HLT-37-11-00017-P Qualified Health Information Technology Entities

9/14/11 N.Y. St. Reg. HLT-37-11-00017-P

NEW YORK STATE REGISTER

VOLUME XXXIII, ISSUE 37

September 14, 2011

RULE MAKING ACTIVITIES

DEPARTMENT OF HEALTH

PROPOSED RULE MAKING

NO HEARING(S) SCHEDULED

 

I.D No. HLT-37-11-00017-P

Qualified Health Information Technology Entities

PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following proposed rule:

Proposed Action:

Amendment of section 504.9 of Title 18 NYCRR.

Statutory authority:

Public Health Law, sections 201 and 206; and Social Services Law, sections 363-a and 365-a(2)

Subject:

Qualified Health Information Technology Entities.

Purpose:

To broaden the definition of a Service Bureau to include Qualified Entities.

Text of proposed rule:

Subdivision (h) of section 504.9 is added to read as follows:

(h)(1) A Qualified Health Information Technology Entity, as defined in paragraph (2) of this subdivision, seeking access to medical assistance information must enroll in the medical assistance program in accordance with this Part and must meet the appropriate additional requirements set forth in this section.

(2) Qualified Health Information Technology Entities, which may include but are not limited to regional health information organizations (RHIOs), are entities to whom recipient-specific medical assistance information is released, with the consent of the medical assistance recipient, for the purpose of sharing such information with one or more of its members that are providing medical care, services, or supplies to such recipient. The release of such information is intended to improve the quality of care delivered to medical assistance recipients, reduce the occurrence of medically adverse events, and reduce costs through better coordination of care.

(3) As a condition of enrollment and of receipt of medical assistance information pursuant to this subdivision, Qualified Health Information Technology Entities must develop and maintain policies and procedures:

(a) to ensure that informed consent is obtained from medical assistance recipients for the release of confidential information;

(b) to handle and safeguard confidential information in compliance with all applicable federal and state laws and regulations; and

(c) to ensure that their members comply with all applicable federal and state laws and regulations regarding confidential information.

Text of proposed rule and any required statements and analyses may be obtained from:

Katherine Ceroalo, DOH, Bureau of House Counsel, Regulatory Affairs Unit, Room 2438, ESP, Tower Building, Albany, NY 12237, [phone], email: [e-mail]

Data, views or arguments may be submitted to:

Same as above.

Public comment will be received until:

45 days after publication of this notice.

This action was not under consideration at the time this agency's regulatory agenda was submitted.

Regulatory Impact Statement

Statutory Authority:

Social Services Law section 363-a and Public Health Law section 201(1)(v) provide that the Department of Health is the single state agency responsible for supervising the administration of the State's medical assistance ("Medicaid") program and for adopting such regulations, not inconsistent with law, as may be necessary to implement the State's Medicaid program. In addition, Public Health Law section 206(l8-a)(b) authorizes the Commissioner to promulgate regulations to implement provisions of the federal American Recovery and Reinvestment Act of 2009 relating to the use of electronic health record ("EHR") technology by Medicaid providers.

Legislative Objectives:

Federal law at 42 U.S.C. section 1396b(t) establishes a program for incentive payments to Medicaid providers who demonstrate meaningful use of certified EHR technology through a means that is approved by the State, with the ultimate goal of promoting health care quality and health information exchange. In furtherance of this goal, Public Health Law section 206(18-a) creates a demonstration program to promote the development of EHR technologies and authorizes the Commissioner to promulgate regulations necessary to disburse the incentive payments provided for in 42 U.S.C. section 1396b(t). These incentive payments will be made to Medicaid providers who purchase, implement, and operate certified EHR technology. These providers will be the end users of data that is compiled and analyzed by Qualified Health Information Technology Entities.

Needs and Benefits:

The proposed regulatory amendment would define the term "Qualified Health Information Technology Entity" to mean an entity that, with the consent of a Medicaid recipient, is given recipient-specific information to share with Medicaid providers who are members of the entity and who are providing medical care, services, or supplies to the recipient. In addition, the regulation would require entities seeking to act as Qualified Health Information Technology Entities to enroll in the Medicaid program for such purpose, to enable the Department to regulate and control the terms under which Medicaid data is made available to such entities and to assure the confidentiality of individually identifiable confidential enrollee health information.

Costs:

There should be no additional costs associated with this regulatory amendment.

Local Government Mandates:

The proposed regulatory amendment does not impose any new mandates to local social services districts.

Paperwork:

The proposed regulatory amendment will result in a minimal amount of additional paperwork for medical providers, since the Qualified Entities will be required to submit the same documentation to the Medicaid program as other such enrolled providers.

Duplication:

This proposed regulatory amendment does not duplicate, overlap, or conflict with any other State or federal law or regulations.

Alternatives:

One alternative would be for Medicaid to take responsibility for distributing beneficiary specific information to thousands of individual providers, and establish interfaces with dozens of different electronic health records systems directly. Given that the Department has already established a governance policy and technical infrastructure to manage those responsibilities through the existing RHIOs, this alternative is not practical. The other alternative would be to take no action, which in turn would limit access to data for Medicaid providers and potentially make it more difficult for them to qualify for the EHR incentive payment program. This alternative would result in reduced federal funds coming to New York State and slow down the process of physicians adopting and using EHRs.

Federal Standards:

The proposed regulatory amendment does not exceed any minimum federal standards.

Compliance Schedule:

The proposed regulatory amendment will become effective upon publication of a Notice of Adoption in the New York State Register.

Regulatory Flexibility Analysis

A Regulatory Flexibility Analysis is not required because the proposed rule will not have a substantial adverse impact on small businesses or local governments.

Rural Area Flexibility Analysis

A Rural Area Flexibility Analysis is not required because the proposed rule will not have any adverse impact on rural areas.

Job Impact Statement

A Job Impact Statement is not required because the proposed rule will not have any adverse impact on jobs and employment opportunities.