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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| SENATE BILL |
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| INTRODUCED BY WONDERLING, ERICKSON, PILEGGI, CORMAN, VANCE, GORDNER, TARTAGLIONE, BOSCOLA, STACK, FERLO, RAFFERTY, STOUT, COSTA, KITCHEN, PIPPY, BROWNE, BRUBAKER, BAKER, ORIE, M. WHITE, KASUNIC, ALLOWAY AND EARLL, APRIL 3, 2009 |
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| REFERRED TO PUBLIC HEALTH AND WELFARE, APRIL 3, 2009 |
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| AN ACT |
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1 | Providing loans for health information technology. |
2 | The General Assembly of the Commonwealth of Pennsylvania |
3 | hereby enacts as follows: |
4 | Section 1. Short title. |
5 | This act shall be known and may be cited as the Health |
6 | Information Technology Act. |
7 | Section 2. Definitions. |
8 | The following words and phrases when used in this act shall |
9 | have the meanings given to them in this section unless the |
10 | context clearly indicates otherwise: |
11 | "Clinical decision support system." Interactive computer |
12 | programs which are evidence based and designed to assess |
13 | physicians and other health professionals with decision making |
14 | tasks. |
15 | "Community-based health care provider." Any of the following |
16 | nonprofit health care centers which provide primary health care |
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1 | services: |
2 | (1) A federally qualified health center as defined in |
3 | section 1905(1)(2)(B) of the Social Security Act (49 Stat. |
4 | 620, 42 U.S.C. § 1396d(1)(2)(B). |
5 | (2) A rural health clinic as defined in section 1861 |
6 | (aa)(2) of the Social Security Act (49 Stat. 620, 42 U.S.C. § |
7 | 1395x(aa)(2)), certified by Medicare. |
8 | (3) A freestanding hospital clinic serving a federally |
9 | designated health care professional shortage area. |
10 | (4) A free or partial-pay health clinic which provides |
11 | services by volunteer medical providers. |
12 | "Department." The Department of Health of the Commonwealth. |
13 | "Electronic health record." A medical record that complies |
14 | with implementation specification and certification criteria |
15 | adopted by the National Coordinator. |
16 | "Fund." The Health Information Technology Loan Fund. |
17 | "Health care provider." A health care facility or health |
18 | care practitioner as defined in section 103 of the act of July |
19 | 19, 1979 (P.L.130, No.48), known as the Health Care Facilities |
20 | Act, a group practice or a community-based health care provider. |
21 | "Health information." The medical records of a patient. |
22 | "Health information technology." The application of |
23 | information processing of electronic health records utilizing |
24 | products, devices, including hardware and software, integrated |
25 | technologies, licenses, intellectual property, upgrades, |
26 | packaged solutions or related systems sold as services that are |
27 | designed for or support the collection, storage, retrieval, |
28 | exchange, sharing, creation, maintenance, access, management or |
29 | use of health information. |
30 | "Health information technology regional extension center." |
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1 | Any United States based nonprofit institution or organization, |
2 | or group thereof, that provides technical assistance and |
3 | disseminates best practices to support and accelerate efforts to |
4 | adopt, implement and effectively utilize health information |
5 | technology that allows for the electronic exchange and use of |
6 | information in compliance with standards, implementation |
7 | specifications and certification criteria adopted by the |
8 | National Coordinator. |
9 | "Health information technology system." An automated, |
10 | interoperable system that utilizes health information technology |
11 | to integrate health records, clinical activities and data |
12 | sharing in any of the following: |
13 | (1) Pharmacy ordering and tracking. |
14 | (2) Laboratory testing. |
15 | (3) Physician order management. |
16 | (4) Access by clinicians. |
17 | (5) Access by consumers. |
18 | (6) Telemedicine. |
19 | (7) Data sharing among health care facilities, |
20 | physicians and health insurers. |
21 | (8) Other transaction monitoring or other exchange of |
22 | health information that promotes patient safety and |
23 | efficiency in the delivery of health care. |
24 | "Health insurer." Any of the following providers of health |
25 | care insurance coverage: |
26 | (1) An insurer licensed under the act of May 17, 1921 |
27 | (P.L.682, No.284), known as The Insurance Company Law of |
28 | 1921. |
29 | (2) A health maintenance organization as defined in |
30 | section 3 of the act of December 29, 1972 (P.L.1701, No.364), |
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1 | known as the Health Maintenance Organization Act. |
2 | (3) A not-for-profit health plan corporation operating |
3 | under 40 Pa.C.S. Chs. 61 (relating to hospital plan |
4 | corporations) and 63 (relating to professional health |
5 | services plan corporations). |
6 | "Interoperability." The ability to communicate and exchange |
7 | data accurately, effectively, securely and consistently among |
8 | different technology systems, software applications and networks |
9 | in a manner that maintains and preserves the clinical purpose of |
10 | the data. |
11 | "National Coordinator." The head of the Office of the |
12 | National Coordinator for Health Information Technology. |
13 | "Program." The Health Information Technology Program |
14 | established in section 3. |
15 | "Regional health information organization." A not-for-profit |
16 | organization that adopts bylaws, memoranda of understanding or |
17 | other documents that provide for the establishment of governance |
18 | structure to enable participation by multiple health care |
19 | providers in the development and use of health information |
20 | technology. |
21 | Section 3. Health Information Technology Program. |
22 | (a) Establishment.--A Health Information Technology Program |
23 | is established in the department to administer grants received |
24 | under section 3014 of the American Recovery and Reinvestment Act |
25 | of 2009 (Public Law 111-5, 123 Stat. 115) and from other sources |
26 | to be used to provide loans to health care providers or health |
27 | information technology regional extension centers to implement |
28 | health information technology systems. |
29 | (b) Eligible activities.--The program shall provide loans |
30 | for the following: |
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1 | (1) The purchase or enhancement of health information |
2 | technology or telecommunications necessary to create an |
3 | interoperable and integrated health information technology |
4 | system. |
5 | (2) The payment of costs and expenses associated with |
6 | the preparation of plans, specifications, studies and surveys |
7 | necessary to determine the scope and effectiveness of a |
8 | health information technology system. |
9 | (3) The training of physicians and personnel in the use |
10 | of health information technology. |
11 | (4) The improvement of security in the exchange of |
12 | electronic health records. |
13 | (5) Clinical decision support systems. |
14 | (c) Limitations.--The amount of a loan to a health care |
15 | provider or regional health information technology organization |
16 | may not exceed $1,000,000. No less than 50% of available funds |
17 | shall be used for loans to health care providers in counties of |
18 | the fourth, fifth, sixth, seventh or eighth class. |
19 | (d) Loan requirement.--Any loan made under this section |
20 | shall comply with all of the following: |
21 | (1) Have an interest rate that does not exceed the |
22 | market interest rate. |
23 | (2) Require the repayment of principal and interest |
24 | payments to begin no later than one year after the date the |
25 | loan was awarded. |
26 | (e) Administrative costs.--No more than 3% of money in the |
27 | fund may be used for the administration of the program. |
28 | Section 4. Fund. |
29 | A fund is established in the State Treasury to be known as |
30 | the Health Information Technology Loan Fund. The following shall |
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1 | be deposited in the fund: |
2 | (1) Money appropriated to the fund by the General |
3 | Assembly. |
4 | (2) Grants received under the American Recovery and |
5 | Reinvestment Act of 2009 (Public Law 111-5, 123 Stat. 115) or |
6 | other Federal law. |
7 | (3) Earnings derived from the investment of the money in |
8 | the fund after deducting investment expenses. |
9 | (4) Loan repayments of principal and interest. |
10 | Section 5. Eligibility requirement. |
11 | In order to be eligible for a loan under section 3, a health |
12 | care provider must provide medically necessary services to |
13 | individuals regardless of the individual's ability to pay for |
14 | the services and must be a participating provider with the |
15 | Department of Public Welfare of services to individuals eligible |
16 | for medical assistance. |
17 | Section 6. Application. |
18 | (a) Submission.--In order to receive a loan under section 3, |
19 | a health care provider or health information technology regional |
20 | extension center shall submit an application in a form and |
21 | manner prescribed by the department. |
22 | (b) Requirements.--An application submitted under subsection |
23 | (a) shall set forth the manner in which the health information |
24 | technology system will do the following: |
25 | (1) Comply with all criteria adopted by the National |
26 | Coordinator. |
27 | (2) Protect privacy and security of health information. |
28 | (3) Maintain and provide permitted access to health |
29 | information. |
30 | (4) Improve the quality of health care by reducing |
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1 | health care costs, medical errors, inappropriate care and |
2 | incomplete information and the coordination of care and |
3 | information among health care providers, health insurers and |
4 | other entities. |
5 | (5) Ensure interoperability with other systems and |
6 | health care providers. |
7 | (6) Provide consumer access to personal medical |
8 | information. |
9 | (7) Comply with all Federal and State laws and |
10 | regulations relating to security and notification of any |
11 | breach of electronic medical records. |
12 | (c) Additional information.--In addition to the information |
13 | under subsection (b), the applicant shall provide: |
14 | (1) A feasibility study of the proposed health |
15 | information technology system. |
16 | (2) A business or financial plan that describes the |
17 | long-term sustainability and proposed benefits of the plan |
18 | and the financial cost to the applicant. |
19 | (3) A strategic plan and schedule for the development |
20 | and implementation of the health information technology |
21 | system. |
22 | Section 7. Medicaid provider health information technology |
23 | adoption and operation payments. |
24 | (a) Secretary of Public Welfare.--The Secretary of Public |
25 | Welfare shall, within 60 days following the effective date of |
26 | this section, make payments to eligible health care providers |
27 | for the purchase or enhancement of health information technology |
28 | or telecommunications necessary to create an interoperable and |
29 | integrated health information technology system, including the |
30 | payment of costs and expenses associated with the preparation of |
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1 | plans, specifications, studies, training and surveys in |
2 | accordance with the requirements of section 4201 of the American |
3 | Recovery and Reinvestment Act of 2009 (Public Law 111-5, 123 |
4 | Stat. 115). |
5 | (b) Duplicative requirements.--The Secretary of Public |
6 | Welfare shall seek to avoid duplicative requirements from the |
7 | Federal Government to demonstrate meaningful use of certified |
8 | health information technology under this act. The Secretary of |
9 | Public Welfare may deem satisfaction of Federal requirements to |
10 | be sufficient to qualify as meaningful use under this section. |
11 | Section 8. Accountability. |
12 | (a) Information required.--Within one year of the award of a |
13 | loan under this act, the recipient shall provide all of the |
14 | following to the department: |
15 | (1) A report on the status of the strategic plan and the |
16 | development of the health information technology system. |
17 | (2) An accounting of the expenditure of funds from the |
18 | loan and from other sources. |
19 | (3) A report on any reductions in medical errors, |
20 | increases in efficiency and advances in the delivery of |
21 | patient-centered medical care. |
22 | (b) Annual report.--The department shall submit an annual |
23 | report to the chairman and minority chairman of the Public |
24 | Health and Welfare Committee of the Senate and the chairman and |
25 | minority chairman of the Health and Human Services Committee of |
26 | the House of Representatives, which shall include the number and |
27 | amount of loans awarded, a description of the system being |
28 | funded, total amount of funds spent and the impact on the |
29 | delivery of health care. |
30 | Section 9. Duties of department. |
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1 | The department shall do all of the following: |
2 | (1) Develop a strategic plan for the implementation of a |
3 | Statewide interoperable health information technology system |
4 | for all health care providers, health insurers and consumers. |
5 | (2) Administer the health information technology program |
6 | to provide loans to eligible health care providers. |
7 | (3) Award loans in all geographic areas of the |
8 | Commonwealth. |
9 | (4) Adopt standards for health information technology |
10 | that are consistent with those developed by the National |
11 | Coordinator. |
12 | (5) Provide a loan application form within 90 days of |
13 | the effective date of this section. |
14 | (6) Ensure that health information technology policies |
15 | and programs of the department are coordinated with the |
16 | Department of Public Welfare and other executive branch |
17 | agencies and with Federal agencies. |
18 | (7) Share appropriate data relating to the use of health |
19 | information technology systems with the Department of Public |
20 | Welfare, the Health Care Cost Containment Council, the |
21 | Patient Safety Authority and other State agencies. Any data |
22 | collected by a State agency relating to the operation of |
23 | health information technology systems in the Commonwealth |
24 | shall be shared with the department. |
25 | (8) Give preference to applications which provide |
26 | regional health information technology systems that link |
27 | multiple health care providers and which provide direct |
28 | patient access to health care information. |
29 | (9) Audit loans awarded under this act. |
30 | (10) Provide ongoing assessment of the benefits and |
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1 | costs of health information technology systems, including |
2 | information relating to reduction in medical errors, |
3 | reduction in physician visits, economic impact, efficiencies |
4 | and other information. |
5 | (11) Develop a public information program to inform the |
6 | public of the efficiency and safety advantage of health |
7 | information technology. |
8 | Section 20. Effective date. |
9 | This act shall take effect in 60 days. |
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