Bill Text: GA HB646 | 2011-2012 | Regular Session | Introduced
Bill Title: Health; designation of health information exchange; provisions
Sponsorship: Partisan Bill (Democrat 1)
Status: (Introduced - Dead) 2012-01-09 - House Second Readers [HB646 Detail]
Download: Georgia-2011-HB646-Introduced.html
11 LC 33
4287
House
Bill 646
By:
Representative Dawkins-Haigler of the
93rd
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Title 31 of the Official Code of Georgia Annotated, relating to health, so
as to provide for the designation of a health information exchange for the
state; to provide for definitions; to provide for reports on progress in
implementing certain requirements; to provide for public comment on a report on
health information technology; to provide for regulations requiring certain
payors to provide incentives to health care providers to use electronic health
records; to provide that the incentives may include certain items and services;
to require the designation of a management service organization; to amend
Chapter 1 of Title 33 of the Official Code of Georgia Annotated, relating to
general provisions relative to insurance, so as to provide that carriers and
health maintenance organizations provide incentives to health care providers to
use electronic health records; to amend Part 1 of Article 1 of Chapter 18 of
Title 45 of the Official Code of Georgia Annotated, relating to the state
employees' health insurance plan, so as to require that such plan comply with
the requirements relating to electronic health records; to provide for related
matters; to repeal conflicting laws; and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Title
31 of the Official Code of Georgia Annotated, relating to health, is amended by
adding a new chapter to read as follows:
"CHAPTER
33A
31-33A-1.
As
used in this chapter, the term:
(1)
'Carrier' means an accident and sickness insurer, fraternal benefit society,
hospital service corporation, medical service corporation, health care plan as
defined in Code Section 33-20-3, health care corporation, health maintenance
organization, provider sponsored health care corporation, or any similar entity
and any self-insured health benefit plan not subject to the exclusive
jurisdiction of the federal Employee Retirement Income Security Act of 1974, 29
U.S.C. Section 1001, et seq., which is a licensed entity providing a plan of
health insurance or health benefits subject to state insurance
regulation.
(2)
'Council' means the Health Strategies Council created pursuant to Code Section
31-6-20.
(3)
'Electronic health record' means an electronic record of health related
information on an individual that:
(A)
Includes patient demographic and clinical health information; and
(B)
Has the capacity to:
(i)
Provide clinical decision support;
(ii)
Support physician order entry;
(iii)
Capture and query information relevant to health care quality; and
(iv)
Exchange electronic health information with and integrate the information from
other sources.
(4)
'Health benefit plan' means a hospital or medical policy, contract, or
certificate issued by a carrier. Such term does not include:
(A)
Coverage for accident or disability income insurance;
(B)
Coverage issued as a supplement to liability insurance;
(C)
Liability insurance, including general liability insurance and automobile
liability insurance;
(D)
Workers' compensation or similar insurance;
(E)
Automobile or property medical payment insurance;
(F)
Credit only insurance;
(G)
Coverage for on-site medical clinics;
(H)
Dental or vision insurance;
(I)
Long-term care insurance or benefits for nursing home care, home health care,
community based care, or any combination of these;
(J)
Coverage only for a specified disease or illness;
(K)
Hospital indemnity or other fixed indemnity insurance; or
(L)
The following benefits if offered as a separate insurance policy:
(i)
Medicare supplemental health insurance, as defined in Section 1882(g)(1) of the
federal Social Security Act;
(ii)
Coverage supplemental to the coverage provided under 10 U.S.C. Chapter 55;
or
(iii)
Similar supplemental coverage provided to coverage under an employer sponsored
plan.
(5)
'Health care provider' means:
(A)
A person who is licensed, certified, or otherwise authorized as a health care
professional under Chapter 9, 10A, 11, 11A, 26, 28, 30, 33, 34, 35, 39, or 44 of
Title 43 to provide health care in the ordinary course of business or practice
of a profession or in an approved education or training program; or
(B)
A facility where health care is provided to patients or recipients, including
any hospital, nursing home, personal care home, ambulatory surgical center, home
health agency, or other health care facility licensed or defined under Chapter 7
of this title.
The
term does not include a health maintenance organization certificated under
Chapter 21 of Title 33.
(6)
'Health information exchange' means a state-wide infrastructure that provides
organizational and technical capabilities to enable the electronic exchange of
health information between health care providers and other health services
organizations authorized by the council.
(7)
'Management service organization' means an organization that offers one or more
hosted electronic health record solutions and other management services to
multiple health care providers.
(8)
'State regulated payor' means:
(A)
The health insurance plan for state employees pursuant to Article 1 of Chapter
18 of Title 45; and
(B)
A carrier issuing or delivering health benefit plans in this state.
The
term does not include a provider of medical assistance for Medicaid purposes
pursuant to Article 7 of Chapter 4 of Title 49.
31-33A-2.
(a)
On or before October 1, 2011, the council and the department shall designate a
health information exchange for the state.
(b)
On or before January 1, 2012, the council shall:
(1)
Report to the Senate Health and Human Services Committee and the House Committee
on Health and Human Services on progress in implementing the requirements of
subsections (a) and (d) of this Code section; and
(2)
Include in the report recommendations for legislation specifying how incentives
required for state regulated payors that are national carriers shall take into
account existing carrier activities that promote the adoption and meaningful use
of electronic health records.
(c)(1)
On or before January 1, 2013, following consultations with appropriate
stakeholders, the council shall post on its website for public comment and
submit to the Governor, the Senate Health and Human Services Committee, and the
House Committee on Health and Human Services a report on:
(A)
The development of a coordinated public-private approach to improve this state's
health information infrastructure;
(B)
Any changes in state laws that are necessary to protect the privacy and security
of health information stored in electronic health records or exchanged through a
health information exchange in this state;
(C)
Any changes in state laws that are necessary to provide for the effective
operation of a health information exchange;
(D)
Any actions that are necessary to align funding opportunities under the federal
American Recovery and Reinvestment Act of 2009 with other state and private
sector initiatives related to health information technology,
including:
(i)
The patient centered medical home;
(ii)
The electronic health record demonstration project supported by the Centers for
Medicare and Medicaid Services;
(iii)
The health information exchange; and
(iv)
The federal Medicaid Information Technology Architecture Initiative;
and
(E)
Recommended language for the regulations required under subsection (d) of this
Code section.
(2)
The Senate Health and Human Services Committee and the House Committee on Health
and Human Services shall have 60 days from receipt of the report for review and
comment.
(d)(1)
On or before September 1, 2013, the council, in consultation with the
department, state regulated payors, and health care providers, shall adopt
regulations that require state regulated payors to provide incentives to health
care providers to promote the adoption and meaningful use of electronic health
records.
(2)
Incentives required under the regulations:
(A)
Shall have monetary value;
(B)
Shall facilitate the use of electronic health records by health care providers
in this state;
(C)
To the extent feasible, shall recognize and be consistent with existing state
regulated payor incentives that promote the adoption and meaningful use of
electronic health records;
(D)
Shall take into account:
(i)
Incentives provided to health care providers under medicare and Medicaid;
and
(ii)
Any grants or loans that are available to health care providers from the federal
government; and
(E)
May include:
(i)
Increased reimbursement for specific services;
(ii)
Lump sum payments;
(iii)
Gain-sharing arrangements;
(iv)
Rewards for quality and efficiency;
(v)
In-kind payments; and
(vi)
Other items or services to which a specific monetary value can be
assigned.
(3)
The regulations need not require incentives for the adoption and meaningful use
of electronic health records by health care providers.
(4)
If federal law is amended to allow the state to regulate payments made by
entities that self-insure their health benefit plans, regulations adopted under
this Code section shall apply to those entities to the same extent to which they
apply to state regulated payors.
(e)
The department, in consultation with hospitals, state regulated payors, and the
Centers for Medicare and Medicaid Services, shall take the actions necessary
to:
(1)
Assure that hospitals in this state receive the payments provided under Section
4102 of the federal American Recovery and Reinvestment Act of 2009 and any
subsequent federal rules and regulations; and
(2)
Implement any changes in hospital rates required by the Centers for Medicare and
Medicaid Services to ensure compliance with Section 4102 of the federal American
Recovery and Reinvestment Act of 2009 and any subsequent federal rules and
regulations.
(f)
The department, in consultation with the council, shall develop a mechanism to
assure that health care providers that participate in the Medicaid program
pursuant to Article 7 of Chapter 4 of Title 49 receive the payments provided for
adoption and use of electronic health records technology under Section 4201 of
the federal American Recovery and Reinvestment Act of 2009 and any subsequent
federal rules and regulations.
(g)
On or before October 1, 2014, the council shall report to the Governor and the
General Assembly on progress achieved toward adoption and meaningful use of
electronic health records by health care providers in this state and
recommendations for any changes in state laws that are necessary to achieve
optimal adoption and use.
(h)(1)
On or before October 1, 2014, the council shall designate one or more management
service organizations to offer services throughout the state.
(2)
The council may use federal grants and loans to help subsidize the use of the
designated management service organizations by health care
providers.
(i)
On and after the later of January 1, 2017, or the date established for the
imposition of penalties under Section 4102 of the federal American Recovery and
Reinvestment Act of 2009:
(1)
Each health care provider using an electronic health record that seeks payment
from a state regulated payor shall use electronic health records that
are:
(A)
Certified by a national certification organization designated by the council;
and
(B)
Capable of connecting to and exchanging data with the health information
exchange designated by the council under subsection (a) of this Code section;
and
(2)
The incentives required under subsection (d) of this Code section may include
reductions in payments to a health care provider that does not use electronic
health records that meet the requirements of paragraph (1) of this
subsection."
SECTION
3.
Chapter
1 of Title 33 of the Official Code of Georgia Annotated, relating to general
provisions relative to insurance, is amended by adding a new Code section to
read as follows:
"33-1-19.
(a)
As used in this Code section, the term:
(a)
'Carrier' has the same meaning as in paragraph (1) of Code Section
31-33A-1.
(b)
'Health maintenance organization' means an entity certificated under Chapter 21
of this title.
(b)
All carriers and health maintenance organizations shall provide incentives to
health care providers in accordance with the requirements of Chapter 33A of
Title 31."
SECTION
4.
Part
1 of Article 1 of Chapter 18 of Title 45 of the Official Code of Georgia
Annotated, relating to the state employees' health insurance plan, is amended by
revising Code Section 45-18-3, relating to the design of the plan, as
follows:
"45-18-3.
The
health insurance plan shall be designed by the board to:
(1)
Provide a reasonable relationship between the hospital, surgical, and medical
benefits to be included and the expected distribution of expenses of each such
type to be incurred by the covered employees and dependents;
and
(2)
Include reasonable controls, which may include deductible and reinsurance
provisions applicable to some or all of the benefits, to reduce unnecessary
utilization of the various hospital, surgical, and medical services to be
provided and to provide reasonable assurance of stability in future years of the
plan;
and
(3)
Ensure that it includes incentives to health care providers in accordance with
the requirements of Chapter 33A of Title
31."
SECTION
5.
All
laws and parts of laws in conflict with this Act are repealed.
