CHAPTER 143

FORMERLY

HOUSE BILL NO. 285

AS AMENDED BY HOUSE AMENDMENT NO. 1

AN ACT TO AMEND TITLE 16 OF THE DELAWARE CODE RELATING TO THE VALIDITY AND CONFIDENTIALITY OF HEALTH DATA.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend Part VIII, Title 16 of the Delaware Code by adding thereto a new chapter, designated as Chapter 20, which new Chapter shall read as follows:

"Chapter 20. UNIFORM HEALTH DATA ACT.

§2001. Purpose.

It Is the purpose of this Chapter to establish a health information data base that will assist the health care system to advance the general well-being of the population by better directing and improving the availability of health care services.

It is the policy of this State to foster appropriate and efficient use of health care resources by requiring information necessary for evaluating utilization patterns and costs to the community and the State for health care services. This Information (In the aggregate with respect to charges or diagnoses) shall be available to health care purchasers, health care insurers, health care providers, health care planners and the general public without compromise of patient confidentiality. Such Information will Improve decision-making with regards to access, identified needs, patterns of health care delivery, charges and use of health care services.

§2002. Definitions.

The following words, terms and phrases, when used in this Chapter, shall have the meaning ascribed to them in this section, except where the context indicates a different meaning:

(1) 'Council' shall mean the Health Resources Management Council, a body established pursuant to Chapter 93 of this title.

(2) 'Delaware uniform claims and billing data set' shall mean that data approved for use by the State Uniform Billing Committee.

(3) 'Hospital' shall mean any non-federal facility licensed as such pursuant to Chapter 10 of this title.

(4) 'Individual' shall mean a singular human being.

(5) 'Nursing home' shall mean any non-federal facility licensed as such pursuant to Chapter 11 of this title and more particularly Sections 57 (Skilled Care) and 58 (Intermediate Care) of the State Board of Health Regulations.

(6) 'Person' shall mean an individual, trust or estate, a partnership, a corporation (including associations, joint stock companies and insurance companies), a state or political subdivision or instrumentality (including a municipal corporation) of a state.

(7) 'Raw data shall mean any information collected pursuant to this Chapter which has not been approved for release by the Council.

(8) 'State agency' shall mean the Bureau of Health Planning and Resources Management within the Department of Health and Social Services. The Bureau of Health Planning and Resources Management shall serve as the designated Statistical Agency under Public Law 95-623 for data analysis and statistical research related to The National Center for Health Statistics activities and for the designation of Health Manpower Shortage Areas (HMSAs) and Medically underserved Areas (MUAs) by the U.S. Department of Health and Social Services.

(9) 'Third-party payers' shall mean any person authorized to transact health insurance or to engage in the business of a health service corporation In this State.

§2003. Duties and authority of Health Resources Management Council.

(a) The Council shall compile, correlate, analyze and develop data which it collects pursuant to this Chapter. The Council shall prepare and distribute or make available reports to health care purchasers, health care insurers, health care providers and the general public. The data shall be collected in the most efficient and cost-effective manner. Data collected shall be limited to that contained in the Delaware Uniform Claims and Billing data set (U0-82 or successor form).

(b) Staff support for the Council in carrying out activities pursuant to this Chapter shall be provided by the State agency.

(c) The Council shall periodically compile and disseminate reports on the data collected such as, but not limited to: aggregate charge levels, age-specific utilization patterns, morbidity patterns, patient origin, and trends in health care charges. No data for specific hospitals or nursing homes shall be released by the Council without the written approval of the Association of Delaware Hospitals or the Delaware Health Care Facilities Association respectively. Prior to release or dissemination of any compilations, the Council Shall provide a specified time period for hospitals and nursing homes to review the information they have submitted and to submit corrections. The Council shall incorporate any valid corrections prior to release. Hospitals and nursing homes shall have the right to provide independent data interpretation which shall be disseminated along with the report,

(d) The Council shall adopt such policies and procedures as necessary to carry out this Chapter.

(e) The Council shall establish a technical advisory committee, including individuals who are not Council members, to study issues such as the collection, compilation, dissemination and confidentiality of data and may establish other committees as deemed appropriate.

(f) The Council shall issue annual reports to the General Assembly outlining actions and accomplishments as well as recommendations for changes needed to further the purpose of this Chapter.

(g) The Council may study and issue reports on special medical needs, demographic characteristics, access to health care services and need for financing of health care services for the entire population or various population sub-groups.

(h) The Council may also study and issue reports on health status issues such as:

(1) the incidence of medical and surgical procedures;

(2) mortality rates for specified diagnoses and treatments;

(3) rates of infection for specified diagnoses and treatments;

(4) morbidity rates for specified diagnoses and treatments;

(5) readmission rates for specified diagnoses and treatments; and

(6) rate of incidence for selected diagnoses and procedures.

§2004. Reporting requirements.

(a) The Delaware Uniform Claims and Billing data set (1113-82 or successor form) shall be completed for all hospital inpatient discharges after June 30, 1991 and shall be submitted by all hospitals to the Council according to a schedule established pursuant to sub-section (d) of this section. All third-party payers shall be required to accept this Uniform Claims and Billing form. The Council shall recognize the capabilities of each hospital in specifying the medium or mediums to be used In submitting data (hard copy, data tape or other appropriate electronic media).

(b) The Delaware Uniform Claims and Billing data set (U0-82 or successor form) shall be completed for all nursing home inpatient discharges beginning not sooner than June 30, 1991 and shall be submitted by all nursing homes to the Council according to a schedule established pursuant to sub-section (d) of this section. All third-party payers shall be required to accept the Delaware Uniform Claims and Billing form. Prior to this time, nursing homes shall continue to submit data in a medium and format as agreed to by the Council and the Delaware Health Care Facilities Association.

(c) The development of any report that includes comparative data between specific hospitals or nursing homes shall contain modifiers as determined by the Council to be necessary to assure that such comparisons are reliable, valid and informative. The Council may request that providers submit the data needed to develop these modifiers. No data for specific hospitals or nursing homes with respect to charges or diagnoses shall be released by the Council without the written approval of the Association of Delaware Hospitals, Inc. or the Delaware Health Care Facilities Association respectively.

(d) The Council shall establish schedules for the timely submission of data and information collected pursuant to this section. The Council may grant waivers from such schedules for good cause shown.

§2005. Confidentiality and access to data.

(a) The collection, compilation, data analysis and dissemination of reports and studies shall be done in a manner that protects the privacy of any individual about whom information is given. The Council shall consider confidential any information that explicitly or implicitly identifies an individual. Raw data shall not be available for public inspection nor is it a public record within the meaning of the Delaware Freedom of Information Act.

(b) All compilations prepared and authorized by the Council for release and dissemination shall be public records and efforts will be made to assure their accessibility.

§2006. Sanctions.

(a) A hospital or nursing home which willfully violates this Chapter shall be reported to the State Board of Health which may take such action as deemed appropriate to enforce compliance. No action shall be taken by the Board without first providing an opportunity to the hospital or nursing home for a fair hearing.

(b) A hospital or nursing home which is aggrieved by any action taken by the State Board of Health pursuant to this section may, within 30 days of being notified of such action, appeal to the Superior Court.

§2007. Immunity.

No person shall be subject to, and shall be immune from, any claim, suit, liability, damages or any other recourse, civil or criminal, arising from any act or proceeding, decision or determination undertaken or performed, or recommendation made while discharging any duty or authority under this Chapter, so long as such person acted In good faith, without malice, and within the scope of his duty or authority under this Chapter or any other provisions of the Delaware law, Federal law or regulations or duly adopted rules and regulations providing for the administration of this Chapter, good faith being presumed until proven otherwise, with malice required to be shown by the complainant."

Section 2. If any clause, sentence, section, provision or part of this Act shall be adjudged to be unconstitutional or invalid for any reason by any court of competent jurisdiction, such judgement shall not impair, invalidate or affect the remainder of this Act which shall remain in full force and effect.

Section 3. Repealing Clause.

All laws and parts of laws in conflict herewith are hereby repealed to the extent of such conflict.

Approved July 19, 1989.