CS/CS/HB 911

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

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