Revision: March 17, 2011, midnight
HB 489-FN – AS INTRODUCED
2011 SESSION
01/04
HOUSE BILL 489-FN
AN ACT relative to health information exchange.
SPONSORS: Rep. Millham, Belk 5; Rep. Rosenwald, Hills 22; Rep. Cebrowski, Hills 18; Rep. Harding, Graf 11; Sen. Kelly, Dist 10
COMMITTEE: Health, Human Services and Elderly Affairs
This bill establishes the health information organization corporation which shall have a distinct legal existence from the state. The corporation shall establish and maintain a health information organization for the electronic exchange of health information. This bill also requires the commissioner of the department of health and human services to enter into a contract with the health information exchange to administer the grant for the New Hampshire Information Exchange Planning and Implementation Project.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
11-0674
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eleven
AN ACT relative to health information exchange.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Medical Records and Patient Information. Amend the chapter heading of RSA 332-I to read as follows:
CHAPTER 332-I
MEDICAL RECORDS [AND], PATIENT INFORMATION,
AND THE HEALTH INFORMATION ORGANIZATION CORPORATION
2 Medical Records; Definitions. Amend RSA 332-I:1, II(c) to read as follows:
(c) “Health information [exchange] organization” means [an entity] the organization and governance structure and the health information exchange technical infrastructure created under this chapter and established for the primary purpose of enabling and overseeing the exchange of protected health information for clinical decision-making purposes. The [entity] organization may operate on a regional, statewide, or multi-state basis. [The entity may be developed by multiple stakeholders, including, but not limited to, the department of health and human services, a non-profit entity, or a for-profit entity.] For the purpose of this chapter, “health information [exchange] organization” does not include entities solely owned and operated by health care providers, integrated delivery systems, or pharmacy exchanges.
3 New Subparagraphs; Definitions Added. Amend RSA 332-I:1, II by inserting after subparagraph (f) the following new subparagraphs:
(g) “Board” means the health information organization board established in RSA 332-I:8.
(h) “Corporation” means the health information organization corporation established in RSA 332-I:7.
4 Use and Disclosure of Protected Health Information; Health Information Organization. Amend RSA 332-I:3 to read as follows:
332-I:3 Use and Disclosure of Protected Health Information; Health Information Exchange.
I. Except as provided in paragraph VI, a health care provider or a business associate of a health care provider may [disclose] transmit an individual’s protected health information [and information about the location of the individual’s medical records to a] through the health information [exchange] organization. Only a health care provider, for purposes of treatment, may have access to protected health information [in a] transmitted through the health information [exchange] organization.
II. [A] The health information [exchange] organization shall adhere to the protected health information requirements for health care providers in state and federal law.
III. [A] The health information [exchange] organization shall maintain an audit log of [health care providers who access protected health information] the transactions transmitted through the health information organization. The parties transmitting or receiving information through the health information organization shall maintain audit logs, including:
(a) The identity of the health care provider accessing the information;
(b) The identity of the individual whose protected health information was accessed by the health care provider;
(c) The date the protected health information was accessed; and
(d) The area of the record that was accessed.
IV. [A] The health information [exchange] organization shall be certified, when federal certification standards are established, to be in compliance with nationally accepted interoperability standards and practices.
V. No person shall require a health care provider to participate in [a] the health information [exchange] organization as a condition of payment or participation.
VI. An individual shall be given an opportunity to opt out of sharing his or her name and address and his or her protected health care information through [a] the health information [exchange] organization.
5 New Sections; Health Information Organization Corporation Established. Amend RSA 332-I by inserting after section 6 the following new sections:
332-I:7 Corporation Established. There is hereby created a body politic and corporate having a distinct legal existence separate from the state and not constituting a department of state government, to be known as the New Hampshire health information organization corporation to carry out the provisions of this chapter. The corporation is hereby deemed to be a public instrumentality and the exercise by the authority of the powers conferred by this chapter shall be deemed and held to be the performance of essential health information organization functions. The corporation shall be the state’s designated provider of health information exchange services. The corporation shall be a private nonprofit corporation and shall have all the powers necessary to carry out the purposes of this chapter, including, but not limited to, the power to receive and accept grants, loans, or advances of funds from any public or private agency and to receive and accept from any source, contributions of money, property, labor, or any other thing of value, to be held, used, and applied for the purposes of this chapter. It is intended that the health information organization established under this chapter be a public-private partnership for the benefit of all the citizens of New Hampshire.
332-I:8 Health Information Organization Board.
I. The powers of the corporation shall be vested in 11 members and up to 4 at large members. Except for the members appointed under subparagraphs I(b)-(d), members shall serve 3-year terms. No member shall serve more than 2 full consecutive terms. Members shall be appointed as follows:
(a) A consumer not affiliated with the health care industry, appointed by the governor.
(b) A member of the house of representatives, appointed by the speaker of the house of representatives.
(c) A member of the senate, appointed by the president of the senate.
(d) The commissioner of the department of health and human services, or designee.
(e) A member of the department of health and human services, office of medicaid business and policy, appointed by the commissioner.
(f) Two members, one representing a large hospital and one representing a critical access hospital, appointed by the New Hampshire Hospital Association.
(g) One independent practice physician not affiliated with any hospital, appointed by the New Hampshire Medical Society.
(h) One representative of community health centers, appointed by Bi-State Primary Care Association.
(i) One representative of community mental health centers, appointed by the New Hampshire Community Behavioral Health Association.
(j) One retail pharmacist, appointed by the pharmacy board.
(k) The board may appoint up to 4 at-large members with qualifications, experience and expertise as identified and determined by the board.
II. The members shall elect annually from among their number a chairperson and such officers as they may determine. A member shall hold office until a successor has been appointed and qualified. Members shall receive no salary for the performance of their duties under this section, but each member shall be reimbursed for reasonable expenses incurred in carrying out duties under this section. Any such expenses by board members shall have prior approval by 6 members of the board of directors before reimbursement. A member of the board of directors may be removed for cause by the official who appointed that member.
III. There shall be no liability on the part of, and no cause of action shall arise against, any member of the board of directors, or its employees or agents, for any action they take in the performance of their powers and duties under this chapter.
IV. The board shall have complete fiscal control over the corporation and shall be responsible for all corporate operations.
332-I:9 Meetings of Board. Meetings shall be held at the call of the chairperson or when 4 members so request. Six members of the board shall constitute a quorum and the affirmative vote of 6 members shall be necessary for any action taken by the authority. No vacancy in the membership of the board shall impair the right of a quorum to exercise all the rights and perform all the duties of the corporation.
332-I:10 Powers and Duties. The corporation shall:
I. Establish and maintain a health information organization that facilitates the private and secure electronic exchange of health information that promotes quality and patient safety, and increases efficiencies in health care delivery.
II. Establish and maintain a financially sustainable model to provide funding for the continued operation of the health information organization by creating value for stakeholders and sharing of costs among stakeholders by establishing funding mechanisms such as, but not limited to, subscriptions or user fees as it deems necessary.
III. Implement recognized national standards for interoperability and transmission security. Transmission security standards shall guard against unauthorized access to electronic health information that is being transmitted over an electronic communications network and shall include appropriate integrity controls and encryption mechanisms in accordance with HIPAA security regulations.
IV. Establish all administrative, operational, and financial functions to support the health information organization including, but not limited to, implementing and enforcing policies as appropriate to carry out and discharge its powers, duties, and functions. Such policies shall include protecting the privacy of patients and safeguarding confidential health care information.
V. Enter into grants, contracts, or agreements as necessary to the operation of the corporation including any such grants, contracts, or agreements, or the transfer thereof, as necessary to effect the transition of the planning, implementation and operation of the health information organization from the department of health and human services to the board.
VI. Adopt bylaws to govern the conduct of its affairs and to carry out and discharge its powers, duties and functions and to adopt policies as appropriate. Such bylaws shall include a provision pertaining to conflicts of interest and that board members, staff and others conducting business or associated with the health information organization shall be required to sign conflict of interest statements.
VII. Provide an annual report, including any recommendations, on or before January 1 of each year to the governor, commissioner of the department of health and human services, chair of the department of health and human services oversight committee, speaker of the house of representatives, and senate president, on the development and status of the health information organization.
332-I:11 Limited Immunity. Any health care provider who relies in good faith upon any information provided through the health information organization in the treatment of a patient, shall be immune from any criminal or civil liability arising from any damages caused by such good faith reliance. This immunity shall not apply to acts or omissions constituting negligence or reckless, wanton, or intentional misconduct.
6 Initial Terms for Members of Health Information Organization Board; First Meeting. The initial terms of office for the members appointed to the health information organization board established in RSA 332-I:8 as inserted by section 5 of this act shall be as follows: the members in subparagraphs I(e), (f) and (g) shall serve for 3 years; the members in subparagraphs I(a), (h), (i) and (j) shall serve for 2 years. The members in subparagraphs I (b), (c) and (d) shall serve coterminous with their term or terms in office. The at large members in subparagraph I(k), if any, shall serve for terms not exceeding 3 years as determined by the board. Initial appointments shall be made within 30 days of the effective date of this section. The first meeting shall be held within 60 days of the effective date of this section and shall be called by the member of the house of representatives.
7 New Paragraph; Duties of Commissioner; Health Information Organization. Amend RSA 126-A:5 by inserting after paragraph XVIII the following new paragraph:
XIX. The commissioner shall enter into a contract with the health information organization established pursuant to RSA 332-I to administer the grant for the New Hampshire Information Exchange Planning and Implementation Project.
8 Effective Date. This act shall take effect upon its passage.
LBAO
11-0674
Revised 02/07/11
HB 489 FISCAL NOTE
AN ACT relative to health information exchange.
FISCAL IMPACT:
The Department of Health and Human Services state this bill will have no fiscal impact on state, county, and local revenues or expenditures in FY 2011 and each year thereafter.
METHODOLOGY:
The Department of Health and Human Services states this bill establishes a health information organization as a private nonprofit organization with a distinct legal existence separate from the state. The Department states it is currently responsible for leading the State of New Hampshire Information Exchange Planning and Implementation Project (NH HIEPI) as the grantee of a federal grant from federal fiscal years 2010 through 2013. The Department states this bill would transfer administration of the grant from the Department to a health information organization for implementation of the NH HIEPI. The Department assumes the private nonprofit health information organization will be sustained by the users of the health information exchange system and will operate without state funding.