A. Every health care provider shall submit data as required pursuant toregulations of the Board, consistent with the recommendations of thenonprofit organization in its strategic plans submitted and approved pursuantto § 32.1-276.4, and as required by this section. Notwithstanding theprovisions of Chapter 38 (§ 2.2-3800 et seq.) of Title 2.2, it shall belawful to provide information in compliance with the provisions of thischapter.
B. In addition, health maintenance organizations shall annually submit to theCommissioner, to make available to consumers who make health benefitenrollment decisions, audited data consistent with the latest version of theHealth Employer Data and Information Set (HEDIS), as required by the NationalCommittee for Quality Assurance, or any other quality of care or performanceinformation set as approved by the Board. The Commissioner, at hisdiscretion, may grant a waiver of the HEDIS or other approved quality of careor performance information set upon a determination by the Commissioner thatthe health maintenance organization has met Board-approved exemptioncriteria. The Board shall promulgate regulations to implement the provisionsof this section.
C. Every medical care facility as that term is defined in § 32.1-102.1 thatfurnishes, conducts, operates, or offers any reviewable service shall reportdata on utilization of such service to the Commissioner, who shall contractwith the nonprofit organization authorized under this chapter to collect anddisseminate such data. For purposes of this section, "reviewable service"shall mean inpatient beds, operating rooms, nursing home services, cardiaccatheterization, computed tomographic (CT) scanning, stereotacticradiosurgery, lithotripsy, magnetic resonance imaging (MRI), magnetic sourceimaging, medical rehabilitation, neonatal special care, obstetrical services,open heart surgery, positron emission tomographic (PET) scanning, psychiatricservices, organ and tissue transplant services, radiation therapy,stereotactic radiotherapy, proton beam therapy, nuclear medicine imagingexcept for the purpose of nuclear cardiac imaging, and substance abusetreatment.
The Commissioner shall also negotiate and contract with a nonprofitorganization authorized under § 32.1-276.4 for compiling, storing, and makingavailable to consumers the data submitted by health maintenance organizationspursuant to this section. The nonprofit organization shall assist the Boardin developing a quality of care or performance information set for suchhealth maintenance organizations and shall, at the Commissioner's discretion,periodically review this information set for its effectiveness.
D. The Board shall evaluate biennially the impact and effectiveness of suchdata collection.
(1996, c. 902; 2000, c. 897; 2006, c. 426; 2009, c. 175.)
A. Every health care provider shall submit data as required pursuant toregulations of the Board, consistent with the recommendations of thenonprofit organization in its strategic plans submitted and approved pursuantto § 32.1-276.4, and as required by this section. Notwithstanding theprovisions of Chapter 38 (§ 2.2-3800 et seq.) of Title 2.2, it shall belawful to provide information in compliance with the provisions of thischapter.
B. In addition, health maintenance organizations shall annually submit to theCommissioner, to make available to consumers who make health benefitenrollment decisions, audited data consistent with the latest version of theHealth Employer Data and Information Set (HEDIS), as required by the NationalCommittee for Quality Assurance, or any other quality of care or performanceinformation set as approved by the Board. The Commissioner, at hisdiscretion, may grant a waiver of the HEDIS or other approved quality of careor performance information set upon a determination by the Commissioner thatthe health maintenance organization has met Board-approved exemptioncriteria. The Board shall promulgate regulations to implement the provisionsof this section.
C. Every medical care facility as that term is defined in § 32.1-102.1 thatfurnishes, conducts, operates, or offers any reviewable service shall reportdata on utilization of such service to the Commissioner, who shall contractwith the nonprofit organization authorized under this chapter to collect anddisseminate such data. For purposes of this section, "reviewable service"shall mean inpatient beds, operating rooms, nursing home services, cardiaccatheterization, computed tomographic (CT) scanning, stereotacticradiosurgery, lithotripsy, magnetic resonance imaging (MRI), magnetic sourceimaging, medical rehabilitation, neonatal special care, obstetrical services,open heart surgery, positron emission tomographic (PET) scanning, psychiatricservices, organ and tissue transplant services, radiation therapy,stereotactic radiotherapy, proton beam therapy, nuclear medicine imagingexcept for the purpose of nuclear cardiac imaging, and substance abusetreatment.
The Commissioner shall also negotiate and contract with a nonprofitorganization authorized under § 32.1-276.4 for compiling, storing, and makingavailable to consumers the data submitted by health maintenance organizationspursuant to this section. The nonprofit organization shall assist the Boardin developing a quality of care or performance information set for suchhealth maintenance organizations and shall, at the Commissioner's discretion,periodically review this information set for its effectiveness.
D. The Board shall evaluate biennially the impact and effectiveness of suchdata collection.
(1996, c. 902; 2000, c. 897; 2006, c. 426; 2009, c. 175.)
A. Every health care provider shall submit data as required pursuant toregulations of the Board, consistent with the recommendations of thenonprofit organization in its strategic plans submitted and approved pursuantto § 32.1-276.4, and as required by this section. Notwithstanding theprovisions of Chapter 38 (§ 2.2-3800 et seq.) of Title 2.2, it shall belawful to provide information in compliance with the provisions of thischapter.
B. In addition, health maintenance organizations shall annually submit to theCommissioner, to make available to consumers who make health benefitenrollment decisions, audited data consistent with the latest version of theHealth Employer Data and Information Set (HEDIS), as required by the NationalCommittee for Quality Assurance, or any other quality of care or performanceinformation set as approved by the Board. The Commissioner, at hisdiscretion, may grant a waiver of the HEDIS or other approved quality of careor performance information set upon a determination by the Commissioner thatthe health maintenance organization has met Board-approved exemptioncriteria. The Board shall promulgate regulations to implement the provisionsof this section.
C. Every medical care facility as that term is defined in § 32.1-102.1 thatfurnishes, conducts, operates, or offers any reviewable service shall reportdata on utilization of such service to the Commissioner, who shall contractwith the nonprofit organization authorized under this chapter to collect anddisseminate such data. For purposes of this section, "reviewable service"shall mean inpatient beds, operating rooms, nursing home services, cardiaccatheterization, computed tomographic (CT) scanning, stereotacticradiosurgery, lithotripsy, magnetic resonance imaging (MRI), magnetic sourceimaging, medical rehabilitation, neonatal special care, obstetrical services,open heart surgery, positron emission tomographic (PET) scanning, psychiatricservices, organ and tissue transplant services, radiation therapy,stereotactic radiotherapy, proton beam therapy, nuclear medicine imagingexcept for the purpose of nuclear cardiac imaging, and substance abusetreatment.
The Commissioner shall also negotiate and contract with a nonprofitorganization authorized under § 32.1-276.4 for compiling, storing, and makingavailable to consumers the data submitted by health maintenance organizationspursuant to this section. The nonprofit organization shall assist the Boardin developing a quality of care or performance information set for suchhealth maintenance organizations and shall, at the Commissioner's discretion,periodically review this information set for its effectiveness.
D. The Board shall evaluate biennially the impact and effectiveness of suchdata collection.
(1996, c. 902; 2000, c. 897; 2006, c. 426; 2009, c. 175.)
