the identity of patients is protected when information obtained by the department or by the entity under contract under s. 153.05 (2m) (a) is disseminated, the department and the entity shall do all of the following:

SB44-SSA1, s. 2095c Section 2095c. 153.50 (3) (a) of the statutes is amended to read:

SB44-SSA1,832,22 153.50 (3) (a) Aggregate any data element category containing small numbers, using. The department, in so doing, shall use procedures that are developed by the department and approved by the board and that follow commonly accepted statistical methodology.

SB44-SSA1, s. 2095d Section 2095d. 153.50 (3) (b) (intro.) of the statutes is amended to read:

SB44-SSA1,833,3 153.50 (3) (b) (intro.) Remove and destroy all of the following data elements on the uniform patient billing forms that are received by the department or by the entity under the requirements of this chapter:

SB44-SSA1, s. 2095e Section 2095e. 153.50 (3) (b) 7. of the statutes is amended to read:

SB44-SSA1,833,6 153.50 (3) (b) 7. The patient's account number, after use only as verification of data by the department or by the entity.

SB44-SSA1, s. 2095f Section 2095f. 153.50 (3) (d) of the statutes is amended to read:

SB44-SSA1,833,10 153.50 (3) (d) Require that a purchaser of data under this chapter sign and have notarized the data use agreement of the department or of the entity specified in par. (c).

SB44-SSA1, s. 2095g Section 2095g. 153.50 (4) (a) 1. of the statutes is renumbered 153.50 (4) (a) 1. a.

SB44-SSA1, s. 2095h Section 2095h. 153.50 (4) (a) 1. b. of the statutes is created to read:

SB44-SSA1,833,16 153.50 (4) (a) 1. b. An agent of the entity under contract under s. 153.05 (2m) (a) who is responsible for the patient-identifiable data of the entity, in order to store the data and ensure the accuracy of the information in the database of the entity.

SB44-SSA1, s. 2095i Section 2095i. 153.50 (4) (a) 2. of the statutes is amended to read:

SB44-SSA1,833,23 153.50 (4) (a) 2. A health care provider that is not a hospital or ambulatory surgery center or the agent of such a health care provider, to ensure the accuracy of the information in the database of the department, or a health care provider that is a hospital or ambulatory surgery center or the agent of such a health care provider, to ensure the accuracy of the information in the database of the entity under contract under s. 153.05 (2m) (a).

SB44-SSA1, s. 2095j Section 2095j. 153.50 (4) (a) 3. of the statutes is amended to read:

SB44-SSA1,834,3 153.50 (4) (a) 3. The department, for purposes of epidemiological investigation or, with respect to information from health care providers that are not hospitals or ambulatory surgery centers, to eliminate the need for duplicative databases.

SB44-SSA1, s. 2095k Section 2095k. 153.50 (4) (a) 4. of the statutes is amended to read:

SB44-SSA1,834,7 153.50 (4) (a) 4. An entity agency or organization that is required by federal or state statute to obtain patient-identifiable data for purposes of epidemiological investigation or to eliminate the need for duplicative databases.

SB44-SSA1, s. 2095L Section 2095L. 153.50 (5) (a) (intro.) of the statutes is amended to read:

SB44-SSA1,834,13 153.50 (5) (a) (intro.) The department or an entity that is under contract under s. 153.05 (2m) (a) may not release or provide access to patient-identifiable data to a person authorized under sub. (4) (a) unless the authorized person requests the department or entity, in writing, to release the patient-identifiable data. The request shall include all of the following:

SB44-SSA1, s. 2095m Section 2095m. 153.50 (5) (a) 4. (intro.) of the statutes is amended to read:

SB44-SSA1,834,17 153.50 (5) (a) 4. (intro.) For an entity agency or organization that is authorized under sub. (4) (a) 4. to receive or have access to patient-identifiable data, evidence, in writing, of all of the following:

SB44-SSA1, s. 2095n Section 2095n. 153.50 (5) (b) (intro.) of the statutes is amended to read:

SB44-SSA1,834,22 153.50 (5) (b) (intro.) Upon receipt of a request under par. (a), the department or entity under contract under s. 153.05 (2m) (a), whichever is appropriate, shall, as soon as practicable, comply with the request or notify the requester, in writing, of all of the following:

SB44-SSA1, s. 2095p Section 2095p. 153.50 (5) (b) 1. of the statutes is amended to read:

SB44-SSA1,834,25 153.50 (5) (b) 1. That the department or entity is denying the request in whole or in part.

SB44-SSA1, s. 2095q Section 2095q. 153.50 (6) (a) of the statutes is amended to read:

SB44-SSA1,835,4 153.50 (6) (a) The department or entity under contract under s. 153.05 (2m) (a) may not require a health care provider submitting health care information under this chapter to include the patient's name, street address or social security number.

SB44-SSA1, s. 2095rc Section 2095rc. 153.60 (1) of the statutes is amended to read:

SB44-SSA1,836,3 153.60 (1) The department shall, by the first October 1 after the commencement of each fiscal year, estimate the total amount of expenditures under this chapter for the department and the board for that fiscal year for data collection, database development and maintenance, generation of data files and standard reports, orientation and training provided under s. 153.05 (9) (a) and maintaining the board. The department shall assess the estimated total amount for that fiscal year less the estimated total amount to be received for purposes of administration of this chapter under s. 20.435 (4) (hi) during the fiscal year, the unencumbered balance of the amount received for purposes of administration of this chapter under s. 20.435 (4) (hi) from the prior fiscal year and the amount in the appropriation account under s. 20.435 (1) (dg), 1997 stats., for the fiscal year, to health care providers, other than hospitals and ambulatory surgery centers, who are in a class of health care providers from whom the department collects data under this chapter in a manner specified by the department by rule. The department shall obtain approval from the board for the amounts of assessments for health care providers other than hospitals and ambulatory surgery centers. The department shall work together with the department of regulation and licensing to develop a mechanism for collecting assessments from health care providers other than hospitals and ambulatory surgery centers. No health care provider that is not a facility may be assessed under this subsection an amount that exceeds $75 per fiscal year. Each hospital shall pay the assessment on or before December 1. All payments of assessments shall be deposited in credited to the appropriation under s. 20.435 (4) (hg).

SB44-SSA1, s. 2095rd Section 2095rd. 153.65 of the statutes is renumbered 153.65 (1) and amended to read:

SB44-SSA1,836,12 153.65 (1) The department may, but is not required to, provide, upon request from a person, a data compilation or a special report based on the information collected by the department. The department shall establish user fees for the provision of these compilations or reports, payable by the requester, which shall be sufficient to fund the actual necessary and direct cost of the compilation or report. All moneys collected under this section subsection shall be credited to the appropriation under s. 20.435 (4) (hi).

SB44-SSA1, s. 2095re Section 2095re. 153.65 (2) of the statutes is created to read:

SB44-SSA1,836,23 153.65 (2) Beginning January 1, 2004, unless the entity under contract under s. 153.05 (2m) (a) otherwise agrees and except as provided in s. 153.46 (6), the entity has the exclusive right to use and to provide for a fee, upon request from a person, a data compilation or a special report based on the information concerning hospitals and ambulatory surgery centers that is collected by the entity or provided by the department to the entity. Subject to approval by the group specified under s. 153.01 (4j) (b), the entity shall establish reasonable and necessary user fees for the provision of a compilation or report, payable by the requester, which shall be sufficient to fund the actual necessary and direct cost of the compilation or report. The entity may retain all user fees paid under this subsection.

SB44-SSA1, s. 2095rf Section 2095rf. 153.75 (1) (a) of the statutes is amended to read:

SB44-SSA1,837,3 153.75 (1) (a) Providing procedures, for information submitted by health care providers who are not hospitals or ambulatory surgery centers, to ensure the protection of patient confidentiality under s. 153.50.

SB44-SSA1, s. 2095rg Section 2095rg. 153.75 (1) (b) of the statutes is amended to read:

SB44-SSA1,837,7 153.75 (1) (b) Establishing procedures under which health care providers who are not hospitals or ambulatory surgery centers are permitted to review, verify and comment on information and include the comments with the information.

SB44-SSA1, s. 2095rh Section 2095rh. 153.75 (1) (L) of the statutes is repealed.

SB44-SSA1, s. 2095ri Section 2095ri. 153.75 (1) (m) of the statutes is amended to read:

SB44-SSA1,837,12 153.75 (1) (m) Specifying the classes of health care providers, other than hospitals and ambulatory surgery centers, from whom claims data and other health care information will be collected.

SB44-SSA1, s. 2095rj Section 2095rj. 153.75 (1) (n) of the statutes is amended to read:

SB44-SSA1,837,16 153.75 (1) (n) Specifying the uniform data set of health care information, as adjusted for case mix and severity, to be collected from health care providers other than hospitals and ambulatory surgery centers.

SB44-SSA1, s. 2095rk Section 2095rk. 153.75 (1) (p) of the statutes is amended to read:

SB44-SSA1,837,22 153.75 (1) (p) Specifying the methods for using and disseminating health care data in order for health care providers other than hospitals and ambulatory surgery centers to provide health care that is effective and economically efficient and for consumers and purchasers to make informed decisions in selecting health care plans and health care providers.

SB44-SSA1, s. 2095rL Section 2095rL. 153.75 (1) (q) of the statutes is amended to read:

SB44-SSA1,837,25 153.75 (1) (q) Specifying the information to be provided by the department in the consumer guide under s. 153.21 (1).

SB44-SSA1, s. 2095rm Section 2095rm. 153.75 (1) (r) of the statutes is amended to read:

SB44-SSA1,838,3 153.75 (1) (r) Specifying the standard reports that will be issued by the department in addition to those required in ss. 153.20 and s. 153.21 (1).

SB44-SSA1, s. 2095rn Section 2095rn. 153.75 (1) (t) of the statutes is amended to read:

SB44-SSA1,838,7 153.75 (1) (t) Establishing standards for determining under s. 153.05 (13) (a) if a requirement under s. 153.05 (1) (a), (5) (a), or (8) (a) is burdensome for a health care provider other than a hospital or ambulatory surgery center.

SB44-SSA1, s. 2095rp Section 2095rp. 153.75 (1) (u) of the statutes is amended to read:

SB44-SSA1,838,11 153.75 (1) (u) Specifying the methods for adjusting health care information obtained from health care providers other than hospitals and ambulatory surgery centers for case mix and severity.

SB44-SSA1, s. 2095rt Section 2095rt. 153.75 (2) (a) of the statutes is amended to read:

SB44-SSA1,838,15 153.75 (2) (a) Exempting certain classes of health care providers that are not hospitals or ambulatory surgery centers from providing all or portions of the data required under this chapter.