| 1 | The Health & Families Council recommends the following: |
| 2 |
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| 3 | Council/Committee Substitute |
| 4 | Remove the entire bill and insert: |
| 5 | A bill to be entitled |
| 6 | An act relating to health care information; providing a |
| 7 | short title; providing purpose; amending s. 408.05, F.S.; |
| 8 | renaming the State Center for Health Statistics; revising |
| 9 | criteria for collection and use of certain health-related |
| 10 | data; providing responsibilities of the Agency for Health |
| 11 | Care Administration; providing for agency consultation |
| 12 | with the State Consumer Health Information and Policy |
| 13 | Advisory Council for the dissemination of certain consumer |
| 14 | information; requiring the Florida Center for Health |
| 15 | Information and Policy Analysis to provide certain |
| 16 | technical assistance services; authorizing the agency to |
| 17 | monitor certain grants; removing a provision that |
| 18 | establishes the Comprehensive Health Information System |
| 19 | Trust Fund as the repository of certain funds; renaming |
| 20 | the State Comprehensive Health Information System Advisory |
| 21 | Council; providing for duties and responsibilities of the |
| 22 | State Consumer Health Information and Policy Advisory |
| 23 | Council; providing for membership, terms, officers, and |
| 24 | meetings; amending s. 408.061, F.S.; providing for health |
| 25 | care providers to submit additional data to the agency; |
| 26 | correcting a reference; amending s. 408.062, F.S.; |
| 27 | revising provisions relating to availability of specified |
| 28 | information on the agency's Internet website; requiring a |
| 29 | report; removing an obsolete provision; authorizing the |
| 30 | agency to develop an electronic health information |
| 31 | network; amending ss. 20.42, 381.001, 395.602, 395.6025, |
| 32 | 408.07, and 408.18, F.S.; conforming references to changes |
| 33 | made by the act; amending ss. 381.026, 395.301, 627.6499, |
| 34 | and 641.54, F.S.; conforming a cross-reference; amending |
| 35 | s. 465.0244, F.S.; conforming a cross-reference; |
| 36 | prohibiting pharmacies from entering into contracts with |
| 37 | insurers and health maintenance organizations under |
| 38 | certain circumstances; providing communication criteria |
| 39 | for insurers and health maintenance organizations; |
| 40 | providing an effective date. |
| 41 |
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| 42 | Be It Enacted by the Legislature of the State of Florida: |
| 43 |
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| 44 | Section 1. This act may be cited as the "Coordinated |
| 45 | Health Care Information and Transparency Act of 2006." |
| 46 | Section 2. The purpose of this act is to provide better |
| 47 | coordination of health information for purposes of public |
| 48 | health, policy analysis, and transparency of consumer health |
| 49 | care information. |
| 50 | Section 3. Section 408.05, Florida Statutes, is amended to |
| 51 | read: |
| 52 | 408.05 Florida State Center for Health Information and |
| 53 | Policy Analysis Statistics.-- |
| 54 | (1) ESTABLISHMENT.--The agency shall establish a Florida |
| 55 | State Center for Health Information and Policy Analysis |
| 56 | Statistics. The center shall establish a comprehensive health |
| 57 | information system to provide for the collection, compilation, |
| 58 | coordination, analysis, indexing, dissemination, and utilization |
| 59 | of both purposefully collected and extant health-related data |
| 60 | and statistics. The center shall be staffed with public health |
| 61 | experts, biostatisticians, information system analysts, health |
| 62 | policy experts, economists, and other staff necessary to carry |
| 63 | out its functions. |
| 64 | (2) HEALTH-RELATED DATA STATISTICS.--The comprehensive |
| 65 | health information system operated by the Florida State Center |
| 66 | for Health Information and Policy Analysis Statistics shall |
| 67 | identify the best available data sources and coordinate the |
| 68 | compilation of extant health-related data and statistics and |
| 69 | purposefully collect data on: |
| 70 | (a) The extent and nature of illness and disability of the |
| 71 | state population, including life expectancy, the incidence of |
| 72 | various acute and chronic illnesses, and infant and maternal |
| 73 | morbidity and mortality. |
| 74 | (b) The impact of illness and disability of the state |
| 75 | population on the state economy and on other aspects of the |
| 76 | well-being of the people in this state. |
| 77 | (c) Environmental, social, and other health hazards. |
| 78 | (d) Health knowledge and practices of the people in this |
| 79 | state and determinants of health and nutritional practices and |
| 80 | status. |
| 81 | (e) Health resources, including physicians, dentists, |
| 82 | nurses, and other health professionals, by specialty and type of |
| 83 | practice and acute, long-term care and other institutional care |
| 84 | facility supplies and specific services provided by hospitals, |
| 85 | nursing homes, home health agencies, and other health care |
| 86 | facilities. |
| 87 | (f) Utilization of health care by type of provider. |
| 88 | (g) Health care costs and financing, including trends in |
| 89 | health care prices and costs, the sources of payment for health |
| 90 | care services, and federal, state, and local expenditures for |
| 91 | health care. |
| 92 | (h) Family formation, growth, and dissolution. |
| 93 | (i) The extent of public and private health insurance |
| 94 | coverage in this state. |
| 95 | (j) The quality of care provided by various health care |
| 96 | providers. |
| 97 | (3) COMPREHENSIVE HEALTH INFORMATION SYSTEM.--In order to |
| 98 | produce comparable and uniform health information and statistics |
| 99 | for the development of policy recommendations, the agency shall |
| 100 | perform the following functions: |
| 101 | (a) Coordinate the activities of state agencies involved |
| 102 | in the design and implementation of the comprehensive health |
| 103 | information system. |
| 104 | (b) Undertake research, development, and evaluation |
| 105 | respecting the comprehensive health information system. |
| 106 | (c) Review the statistical activities of state agencies to |
| 107 | ensure the Department of Health to assure that they are |
| 108 | consistent with the comprehensive health information system. |
| 109 | (d) Develop written agreements with local, state, and |
| 110 | federal agencies for the sharing of health-care-related data or |
| 111 | using the facilities and services of such agencies. State |
| 112 | agencies, local health councils, and other agencies under state |
| 113 | contract with the Department of Health shall assist the center |
| 114 | in obtaining, compiling, and transferring health-care-related |
| 115 | data maintained by state and local agencies. Written agreements |
| 116 | must specify the types, methods, and periodicity of data |
| 117 | exchanges and specify the types of data that will be transferred |
| 118 | to the center. |
| 119 | (e) The agency shall Establish by rule the types of data |
| 120 | collected, compiled, processed, used, or shared. Decisions |
| 121 | regarding center data sets should be made based on consultation |
| 122 | with the State Consumer Comprehensive Health Information and |
| 123 | Policy System Advisory Council and other public and private |
| 124 | users regarding the types of data which should be collected and |
| 125 | their uses. |
| 126 | (f) The center shall establish standardized means for |
| 127 | collecting health information and statistics under laws and |
| 128 | rules administered by the agency. |
| 129 | (f)(g) Establish minimum health-care-related data sets |
| 130 | which are necessary on a continuing basis to fulfill the |
| 131 | collection requirements of the center and which shall be used by |
| 132 | state agencies in collecting and compiling health-care-related |
| 133 | data. The agency shall periodically review ongoing health care |
| 134 | data collections of the Department of Health and other state |
| 135 | agencies to determine if the collections are being conducted in |
| 136 | accordance with the established minimum sets of data. |
| 137 | (g)(h) Establish advisory standards to ensure assure the |
| 138 | quality of health statistical and epidemiological data |
| 139 | collection, processing, and analysis by local, state, and |
| 140 | private organizations. |
| 141 | (h)(i) Prescribe standards for the publication of health- |
| 142 | care-related data reported pursuant to this section which ensure |
| 143 | the reporting of accurate, valid, reliable, complete, and |
| 144 | comparable data. Such standards should include advisory warnings |
| 145 | to users of the data regarding the status and quality of any |
| 146 | data reported by or available from the center. |
| 147 | (i)(j) Prescribe standards for the maintenance and |
| 148 | preservation of the center's data. This should include methods |
| 149 | for archiving data, retrieval of archived data, and data editing |
| 150 | and verification. |
| 151 | (j)(k) Ensure that strict quality control measures are |
| 152 | maintained for the dissemination of data through publications, |
| 153 | studies, or user requests. |
| 154 | (k)(l) Develop, in conjunction with the State Consumer |
| 155 | Comprehensive Health Information and Policy System Advisory |
| 156 | Council, and implement a long-range plan for making available |
| 157 | health care quality measures performance outcome and financial |
| 158 | data that will allow consumers to compare health care services. |
| 159 | The health care quality measures performance outcomes and |
| 160 | financial data the agency must make available shall include, but |
| 161 | is not limited to, pharmaceuticals, physicians, health care |
| 162 | facilities, and health plans and managed care entities. The |
| 163 | agency shall submit the initial plan to the Governor, the |
| 164 | President of the Senate, and the Speaker of the House of |
| 165 | Representatives by January 1, 2006, and shall update the plan |
| 166 | and report on the status of its implementation annually |
| 167 | thereafter. The agency shall also make the plan and status |
| 168 | report available to the public on its Internet website. As part |
| 169 | of the plan, the agency shall identify the process and |
| 170 | timeframes for implementation, any barriers to implementation, |
| 171 | and recommendations of changes in the law that may be enacted by |
| 172 | the Legislature to eliminate the barriers. As preliminary |
| 173 | elements of the plan, the agency shall: |
| 174 | 1. Make available patient-safety indicators, inpatient |
| 175 | quality indicators, and performance outcome and patient charge |
| 176 | data collected from health care facilities pursuant to s. |
| 177 | 408.061(1)(a) and (2). The terms "patient-safety indicators" and |
| 178 | "inpatient quality indicators" shall be as defined by the |
| 179 | Centers for Medicare and Medicaid Services, the National Quality |
| 180 | Forum, the Joint Commission on Accreditation of Healthcare |
| 181 | Organizations, the Agency for Healthcare Research and Quality, |
| 182 | the Centers for Disease Control and Prevention, or a similar |
| 183 | national entity that establishes standards to measure the |
| 184 | performance of health care providers, or by other states. The |
| 185 | agency shall determine which conditions, and procedures, health |
| 186 | care quality measures performance outcomes, and patient charge |
| 187 | data to disclose based upon input from the council. When |
| 188 | determining which conditions and procedures are to be disclosed, |
| 189 | the council and the agency shall consider variation in costs, |
| 190 | variation in outcomes, and magnitude of variations and other |
| 191 | relevant information. When determining which health care quality |
| 192 | measures performance outcomes to disclose, the agency: |
| 193 | a. Shall consider such factors as volume of cases; average |
| 194 | patient charges; average length of stay; complication rates; |
| 195 | mortality rates; and infection rates, among others, which shall |
| 196 | be adjusted for case mix and severity, if applicable. |
| 197 | b. May consider such additional measures that are adopted |
| 198 | by the Centers for Medicare and Medicaid Studies, National |
| 199 | Quality Forum, the Joint Commission on Accreditation of |
| 200 | Healthcare Organizations, the Agency for Healthcare Research and |
| 201 | Quality, Centers for Disease Control and Prevention, or a |
| 202 | similar national entity that establishes standards to measure |
| 203 | the performance of health care providers, or by other states. |
| 204 |
|
| 205 | When determining which patient charge data to disclose, the |
| 206 | agency shall consider such measures as average charge, average |
| 207 | net revenue per adjusted patient day, average cost per adjusted |
| 208 | patient day, and average cost per admission, among others. |
| 209 | 2. Make available performance measures, benefit design, |
| 210 | and premium cost data from health plans licensed pursuant to |
| 211 | chapter 627 or chapter 641. The agency shall determine which |
| 212 | health care quality measures performance outcome and member and |
| 213 | subscriber cost data to disclose, based upon input from the |
| 214 | council. When determining which data to disclose, the agency |
| 215 | shall consider information that may be required by either |
| 216 | individual or group purchasers to assess the value of the |
| 217 | product, which may include membership satisfaction, quality of |
| 218 | care, current enrollment or membership, coverage areas, |
| 219 | accreditation status, premium costs, plan costs, premium |
| 220 | increases, range of benefits, copayments and deductibles, |
| 221 | accuracy and speed of claims payment, credentials of physicians, |
| 222 | number of providers, names of network providers, and hospitals |
| 223 | in the network. Health plans shall make available to the agency |
| 224 | any such data or information that is not currently reported to |
| 225 | the agency or the office. |
| 226 | 3. Determine the method and format for public disclosure |
| 227 | of data reported pursuant to this paragraph. The agency shall |
| 228 | make its determination based upon input from the State Consumer |
| 229 | Comprehensive Health Information and Policy System Advisory |
| 230 | Council. At a minimum, the data shall be made available on the |
| 231 | agency's Internet website in a manner that allows consumers to |
| 232 | conduct an interactive search that allows them to view and |
| 233 | compare the information for specific providers. The website must |
| 234 | include such additional information as is determined necessary |
| 235 | to ensure that the website enhances informed decisionmaking |
| 236 | among consumers and health care purchasers, which shall include, |
| 237 | at a minimum, appropriate guidance on how to use the data and an |
| 238 | explanation of why the data may vary from provider to provider. |
| 239 | The data specified in subparagraph 1. shall be released no later |
| 240 | than January 1, 2006, for the reporting of infection rates, and |
| 241 | no later than October 1, 2005, for mortality rates and |
| 242 | complication rates. The data specified in subparagraph 2. shall |
| 243 | be released no later than October 1, 2006. |
| 244 | (4) TECHNICAL ASSISTANCE.-- |
| 245 | (a) The center shall provide technical assistance to |
| 246 | persons or organizations engaged in health planning activities |
| 247 | in the effective use of statistics collected and compiled by the |
| 248 | center. The center shall also provide the following additional |
| 249 | technical assistance services: |
| 250 | 1.(a) Establish procedures identifying the circumstances |
| 251 | under which, the places at which, the persons from whom, and the |
| 252 | methods by which a person may secure data from the center, |
| 253 | including procedures governing requests, the ordering of |
| 254 | requests, timeframes for handling requests, and other procedures |
| 255 | necessary to facilitate the use of the center's data. To the |
| 256 | extent possible, the center should provide current data timely |
| 257 | in response to requests from public or private agencies. |
| 258 | 2.(b) Provide assistance to data sources and users in the |
| 259 | areas of database design, survey design, sampling procedures, |
| 260 | statistical interpretation, and data access to promote improved |
| 261 | health-care-related data sets. |
| 262 | 3.(c) Identify health care data gaps and provide technical |
| 263 | assistance to seek cooperative agreements with other public or |
| 264 | private organizations for meeting documented health care data |
| 265 | needs. |
| 266 | 4.(d) Assist other organizations in developing statistical |
| 267 | abstracts of their data sets that could be used by the center. |
| 268 | 5.(e) Provide statistical support to state agencies with |
| 269 | regard to the use of databases maintained by the center. |
| 270 | 6.(f) To the extent possible, respond to multiple requests |
| 271 | for information not currently collected by the center or |
| 272 | available from other sources by initiating data collection. |
| 273 | 7.(g) Maintain detailed information on data maintained by |
| 274 | other local, state, federal, and private agencies in order to |
| 275 | advise those who use the center of potential sources of data |
| 276 | which are requested but which are not available from the center. |
| 277 | 8.(h) Respond to requests for data which are not available |
| 278 | in published form by initiating special computer runs on data |
| 279 | sets available to the center. |
| 280 | 9. Monitor innovations in health information technology, |
| 281 | informatics, and the exchange of health information and maintain |
| 282 | a repository of technical resources to support the development |
| 283 | of a health information network. |
| 284 | (b) The agency shall administer, manage, and monitor |
| 285 | grants to not-for-profit organizations, regional health |
| 286 | information organizations, public health departments, or state |
| 287 | agencies that submit proposals for planning, implementation, or |
| 288 | training projects to advance the development of a health |
| 289 | information network. Any grant contract shall be evaluated to |
| 290 | ensure the effective outcome of the health information project. |
| 291 | (c) The agency shall initiate, oversee, manage, and |
| 292 | evaluate the integration of health care data from each state |
| 293 | agency that collects, stores, and reports on health care issues |
| 294 | and make that data available to any health care practitioner |
| 295 | through a state health information network. |
| 296 | (5) PUBLICATIONS; REPORTS; SPECIAL STUDIES.--The center |
| 297 | shall provide for the widespread dissemination of data which it |
| 298 | collects and analyzes. The center shall have the following |
| 299 | publication, reporting, and special study functions: |
| 300 | (a) The center shall publish and make available |
| 301 | periodically to agencies and individuals health statistics |
| 302 | publications of general interest, including health plan consumer |
| 303 | reports and health maintenance organization member satisfaction |
| 304 | surveys HMO report cards; publications providing health |
| 305 | statistics on topical health policy issues; publications that |
| 306 | provide health status profiles of the people in this state; and |
| 307 | other topical health statistics publications. |
| 308 | (b) The center shall publish, make available, and |
| 309 | disseminate, promptly and as widely as practicable, the results |
| 310 | of special health surveys, health care research, and health care |
| 311 | evaluations conducted or supported under this section. Any |
| 312 | publication by the center must include a statement of the |
| 313 | limitations on the quality, accuracy, and completeness of the |
| 314 | data. |
| 315 | (c) The center shall provide indexing, abstracting, |
| 316 | translation, publication, and other services leading to a more |
| 317 | effective and timely dissemination of health care statistics. |
| 318 | (d) The center shall be responsible for publishing and |
| 319 | disseminating an annual report on the center's activities. |
| 320 | (e) The center shall be responsible, to the extent |
| 321 | resources are available, for conducting a variety of special |
| 322 | studies and surveys to expand the health care information and |
| 323 | statistics available for health policy analyses, particularly |
| 324 | for the review of public policy issues. The center shall develop |
| 325 | a process by which users of the center's data are periodically |
| 326 | surveyed regarding critical data needs and the results of the |
| 327 | survey considered in determining which special surveys or |
| 328 | studies will be conducted. The center shall select problems in |
| 329 | health care for research, policy analyses, or special data |
| 330 | collections on the basis of their local, regional, or state |
| 331 | importance; the unique potential for definitive research on the |
| 332 | problem; and opportunities for application of the study |
| 333 | findings. |
| 334 | (6) PROVIDER DATA REPORTING.--This section does not confer |
| 335 | on the agency the power to demand or require that a health care |
| 336 | provider or professional furnish information, records of |
| 337 | interviews, written reports, statements, notes, memoranda, or |
| 338 | data other than as expressly required by law. |
| 339 | (7) BUDGET; FEES; TRUST FUND.-- |
| 340 | (a) The Legislature intends that funding for the Florida |
| 341 | State Center for Health Information and Policy Analysis |
| 342 | Statistics be appropriated from the General Revenue Fund. |
| 343 | (b) The Florida State Center for Health Information and |
| 344 | Policy Analysis Statistics may apply for and receive and accept |
| 345 | grants, gifts, and other payments, including property and |
| 346 | services, from any governmental or other public or private |
| 347 | entity or person and make arrangements as to the use of same, |
| 348 | including the undertaking of special studies and other projects |
| 349 | relating to health-care-related topics. Funds obtained pursuant |
| 350 | to this paragraph may not be used to offset annual |
| 351 | appropriations from the General Revenue Fund. |
| 352 | (c) The center may charge such reasonable fees for |
| 353 | services as the agency prescribes by rule. The established fees |
| 354 | may not exceed the reasonable cost for such services. Fees |
| 355 | collected may not be used to offset annual appropriations from |
| 356 | the General Revenue Fund. |
| 357 | (d) The agency shall establish a Comprehensive Health |
| 358 | Information System Trust Fund as the repository of all funds |
| 359 | appropriated to, and fees and grants collected for, services of |
| 360 | the State Center for Health Statistics. Any funds, other than |
| 361 | funds appropriated to the center from the General Revenue Fund, |
| 362 | which are raised or collected by the agency for the operation of |
| 363 | the center and which are not needed to meet the expenses of the |
| 364 | center for its current fiscal year shall be available to the |
| 365 | agency in succeeding years. |
| 366 | (8) STATE CONSUMER COMPREHENSIVE HEALTH INFORMATION AND |
| 367 | POLICY SYSTEM ADVISORY COUNCIL.-- |
| 368 | (a) There is established in the agency the State Consumer |
| 369 | Comprehensive Health Information and Policy System Advisory |
| 370 | Council to assist the center in reviewing the comprehensive |
| 371 | health information system, including the identification, |
| 372 | collection, standardization, sharing, and coordination of |
| 373 | health-related data, fraud and abuse data, and professional and |
| 374 | facility licensing data among federal, state, local, and private |
| 375 | entities and to recommend improvements for purposes of public |
| 376 | health, policy analysis, and transparency of consumer health |
| 377 | care information such system. The council shall consist of the |
| 378 | following members: |
| 379 | 1. An employee of the Executive Office of the Governor, to |
| 380 | be appointed by the Governor. |
| 381 | 2. An employee of the Office of Insurance Regulation, to |
| 382 | be appointed by the director of the office. |
| 383 | 3. An employee of the Department of Education, to be |
| 384 | appointed by the Commissioner of Education. |
| 385 | 4. Ten persons, to be appointed by the Secretary of Health |
| 386 | Care Administration, representing other state and local |
| 387 | agencies, state universities, business and health the Florida |
| 388 | Association of Business/Health coalitions, local health |
| 389 | councils, professional health-care-related associations, |
| 390 | consumers, and purchasers. |
| 391 | (b) Each member of the council shall be appointed to serve |
| 392 | for a term of 2 4 years following from the date of appointment, |
| 393 | except the term of appointment shall end 3 years following the |
| 394 | date of appointment for members appointed in 2003, 2004, and |
| 395 | 2005. that A vacancy shall be filled by appointment for the |
| 396 | remainder of the term, and each appointing authority retains the |
| 397 | right to reappoint members whose terms of appointment have |
| 398 | expired. and except that: |
| 399 | 1. Three of the members initially appointed by the |
| 400 | Director of Health Care Administration shall each be appointed |
| 401 | for a term of 3 years. |
| 402 | 2. Two of the members initially appointed by the Director |
| 403 | of Health Care Administration shall each be appointed for a term |
| 404 | of 2 years. |
| 405 | 3. Two of the members initially appointed by the Director |
| 406 | of Health Care Administration shall each be appointed for a term |
| 407 | of 1 year. |
| 408 | (c) The council may meet at the call of its chair, at the |
| 409 | request of the agency department, or at the request of a |
| 410 | majority of its membership, but the council must meet at least |
| 411 | quarterly. |
| 412 | (d) Members shall elect a chair and vice chair annually. |
| 413 | (e) A majority of the members constitutes a quorum, and |
| 414 | the affirmative vote of a majority of a quorum is necessary to |
| 415 | take action. |
| 416 | (f) The council shall maintain minutes of each meeting and |
| 417 | shall make such minutes available to any person. |
| 418 | (g) Members of the council shall serve without |
| 419 | compensation but shall be entitled to receive reimbursement for |
| 420 | per diem and travel expenses as provided in s. 112.061. |
| 421 | (h) The council's duties and responsibilities include, but |
| 422 | are not limited to, the following: |
| 423 | 1. To develop a mission statement, goals, and a plan of |
| 424 | action based on the guiding principles specified in s. 282.3032 |
| 425 | for the identification, collection, standardization, sharing, |
| 426 | and coordination of health-related data across federal, state, |
| 427 | and local government and private-sector entities. |
| 428 | 2. To develop a review process to ensure cooperative |
| 429 | planning among agencies that collect or maintain health-related |
| 430 | data. |
| 431 | 3. To create ad hoc issue-oriented technical workgroups on |
| 432 | an as-needed basis to make recommendations to the council. |
| 433 | (9) APPLICATION TO OTHER AGENCIES.--Nothing in this |
| 434 | section shall limit, restrict, affect, or control the |
| 435 | collection, analysis, release, or publication of data by any |
| 436 | state agency pursuant to its statutory authority, duties, or |
| 437 | responsibilities. |
| 438 | Section 4. Paragraph (b) of subsection (1) and subsection |
| 439 | (10) of section 408.061, Florida Statutes, are amended to read: |
| 440 | 408.061 Data collection; uniform systems of financial |
| 441 | reporting; information relating to physician charges; |
| 442 | confidential information; immunity.-- |
| 443 | (1) The agency shall require the submission by health care |
| 444 | facilities, health care providers, and health insurers of data |
| 445 | necessary to carry out the agency's duties. Specifications for |
| 446 | data to be collected under this section shall be developed by |
| 447 | the agency with the assistance of technical advisory panels |
| 448 | including representatives of affected entities, consumers, |
| 449 | purchasers, and such other interested parties as may be |
| 450 | determined by the agency. |
| 451 | (b) Data to be submitted by health care providers may |
| 452 | include, but are not limited to: professional organization and |
| 453 | specialty board affiliations, Medicare and Medicaid |
| 454 | participation, types of services offered to patients, amount of |
| 455 | revenue and expenses of the health care provider, and such other |
| 456 | data which are reasonably necessary to study utilization |
| 457 | patterns. Data submitted shall be certified by the appropriate |
| 458 | duly authorized representative or employee of the health care |
| 459 | provider that the information submitted is true and accurate. |
| 460 | (10) The agency shall be the primary source for collection |
| 461 | and dissemination of health care data. No other agency of state |
| 462 | government may gather data from a health care provider licensed |
| 463 | or regulated under this chapter without first determining if the |
| 464 | data is currently being collected by the agency and |
| 465 | affirmatively demonstrating that it would be more cost-effective |
| 466 | for an agency of state government other than the agency to |
| 467 | gather the health care data. The secretary director shall ensure |
| 468 | that health care data collected by the divisions within the |
| 469 | agency is coordinated. It is the express intent of the |
| 470 | Legislature that all health care data be collected by a single |
| 471 | source within the agency and that other divisions within the |
| 472 | agency, and all other agencies of state government, obtain data |
| 473 | for analysis, regulation, and public dissemination purposes from |
| 474 | that single source. Confidential information may be released to |
| 475 | other governmental entities or to parties contracting with the |
| 476 | agency to perform agency duties or functions as needed in |
| 477 | connection with the performance of the duties of the receiving |
| 478 | entity. The receiving entity or party shall retain the |
| 479 | confidentiality of such information as provided for herein. |
| 480 | Section 5. Paragraphs (h) and (j) of subsection (1) and |
| 481 | subsections (2) and (5) of section 408.062, Florida Statutes, |
| 482 | are amended to read: |
| 483 | 408.062 Research, analyses, studies, and reports.-- |
| 484 | (1) The agency shall conduct research, analyses, and |
| 485 | studies relating to health care costs and access to and quality |
| 486 | of health care services as access and quality are affected by |
| 487 | changes in health care costs. Such research, analyses, and |
| 488 | studies shall include, but not be limited to: |
| 489 | (h) The collection of a statistically valid sample of data |
| 490 | on the retail prices charged by pharmacies for the 100 50 most |
| 491 | frequently prescribed medicines from any pharmacy licensed by |
| 492 | this state as a special study authorized by the Legislature to |
| 493 | be performed by the agency quarterly. If the drug is available |
| 494 | generically, price data shall be reported for the generic drug |
| 495 | and price data of a brand-named drug for which the generic drug |
| 496 | is the equivalent shall be reported. The agency shall make |
| 497 | available on its Internet website for each pharmacy, no later |
| 498 | than October 1, 2006 2005, drug prices for a 30-day supply at a |
| 499 | standard dose. The data collected shall be reported for each |
| 500 | drug by pharmacy and by metropolitan statistical area or region |
| 501 | and updated quarterly. |
| 502 | (j) The making available on its Internet website beginning |
| 503 | no later than October 1, 2004, and in a hard-copy format upon |
| 504 | request, of patient charge, volumes, length of stay, and |
| 505 | performance outcome indicators collected from health care |
| 506 | facilities pursuant to s. 408.061(1)(a) for specific medical |
| 507 | conditions, surgeries, and procedures provided in inpatient and |
| 508 | outpatient facilities as determined by the agency. In making the |
| 509 | determination of specific medical conditions, surgeries, and |
| 510 | procedures to include, the agency shall consider such factors as |
| 511 | volume, severity of the illness, urgency of admission, |
| 512 | individual and societal costs, and whether the condition is |
| 513 | acute or chronic. Performance outcome indicators shall be risk |
| 514 | adjusted or severity adjusted, as applicable, using nationally |
| 515 | recognized risk adjustment methodologies or software consistent |
| 516 | with the standards of the Agency for Healthcare Research and |
| 517 | Quality and as selected by the agency. The website shall also |
| 518 | provide an interactive search that allows consumers to view and |
| 519 | compare the information for specific facilities, a map that |
| 520 | allows consumers to select a county or region, definitions of |
| 521 | all of the data, descriptions of each procedure, and an |
| 522 | explanation about why the data may differ from facility to |
| 523 | facility. Such public data shall be updated quarterly. The |
| 524 | agency shall submit an annual status report on the collection of |
| 525 | data and publication of health care quality measures performance |
| 526 | outcome indicators to the Governor, the Speaker of the House of |
| 527 | Representatives, the President of the Senate, and the |
| 528 | substantive legislative committees with the first status report |
| 529 | due January 1, 2005. |
| 530 | (2) The agency may assess annually the caesarean section |
| 531 | rate in Florida hospitals using the analysis methodology that |
| 532 | the agency determines most appropriate. The data from this |
| 533 | assessment shall be published periodically on the agency's |
| 534 | Internet website. To assist the agency in determining the impact |
| 535 | of this chapter on Florida hospitals' caesarean section rates, |
| 536 | each provider hospital, as defined in s. 383.336, shall notify |
| 537 | the agency of the date of implementation of the practice |
| 538 | parameters and the date of the first meeting of the hospital |
| 539 | peer review board created pursuant to this chapter. The agency |
| 540 | shall use these dates in monitoring any change in provider |
| 541 | hospital caesarean section rates. An annual report based on this |
| 542 | monitoring and assessment shall be submitted to the Governor, |
| 543 | the Speaker of the House of Representatives, and the President |
| 544 | of the Senate by the agency, with the first annual report due |
| 545 | January 1, 1993. |
| 546 | (5) The agency shall develop and implement a strategy for |
| 547 | the adoption and use of electronic health records, including the |
| 548 | development of an electronic health information network for the |
| 549 | sharing of electronic health records among health care |
| 550 | facilities, health care providers, and health insurers. The |
| 551 | agency may develop rules to facilitate the functionality and |
| 552 | protect the confidentiality of electronic health records. The |
| 553 | agency shall report to the Governor, the Speaker of the House of |
| 554 | Representatives, and the President of the Senate on legislative |
| 555 | recommendations to protect the confidentiality of electronic |
| 556 | health records. |
| 557 | Section 6. Subsection (3) of section 20.42, Florida |
| 558 | Statutes, is amended to read: |
| 559 | 20.42 Agency for Health Care Administration.-- |
| 560 | (3) The department shall be the chief health policy and |
| 561 | planning entity for the state. The department is responsible for |
| 562 | health facility licensure, inspection, and regulatory |
| 563 | enforcement; investigation of consumer complaints related to |
| 564 | health care facilities and managed care plans; the |
| 565 | implementation of the certificate of need program; the operation |
| 566 | of the Florida State Center for Health Information and Policy |
| 567 | Analysis Statistics; the administration of the Medicaid program; |
| 568 | the administration of the contracts with the Florida Healthy |
| 569 | Kids Corporation; the certification of health maintenance |
| 570 | organizations and prepaid health clinics as set forth in part |
| 571 | III of chapter 641; and any other duties prescribed by statute |
| 572 | or agreement. |
| 573 | Section 7. Subsection (3) of section 381.001, Florida |
| 574 | Statutes, is amended to read: |
| 575 | 381.001 Legislative intent; public health system.-- |
| 576 | (3) It is, furthermore, the intent of the Legislature that |
| 577 | the public health system include comprehensive planning, data |
| 578 | collection, technical support, and health resource development |
| 579 | functions. These functions include, but are not limited to, |
| 580 | state laboratory and pharmacy services, the state vital |
| 581 | statistics system, the Florida State Center for Health |
| 582 | Information and Policy Analysis Statistics, emergency medical |
| 583 | services coordination and support, and recruitment, retention, |
| 584 | and development of preventive and primary health care |
| 585 | professionals and managers. |
| 586 | Section 8. Paragraph (e) of subsection (2) of section |
| 587 | 395.602, Florida Statutes, is amended to read: |
| 588 | 395.602 Rural hospitals.-- |
| 589 | (2) DEFINITIONS.--As used in this part: |
| 590 | (e) "Rural hospital" means an acute care hospital licensed |
| 591 | under this chapter, having 100 or fewer licensed beds and an |
| 592 | emergency room, which is: |
| 593 | 1. The sole provider within a county with a population |
| 594 | density of no greater than 100 persons per square mile; |
| 595 | 2. An acute care hospital, in a county with a population |
| 596 | density of no greater than 100 persons per square mile, which is |
| 597 | at least 30 minutes of travel time, on normally traveled roads |
| 598 | under normal traffic conditions, from any other acute care |
| 599 | hospital within the same county; |
| 600 | 3. A hospital supported by a tax district or subdistrict |
| 601 | whose boundaries encompass a population of 100 persons or fewer |
| 602 | per square mile; |
| 603 | 4. A hospital in a constitutional charter county with a |
| 604 | population of over 1 million persons that has imposed a local |
| 605 | option health service tax pursuant to law and in an area that |
| 606 | was directly impacted by a catastrophic event on August 24, |
| 607 | 1992, for which the Governor of Florida declared a state of |
| 608 | emergency pursuant to chapter 125, and has 120 beds or less that |
| 609 | serves an agricultural community with an emergency room |
| 610 | utilization of no less than 20,000 visits and a Medicaid |
| 611 | inpatient utilization rate greater than 15 percent; |
| 612 | 5. A hospital with a service area that has a population of |
| 613 | 100 persons or fewer per square mile. As used in this |
| 614 | subparagraph, the term "service area" means the fewest number of |
| 615 | zip codes that account for 75 percent of the hospital's |
| 616 | discharges for the most recent 5-year period, based on |
| 617 | information available from the hospital inpatient discharge |
| 618 | database in the Florida State Center for Health Information and |
| 619 | Policy Analysis Statistics at the Agency for Health Care |
| 620 | Administration; or |
| 621 | 6. A hospital designated as a critical access hospital, as |
| 622 | defined in s. 408.07(15). |
| 623 |
|
| 624 | Population densities used in this paragraph must be based upon |
| 625 | the most recently completed United States census. A hospital |
| 626 | that received funds under s. 409.9116 for a quarter beginning no |
| 627 | later than July 1, 2002, is deemed to have been and shall |
| 628 | continue to be a rural hospital from that date through June 30, |
| 629 | 2012, if the hospital continues to have 100 or fewer licensed |
| 630 | beds and an emergency room, or meets the criteria of |
| 631 | subparagraph 4. An acute care hospital that has not previously |
| 632 | been designated as a rural hospital and that meets the criteria |
| 633 | of this paragraph shall be granted such designation upon |
| 634 | application, including supporting documentation to the Agency |
| 635 | for Health Care Administration. |
| 636 | Section 9. Section 395.6025, Florida Statutes, is amended |
| 637 | to read: |
| 638 | 395.6025 Rural hospital replacement |
| 639 | facilities.--Notwithstanding the provisions of s. 408.036, a |
| 640 | hospital defined as a statutory rural hospital in accordance |
| 641 | with s. 395.602, or a not-for-profit operator of rural |
| 642 | hospitals, is not required to obtain a certificate of need for |
| 643 | the construction of a new hospital located in a county with a |
| 644 | population of at least 15,000 but no more than 18,000 and a |
| 645 | density of less than 30 persons per square mile, or a |
| 646 | replacement facility, provided that the replacement, or new, |
| 647 | facility is located within 10 miles of the site of the currently |
| 648 | licensed rural hospital and within the current primary service |
| 649 | area. As used in this section, the term "service area" means the |
| 650 | fewest number of zip codes that account for 75 percent of the |
| 651 | hospital's discharges for the most recent 5-year period, based |
| 652 | on information available from the hospital inpatient discharge |
| 653 | database in the Florida State Center for Health Information and |
| 654 | Policy Analysis Statistics at the Agency for Health Care |
| 655 | Administration. |
| 656 | Section 10. Paragraph (d) of subsection (43) of section |
| 657 | 408.07, Florida Statutes, is amended to read: |
| 658 | 408.07 Definitions.--As used in this chapter, with the |
| 659 | exception of ss. 408.031-408.045, the term: |
| 660 | (43) "Rural hospital" means an acute care hospital |
| 661 | licensed under chapter 395, having 100 or fewer licensed beds |
| 662 | and an emergency room, and which is: |
| 663 | (d) A hospital with a service area that has a population |
| 664 | of 100 persons or fewer per square mile. As used in this |
| 665 | paragraph, the term "service area" means the fewest number of |
| 666 | zip codes that account for 75 percent of the hospital's |
| 667 | discharges for the most recent 5-year period, based on |
| 668 | information available from the hospital inpatient discharge |
| 669 | database in the Florida State Center for Health Information and |
| 670 | Policy Analysis Statistics at the Agency for Health Care |
| 671 | Administration; or |
| 672 |
|
| 673 | Population densities used in this subsection must be based upon |
| 674 | the most recently completed United States census. A hospital |
| 675 | that received funds under s. 409.9116 for a quarter beginning no |
| 676 | later than July 1, 2002, is deemed to have been and shall |
| 677 | continue to be a rural hospital from that date through June 30, |
| 678 | 2012, if the hospital continues to have 100 or fewer licensed |
| 679 | beds and an emergency room, or meets the criteria of s. |
| 680 | 395.602(2)(e)4. An acute care hospital that has not previously |
| 681 | been designated as a rural hospital and that meets the criteria |
| 682 | of this subsection shall be granted such designation upon |
| 683 | application, including supporting documentation, to the Agency |
| 684 | for Health Care Administration. |
| 685 | Section 11. Paragraph (a) of subsection (4) of section |
| 686 | 408.18, Florida Statutes, is amended to read: |
| 687 | 408.18 Health Care Community Antitrust Guidance Act; |
| 688 | antitrust no-action letter; market-information collection and |
| 689 | education.-- |
| 690 | (4)(a) Members of the health care community who seek |
| 691 | antitrust guidance may request a review of their proposed |
| 692 | business activity by the Attorney General's office. In |
| 693 | conducting its review, the Attorney General's office may seek |
| 694 | whatever documentation, data, or other material it deems |
| 695 | necessary from the Agency for Health Care Administration, the |
| 696 | Florida State Center for Health Information and Policy Analysis |
| 697 | Statistics, and the Office of Insurance Regulation of the |
| 698 | Financial Services Commission. |
| 699 | Section 12. Paragraph (c) of subsection (4) of section |
| 700 | 381.026, Florida Statutes, is amended to read: |
| 701 | 381.026 Florida Patient's Bill of Rights and |
| 702 | Responsibilities.-- |
| 703 | (4) RIGHTS OF PATIENTS.--Each health care facility or |
| 704 | provider shall observe the following standards: |
| 705 | (c) Financial information and disclosure.-- |
| 706 | 1. A patient has the right to be given, upon request, by |
| 707 | the responsible provider, his or her designee, or a |
| 708 | representative of the health care facility full information and |
| 709 | necessary counseling on the availability of known financial |
| 710 | resources for the patient's health care. |
| 711 | 2. A health care provider or a health care facility shall, |
| 712 | upon request, disclose to each patient who is eligible for |
| 713 | Medicare, in advance of treatment, whether the health care |
| 714 | provider or the health care facility in which the patient is |
| 715 | receiving medical services accepts assignment under Medicare |
| 716 | reimbursement as payment in full for medical services and |
| 717 | treatment rendered in the health care provider's office or |
| 718 | health care facility. |
| 719 | 3. A health care provider or a health care facility shall, |
| 720 | upon request, furnish a person, prior to provision of medical |
| 721 | services, a reasonable estimate of charges for such services. |
| 722 | Such reasonable estimate shall not preclude the health care |
| 723 | provider or health care facility from exceeding the estimate or |
| 724 | making additional charges based on changes in the patient's |
| 725 | condition or treatment needs. |
| 726 | 4. Each licensed facility not operated by the state shall |
| 727 | make available to the public on its Internet website or by other |
| 728 | electronic means a description of and a link to the performance |
| 729 | outcome and financial data that is published by the agency |
| 730 | pursuant to s. 408.05(3)(k)(l). The facility shall place a |
| 731 | notice in the reception area that such information is available |
| 732 | electronically and the website address. The licensed facility |
| 733 | may indicate that the pricing information is based on a |
| 734 | compilation of charges for the average patient and that each |
| 735 | patient's bill may vary from the average depending upon the |
| 736 | severity of illness and individual resources consumed. The |
| 737 | licensed facility may also indicate that the price of service is |
| 738 | negotiable for eligible patients based upon the patient's |
| 739 | ability to pay. |
| 740 | 5. A patient has the right to receive a copy of an |
| 741 | itemized bill upon request. A patient has a right to be given an |
| 742 | explanation of charges upon request. |
| 743 | Section 13. Subsection (10) of section 395.301, Florida |
| 744 | Statutes, is amended to read: |
| 745 | 395.301 Itemized patient bill; form and content prescribed |
| 746 | by the agency.-- |
| 747 | (10) Each licensed facility shall make available on its |
| 748 | Internet website a link to the performance outcome and financial |
| 749 | data that is published by the Agency for Health Care |
| 750 | Administration pursuant to s. 408.05(3)(k)(l). The facility |
| 751 | shall place a notice in the reception area that the information |
| 752 | is available electronically and the facility's Internet website |
| 753 | address. |
| 754 | Section 14. Section 465.0244, Florida Statutes, is amended |
| 755 | to read: |
| 756 | 465.0244 Information disclosure.-- |
| 757 | (1) Every pharmacy shall make available on its Internet |
| 758 | website a link to the performance outcome and financial data |
| 759 | that is published by the Agency for Health Care Administration |
| 760 | pursuant to s. 408.05(3)(k)(l) and shall place in the area where |
| 761 | customers receive filled prescriptions notice that such |
| 762 | information is available electronically and the address of its |
| 763 | Internet website. |
| 764 | (2) A pharmacy may not enter into a contract with an |
| 765 | insurer or health maintenance organization that in any way |
| 766 | prohibits, restricts, or discourages the insurer or health |
| 767 | maintenance organization from communicating to enrollees or |
| 768 | providers any information on the prices of medications charged |
| 769 | by the pharmacy. |
| 770 | Section 15. Subsection (2) of section 627.6499, Florida |
| 771 | Statutes, is amended to read: |
| 772 | 627.6499 Reporting by insurers and third-party |
| 773 | administrators.-- |
| 774 | (2) Each health insurance issuer shall make available on |
| 775 | its Internet website a link to the performance outcome and |
| 776 | financial data that is published by the Agency for Health Care |
| 777 | Administration pursuant to s. 408.05(3)(k)(l) and shall include |
| 778 | in every policy delivered or issued for delivery to any person |
| 779 | in the state or any materials provided as required by s. |
| 780 | 627.64725 notice that such information is available |
| 781 | electronically and the address of its Internet website. |
| 782 | Section 16. Subsection (7) of section 641.54, Florida |
| 783 | Statutes, is amended to read: |
| 784 | 641.54 Information disclosure.-- |
| 785 | (7) Each health maintenance organization shall make |
| 786 | available on its Internet website a link to the performance |
| 787 | outcome and financial data that is published by the Agency for |
| 788 | Health Care Administration pursuant to s. 408.05(3)(k)(l) and |
| 789 | shall include in every policy delivered or issued for delivery |
| 790 | to any person in the state or any materials provided as required |
| 791 | by s. 627.64725 notice that such information is available |
| 792 | electronically and the address of its Internet website. |
| 793 | Section 17. This act shall take effect upon becoming a |
| 794 | law. |