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HF 59

as introduced - 92nd Legislature (2021 - 2022) Posted on 02/25/2021 04:18pm

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to health; modifying provisions governing submission of data to and use
of data in the all-payer claims database; requiring recommendations from the
commissioner of health regarding use of data by outside entities; amending
Minnesota Statutes 2020, section 62U.04, subdivisions 4, 5, 11.

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

Section 1.

Minnesota Statutes 2020, section 62U.04, subdivision 4, is amended to read:


Subd. 4.

Encounter data.

(a) deleted text beginBeginning July 1, 2009, and every six months thereafter,deleted text end
All health plan companies and third-party administrators shall submit encounter datanew text begin on a
monthly basis
new text end 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, for claims incurred on or after
January 1, 2019, data deemed necessary by the commissioner to uniquely identify claims
in the individual health insurance market; 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 the commissioner's 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. new text beginNotwithstanding the data classifications in this
paragraph, data on providers collected under this subdivision may be released or published
as authorized in subdivision 11.
new text endNotwithstanding 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.

(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.

Sec. 2.

Minnesota Statutes 2020, section 62U.04, subdivision 5, is amended to read:


Subd. 5.

Pricing data.

(a) Beginning July 1, 2009, and annually on January 1 thereafter,
all health plan companies and third-party administrators shall submit data on their contracted
prices with health care providers to a private entity designated by the commissioner of health
for the purposes of performing the analyses required under this subdivision. The data shall
be submitted in the form and manner specified by the commissioner of health.

(b) The commissioner or the commissioner's designee shall only use the data submitted
under this subdivision to carry out the commissioner's responsibilities under 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 collected under this subdivision are nonpublic data as defined in section 13.02.
new text begin Notwithstanding the data classification in this paragraph, data collected under this subdivision
may be released or published as authorized in subdivision 11.
new text endNotwithstanding the definition
of summary data in section 13.02, subdivision 19, summary data prepared under this section
may be derived from nonpublic data. The commissioner shall establish procedures and
safeguards to protect the integrity and confidentiality of any data that it maintains.

Sec. 3.

Minnesota Statutes 2020, section 62U.04, subdivision 11, is amended to read:


Subd. 11.

Restricted uses of the all-payer claims data.

(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:

(1) to evaluate the performance of the health care home program as authorized under
section 62U.03, subdivision 7;

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

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

(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; and

(5) to compile one or more public use files of summary data or tables that must:

(i) be available to the public for no or minimal cost by March 1, 2016, and available by
web-based electronic data download by June 30, 2019;

(ii) not identify individual patientsdeleted text begin,deleted text endnew text begin but that may identify individualnew text end payersdeleted text begin, ordeleted text endnew text begin and
individual
new text end providers;

(iii) be updated by the commissioner, at least annually, with the most current data
available;

(iv) contain clear and conspicuous explanations of the characteristics of the data, such
as the dates of the data contained in the files, the absence of costs of care for uninsured
patients or nonresidents, and other disclaimers that provide appropriate context; and

(v) not lead to the collection of additional data elements beyond what is authorized under
this section as of June 30, 2015.

(b) The commissioner may publish the results of the authorized uses identified in
paragraph (a) deleted text beginso 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
deleted text end.new text begin
The data published under this paragraph may identify individual hospitals, clinics, or other
providers.
new text end

(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.

(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,
2023.

(e) The commissioner shall consult with the all-payer claims database work group
established under subdivision 12 regarding the technical considerations necessary to create
the public use files of summary data described in paragraph (a), clause (5).

Sec. 4. new text beginRECOMMENDATIONS; EXPANDED ACCESS TO DATA FROM
ALL-PAYER CLAIMS DATABASE.
new text end

new text begin The commissioner of health shall develop recommendations to expand access to data
in the all-payer claims database under Minnesota Statutes, section 62U.04, to additional
outside entities for public health or research purposes. In the recommendations, the
commissioner must address an application process for outside entities to access the data,
how the department will exercise ongoing oversight over data use by outside entities,
purposes for which the data may be used by outside entities, establishment of a data access
committee to advise the department on selecting outside entities that may access the data,
and steps outside entities must take to protect data held by those entities from unauthorized
use. The commissioner shall submit these recommendations by December 15, 2021, to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health policy and civil law.
new text end