BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1812|
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CONSENT
Bill No: AB 1812
Author: Pan (D)
Amended: 6/17/14 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 6/11/14
AYES: Hernandez, Morrell, Beall, De León, DeSaulnier, Evans,
Monning, Nielsen, Wolk
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 75-0, 4/24/14 (Consent) - See last page for
vote
SUBJECT : Health facilities: information: disclosure
SOURCE : Author
DIGEST : This bill expands the list of entities to which the
Office of Statewide Health Planning and Development (OSHPD) is
required to disclose information it collects to include any
subsidiary of the United States Department of Health and Human
Services, for the purposes of conducting a statutorily
authorized activity.
ANALYSIS :
Existing law:
1. Establishes the OSHPD, and designates OSHPD as the single
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state agency to collect specified health facility or clinic
data for use by all state agencies.
2. Requires hospitals to make and file with OSHPD certain
specified reports, including a Hospital Discharge Abstract
Data Record, an Emergency Care Data Record, and an Ambulatory
Surgery Data Record, which are required to include specified
data elements for each admission or patient encounter,
including information on age, sex, ethnicity, ZIP code,
diagnoses and disposition of the patient.
3. Requires OSHPD to compile and publish summaries of individual
facility and aggregate data that do not contain
patient-specific information for the purposes of public
disclosure.
4. Requires OSHPD to disclose patient-level data collected
pursuant to 2) above to any California hospital and any local
health department or local health officer, and to the
National Center for Health Statistics or any other unit of
the Centers for Disease Control and Prevention (CDC), or the
Agency for Healthcare Research and Quality of the United
States Department of Health and Human Services, for the
purposes of conducting a statutorily authorized activity.
5. Establishes, under federal law, the Health Insurance
Portability and Accountability Act of 1996 (HIPAA), which
among various provisions, mandates industry-wide standards
for health care information on electronic billing and other
processes; and, requires the protection and confidential
handling of protected health information.
This bill expands the list of entities to which OSHPD is
required to disclose information it collects through its
Hospital Discharge Abstract Data Record, Emergency Care Data
Record, and Ambulatory Surgery Data Record, to include any
subsidiary of the United States Department of Health and Human
Services, including the Centers for Medicare and Medicaid
Services, the Health Resources and Services Administration, the
Indian Health Service, the Tribal Epidemiology Centers, the
National Institutes of Health, or the National Cancer Institute,
as well as the Veterans Health Care Administration within the
United States Department of Veterans Affairs, for the purposes
of conducting a statutorily authorized activity.
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Background
HIPAA . HIPAA became law in 1996 and was intended to expand
health coverage by improving the portability and continuity of
health insurance coverage in both group and individual markets.
It is also designed to combat waste in health service delivery,
and simplify the administration of health insurance. Public
agencies are not exempt from HIPAA rules if they meet the HIPAA
criteria as covered entities, with limited exemptions. HIPAA
includes a Privacy Rule which provides federal protections for
individually identifiable health information held by covered
entities (health care providers and others) and their business
associates and gives patients an array of rights with respect to
that information.
Under the HIPAA Privacy Rule, health information that does not
identify an individual, and there is no reasonable basis to
believe that the information can be used to identify an
individual, is not individually identifiable health information.
In order to ensure that health information is not individually
identifiable, certain actions must be taken, including removing
information about age and geographic location, including zip
code. However, the HIPAA Privacy Rule does permit covered
entities to use or disclose a "limited data set," which permits
additional information such as age and geographic location to be
included, if the covered entity enters into a data use agreement
with the limited data set recipient. The provisions of law that
this bill is amending require "all disclosures to be consistent
with the standards and limitations applicable to the disclosure
of limited data sets" as provided in the HIPAA Privacy Rule.
Comments
According to the author's office, OSHPD hospital inpatient,
outpatient, and emergency department patient-level data is a
primary source of information on population health, utilization
of healthcare services, and disease surveillance. Authorizing
OSHPD to release confidential hospital patient-level data to the
additional federal entities will allow them to better assess
population health needs in allocating federal funds, publicly
reporting geographic, demographic, or other variations in
healthcare and in developing interventions to improve population
heath. This bill authorizes OSHPD to release confidential
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hospital patient-level data to the specified federal entities
only under specific data use agreements that are used under
current state law for release of confidential data to University
of California and other non-profit educational institutions,
California local public health officers and two federal agencies
- the Agency for Healthcare Research and Quality (AHRQ), and the
CDC. Under existing law, with the exception of the AHRQ and
CDC, other federal agencies cannot access this data directly
from OSHPD.
Prior legislation
AB 2876 (Frommer, Chapter 434, Statutes of 2004) requires OSHPD,
upon request, to disclose patient encounter and discharge data
to hospitals and local health departments or local health
officers, and to any unit of the CDC or AHRQ of the United
States Department of Health and Human Services for the purposes
of conducting a statutorily authorized activity.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
ASSEMBLY FLOOR : 75-0, 4/24/14
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,
Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian
Calderon, Campos, Chau, Chávez, Chesbro, Conway, Cooley,
Dababneh, Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox,
Frazier, Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon,
Gorell, Grove, Hagman, Hall, Roger Hernández, Holden, Jones,
Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,
Medina, Melendez, Mullin, Muratsuchi, Nestande, Olsen, Pan,
Patterson, Perea, V. Manuel Pérez, Quirk, Quirk-Silva, Rendon,
Ridley-Thomas, Rodriguez, Salas, Skinner, Stone, Ting, Wagner,
Waldron, Weber, Wieckowski, Wilk, Williams, Yamada, John A.
Pérez
NO VOTE RECORDED: Gray, Harkey, Mansoor, Nazarian, Vacancy
JL:d:n 6/25/14 Senate Floor Analyses
SUPPORT/OPPOSITION: NONE RECEIVED
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