Florida Senate - 2010                       CS for CS for SB 958
       
       
       
       By the Committees on Judiciary; and Health Regulation; and
       Senator Ring
       
       
       
       590-04402-10                                           2010958c2
    1                        A bill to be entitled                      
    2         An act relating to electronic health information;
    3         amending s. 408.05, F.S.; requiring the State Consumer
    4         Health Information and Policy Advisory Council to
    5         develop the Agency for Health Care Administration’s
    6         strategic plan relating to electronic health records;
    7         amending s. 408.051, F.S.; defining the terms “agency”
    8         and “health information exchange participation
    9         agreement”; creating s. 408.0513, F.S.; requiring the
   10         agency to develop uniform elements of a Florida Health
   11         Information Exchange Participation Agreement for use
   12         by health care providers; requiring the agency to post
   13         the agreement on the agency’s Internet website;
   14         providing for immunity from civil liability for
   15         accessing or releasing certain health records;
   16         providing that health care providers are not required
   17         to incorporate the uniform elements of the agreement;
   18         creating s. 408.0514, F.S.; requiring the agency to
   19         coordinate with regional extension centers to
   20         implement the use of electronic health records;
   21         authorizing the agency to establish guidelines for
   22         center services and state Medicaid participation and
   23         use of such services; amending s. 408.061, F.S.;
   24         deleting a reference to an administrative rule
   25         relating to certain data reported by health care
   26         facilities; amending s. 408.0611, F.S.; revising
   27         provisions relating to a clearinghouse on information
   28         on electronic prescribing; requiring the State
   29         Consumer Health Information and Policy Advisory
   30         Council or a workgroup representing electronic
   31         prescribing and other health information technology
   32         stakeholders to participate in quarterly meetings on
   33         the implementation of electronic prescribing;
   34         requiring the agency to provide a report on the
   35         agency’s Internet website; amending s. 408.062, F.S.;
   36         requiring the agency to post certain information on
   37         health care expenditures on the agency’s Internet
   38         website; amending s. 408.063, F.S.; deleting the
   39         requirement that the agency annually publish a report
   40         on state health expenditures; providing an effective
   41         date.
   42  
   43         WHEREAS, the use of electronic health information
   44  technology has improved the quality of health care, and
   45         WHEREAS, coordinating federally funded training and
   46  outreach activities with a state-based health information
   47  technology program will advance the adoption and meaningful use
   48  of electronic health records, and
   49         WHEREAS, the Agency for Health Care Administration is
   50  responsible for developing a strategy for the implementation of
   51  an electronic health information network in this state, NOW,
   52  THEREFORE,
   53  
   54  Be It Enacted by the Legislature of the State of Florida:
   55  
   56         Section 1. Paragraph (h) of subsection (8) of section
   57  408.05, Florida Statutes, is amended to read:
   58         408.05 Florida Center for Health Information and Policy
   59  Analysis.—
   60         (8) STATE CONSUMER HEALTH INFORMATION AND POLICY ADVISORY
   61  COUNCIL.—
   62         (h) The council’s duties and responsibilities include, but
   63  are not limited to, the following:
   64         1. Developing To develop a mission statement, goals, and a
   65  plan of action for the identification, collection,
   66  standardization, sharing, and coordination of health-related
   67  data across federal, state, and local government and private
   68  sector entities.
   69         2. Developing the agency’s strategic plan for the adoption
   70  and use of electronic health records, as specified in s.
   71  408.062(5).
   72         3.2.Developing To develop a review process that ensures to
   73  ensure cooperative planning among agencies that collect or
   74  maintain health-related data.
   75         4.3.Establishing To create ad hoc, issue-oriented
   76  technical workgroups as needed on an as-needed basis to make
   77  recommendations to the council.
   78         Section 2. Subsection (2) of section 408.051, Florida
   79  Statutes, is reordered and amended to read:
   80         408.051 Florida Electronic Health Records Exchange Act.—
   81         (2) DEFINITIONS.—As used in this section and ss. 408.0512
   82  408.0514, the term:
   83         (a) “Agency” means the Agency for Health Care
   84  Administration.
   85         (c)(a) “Electronic health record” means a record of an
   86  individual’s a person’s medical treatment which is created by a
   87  licensed health care provider and stored in an interoperable and
   88  accessible digital format.
   89         (i)(b) “Qualified electronic health record” means an
   90  electronic record of health-related information concerning an
   91  individual which includes patient demographic and clinical
   92  health information, such as medical history and problem lists,
   93  and which has the capacity to provide clinical decision support,
   94  to support physician order entry, to capture and query
   95  information relevant to health care quality, and to exchange
   96  electronic health information with, and integrate such
   97  information from, other sources.
   98         (b)(c) “Certified electronic health record technology”
   99  means a qualified electronic health record that is certified
  100  pursuant to s. 3001(c)(5) of the Public Health Service Act as
  101  meeting standards adopted under s. 3004 of that such act which
  102  are applicable to the type of record involved, such as an
  103  ambulatory electronic health record for office-based physicians
  104  or an inpatient hospital electronic health record for hospitals.
  105         (d) “Health information exchange participation agreement”
  106  means a comprehensive, multiparty trust agreement that can be
  107  used by health care providers and other organizations, both
  108  public and private, that wish to participate in a health
  109  information exchange network. The agreement provides the legal
  110  framework that governs participation in the network by requiring
  111  the signatories to abide by a common set of terms and conditions
  112  to support the secure, interoperable exchange of health care
  113  data among authorized participants.
  114         (e)(d) “Health record” means any information, recorded in
  115  any form or medium, which relates to the past, present, or
  116  future health of an individual for the primary purpose of
  117  providing health care and health-related services.
  118         (f)(e) “Identifiable health record” means a any health
  119  record that identifies the patient or for with respect to which
  120  there is a reasonable basis to believe the information can be
  121  used to identify the patient.
  122         (g)(f) “Patient” means an individual who has sought, is
  123  seeking, is undergoing, or has undergone care or treatment in a
  124  health care facility or by a health care provider.
  125         (h)(g) “Patient representative” means a parent of a minor
  126  patient, a court-appointed guardian for the patient, a health
  127  care surrogate, or a person holding a power of attorney or
  128  notarized consent appropriately executed by the patient granting
  129  permission for to a health care facility or health care provider
  130  to disclose the patient’s health care information to that
  131  person. In the case of a deceased patient, the term also means
  132  the personal representative of the estate of the deceased
  133  patient; the deceased patient’s surviving spouse, surviving
  134  parent, or surviving adult child; the parent or guardian of a
  135  surviving minor child of the deceased patient; the attorney for
  136  the patient’s surviving spouse, parent, or adult child; or the
  137  attorney for the parent or guardian of a surviving minor child.
  138         Section 3. Section 408.0513, Florida Statutes, is created
  139  to read:
  140         408.0513 Florida Health Information Exchange Participation
  141  Agreement.—
  142         (1) By July 1, 2011, the agency shall identify and describe
  143  elements of a Florida Health Information Exchange Participation
  144  Agreement (or Florida HIE Participation Agreement) for use by
  145  health care providers and other organizations which specifies
  146  the terms and conditions for the exchange of health information.
  147         (2) The agency shall adopt by rule the elements for a
  148  Florida HIE Participation Agreement and make the uniform
  149  elements available on the agency’s Internet website, pursuant to
  150  s. 408.05. The elements of the agreement must include a
  151  requirement to use the universal patient authorization form, as
  152  provided in s. 408.051(4), when such form is adopted by rule.
  153         (3) A health care provider that participates in the
  154  exchange of health information in reliance on a Florida HIE
  155  Participation Agreement containing all of the uniform elements
  156  does not violate any right of confidentiality and is immune from
  157  civil liability for accessing or releasing an identifiable
  158  health record under the agreement.
  159         (4) A health care provider is not required under this
  160  section to incorporate one or more of the uniform elements
  161  adopted and distributed by the agency in an agreement to
  162  participate in the exchange of health information.
  163         Section 4. Section 408.0514, Florida Statutes, is created
  164  to read:
  165         408.0514 Regional extension centers.—
  166         (1) The agency shall coordinate with federally funded
  167  regional extension centers operating in this state to increase
  168  provider readiness in implementing the use of electronic health
  169  records in order to enable provider participation in health
  170  information exchange and electronic prescribing, including, but
  171  not limited to, readiness to prepare, use, and report
  172  performance measures required to qualify for federal and state
  173  electronic health record adoption incentive programs.
  174         (2) The agency may establish guidelines for services
  175  provided to Medicaid providers by regional extension centers and
  176  conditions for state Medicaid participation and use of such
  177  services.
  178         Section 5. Paragraph (a) of subsection (1) of section
  179  408.061, Florida Statutes, is amended to read:
  180         408.061 Data collection; uniform systems of financial
  181  reporting; information relating to physician charges;
  182  confidential information; immunity.—
  183         (1) The agency shall require the submission by health care
  184  facilities, health care providers, and health insurers of data
  185  necessary to carry out the agency’s duties. Specifications for
  186  data to be collected under this section shall be developed by
  187  the agency with the assistance of technical advisory panels
  188  including representatives of affected entities, consumers,
  189  purchasers, and such other interested parties as may be
  190  determined by the agency.
  191         (a) Data submitted by health care facilities, including the
  192  facilities as defined in chapter 395, must shall include, but is
  193  are not limited to: case-mix data;, patient admission and
  194  discharge data;, hospital emergency department data, which
  195  includes shall include the number of patients treated in the
  196  hospital’s emergency department and of a licensed hospital
  197  reported by patient acuity level;, data on hospital-acquired
  198  infections as specified by rule;, data on complications as
  199  specified by rule;, data on readmissions as specified by rule,
  200  which includes with patient and provider-specific identifiers;
  201  included, actual charge data by diagnostic groups;, financial
  202  data;, accounting data;, operating expenses;, expenses incurred
  203  for rendering services to patients who cannot or do not pay;,
  204  interest charges;, depreciation expenses based on the expected
  205  useful life of the property and equipment involved;, and
  206  demographic data. The agency shall adopt nationally recognized
  207  risk adjustment methodologies or software consistent with the
  208  standards of the Agency for Healthcare Research and Quality and
  209  as selected by the agency for all data submitted under as
  210  required by this section. Data may be obtained from documents
  211  such as, but not limited to: leases, contracts, debt
  212  instruments, itemized patient bills, medical record abstracts,
  213  and related diagnostic information. Reported data elements shall
  214  be reported electronically, and in accordance with rule 59E
  215  7.012, Florida Administrative Code. Data submitted shall be
  216  certified by the chief executive officer or an appropriate and
  217  duly authorized representative or employee of the licensed
  218  facility must certify that the information submitted is true and
  219  accurate.
  220         Section 6. Subsections (3) and (4) of section 408.0611,
  221  Florida Statutes, are amended to read:
  222         408.0611 Electronic prescribing clearinghouse.—
  223         (3) The agency shall work in collaboration with private
  224  sector electronic prescribing initiatives and relevant
  225  stakeholders to create a clearinghouse of information on
  226  electronic prescribing for health care practitioners, health
  227  care facilities, regional health information organizations,
  228  health care consumers, and pharmacies, and regional extension
  229  centers that promote adoption of electronic health records.
  230  These stakeholders shall include organizations that represent
  231  health care practitioners, organizations that represent health
  232  care facilities, organizations that represent pharmacies,
  233  organizations that operate electronic prescribing networks,
  234  organizations that create electronic prescribing products, and
  235  regional health information organizations. Specifically, the
  236  agency shall, by October 1, 2007:
  237         (a) Provide on its website:
  238         1. Information regarding the process of electronic
  239  prescribing and the availability of electronic prescribing
  240  products, including no-cost or low-cost products;
  241         2. Information regarding the advantages of electronic
  242  prescribing, including using medication history data to prevent
  243  drug interactions, prevent allergic reactions, and deter doctor
  244  and pharmacy shopping for controlled substances;
  245         3. Links to federal and private sector websites that
  246  provide guidance on selecting an appropriate electronic
  247  prescribing product; and
  248         4. Links to state, federal, and private sector incentive
  249  programs for the implementation of electronic prescribing.
  250         (b) Convene quarterly meetings of the State Consumer Health
  251  Information and Policy Advisory Council or a workgroup
  252  representing electronic prescribing and other health information
  253  technology stakeholders to assess and accelerate the
  254  implementation of electronic prescribing.
  255         (4) Pursuant to s. 408.061, the agency shall monitor the
  256  implementation of electronic prescribing by health care
  257  practitioners, health care facilities, and pharmacies. By
  258  January 31 of each year, the agency shall report metrics on the
  259  progress of implementation of electronic prescribing on the
  260  agency’s Internet website to the Governor and the Legislature.
  261  The information reported must pursuant to this subsection shall
  262  include federal and private sector electronic prescribing
  263  initiatives and, to the extent that data is readily available
  264  from organizations that operate electronic prescribing networks,
  265  the number of health care practitioners using electronic
  266  prescribing and the number of prescriptions electronically
  267  transmitted.
  268         Section 7. Paragraph (e) of subsection (1) of section
  269  408.062, Florida Statutes, is amended to read:
  270         408.062 Research, analyses, studies, and reports.—
  271         (1) The agency shall conduct research, analyses, and
  272  studies relating to health care costs and access to and quality
  273  of health care services as access and quality are affected by
  274  changes in health care costs. Such research, analyses, and
  275  studies shall include, but not be limited to:
  276         (e) Total health care expenditures in the state according
  277  to the sources of payment and the type of expenditure shall be
  278  published on the agency’s Internet website.
  279         Section 8. Subsections (5) and (6) of section 408.063,
  280  Florida Statutes, are amended to read:
  281         408.063 Dissemination of health care information.—
  282         (5) The agency shall publish annually a comprehensive
  283  report of state health expenditures. The report shall identify:
  284         (a) The contribution of health care dollars made by all
  285  payors.
  286         (b) The dollars expended by type of health care service in
  287  Florida.
  288         (5)(6)The staff of the Agency staff may conduct or sponsor
  289  consumer information and education seminars at locations
  290  throughout the state and may hold public hearings to solicit
  291  consumer concerns or complaints relating to health care costs
  292  and make recommendations to the agency for study, action, or
  293  investigation.
  294         Section 9. This act shall take effect July 1, 2010.