BILL ANALYSIS �
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1812
AUTHOR: Pan
INTRODUCED: February 18, 2014
HEARING DATE: June 11, 2014
CONSULTANT: Marchand
SUBJECT : Health facilities: information: disclosure.
SUMMARY : Expands the list of entities to which the Office of
Statewide Health Planning and Development 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
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.
Existing law:
1.Establishes the Office of Statewide Health Planning and
Development (OSHPD), and designates OSHPD as the single 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
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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.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, negligible state fiscal effect.
PRIOR VOTES :
Assembly Health: 19- 0
Assembly Appropriations:17- 0
Assembly Floor: 75- 0
COMMENTS :
1.Author's statement. According to the author, 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. The bill
would authorize OSHPD to release confidential 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 current law, with the exception of
the AHRQ and CDC, other federal agencies cannot access this
data directly from OSHPD.
2.Background on 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
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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.
3.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.
SUPPORT AND OPPOSITION :
Support: None received
Oppose: None received
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