<a id="pl.1.3"></a><var>1.3</var>providing for administrative penalties; appropriating money;amending <br/>
<a id="pl.1.4"></a><var>1.4</var>Minnesota Statutes 2009 Supplement, section 62J.495, subdivisions 1a, 3; <br/>
<a id="pl.1.5"></a><var>1.5</var>proposing coding for new law in Minnesota Statutes, chapter 62J.<br/>
<a id="pl.1.6"></a><var>1.6</var>BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:<br/>
<br/>
<a id="bill.0.1.0"></a><a id="pl.1.7"></a><var>1.7</var>    Section 1. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 1a, <br/>
<a id="pl.1.8"></a><var>1.8</var>is amended to read:<br/>
<a id="pl.1.9"></a><var>1.9</var>    Subd. 1a. <b>Definitions.</b> (a) "Certified electronic health record technology" means an <br/>
<a id="pl.1.10"></a><var>1.10</var>electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH <br/>
<a id="pl.1.11"></a><var>1.11</var>Act to meet the standards and implementation specifications adopted under section 3004 <br/>
<a id="pl.1.12"></a><var>1.12</var>as applicable.<br/>
<a id="pl.1.13"></a><var>1.13</var>(b) "Commissioner" means the commissioner of health.<br/>
<a id="pl.1.14"></a><var>1.14</var>(c) "Pharmaceutical electronic data intermediary" means any entity that provides <br/>
<a id="pl.1.15"></a><var>1.15</var>the infrastructure to connect computer systems or other electronic devices utilized <br/>
<a id="pl.1.16"></a><var>1.16</var>by prescribing practitioners with those used by pharmacies, health plans, third-party <br/>
<a id="pl.1.17"></a><var>1.17</var>administrators, and pharmacy benefit managers in order to facilitate the secure <br/>
<a id="pl.1.18"></a><var>1.18</var>transmission of electronic prescriptions, refill authorization requests, communications, <br/>
<a id="pl.1.19"></a><var>1.19</var>and other prescription-related information between such entities.<br/>
<a id="pl.1.20"></a><var>1.20</var>(d) "HITECH Act" means the Health Information Technology for Economic and <br/>
<a id="pl.1.21"></a><var>1.21</var>Clinical Health Act in division A, title XIII and division B, title IV of the American <br/>
<a id="pl.1.22"></a><var>1.22</var>Recovery and Reinvestment Act of 2009, including federal regulations adopted under <br/>
<a id="pl.1.23"></a><var>1.23</var>that act.<br/>
<a id="pl.1.24"></a><var>1.24</var>(e) "Interoperable electronic health record" means an electronic health record that <br/>
<a id="pl.1.25"></a><var>1.25</var>securely exchanges health information with another electronic health record system that <br/>
<a id="pl.2.1"></a><var>2.1</var>meets requirements specified in subdivision 3, and national requirements for certification <br/>
<a id="pl.2.2"></a><var>2.2</var>under the HITECH Act.<br/>
<a id="pl.2.3"></a><var>2.3</var>(f) "Qualified electronic health record" means an electronic record of health-related <br/>
<a id="pl.2.4"></a><var>2.4</var>information on an individual that includes patient demographic and clinical health <br/>
<a id="pl.2.5"></a><var>2.5</var>information and has the capacity to:<br/>
<a id="pl.2.6"></a><var>2.6</var>(1) provide clinical decision support;<br/>
<a id="pl.2.7"></a><var>2.7</var>(2) support physician order entry;<br/>
<a id="pl.2.8"></a><var>2.8</var>(3) capture and query information relevant to health care quality; and<br/>
<a id="pl.2.9"></a><var>2.9</var>(4) exchange electronic health information with, and integrate such information <br/>
<a id="pl.2.10"></a><var>2.10</var>from, other sources.<br/>
<br/>
<a id="bill.0.2.0"></a><a id="pl.2.11"></a><var>2.11</var>    Sec. 2. Minnesota Statutes 2009 Supplement, section 62J.495, subdivision 3, is <br/>
<a id="pl.2.12"></a><var>2.12</var>amended to read:<br/>
<a id="pl.2.13"></a><var>2.13</var>    Subd. 3. <b>Interoperable electronic health record requirements.</b>  To meet the <br/>
<a id="pl.2.14"></a><var>2.14</var>requirements of subdivision 1, hospitals and health care providers must meet the following <br/>
<a id="pl.2.15"></a><var>2.15</var>criteria when implementing an interoperable electronic health records system within their <br/>
<a id="pl.2.16"></a><var>2.16</var>hospital system or clinical practice setting.<br/>
<a id="pl.2.17"></a><var>2.17</var>(a) The electronic health record must be a qualified electronic health record.<br/>
<a id="pl.2.18"></a><var>2.18</var>    (b) The electronic health record must be certified by the Office of the National <br/>
<a id="pl.2.19"></a><var>2.19</var>Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and <br/>
<a id="pl.2.20"></a><var>2.20</var>health care providers only if a certified electronic health record product for the provider's <br/>
<a id="pl.2.21"></a><var>2.21</var>particular practice setting is available. This criterion shall be considered met if a hospital <br/>
<a id="pl.2.22"></a><var>2.22</var>or health care provider is using an electronic health records system that has been certified <br/>
<a id="pl.2.23"></a><var>2.23</var>within the last three years, even if a more current version of the system has been certified <br/>
<a id="pl.2.24"></a><var>2.24</var>within the three-year period.<br/>
<a id="pl.2.25"></a><var>2.25</var>(c) The electronic health record must meet the standards established according to <br/>
<a id="pl.2.26"></a><var>2.26</var>section 3004 of the HITECH Act as applicable.<br/>
<a id="pl.2.27"></a><var>2.27</var>(d) The electronic health record must have the ability to generate information on <br/>
<a id="pl.2.28"></a><var>2.28</var>clinical quality measures and other measures reported under sections 4101, 4102, and <br/>
<a id="pl.2.29"></a><var>2.29</var>4201 of the HITECH Act.<br/>
<a id="pl.2.30"></a><var>2.30</var>(e) The electronic health record system must be connected to a state-certified <br/>
<a id="pl.2.31"></a><var>2.31</var>health information organization either directly or through a connection facilitated by a <br/>
<a id="pl.2.32"></a><var>2.32</var>state-certified health data intermediary as defined in section 62J.498.<br/>
<a id="pl.2.33"></a><var>2.33</var>    (e) (f) A health care provider who is a prescriber or dispenser of legend drugs must <br/>
<a id="pl.2.34"></a><var>2.34</var>have an electronic health record system that meets the requirements of section 
         <statute_ref>62J.497</statute_ref>.<br/>
<br/>
<a id="bill.0.3.0"></a><a id="pl.3.1"></a><var>3.1</var>    Sec. 3. <b>[62J.498] HEALTH INFORMATION EXCHANGE.</b><br/>
<a id="pl.3.2"></a><var>3.2</var>    Subdivision 1. <b> Definitions.</b>  The following definitions apply to sections 62J.498 to <br/>
<a id="pl.3.3"></a><var>3.3</var>62J.4982:<br/>
<a id="pl.3.4"></a><var>3.4</var>(a) "Clinical transaction" means any meaningful use transaction that is not covered <br/>
<a id="pl.3.5"></a><var>3.5</var>by section 62J.536.<br/>
<a id="pl.3.6"></a><var>3.6</var>(b) "Commissioner" means the commissioner of health.<br/>
<a id="pl.3.7"></a><var>3.7</var>(c) "Direct health information exchange" means the electronic transmission of <br/>
<a id="pl.3.8"></a><var>3.8</var>health-related information through a direct connection between the electronic health <br/>
<a id="pl.3.9"></a><var>3.9</var>record systems of health care providers without the use of a health data intermediary.<br/>
<a id="pl.3.10"></a><var>3.10</var>(d) "Health care provider" or "provider" means a health care provider or provider as <br/>
<a id="pl.3.11"></a><var>3.11</var>defined in section 62J.03, subdivision 8.<br/>
<a id="pl.3.12"></a><var>3.12</var>(e) "Health data intermediary" means an entity that provides the infrastructure to <br/>
<a id="pl.3.13"></a><var>3.13</var>connect computer systems or other electronic devices used by health care providers, <br/>
<a id="pl.3.14"></a><var>3.14</var>laboratories, pharmacies, health plans, third-party administrators, or pharmacy benefit <br/>
<a id="pl.3.15"></a><var>3.15</var>managers to facilitate the secure transmission of health information, including <br/>
<a id="pl.3.16"></a><var>3.16</var>pharmaceutical electronic data intermediaries as defined in section 62J.495.  This does not <br/>
<a id="pl.3.17"></a><var>3.17</var>include health care providers engaged in direct health information exchange.<br/>
<a id="pl.3.18"></a><var>3.18</var>(f) "Health information exchange" means the electronic transmission of <br/>
<a id="pl.3.19"></a><var>3.19</var>health-related information between organizations according to nationally recognized <br/>
<a id="pl.3.20"></a><var>3.20</var>standards.<br/>
<a id="pl.3.21"></a><var>3.21</var>(g) "Health information exchange service provider" means a health data intermediary <br/>
<a id="pl.3.22"></a><var>3.22</var>or health information organization that has been issued a certificate of authority by the <br/>
<a id="pl.3.23"></a><var>3.23</var>commissioner under section 62J.4981.<br/>
<a id="pl.3.24"></a><var>3.24</var>(h) "Health information organization" means an organization that oversees, governs, <br/>
<a id="pl.3.25"></a><var>3.25</var>and facilitates the exchange of health-related information among organizations according <br/>
<a id="pl.3.26"></a><var>3.26</var>to nationally recognized standards.<br/>
<a id="pl.3.27"></a><var>3.27</var>(i) "HITECH Act" means the Health Information Technology for Economic and <br/>
<a id="pl.3.28"></a><var>3.28</var>Clinical Health Act as defined in section 62J.495.<br/>
<a id="pl.3.29"></a><var>3.29</var>(j) "Major participating entity" means:<br/>
<a id="pl.3.30"></a><var>3.30</var>(1) a participating entity that receives compensation for services that is greater <br/>
<a id="pl.3.31"></a><var>3.31</var>than 30 percent of the health information organization's gross annual revenues from the <br/>
<a id="pl.3.32"></a><var>3.32</var>health information exchange service provider;<br/>
<a id="pl.3.33"></a><var>3.33</var>(2) a participating entity providing administrative, financial, or management services <br/>
<a id="pl.3.34"></a><var>3.34</var>to the health information organization, if the total payment for all services provided by the <br/>
<a id="pl.3.35"></a><var>3.35</var>participating entity exceeds three percent of the gross revenue of the health information <br/>
<a id="pl.3.36"></a><var>3.36</var>organization; and<br/>
<a id="pl.4.1"></a><var>4.1</var>(3) a participating entity that nominates or appoints 30 percent or more of the board <br/>
<a id="pl.4.2"></a><var>4.2</var>of directors of the health information organization.<br/>
<a id="pl.4.3"></a><var>4.3</var>(k) "Meaningful use" means use of certified electronic health record technology that <br/>
<a id="pl.4.4"></a><var>4.4</var>includes e-prescribing, and is connected in a manner that provides for the electronic <br/>
<a id="pl.4.5"></a><var>4.5</var>exchange of health information and used for the submission of clinical quality measures <br/>
<a id="pl.4.6"></a><var>4.6</var>as established by the Center for Medicare and Medicaid Services and the Minnesota <br/>
<a id="pl.4.7"></a><var>4.7</var>Department of Human Services pursuant to sections 4101, 4102, and 4201 of the HITECH <br/>
<a id="pl.4.8"></a><var>4.8</var>Act.<br/>
<a id="pl.4.9"></a><var>4.9</var>(l) "Meaningful use transaction" means an electronic transaction that a health care <br/>
<a id="pl.4.10"></a><var>4.10</var>provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare <br/>
<a id="pl.4.11"></a><var>4.11</var>penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.<br/>
<a id="pl.4.12"></a><var>4.12</var>(m) "Participating entity" means any of the following persons, health care providers, <br/>
<a id="pl.4.13"></a><var>4.13</var>companies, or other organizations with which a health information organization or health <br/>
<a id="pl.4.14"></a><var>4.14</var>data intermediary has contracts or other agreements for the provision of health information <br/>
<a id="pl.4.15"></a><var>4.15</var>exchange service providers: <br/>
<a id="pl.4.16"></a><var>4.16</var>(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home <br/>
<a id="pl.4.17"></a><var>4.17</var>licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise <br/>
<a id="pl.4.18"></a><var>4.18</var>licensed under the laws of this state or registered with the commissioner;<br/>
<a id="pl.4.19"></a><var>4.19</var>(2) a health care provider, and any other health care professional otherwise licensed <br/>
<a id="pl.4.20"></a><var>4.20</var>under the laws of this state or registered with the commissioner;<br/>
<a id="pl.4.21"></a><var>4.21</var>(3) a group, professional corporation, or other organization that provides the <br/>
<a id="pl.4.22"></a><var>4.22</var>services of individuals or entities identified in clause (2), including but not limited to a <br/>
<a id="pl.4.23"></a><var>4.23</var>medical clinic, a medical group, a home health care agency, an urgent care center, and <br/>
<a id="pl.4.24"></a><var>4.24</var>an emergent care center;<br/>
<a id="pl.4.25"></a><var>4.25</var>(4) a health plan as defined in section 62A.011, subdivision 3; and<br/>
<a id="pl.4.26"></a><var>4.26</var>(5) a state agency as defined in section 13.02, subdivision 17.<br/>
<a id="pl.4.27"></a><var>4.27</var>(n) "Reciprocal agreement" means an arrangement in which two or more health <br/>
<a id="pl.4.28"></a><var>4.28</var>information exchange service providers agree to share in-kind services and resources to <br/>
<a id="pl.4.29"></a><var>4.29</var>allow for the pass-through of meaningful use transactions.<br/>
<a id="pl.4.30"></a><var>4.30</var>(o) "State-certified health data intermediary" means a health data intermediary that:<br/>
<a id="pl.4.31"></a><var>4.31</var>(1) provides a subset of the meaningful use transaction capabilities necessary for <br/>
<a id="pl.4.32"></a><var>4.32</var>hospitals and providers to achieve meaningful use of electronic health records;<br/>
<a id="pl.4.33"></a><var>4.33</var>(2) is not exclusively engaged in the exchange of meaningful use transactions <br/>
<a id="pl.4.34"></a><var>4.34</var>covered by section 62J.536; and<br/>
<a id="pl.4.35"></a><var>4.35</var>(3) has been issued a certificate of authority to operate in Minnesota.<br/>
<a id="pl.5.1"></a><var>5.1</var>(p) "State-certified health information organization" means a nonprofit health <br/>
<a id="pl.5.2"></a><var>5.2</var>information organization that provides transaction capabilities necessary to fully support <br/>
<a id="pl.5.3"></a><var>5.3</var>clinical transactions required for meaningful use of electronic health records that has been <br/>
<a id="pl.5.4"></a><var>5.4</var>issued a certificate of authority to operate in Minnesota.<br/>
<a id="pl.5.5"></a><var>5.5</var>    Subd. 2. <b> Health information exchange oversight.</b>  (a) The commissioner shall <br/>
<a id="pl.5.6"></a><var>5.6</var>protect the public interest on matters pertaining to health information exchange. The <br/>
<a id="pl.5.7"></a><var>5.7</var>commissioner shall:<br/>
<a id="pl.5.8"></a><var>5.8</var>(1) review and act on applications from health data intermediaries and health <br/>
<a id="pl.5.9"></a><var>5.9</var>information organizations for certificates of authority to operate in Minnesota;<br/>
<a id="pl.5.10"></a><var>5.10</var>(2) provide ongoing monitoring to ensure compliance with criteria established under <br/>
<a id="pl.5.11"></a><var>5.11</var>sections 62J.498 to 62J.4982;<br/>
<a id="pl.5.12"></a><var>5.12</var>(3) respond to public complaints related to health information exchange services;<br/>
<a id="pl.5.13"></a><var>5.13</var>(4) take enforcement actions as necessary, including the imposition of fines, <br/>
<a id="pl.5.14"></a><var>5.14</var>suspension, or revocation of certificates of authority as outlined in section 62J.4982;<br/>
<a id="pl.5.15"></a><var>5.15</var>(5) provide a biannual report on the status of health information exchange services <br/>
<a id="pl.5.16"></a><var>5.16</var>that includes but is not limited to:<br/>
<a id="pl.5.17"></a><var>5.17</var>(i) recommendations on actions necessary to ensure that health information exchange <br/>
<a id="pl.5.18"></a><var>5.18</var>services are adequate to meet the needs of Minnesota citizens and providers statewide;<br/>
<a id="pl.5.19"></a><var>5.19</var>(ii) recommendations on enforcement actions to ensure that health information <br/>
<a id="pl.5.20"></a><var>5.20</var>exchange service providers act in the public interest without causing disruption in health <br/>
<a id="pl.5.21"></a><var>5.21</var>information exchange services;<br/>
<a id="pl.5.22"></a><var>5.22</var>(iii) recommendations on updates to criteria for obtaining certificates of authority <br/>
<a id="pl.5.23"></a><var>5.23</var>under this section; and<br/>
<a id="pl.5.24"></a><var>5.24</var>(iv) recommendations on standard operating procedures for health information <br/>
<a id="pl.5.25"></a><var>5.25</var>exchange, including but not limited to the management of consumer preferences;<br/>
<a id="pl.5.26"></a><var>5.26</var>(6) other duties necessary to protect the public interest.<br/>
<a id="pl.5.27"></a><var>5.27</var>(b) As part of the application review process for certification under paragraph (a), <br/>
<a id="pl.5.28"></a><var>5.28</var>prior to issuing a certificate of authority, the commissioner shall:<br/>
<a id="pl.5.29"></a><var>5.29</var>(1) hold public hearings that provide an adequate opportunity for participating <br/>
<a id="pl.5.30"></a><var>5.30</var>entities and consumers to provide feedback and recommendations on the application under <br/>
<a id="pl.5.31"></a><var>5.31</var>consideration. The commissioner shall make all portions of the application classified <br/>
<a id="pl.5.32"></a><var>5.32</var>as public data available to the public at least ten days in advance of the hearing. The <br/>
<a id="pl.5.33"></a><var>5.33</var>applicant shall participate in the hearing by presenting an overview of their application <br/>
<a id="pl.5.34"></a><var>5.34</var>and responding to questions from interested parties;<br/>
<a id="pl.5.35"></a><var>5.35</var>(2) make available all feedback and recommendations from the hearing available to <br/>
<a id="pl.5.36"></a><var>5.36</var>the public prior to issuing a certificate of authority; and<br/>
<a id="pl.6.1"></a><var>6.1</var>(3) consult with hospitals, physicians, and other professionals eligible to receive <br/>
<a id="pl.6.2"></a><var>6.2</var>meaningful use incentive payments or subject to penalties as established in the HITECH <br/>
<a id="pl.6.3"></a><var>6.3</var>Act, and their respective statewide associations, prior to issuing a certificate of authority.<br/>
<a id="pl.6.4"></a><var>6.4</var>(c)(1) When the commissioner is actively considering a suspension or revocation of <br/>
<a id="pl.6.5"></a><var>6.5</var>a certificate of authority as described in section 62J.4982, subdivision 3, all investigatory <br/>
<a id="pl.6.6"></a><var>6.6</var>data that are collected, created, or maintained related to the suspension or revocation <br/>
<a id="pl.6.7"></a><var>6.7</var>are classified as confidential data on individuals and as protected nonpublic data in the <br/>
<a id="pl.6.8"></a><var>6.8</var>case of data not on individuals.<br/>
<a id="pl.6.9"></a><var>6.9</var>(2) The commissioner may disclose data classified as protected nonpublic or <br/>
<a id="pl.6.10"></a><var>6.10</var>confidential under this paragraph if disclosing the data will protect the health or safety of <br/>
<a id="pl.6.11"></a><var>6.11</var>patients.<br/>
<a id="pl.6.12"></a><var>6.12</var>(d) After the commissioner makes a final determination regarding a suspension or <br/>
<a id="pl.6.13"></a><var>6.13</var>revocation of a certificate of authority, all minutes, orders for hearing, findings of fact, <br/>
<a id="pl.6.14"></a><var>6.14</var>conclusions of law, and the specification of the final disciplinary action, are classified <br/>
<a id="pl.6.15"></a><var>6.15</var>as public data.<br/>
<br/>
<a id="bill.0.4.0"></a><a id="pl.6.16"></a><var>6.16</var>    Sec. 4. <b>[62J.4981] CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH </b><br/>
<a id="pl.6.17"></a><var>6.17</var><b>INFORMATION EXCHANGE SERVICES.</b><br/>
<a id="pl.6.18"></a><var>6.18</var>    Subdivision 1. <b> Authority to require organizations to apply.</b>  The commissioner <br/>
<a id="pl.6.19"></a><var>6.19</var>shall require an entity providing health information exchange services to apply for a <br/>
<a id="pl.6.20"></a><var>6.20</var>certificate of authority under this section. An applicant may continue to operate until <br/>
<a id="pl.6.21"></a><var>6.21</var>the commissioner acts on the application. If the application is denied, the applicant is <br/>
<a id="pl.6.22"></a><var>6.22</var>considered a health information organization whose certificate of authority has been <br/>
<a id="pl.6.23"></a><var>6.23</var>revoked under section 62J.4982, subdivision 2, paragraph (d).<br/>
<a id="pl.6.24"></a><var>6.24</var>    Subd. 2. <b> Certificate of authority for health data intermediaries.</b>  (a) A health <br/>
<a id="pl.6.25"></a><var>6.25</var>data intermediary that provides health information exchange services for the transmission <br/>
<a id="pl.6.26"></a><var>6.26</var>of one or more clinical transactions necessary for hospitals, providers, or eligible <br/>
<a id="pl.6.27"></a><var>6.27</var>professionals to achieve meaningful use must be registered with the state and comply with <br/>
<a id="pl.6.28"></a><var>6.28</var>requirements established in this section.<br/>
<a id="pl.6.29"></a><var>6.29</var>(b) Notwithstanding any law to the contrary, any corporation organized to do so <br/>
<a id="pl.6.30"></a><var>6.30</var>may apply to the commissioner for a certificate of authority to establish and operate as <br/>
<a id="pl.6.31"></a><var>6.31</var>a health data intermediary in compliance with this section. No person shall establish or <br/>
<a id="pl.6.32"></a><var>6.32</var>operate a health data intermediary in this state, nor sell or offer to sell, or solicit offers <br/>
<a id="pl.6.33"></a><var>6.33</var>to purchase or receive advance or periodic consideration in conjunction with a health <br/>
<a id="pl.6.34"></a><var>6.34</var>data intermediary contract unless the organization has a certificate of authority or has an <br/>
<a id="pl.6.35"></a><var>6.35</var>application under active consideration under  this section.<br/>
<a id="pl.7.1"></a><var>7.1</var>(c) In issuing the certificate of authority, the commissioner shall determine whether <br/>
<a id="pl.7.2"></a><var>7.2</var>the applicant for the certificate of authority has demonstrated that the applicant meets <br/>
<a id="pl.7.3"></a><var>7.3</var>the following minimum criteria:<br/>
<a id="pl.7.4"></a><var>7.4</var>(1) interoperate with at least one state-certified health information organization;<br/>
<a id="pl.7.5"></a><var>7.5</var>(2) provide an option for Minnesota entities to connect to their services through at <br/>
<a id="pl.7.6"></a><var>7.6</var>least one state-certified health information organization;<br/>
<a id="pl.7.7"></a><var>7.7</var>(3) have a record locator service as defined in section 144.291, subdivision 2, <br/>
<a id="pl.7.8"></a><var>7.8</var>paragraph (i), that is compliant with the requirements of section 144.293, subdivision 8, <br/>
<a id="pl.7.9"></a><var>7.9</var>when conducting meaningful use transactions; and<br/>
<a id="pl.7.10"></a><var>7.10</var>(4) hold reciprocal agreements with at least one state-certified health information <br/>
<a id="pl.7.11"></a><var>7.11</var>organization to enable access to record locator services to find patient data, and for the <br/>
<a id="pl.7.12"></a><var>7.12</var>transmission and receipt of meaningful use transactions consistent with the format and <br/>
<a id="pl.7.13"></a><var>7.13</var>content required by national standards established by Centers for Medicare and Medicaid <br/>
<a id="pl.7.14"></a><var>7.14</var>Services. Reciprocal agreements must meet the requirements established in subdivision 5.<br/>
<a id="pl.7.15"></a><var>7.15</var>    Subd. 3. <b> Certificate of authority for health information organizations.</b><br/>
<a id="pl.7.16"></a><var>7.16</var>(a) A health information organization that provides all electronic capabilities for the <br/>
<a id="pl.7.17"></a><var>7.17</var>transmission of clinical transactions necessary for meaningful use of electronic health <br/>
<a id="pl.7.18"></a><var>7.18</var>records must obtain a certificate of authority from the commissioner and demonstrate <br/>
<a id="pl.7.19"></a><var>7.19</var>compliance with the criteria in paragraph (c).<br/>
<a id="pl.7.20"></a><var>7.20</var>(b) Notwithstanding any law to the contrary, a nonprofit corporation organized to do <br/>
<a id="pl.7.21"></a><var>7.21</var>so may apply for a certificate of authority to establish and operate a health information <br/>
<a id="pl.7.22"></a><var>7.22</var>organization under this section. No person shall establish or operate a health information <br/>
<a id="pl.7.23"></a><var>7.23</var>organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive <br/>
<a id="pl.7.24"></a><var>7.24</var>advance or periodic consideration in conjunction with a health information organization <br/>
<a id="pl.7.25"></a><var>7.25</var>or health information contract unless the organization has a certificate of authority under <br/>
<a id="pl.7.26"></a><var>7.26</var>this section.<br/>
<a id="pl.7.27"></a><var>7.27</var>(c) In issuing the certificate of authority, the commissioner shall determine whether <br/>
<a id="pl.7.28"></a><var>7.28</var>the applicant for the certificate of authority has demonstrated that the applicant meets <br/>
<a id="pl.7.29"></a><var>7.29</var>the following minimum criteria:<br/>
<a id="pl.7.30"></a><var>7.30</var>(1) the entity is a legally established, nonprofit organization;<br/>
<a id="pl.7.31"></a><var>7.31</var>(2) appropriate insurance, including liability insurance, for the operation of the <br/>
<a id="pl.7.32"></a><var>7.32</var>health information organization is in place and sufficient to protect the interest of the <br/>
<a id="pl.7.33"></a><var>7.33</var>public and participating entities;<br/>
<a id="pl.7.34"></a><var>7.34</var>(3) strategic and operational plans clearly address how the organization will expand <br/>
<a id="pl.7.35"></a><var>7.35</var>technical capacity of the health information organization to support providers in achieving <br/>
<a id="pl.7.36"></a><var>7.36</var>meaningful use of electronic health records over time;<br/>
<a id="pl.8.1"></a><var>8.1</var>(4) the entity addresses the parameters to be used with participating entities and <br/>
<a id="pl.8.2"></a><var>8.2</var>other health information organizations for meaningful use transactions, compliance with <br/>
<a id="pl.8.3"></a><var>8.3</var>Minnesota law, and interstate health information exchange in trust agreements;<br/>
<a id="pl.8.4"></a><var>8.4</var>(5) the entity's board of directors is comprised of members that broadly represent the <br/>
<a id="pl.8.5"></a><var>8.5</var>health information organization's participating entities and consumers;<br/>
<a id="pl.8.6"></a><var>8.6</var>(6) the entity maintains a professional staff responsible to the board of directors with <br/>
<a id="pl.8.7"></a><var>8.7</var>the capacity to ensure accountability to the organization's mission;<br/>
<a id="pl.8.8"></a><var>8.8</var>(7) the organization is compliant with criteria established under the Health <br/>
<a id="pl.8.9"></a><var>8.9</var>Information Exchange Accreditation Program of the Electronic Healthcare Network <br/>
<a id="pl.8.10"></a><var>8.10</var>Accreditation Commission (EHNAC) or equivalent criteria established by the <br/>
<a id="pl.8.11"></a><var>8.11</var>commissioner;<br/>
<a id="pl.8.12"></a><var>8.12</var>(8) the entity maintains a record locator service as defined in section 144.291, <br/>
<a id="pl.8.13"></a><var>8.13</var>subdivision 2, paragraph (i), that is compliant with the requirements of section 144.293, <br/>
<a id="pl.8.14"></a><var>8.14</var>subdivision 8, when conducting meaningful use transactions;<br/>
<a id="pl.8.15"></a><var>8.15</var>(9) the organization demonstrates interoperability with all other state-certified health <br/>
<a id="pl.8.16"></a><var>8.16</var>information organizations using nationally recognized standards;<br/>
<a id="pl.8.17"></a><var>8.17</var>(10) the organization demonstrates compliance with all privacy and security <br/>
<a id="pl.8.18"></a><var>8.18</var>requirements required by state and federal law; and<br/>
<a id="pl.8.19"></a><var>8.19</var>(11) the organization uses financial policies and procedures consistent with generally <br/>
<a id="pl.8.20"></a><var>8.20</var>accepted accounting principles and has an independent audit of the organization's <br/>
<a id="pl.8.21"></a><var>8.21</var>financials on an annual basis.<br/>
<a id="pl.8.22"></a><var>8.22</var>(d) Health information organizations that have obtained a certificate of authority <br/>
<a id="pl.8.23"></a><var>8.23</var>must:<br/>
<a id="pl.8.24"></a><var>8.24</var>(1) meet the requirements established for connecting to the Nationwide Health <br/>
<a id="pl.8.25"></a><var>8.25</var>Information Network (NHIN) within the federally mandated timeline or within a time <br/>
<a id="pl.8.26"></a><var>8.26</var>frame established by the commissioner and published in the State Register. If the state <br/>
<a id="pl.8.27"></a><var>8.27</var>timeline for implementation varies from the federal timeline, the State Register notice <br/>
<a id="pl.8.28"></a><var>8.28</var>shall include an explanation for the variation;<br/>
<a id="pl.8.29"></a><var>8.29</var>(2) annually submit strategic and operational plans for review by the commissioner <br/>
<a id="pl.8.30"></a><var>8.30</var>that address:<br/>
<a id="pl.8.31"></a><var>8.31</var>(i) increasing adoption rates to include a sufficient number of participating entities to <br/>
<a id="pl.8.32"></a><var>8.32</var>achieve financial sustainability; and<br/>
<a id="pl.8.33"></a><var>8.33</var>(ii) progress in achieving objectives included in previously submitted strategic <br/>
<a id="pl.8.34"></a><var>8.34</var>and operational plans across the following domains:  business and technical operations, <br/>
<a id="pl.8.35"></a><var>8.35</var>technical infrastructure, legal and policy issues, finance, and organizational governance;<br/>
<a id="pl.8.36"></a><var>8.36</var>(3) develop and maintain a business plan that addresses:<br/>
<a id="pl.9.1"></a><var>9.1</var>(i) plans for ensuring the necessary capacity to support meaningful use transactions;<br/>
<a id="pl.9.2"></a><var>9.2</var>(ii) approach for attaining financial sustainability, including public and private <br/>
<a id="pl.9.3"></a><var>9.3</var>financing strategies, and rate structures;<br/>
<a id="pl.9.4"></a><var>9.4</var>(iii) rates of adoption, utilization, and transaction volume, and mechanisms to <br/>
<a id="pl.9.5"></a><var>9.5</var>support health information exchange; and<br/>
<a id="pl.9.6"></a><var>9.6</var>(iv) an explanation of methods employed to address the needs of community clinics, <br/>
<a id="pl.9.7"></a><var>9.7</var>critical access hospitals, and free clinics in accessing health information exchange services;<br/>
<a id="pl.9.8"></a><var>9.8</var>(4) annually submit a rate plan outlining fee structures for health information <br/>
<a id="pl.9.9"></a><var>9.9</var>exchange services for approval by the commissioner. The commissioner shall approve the <br/>
<a id="pl.9.10"></a><var>9.10</var>rate plan if it:<br/>
<a id="pl.9.11"></a><var>9.11</var>(i) distributes costs equitably among users of health information services;<br/>
<a id="pl.9.12"></a><var>9.12</var>(ii) provides predictable costs for participating entities;<br/>
<a id="pl.9.13"></a><var>9.13</var>(iii) covers all costs associated with conducting the full range of meaningful use <br/>
<a id="pl.9.14"></a><var>9.14</var>clinical transactions, including access to health information retrieved through other <br/>
<a id="pl.9.15"></a><var>9.15</var>state-certified health information exchange service providers; and<br/>
<a id="pl.9.16"></a><var>9.16</var>(iv) provides for a predictable revenue stream for the health information organization <br/>
<a id="pl.9.17"></a><var>9.17</var>and generates sufficient resources to maintain operating costs and develop technical <br/>
<a id="pl.9.18"></a><var>9.18</var>infrastructure necessary to serve the public interest;<br/>
<a id="pl.9.19"></a><var>9.19</var>(5) enter into reciprocal agreements with all other state-certified health information <br/>
<a id="pl.9.20"></a><var>9.20</var>organizations to enable access to record locator services to find patient data, and <br/>
<a id="pl.9.21"></a><var>9.21</var>transmission and receipt of meaningful use transactions consistent with the format and <br/>
<a id="pl.9.22"></a><var>9.22</var>content required by national standards established by Centers for Medicare and Medicaid <br/>
<a id="pl.9.23"></a><var>9.23</var>Services. Reciprocal agreements must meet the requirements in subdivision 5; and<br/>
<a id="pl.9.24"></a><var>9.24</var>(6) comply with additional requirements for the certification or recertification of <br/>
<a id="pl.9.25"></a><var>9.25</var>health information organizations that may be established by the commissioner.<br/>
<a id="pl.9.26"></a><var>9.26</var>    Subd. 4. <b> Application for certificate of authority for health information exchange </b><br/>
<a id="pl.9.27"></a><var>9.27</var><b>service providers.</b> (a)  Each application for a certificate of authority shall be in a form <br/>
<a id="pl.9.28"></a><var>9.28</var>prescribed by the commissioner and verified by an officer or authorized representative of <br/>
<a id="pl.9.29"></a><var>9.29</var>the applicant. Each application shall include the following:<br/>
<a id="pl.9.30"></a><var>9.30</var>(1) a copy of the basic organizational document, if any, of the applicant and of <br/>
<a id="pl.9.31"></a><var>9.31</var>each major participating entity, such as the articles of incorporation, or other applicable <br/>
<a id="pl.9.32"></a><var>9.32</var>documents, and all amendments to it;<br/>
<a id="pl.9.33"></a><var>9.33</var>(2) a list of the names, addresses, and official positions of the following:<br/>
<a id="pl.9.34"></a><var>9.34</var>(i) all members of the board of directors, and the principal officers and, if applicable, <br/>
<a id="pl.9.35"></a><var>9.35</var>shareholders of the applicant organization; and<br/>
<a id="pl.10.1"></a><var>10.1</var>(ii) all members of the board of directors, and the principal officers of each major <br/>
<a id="pl.10.2"></a><var>10.2</var>participating entity and, if applicable, each shareholder beneficially owning more than ten <br/>
<a id="pl.10.3"></a><var>10.3</var>percent of any voting stock of the major participating entity;<br/>
<a id="pl.10.4"></a><var>10.4</var>(3) the name and address of each participating entity and the agreed-upon duration <br/>
<a id="pl.10.5"></a><var>10.5</var>of each contract or agreement if applicable;<br/>
<a id="pl.10.6"></a><var>10.6</var>(4) a copy of each standard agreement or contract intended to bind the participating <br/>
<a id="pl.10.7"></a><var>10.7</var>entities and the health information organization. Contractual provisions shall be consistent <br/>
<a id="pl.10.8"></a><var>10.8</var>with the purposes of this section, in regard to the services to be performed under the <br/>
<a id="pl.10.9"></a><var>10.9</var>standard agreement or contract, the manner in which payment for services is determined, <br/>
<a id="pl.10.10"></a><var>10.10</var>the nature and extent of responsibilities to be retained by the health information <br/>
<a id="pl.10.11"></a><var>10.11</var>organization, and contractual termination provisions;<br/>
<a id="pl.10.12"></a><var>10.12</var>(5) a copy of each contract intended to bind major participating entities and the <br/>
<a id="pl.10.13"></a><var>10.13</var>health information organization. Contract information filed with the commissioner under <br/>
<a id="pl.10.14"></a><var>10.14</var>this section shall be nonpublic as defined in section 13.02, subdivision 9;<br/>
<a id="pl.10.15"></a><var>10.15</var>(6) a statement generally describing the health information organization, its health <br/>
<a id="pl.10.16"></a><var>10.16</var>information exchange contracts, facilities, and personnel, including a statement describing <br/>
<a id="pl.10.17"></a><var>10.17</var>the manner in which the applicant proposes to provide participants with comprehensive <br/>
<a id="pl.10.18"></a><var>10.18</var>health information exchange services;<br/>
<a id="pl.10.19"></a><var>10.19</var>(7) financial statements showing the applicant's assets, liabilities, and sources <br/>
<a id="pl.10.20"></a><var>10.20</var>of financial support, including a copy of the applicant's most recent certified financial <br/>
<a id="pl.10.21"></a><var>10.21</var>statement;<br/>
<a id="pl.10.22"></a><var>10.22</var>(8) strategic and operational plans that specifically address how the organization <br/>
<a id="pl.10.23"></a><var>10.23</var>will expand technical capacity of the health information organization to support providers <br/>
<a id="pl.10.24"></a><var>10.24</var>in achieving meaningful use of electronic health records over time, a description of <br/>
<a id="pl.10.25"></a><var>10.25</var>the proposed method of marketing the services, a schedule of proposed charges, and a <br/>
<a id="pl.10.26"></a><var>10.26</var>financial plan that includes a three-year projection of the expenses and income and other <br/>
<a id="pl.10.27"></a><var>10.27</var>sources of future capital;<br/>
<a id="pl.10.28"></a><var>10.28</var>(9) a statement reasonably describing the geographic area or areas to be served and <br/>
<a id="pl.10.29"></a><var>10.29</var>the type or types of participants to be served;<br/>
<a id="pl.10.30"></a><var>10.30</var>(10) a description of the complaint procedures to be used as required under this <br/>
<a id="pl.10.31"></a><var>10.31</var>section;<br/>
<a id="pl.10.32"></a><var>10.32</var>(11) a description of the mechanism by which participating entities will have an <br/>
<a id="pl.10.33"></a><var>10.33</var>opportunity to participate in matters of policy and operation;<br/>
<a id="pl.10.34"></a><var>10.34</var>(12) a copy of any pertinent agreements between the health information organization <br/>
<a id="pl.10.35"></a><var>10.35</var>and insurers, including liability insurers, demonstrating coverage is in place;<br/>
<a id="pl.11.1"></a><var>11.1</var>(13) a copy of the conflict of interest policy that applies to all members of the board <br/>
<a id="pl.11.2"></a><var>11.2</var>of directors and the principal officers of the health information organization; and<br/>
<a id="pl.11.3"></a><var>11.3</var>(14) other information as the commissioner may reasonably require to be provided.<br/>
<a id="pl.11.4"></a><var>11.4</var>(b) Thirty days after the receipt of the application for a certificate of authority, <br/>
<a id="pl.11.5"></a><var>11.5</var>the commissioner shall determine whether or not the application submitted meets the <br/>
<a id="pl.11.6"></a><var>11.6</var>requirements for completion in paragraph (a), and notify the applicant of any further <br/>
<a id="pl.11.7"></a><var>11.7</var>information required for the application to be processed.<br/>
<a id="pl.11.8"></a><var>11.8</var>(c) Ninety days after the receipt of a complete application for a certificate of <br/>
<a id="pl.11.9"></a><var>11.9</var>authority, the commissioner shall issue a certificate of authority to the applicant if the <br/>
<a id="pl.11.10"></a><var>11.10</var>commissioner determines that the applicant meets the minimum criteria requirements <br/>
<a id="pl.11.11"></a><var>11.11</var>of subdivision 2 for health data intermediaries or subdivision 3 for health information <br/>
<a id="pl.11.12"></a><var>11.12</var>organizations. If the commissioner determines that the applicant is not qualified, the <br/>
<a id="pl.11.13"></a><var>11.13</var>commissioner shall notify the applicant and specify the reasons for disqualification.<br/>
<a id="pl.11.14"></a><var>11.14</var>(d) Upon being granted a certificate of authority to operate as a health information <br/>
<a id="pl.11.15"></a><var>11.15</var>organization, the organization must operate in compliance with the provisions of this <br/>
<a id="pl.11.16"></a><var>11.16</var>section. Noncompliance may result in the imposition of a fine or the suspension or <br/>
<a id="pl.11.17"></a><var>11.17</var>revocation of the certificate of authority according to section 62J.4982.<br/>
<a id="pl.11.18"></a><var>11.18</var>    Subd. 5. <b> Reciprocal agreements between health information exchange entities.</b><br/>
<a id="pl.11.19"></a><var>11.19</var>(a) Reciprocal agreements between two health information organizations or between a <br/>
<a id="pl.11.20"></a><var>11.20</var>health information organization and a health data intermediary must include a fair and <br/>
<a id="pl.11.21"></a><var>11.21</var>equitable model for charges between the entities that:<br/>
<a id="pl.11.22"></a><var>11.22</var>(1) does not impede the secure transmission of transactions necessary to achieve <br/>
<a id="pl.11.23"></a><var>11.23</var>meaningful use;<br/>
<a id="pl.11.24"></a><var>11.24</var>(2) does not charge a fee for the exchange of meaningful use transactions transmitted <br/>
<a id="pl.11.25"></a><var>11.25</var>according to nationally recognized standards where no additional value-added service <br/>
<a id="pl.11.26"></a><var>11.26</var>is rendered to the sending or receiving health information organization or health data <br/>
<a id="pl.11.27"></a><var>11.27</var>intermediary either directly or on behalf of the client;<br/>
<a id="pl.11.28"></a><var>11.28</var>(3) is consistent with fair market value and proportionately reflects the value-added <br/>
<a id="pl.11.29"></a><var>11.29</var>services accessed as a result of the agreement; and<br/>
<a id="pl.11.30"></a><var>11.30</var>(4) prevents health care stakeholders from being charged multiple times for the <br/>
<a id="pl.11.31"></a><var>11.31</var>same service.<br/>
<a id="pl.11.32"></a><var>11.32</var>(b) Reciprocal agreements must include comparable quality of service standards that <br/>
<a id="pl.11.33"></a><var>11.33</var>ensure equitable levels of services.<br/>
<a id="pl.11.34"></a><var>11.34</var>(c) Reciprocal agreements are subject to review and approval by the commissioner.<br/>
<a id="pl.12.1"></a><var>12.1</var>(d) Nothing in this section precludes a state-certified health information organization <br/>
<a id="pl.12.2"></a><var>12.2</var>or state-certified health data intermediary from entering into contractual agreements for <br/>
<a id="pl.12.3"></a><var>12.3</var>the provision of value-added services beyond meaningful use. <br/>
<a id="pl.12.4"></a><var>12.4</var>(e) The commissioner of human services or health, when providing access to data or <br/>
<a id="pl.12.5"></a><var>12.5</var>services through a certified health information organization, must offer the same data or <br/>
<a id="pl.12.6"></a><var>12.6</var>services directly through any certified health information organization at the same pricing, <br/>
<a id="pl.12.7"></a><var>12.7</var>if the health information organization pays for all connection costs to the state data or <br/>
<a id="pl.12.8"></a><var>12.8</var>service. For all external connectivity to the respective agencies through existing or future <br/>
<a id="pl.12.9"></a><var>12.9</var>information exchange implementations, the respective agency shall establish the required <br/>
<a id="pl.12.10"></a><var>12.10</var>connectivity methods as well as protocol standards to be utilized.<br/>
<a id="pl.12.11"></a><var>12.11</var>    Subd. 6. <b>State participation in health information exchange.</b> A state agency <br/>
<a id="pl.12.12"></a><var>12.12</var>that connects to a health information exchange service provider for the purpose of <br/>
<a id="pl.12.13"></a><var>12.13</var>exchanging meaningful use transactions must ensure that the contracted health information <br/>
<a id="pl.12.14"></a><var>12.14</var>exchange service provider has reciprocal agreements in place as required by this section. <br/>
<a id="pl.12.15"></a><var>12.15</var>The reciprocal agreements must provide equal access to information supplied by the <br/>
<a id="pl.12.16"></a><var>12.16</var>agency and necessary for meaningful use by the participating entities of the other health <br/>
<a id="pl.12.17"></a><var>12.17</var>information service providers.<br/>
<br/>
<a id="bill.0.5.0"></a><a id="pl.12.18"></a><var>12.18</var>    Sec. 5. <b>[62J.4982] ENFORCEMENT AUTHORITY; COMPLIANCE.</b><br/>
<a id="pl.12.19"></a><var>12.19</var>    Subdivision 1. <b> Penalties and enforcement.</b>  (a) The commissioner may, for any <br/>
<a id="pl.12.20"></a><var>12.20</var>violation of statute or rule applicable to a health information exchange service provider, <br/>
<a id="pl.12.21"></a><var>12.21</var>levy an administrative penalty in an amount up to $25,000 for each violation. In <br/>
<a id="pl.12.22"></a><var>12.22</var>determining the level of an administrative penalty, the commissioner shall consider the <br/>
<a id="pl.12.23"></a><var>12.23</var>following factors:<br/>
<a id="pl.12.24"></a><var>12.24</var>(1) the number of participating entities affected by the violation;<br/>
<a id="pl.12.25"></a><var>12.25</var>(2) the effect of the violation on participating entities' access to health information <br/>
<a id="pl.12.26"></a><var>12.26</var>exchange services;<br/>
<a id="pl.12.27"></a><var>12.27</var>(3) if only one participating entity is affected, the effect of the violation on the <br/>
<a id="pl.12.28"></a><var>12.28</var>patients of that entity;<br/>
<a id="pl.12.29"></a><var>12.29</var>(4) whether the violation is an isolated incident or part of a pattern of violations;<br/>
<a id="pl.12.30"></a><var>12.30</var>(5) the economic benefits derived by the health information organization or a health <br/>
<a id="pl.12.31"></a><var>12.31</var>data intermediary by virtue of the violation;<br/>
<a id="pl.12.32"></a><var>12.32</var>(6) whether the violation hindered or facilitated an individual's ability to obtain <br/>
<a id="pl.12.33"></a><var>12.33</var>health care;<br/>
<a id="pl.12.34"></a><var>12.34</var>(7) whether the violation was intentional;<br/>
<a id="pl.13.1"></a><var>13.1</var>(8) whether the violation was beyond the direct control of the health information <br/>
<a id="pl.13.2"></a><var>13.2</var>exchange service provider;<br/>
<a id="pl.13.3"></a><var>13.3</var>(9) any history of prior compliance with the provisions of this section, including <br/>
<a id="pl.13.4"></a><var>13.4</var>violations;<br/>
<a id="pl.13.5"></a><var>13.5</var>(10) whether and to what extent the health information exchange service provider <br/>
<a id="pl.13.6"></a><var>13.6</var>attempted to correct previous violations;<br/>
<a id="pl.13.7"></a><var>13.7</var>(11) how the health information exchange service provider responded to technical <br/>
<a id="pl.13.8"></a><var>13.8</var>assistance from the commissioner provided in the context of a compliance effort; and<br/>
<a id="pl.13.9"></a><var>13.9</var>(12) the financial condition of the health information exchange service provider <br/>
<a id="pl.13.10"></a><var>13.10</var>including, but not limited to, whether the health information exchange service provider <br/>
<a id="pl.13.11"></a><var>13.11</var>had financial difficulties that affected its ability to comply or whether the imposition of an <br/>
<a id="pl.13.12"></a><var>13.12</var>administrative monetary penalty would jeopardize the ability of the health information <br/>
<a id="pl.13.13"></a><var>13.13</var>exchange service provider to continue to deliver health information exchange services.<br/>
<a id="pl.13.14"></a><var>13.14</var>Reasonable notice in writing to the health information exchange service provider <br/>
<a id="pl.13.15"></a><var>13.15</var>shall be given of the intent to levy the penalty and the reasons for them. A health <br/>
<a id="pl.13.16"></a><var>13.16</var>information exchange service provider may have 15 days within which to contest whether <br/>
<a id="pl.13.17"></a><var>13.17</var>the finding of facts constitute a violation of sections 62J.4981 and 62J.4982, according to <br/>
<a id="pl.13.18"></a><var>13.18</var>the contested case and judicial review provisions of sections 14.57 to 14.69.<br/>
<a id="pl.13.19"></a><var>13.19</var>(b) If the commissioner has reason to believe that a violation of section 62J.4981 or <br/>
<a id="pl.13.20"></a><var>13.20</var>62J.4982 has occurred or is likely, the commissioner may confer with the persons involved <br/>
<a id="pl.13.21"></a><var>13.21</var>before commencing action under subdivision 2. The commissioner may notify the health <br/>
<a id="pl.13.22"></a><var>13.22</var>information exchange service provider and the representatives, or other persons who <br/>
<a id="pl.13.23"></a><var>13.23</var>appear to be involved in the suspected violation, to arrange a voluntary conference with <br/>
<a id="pl.13.24"></a><var>13.24</var>the alleged violators or their authorized representatives. The purpose of the conference is <br/>
<a id="pl.13.25"></a><var>13.25</var>to attempt to learn the facts about the suspected violation and, if it appears that a violation <br/>
<a id="pl.13.26"></a><var>13.26</var>has occurred or is threatened, to find a way to correct or prevent it. The conference is <br/>
<a id="pl.13.27"></a><var>13.27</var>not governed by any formal procedural requirements, and may be conducted as the <br/>
<a id="pl.13.28"></a><var>13.28</var>commissioner considers appropriate.<br/>
<a id="pl.13.29"></a><var>13.29</var>(c) The commissioner may issue an order directing a health information exchange <br/>
<a id="pl.13.30"></a><var>13.30</var>service provider or a representative of a health information exchange service provider to <br/>
<a id="pl.13.31"></a><var>13.31</var>cease and desist from engaging in any act or practice in violation of sections 62J.4981 <br/>
<a id="pl.13.32"></a><var>13.32</var>and 62J.4982.<br/>
<a id="pl.13.33"></a><var>13.33</var>(d) Within 20 days after service of the order to cease and desist, a health information <br/>
<a id="pl.13.34"></a><var>13.34</var>exchange service provider may contest whether the finding of facts constitutes a violation <br/>
<a id="pl.13.35"></a><var>13.35</var>of sections 62J.4981 and 62J.4982 according to the contested case and judicial review <br/>
<a id="pl.13.36"></a><var>13.36</var>provisions of sections 14.57 to 14.69.<br/>
<a id="pl.14.1"></a><var>14.1</var>(e) In the event of noncompliance with a cease and desist order issued under this <br/>
<a id="pl.14.2"></a><var>14.2</var>subdivision, the commissioner may institute a proceeding to obtain injunctive relief or <br/>
<a id="pl.14.3"></a><var>14.3</var>other appropriate relief in Ramsey County District Court.<br/>
<a id="pl.14.4"></a><var>14.4</var>    Subd. 2. <b> Suspension or revocation of certificates of authority.</b> (a) The <br/>
<a id="pl.14.5"></a><var>14.5</var>commissioner may suspend or revoke a certificate of authority issued to a health <br/>
<a id="pl.14.6"></a><var>14.6</var>data intermediary or health information organization under section 62J.4981 if the <br/>
<a id="pl.14.7"></a><var>14.7</var>commissioner finds that:<br/>
<a id="pl.14.8"></a><var>14.8</var>(1) the health information exchange service provider is operating significantly <br/>
<a id="pl.14.9"></a><var>14.9</var>in contravention of its basic organizational document, or in a manner contrary to that <br/>
<a id="pl.14.10"></a><var>14.10</var>described in and reasonably inferred from any other information submitted under section <br/>
<a id="pl.14.11"></a><var>14.11</var>62J.4981, unless amendments to the submissions have been filed with and approved by <br/>
<a id="pl.14.12"></a><var>14.12</var>the commissioner;<br/>
<a id="pl.14.13"></a><var>14.13</var>(2) the health information exchange service provider is unable to fulfill its <br/>
<a id="pl.14.14"></a><var>14.14</var>obligations to furnish comprehensive health information exchange services as required <br/>
<a id="pl.14.15"></a><var>14.15</var>under its health information exchange contract;<br/>
<a id="pl.14.16"></a><var>14.16</var>(3) the health information exchange service provider is no longer financially solvent <br/>
<a id="pl.14.17"></a><var>14.17</var>or may not reasonably be expected to meet its obligations to participating entities;<br/>
<a id="pl.14.18"></a><var>14.18</var>(4) the health information exchange service provider has failed to implement the <br/>
<a id="pl.14.19"></a><var>14.19</var>complaint system in a manner designed to reasonably resolve valid complaints;<br/>
<a id="pl.14.20"></a><var>14.20</var>(5) the health information exchange service provider, or any person acting with its <br/>
<a id="pl.14.21"></a><var>14.21</var>sanction, has advertised or merchandised its services in an untrue, misleading, deceptive, <br/>
<a id="pl.14.22"></a><var>14.22</var>or unfair manner;<br/>
<a id="pl.14.23"></a><var>14.23</var>(6) the continued operation of the health information exchange service provider <br/>
<a id="pl.14.24"></a><var>14.24</var>would be hazardous to its participating entities or the patients served by the participating <br/>
<a id="pl.14.25"></a><var>14.25</var>entities; or<br/>
<a id="pl.14.26"></a><var>14.26</var>(7) the health information exchange service provider has otherwise failed to <br/>
<a id="pl.14.27"></a><var>14.27</var>substantially comply with section 62J.4981 or with any other statute or administrative <br/>
<a id="pl.14.28"></a><var>14.28</var>rule applicable to health information exchange service providers, or has submitted false <br/>
<a id="pl.14.29"></a><var>14.29</var>information in any report required under sections 62J.498 to 62J.4982.<br/>
<a id="pl.14.30"></a><var>14.30</var>(b) A certificate of authority shall be suspended or revoked only after meeting the <br/>
<a id="pl.14.31"></a><var>14.31</var>requirements of subdivision 3.<br/>
<a id="pl.14.32"></a><var>14.32</var>(c) If the certificate of authority of a health information exchange service provider is <br/>
<a id="pl.14.33"></a><var>14.33</var>suspended, the health information exchange service provider shall not, during the period <br/>
<a id="pl.14.34"></a><var>14.34</var>of suspension, enroll any additional participating entities, and shall not engage in any <br/>
<a id="pl.14.35"></a><var>14.35</var>advertising or solicitation.<br/>
<a id="pl.15.1"></a><var>15.1</var>(d) If the certificate of authority of a health information exchange service provider is <br/>
<a id="pl.15.2"></a><var>15.2</var>revoked, the organization shall proceed, immediately following the effective date of the <br/>
<a id="pl.15.3"></a><var>15.3</var>order of revocation, to wind up its affairs, and shall conduct no further business except as <br/>
<a id="pl.15.4"></a><var>15.4</var>necessary to the orderly conclusion of the affairs of the organization. The organization <br/>
<a id="pl.15.5"></a><var>15.5</var>shall engage in no further advertising or solicitation. The commissioner may, by written <br/>
<a id="pl.15.6"></a><var>15.6</var>order, permit further operation of the organization as the commissioner finds to be in the <br/>
<a id="pl.15.7"></a><var>15.7</var>best interest of participating entities, to the end that participating entities will be given the <br/>
<a id="pl.15.8"></a><var>15.8</var>greatest practical opportunity to access continuing health information exchange services.<br/>
<a id="pl.15.9"></a><var>15.9</var>    Subd. 3. <b> Denial, suspension, and revocation; administrative procedures.</b>  (a) <br/>
<a id="pl.15.10"></a><var>15.10</var>When the commissioner has cause to believe that grounds for the denial, suspension, <br/>
<a id="pl.15.11"></a><var>15.11</var>or revocation of a certificate of authority exists, the commissioner shall notify the <br/>
<a id="pl.15.12"></a><var>15.12</var>health information exchange service provider in writing stating the grounds for denial, <br/>
<a id="pl.15.13"></a><var>15.13</var>suspension, or revocation and setting a time within 20 days for a hearing on the matter.<br/>
<a id="pl.15.14"></a><var>15.14</var>(b) After a hearing before the commissioner at which the health information <br/>
<a id="pl.15.15"></a><var>15.15</var>exchange service provider may respond to the grounds for denial, suspension, or <br/>
<a id="pl.15.16"></a><var>15.16</var>revocation, or upon the failure of the health information exchange service provider to <br/>
<a id="pl.15.17"></a><var>15.17</var>appear at the hearing, the commissioner shall take action as deemed necessary and shall <br/>
<a id="pl.15.18"></a><var>15.18</var>issue written findings that shall be mailed to the health information exchange service <br/>
<a id="pl.15.19"></a><var>15.19</var>provider.<br/>
<a id="pl.15.20"></a><var>15.20</var>(c) If suspension, revocation, or an administrative penalty is proposed according <br/>
<a id="pl.15.21"></a><var>15.21</var>to this section, the commissioner must deliver, or send by certified mail with return <br/>
<a id="pl.15.22"></a><var>15.22</var>receipt requested, to the health information exchange service provider written notice of <br/>
<a id="pl.15.23"></a><var>15.23</var>the commissioner's intent to impose a penalty. This notice of proposed determination <br/>
<a id="pl.15.24"></a><var>15.24</var>must include:<br/>
<a id="pl.15.25"></a><var>15.25</var>(1) a reference to the statutory basis for the penalty;<br/>
<a id="pl.15.26"></a><var>15.26</var>(2) a description of the findings of fact regarding the violations with respect to <br/>
<a id="pl.15.27"></a><var>15.27</var>which the penalty is proposed;<br/>
<a id="pl.15.28"></a><var>15.28</var>(3) the nature and/or amount of the proposed penalty;<br/>
<a id="pl.15.29"></a><var>15.29</var>(4) any circumstances described in subdivision 1, paragraph (a), that were considered <br/>
<a id="pl.15.30"></a><var>15.30</var>in determining the amount of the proposed penalty;<br/>
<a id="pl.15.31"></a><var>15.31</var>(5) instructions for responding to the notice, including a statement of the health <br/>
<a id="pl.15.32"></a><var>15.32</var>information exchange service provider's right to a contested case proceeding and a <br/>
<a id="pl.15.33"></a><var>15.33</var>statement that failure to request a contested case proceeding within 30 calendar days <br/>
<a id="pl.15.34"></a><var>15.34</var>permits the imposition of the proposed penalty; and<br/>
<a id="pl.15.35"></a><var>15.35</var>(6) the address to which the contested case proceeding request must be sent.<br/>
<a id="pl.16.1"></a><var>16.1</var>    Subd. 4. <b> Coordination.</b> (a) The commissioner shall, to the extent possible, seek <br/>
<a id="pl.16.2"></a><var>16.2</var>the advice of the Minnesota e-Health Advisory Committee, in the review and update of <br/>
<a id="pl.16.3"></a><var>16.3</var>criteria for the certification and recertification of health information exchange service <br/>
<a id="pl.16.4"></a><var>16.4</var>providers when implementing sections 62J.498 to 62J.4982.<br/>
<a id="pl.16.5"></a><var>16.5</var>(b) By January 1, 2011, the commissioner shall report to the governor and the chairs <br/>
<a id="pl.16.6"></a><var>16.6</var>of the senate and house of representatives committees having jurisdiction over health <br/>
<a id="pl.16.7"></a><var>16.7</var>information policy issues on the status of health information exchange in Minnesota, and <br/>
<a id="pl.16.8"></a><var>16.8</var>provide recommendations on further action necessary to facilitate the secure electronic <br/>
<a id="pl.16.9"></a><var>16.9</var>movement of health information among health providers that will enable Minnesota <br/>
<a id="pl.16.10"></a><var>16.10</var>providers and hospitals to meet meaningful use exchange requirements.<br/>
<a id="pl.16.11"></a><var>16.11</var>    Subd. 5. <b> Fees and monetary penalties.</b>  (a) Every health information exchange <br/>
<a id="pl.16.12"></a><var>16.12</var>service provider subject to sections 62J.4981 and 62J.4982 shall be assessed fees as <br/>
<a id="pl.16.13"></a><var>16.13</var>follows:<br/>
<a id="pl.16.14"></a><var>16.14</var>(1) filing an application for certificate of authority to operate as a health information <br/>
<a id="pl.16.15"></a><var>16.15</var>organization, $10,500;<br/>
<a id="pl.16.16"></a><var>16.16</var>(2) filing an application for certificate of authority to operate as a health data <br/>
<a id="pl.16.17"></a><var>16.17</var>intermediary, $7,000;<br/>
<a id="pl.16.18"></a><var>16.18</var>(3) annual health information organization certificate fee, $14,000;<br/>
<a id="pl.16.19"></a><var>16.19</var>(4) annual health data intermediary certificate fee, $7,000; and<br/>
<a id="pl.16.20"></a><var>16.20</var>(5) fees for other filings, as specified by rule.<br/>
<a id="pl.16.21"></a><var>16.21</var>(b) Administrative monetary penalties imposed under this subdivision shall be <br/>
<a id="pl.16.22"></a><var>16.22</var>deposited into a revolving fund and are appropriated to the commissioner for the purposes <br/>
<a id="pl.16.23"></a><var>16.23</var>of sections 62J.498 to 62J.4982.<br/>
<br/>
<a id="bill.0.6.0"></a><a id="pl.16.24"></a><var>16.24</var>    Sec. 6. <b>APPLICATION PROCESS FOR HEALTH INFORMATION </b><br/>
<a id="pl.16.25"></a><var>16.25</var><b>EXCHANGE.</b><br/>
<a id="pl.16.26"></a><var>16.26</var>To the extent that the commissioner of health applies for additional federal funding <br/>
<a id="pl.16.27"></a><var>16.27</var>to support the commissioner's responsibilities of developing and maintaining state level <br/>
<a id="pl.16.28"></a><var>16.28</var>health information exchange under section 3013 of the HITECH Act, the commissioner of <br/>
<a id="pl.16.29"></a><var>16.29</var>health shall ensure that applications are made through an open process that provides health <br/>
<a id="pl.16.30"></a><var>16.30</var>information exchange service providers equal opportunity to receive funding.<br/>
<br/>
<a id="bill.0.7.0"></a><a id="pl.16.31"></a><var>16.31</var>    Sec. 7. <b>APPROPRIATION; HEALTH INFORMATION EXCHANGE </b><br/>
<a id="pl.16.32"></a><var>16.32</var><b>OVERSIGHT.</b><br/>
<a id="pl.16.33"></a><var>16.33</var>$104,000 in fiscal year 2011 is appropriated from the state government special <br/>
<a id="pl.16.34"></a><var>16.34</var>revenue fund to the commissioner of health for the duties required under sections 62J.498 <br/>
<a id="pl.17.1"></a><var>17.1</var>to 62J.4982. Base funding shall be $97,000 in fiscal year 2012 and $97,000 in fiscal <br/>
<a id="pl.17.2"></a><var>17.2</var>year 2013.<br/>