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.