HB 911

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

CODING: Words stricken are deletions; words underlined are additions.