HF 2656

1st Engrossment - 88th Legislature (2013 - 2014) Posted on 04/09/2014 01:13pm

A bill for an act
relating to health; modifying the use of the all-payer claims data; convening a
work group to make recommendations on expanded uses of the all-payer claims
database; amending Minnesota Statutes 2012, section 62U.04, subdivision 4,
by adding subdivisions.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2012, section 62U.04, subdivision 4, is amended to read:

Subd. 4.

Encounter data.

(a) Beginning July 1, 2009, and every six months
thereafter, all health plan companies and third-party administrators shall submit encounter
data to a private entity designated by the commissioner of health. The data shall be
submitted in a form and manner specified by the commissioner subject to the following
requirements:

(1) the data must be de-identified data as described under the Code of Federal
Regulations, title 45, section 164.514;

(2) the data for each encounter must include an identifier for the patient's health care
home if the patient has selected a health care home; and

(3) except for the identifier described in clause (2), the data must not include
information that is not included in a health care claim or equivalent encounter information
transaction that is required under section 62J.536.

(b) The commissioner or the commissioner's designee shall only use the data
submitted under paragraph (a) to carry out its responsibilities in this section, including
supplying the data to providers so they can verify their results of the peer grouping process
consistent with the recommendations developed pursuant to subdivision 3c, paragraph (d),
and adopted by the commissioner and, if necessary, submit comments to the commissioner
or initiate an appeal.

(c) Data on providers collected under this subdivision are private data on individuals
or nonpublic data, as defined in section 13.02. Notwithstanding the definition of summary
data in section 13.02, subdivision 19, summary data prepared under this subdivision
may be derived from nonpublic data. The commissioner or the commissioner's designee
shall establish procedures and safeguards to protect the integrity and confidentiality of
any data that it maintains.

(d) The commissioner or the commissioner's designee shall not publish analyses or
reports that identify, or could potentially identify, individual patients.

new text begin (e) The commissioner shall compile summary information on the data submitted
under this subdivision. The commissioner shall work with its vendors to assess the
data submitted in terms of compliance with the data submission requirements and the
completeness of the data submitted by comparing the data with summary information
compiled by the commissioner and with established and emerging data quality standards
to ensure data quality.
new text end

Sec. 2.

Minnesota Statutes 2012, section 62U.04, is amended by adding a subdivision
to read:

new text begin Subd. 10. new text end

new text begin Suspension. new text end

new text begin Notwithstanding subdivisions 3, 3a, 3b, 3c, and 3d, the
commissioner shall suspend the development and implementation of the provider peer
grouping system required under this section. This suspension shall continue until the
legislature authorizes the commissioner to resume this activity.
new text end

Sec. 3.

Minnesota Statutes 2012, section 62U.04, is amended by adding a subdivision
to read:

new text begin Subd. 11. new text end

new text begin Restricted uses of the all-payer claims data. new text end

new text begin (a) Notwithstanding
subdivision 4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the
commissioner's designee shall only use the data submitted under subdivisions 4 and 5 for
the following purposes:
new text end

new text begin (1) to evaluate the performance of the health care home program as authorized under
sections 256B.0751, subdivision 6, and 256B.0752, subdivision 2;
new text end

new text begin (2) to study, in collaboration with the reducing avoidable readmissions effectively
(RARE) campaign, hospital readmission trends and rates;
new text end

new text begin (3) to analyze variations in health care costs, quality, utilization, and illness burden
based on geographical areas or populations; and
new text end

new text begin (4) to evaluate the state innovation model (SIM) testing grant received by the
Departments of Health and Human Services, including the analysis of health care cost,
quality, and utilization baseline and trend information for targeted populations and
communities.
new text end

new text begin (b) The commissioner may publish the results of the authorized uses identified
in paragraph (a) so long as the data released publicly do not contain information or
descriptions in which the identity of individual hospitals, clinics, or other providers may
be discerned.
new text end

new text begin (c) Nothing in this subdivision shall be construed to prohibit the commissioner from
using the data collected under subdivision 4 to complete the state-based risk adjustment
system assessment due to the legislature on October 1, 2015.
new text end

new text begin (d) The commissioner or the commissioner's designee may use the data submitted
under subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until
July 1, 2016.
new text end

Sec. 4.

Minnesota Statutes 2012, section 62U.04, is amended by adding a subdivision
to read:

new text begin Subd. 12. new text end

new text begin All-payer claims database work group. new text end

new text begin (a) The commissioner of
health shall convene a work group to develop a framework for the expanded use of the
all-payer claims database established under this section. The work group shall develop
recommendations based on the following questions and other topics as identified by the
work group:
new text end

new text begin (1) what should the parameters be for allowable uses of the all-payer claims data
collected under Minnesota Statutes, section 62U.04, beyond the uses authorized in
Minnesota Statutes, section 62U.04, subdivision 11;
new text end

new text begin (2) what type of advisory or governing body should guide the release of data from
the all-payer claims database;
new text end

new text begin (3) what type of funding or fee structure would be needed to support the expanded
use of all-payer claims data;
new text end

new text begin (4) what should the mechanisms be by which the data would be released or accessed,
including the necessary information technology infrastructure to support the expanded use
of the data under different assumptions related to the number of potential requests and
manner of access;
new text end

new text begin (5) what are the appropriate privacy and security protections needed for the
expanded use of the all-payer claims database; and
new text end

new text begin (6) what additional resources might be needed to support the expanded use of the
all-payer claims database, including expected resources related to information technology
infrastructure, review of proposals, maintenance of data use agreements, staffing an
advisory body, or other new efforts.
new text end

new text begin (b) The commissioner of health shall appoint the members to the work group
as follows:
new text end

new text begin (1) two members recommended by the Minnesota Medical Association;
new text end

new text begin (2) two members recommended by the Minnesota Hospital Association;
new text end

new text begin (3) two members recommended by the Minnesota Council of Health Plans;
new text end

new text begin (4) one member who is a data practices expert from the Department of Administration;
new text end

new text begin (5) three members who are academic researchers with expertise in claims database
analysis;
new text end

new text begin (6) two members representing two state agencies determined by the commissioner;
new text end

new text begin (7) one member representing the Minnesota Health Care Safety Net Coalition; and
new text end

new text begin (8) three members representing consumers.
new text end

new text begin (c) The commissioner of health shall submit a report on the recommendations of
the work group to the chairs and ranking minority members of the legislative committees
and divisions with jurisdiction over health and human services, judiciary, and civil law
by February 1, 2015. In considering the recommendations provided in the report, the
legislature may consider whether the currently authorized uses of the all-payer claims data
under this section should continue to be authorized.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end