§ 23-17.17-11 Data collection andinformation sharing for the health care database. – (a) All insurers shall electronically provide to the director in accordancewith standards and procedures adopted by the director in regulation:
(1) their health insurance claims data;
(2) cross-matched claims data on requested members,subscribers or policyholders; and
(3) member, subscriber or policyholder information necessaryto determine third-party liability for benefits provided.
(b) For purposes of all data collection and public reportingof data under this chapter the collection, storage and release of health caredata and statistical information that is subject to the federal requirements ofthe Health Insurance Portability and Accountability Act ("HIPAA") shall begoverned by the rules adopted in 45 C.F.R. Parts 160 and 164 and otherapplicable law.
(c) All insurers that collect the health employer data andinformation set (HEDIS) shall annually submit the HEDIS information and suchother relevant industry quality standard measures as the director requires tothe director in a form and in a manner prescribed by the director.
(d) The director shall collaborate with the insurancecommissioner within the department of business regulation and all health andhuman service agencies in the development of a comprehensive health careinformation system and shall make all data collected pursuant to this chapteravailable to the insurance commissioner and all relevant government agencies infurtherance of the goals of the database set forth herein. The collaboration isintended to address the formulation of a description of the data sets that willbe included in the comprehensive health care information system, the criteriaand procedures for the development of limited use data sets, the criteria andprocedures to ensure the HIPAA compliant limited use data sets are accessible,and a proposed time frame for the creation of a comprehensive health careinformation system.
(e) To the extent allowed by HIPAA and other applicable law,the data shall be available as a resource for insurers, employers, providers,purchasers of health care, and state agencies to continuously review healthcare utilization, expenditures and performance in Rhode Island and to enhancethe ability of Rhode Island consumers and employers to make informed andcost-effective health care choices. In presenting data for public access,comparative considerations shall be made regarding geography, demographics,general economic factors and institutional size.
(f) The health care quality steering committee shall advisethe director as to the most effective means to make the database accessible tothe public for purposes of improving the quality of health care services inRhode Island.
(g) The director shall adopt regulations to carry out theprovisions of this chapter, including standards and procedures and criteria forthe required filing of such claims data, eligibility data, provider files andother information as the director determines to be necessary to carry out thepurposes of this section and this chapter.
§ 23-17.17-11 Data collection andinformation sharing for the health care database. – (a) All insurers shall electronically provide to the director in accordancewith standards and procedures adopted by the director in regulation:
(1) their health insurance claims data;
(2) cross-matched claims data on requested members,subscribers or policyholders; and
(3) member, subscriber or policyholder information necessaryto determine third-party liability for benefits provided.
(b) For purposes of all data collection and public reportingof data under this chapter the collection, storage and release of health caredata and statistical information that is subject to the federal requirements ofthe Health Insurance Portability and Accountability Act ("HIPAA") shall begoverned by the rules adopted in 45 C.F.R. Parts 160 and 164 and otherapplicable law.
(c) All insurers that collect the health employer data andinformation set (HEDIS) shall annually submit the HEDIS information and suchother relevant industry quality standard measures as the director requires tothe director in a form and in a manner prescribed by the director.
(d) The director shall collaborate with the insurancecommissioner within the department of business regulation and all health andhuman service agencies in the development of a comprehensive health careinformation system and shall make all data collected pursuant to this chapteravailable to the insurance commissioner and all relevant government agencies infurtherance of the goals of the database set forth herein. The collaboration isintended to address the formulation of a description of the data sets that willbe included in the comprehensive health care information system, the criteriaand procedures for the development of limited use data sets, the criteria andprocedures to ensure the HIPAA compliant limited use data sets are accessible,and a proposed time frame for the creation of a comprehensive health careinformation system.
(e) To the extent allowed by HIPAA and other applicable law,the data shall be available as a resource for insurers, employers, providers,purchasers of health care, and state agencies to continuously review healthcare utilization, expenditures and performance in Rhode Island and to enhancethe ability of Rhode Island consumers and employers to make informed andcost-effective health care choices. In presenting data for public access,comparative considerations shall be made regarding geography, demographics,general economic factors and institutional size.
(f) The health care quality steering committee shall advisethe director as to the most effective means to make the database accessible tothe public for purposes of improving the quality of health care services inRhode Island.
(g) The director shall adopt regulations to carry out theprovisions of this chapter, including standards and procedures and criteria forthe required filing of such claims data, eligibility data, provider files andother information as the director determines to be necessary to carry out thepurposes of this section and this chapter.
§ 23-17.17-11 Data collection andinformation sharing for the health care database. – (a) All insurers shall electronically provide to the director in accordancewith standards and procedures adopted by the director in regulation:
(1) their health insurance claims data;
(2) cross-matched claims data on requested members,subscribers or policyholders; and
(3) member, subscriber or policyholder information necessaryto determine third-party liability for benefits provided.
(b) For purposes of all data collection and public reportingof data under this chapter the collection, storage and release of health caredata and statistical information that is subject to the federal requirements ofthe Health Insurance Portability and Accountability Act ("HIPAA") shall begoverned by the rules adopted in 45 C.F.R. Parts 160 and 164 and otherapplicable law.
(c) All insurers that collect the health employer data andinformation set (HEDIS) shall annually submit the HEDIS information and suchother relevant industry quality standard measures as the director requires tothe director in a form and in a manner prescribed by the director.
(d) The director shall collaborate with the insurancecommissioner within the department of business regulation and all health andhuman service agencies in the development of a comprehensive health careinformation system and shall make all data collected pursuant to this chapteravailable to the insurance commissioner and all relevant government agencies infurtherance of the goals of the database set forth herein. The collaboration isintended to address the formulation of a description of the data sets that willbe included in the comprehensive health care information system, the criteriaand procedures for the development of limited use data sets, the criteria andprocedures to ensure the HIPAA compliant limited use data sets are accessible,and a proposed time frame for the creation of a comprehensive health careinformation system.
(e) To the extent allowed by HIPAA and other applicable law,the data shall be available as a resource for insurers, employers, providers,purchasers of health care, and state agencies to continuously review healthcare utilization, expenditures and performance in Rhode Island and to enhancethe ability of Rhode Island consumers and employers to make informed andcost-effective health care choices. In presenting data for public access,comparative considerations shall be made regarding geography, demographics,general economic factors and institutional size.
(f) The health care quality steering committee shall advisethe director as to the most effective means to make the database accessible tothe public for purposes of improving the quality of health care services inRhode Island.
(g) The director shall adopt regulations to carry out theprovisions of this chapter, including standards and procedures and criteria forthe required filing of such claims data, eligibility data, provider files andother information as the director determines to be necessary to carry out thepurposes of this section and this chapter.
