26B-1-413.  Health Data Committee — Purpose, powers, and duties of the committee — Membership — Terms — Chair — Compensation.

(1)  The definitions in Section 26B-8-501 apply to this section.

Terms Used In Utah Code 26B-1-413

  • Advice and consent: Under the Constitution, presidential nominations for executive and judicial posts take effect only when confirmed by the Senate, and international treaties become effective only when the Senate approves them by a two-thirds vote.
  • Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Executive director: means the executive director of the department appointed under Section 26B-1-203. See Utah Code 26B-1-102
  • Person: means :Utah Code 68-3-12.5
  • Quorum: The number of legislators that must be present to do business.
  • State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(2) 

(a)  There is created within the department the Health Data Committee.

(b)  The purpose of the committee is to direct a statewide effort to collect, analyze, and distribute health care data to facilitate the promotion and accessibility of quality and cost-effective health care and also to facilitate interaction among those with concern for health care issues.

(3)  The committee shall:

(a)  with the concurrence of the department and in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, develop and adopt by rule, following public hearing and comment, a health data plan that shall among its elements:

(i)  identify the key health care issues, questions, and problems amenable to resolution or improvement through better data, more extensive or careful analysis, or improved dissemination of health data;

(ii)  document existing health data activities in the state to collect, organize, or make available types of data pertinent to the needs identified in Subsection (3)(a)(i);

(iii)  describe and prioritize the actions suitable for the committee to take in response to the needs identified in Subsection (3)(a)(i) in order to obtain or to facilitate the obtaining of needed data, and to encourage improvements in existing data collection, interpretation, and reporting activities, and indicate how those actions relate to the activities identified under Subsection (3)(a)(ii);

(iv)  detail the types of data needed for the committee’s work, the intended data suppliers, and the form in which such data are to be supplied, noting the consideration given to the potential alternative sources and forms of such data and to the estimated cost to the individual suppliers as well as to the department of acquiring these data in the proposed manner; the plan shall reasonably demonstrate that the committee has attempted to maximize cost-effectiveness in the data acquisition approaches selected;

(v)  describe the types and methods of validation to be performed to assure data validity and reliability;

(vi)  explain the intended uses of and expected benefits to be derived from the data specified in Subsection (3)(a)(iv), including the contemplated tabulation formats and analysis methods; the benefits described shall demonstrably relate to one or more of the following:

(A)  promoting quality health care;

(B)  managing health care costs; or

(C)  improving access to health care services;

(vii)  describe the expected processes for interpretation and analysis of the data flowing to the committee; noting specifically the types of expertise and participation to be sought in those processes; and

(viii)  describe the types of reports to be made available by the committee and the intended audiences and uses;

(b)  have the authority to collect, validate, analyze, and present health data in accordance with the plan while protecting individual privacy through the use of a control number as the health data identifier;

(c)  evaluate existing identification coding methods and, if necessary, require by rule adopted in accordance with Subsection (4), that health data suppliers use a uniform system for identification of patients, health care facilities, and health care providers on health data they submit under this section and 5; and

(d)  advise, consult, contract, and cooperate with any corporation, association, or other entity for the collection, analysis, processing, or reporting of health data identified by control number only in accordance with the plan.

(4)  In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the committee , with the concurrence of the department, may adopt rules to carry out the provisions of this section and Chapter 8, Part 5, Utah Health Data Authority.

(5) 

(a)  Except for data collection, analysis, and validation functions described in this section, nothing in this section or in 5, shall be construed to authorize or permit the committee to perform regulatory functions which are delegated by law to other agencies of the state or federal governments or to perform quality assurance or medical record audit functions that health care facilities, health care providers, or third party payors are required to conduct to comply with federal or state law.

(b)  The committee may not recommend or determine whether a health care provider, health care facility, third party payor, or self-funded employer is in compliance with federal or state laws including federal or state licensure, insurance, reimbursement, tax, malpractice, or quality assurance statutes or common law.

(6) 

(a)  Nothing in this section or in 5, shall be construed to require a data supplier to supply health data identifying a patient by name or describing detail on a patient beyond that needed to achieve the approved purposes included in the plan.

(7)  No request for health data shall be made of health care providers and other data suppliers until a plan for the use of such health data has been adopted.

(8) 

(a)  If a proposed request for health data imposes unreasonable costs on a data supplier, due consideration shall be given by the committee to altering the request.

(b)  If the request is not altered, the committee shall pay the costs incurred by the data supplier associated with satisfying the request that are demonstrated by the data supplier to be unreasonable.

(9)  After a plan is adopted as provided in Section 26B-8-504, the committee may require any data supplier to submit fee schedules, maximum allowable costs, area prevailing costs, terms of contracts, discounts, fixed reimbursement arrangements, capitations, or other specific arrangements for reimbursement to a health care provider.

(10) 

(a)  The committee may not publish any health data collected under Subsection (9) that would disclose specific terms of contracts, discounts, or fixed reimbursement arrangements, or other specific reimbursement arrangements between an individual provider and a specific payer.

(b)  Nothing in Subsection (9) shall prevent the committee from requiring the submission of health data on the reimbursements actually made to health care providers from any source of payment, including consumers.

(11)  The committee shall be composed of 15 members.

(12) 

(a)  One member shall be:

(i)  the commissioner of the Utah Insurance Department; or

(ii)  the commissioner’s designee who shall have knowledge regarding the health care system and characteristics and use of health data.

(b) 

(i)  Fourteen members shall be appointed by the governor with the advice and consent of the Senate in accordance with Subsection (13) and in accordance with 2.

(ii)  No more than seven members of the committee appointed by the governor may be members of the same political party.

(13)  The members of the committee appointed under Subsection (12)(b) shall:

(a)  be knowledgeable regarding the health care system and the characteristics and use of health data;

(b)  be selected so that the committee at all times includes individuals who provide care;

(c)  include one person employed by or otherwise associated with a general acute hospital as defined in Section 26B-2-201, who is knowledgeable about the collection, analysis, and use of health care data;

(d)  include two physicians, as defined in Section 58-67-102:

(i)  who are licensed to practice in this state;

(ii)  who actively practice medicine in this state;

(iii)  who are trained in or have experience with the collection, analysis, and use of health care data; and

(iv)  one of whom is selected by the Utah Medical Association;

(e)  include three persons:

(i)  who are:

(A)  employed by or otherwise associated with a business that supplies health care insurance to the business’s employees; and

(B)  knowledgeable about the collection and use of health care data; and

(ii)  at least one of whom represents an employer employing 50 or fewer employees;

(f)  include three persons representing health insurers:

(i)  at least one of whom is employed by or associated with a third-party payor that is not licensed under Title 31A, Chapter 8, Health Maintenance Organizations and Limited Health Plans;

(ii)  at least one of whom is employed by or associated with a third party that is licensed under Title 31A, Chapter 8, Health Maintenance Organizations and Limited Health Plans; and

(iii)  who are trained in, or experienced with the collection, analysis, and use of health care data;

(g)  include two consumer representatives:

(i)  from organized consumer or employee associations; and

(ii)  knowledgeable about the collection and use of health care data;

(h)  include one person:

(i)  representative of a neutral, non-biased entity that can demonstrate that the entity has the broad support of health care payers and health care providers; and

(ii)  who is knowledgeable about the collection, analysis, and use of health care data; and

(i)  include two persons representing public health who are trained in or experienced with the collection, use, and analysis of health care data.

(14) 

(a)  Except as required by Subsection (14)(b), as terms of current committee members expire, the governor shall appoint each new member or reappointed member to a four-year term.

(b)  Notwithstanding the requirements of Subsection (14)(a), the governor shall, at the time of appointment or reappointment, adjust the length of terms to ensure that the terms of committee members are staggered so that approximately half of the committee is appointed every two years.

(c)  Members may serve after the members’ terms expire until replaced.

(15)  When a vacancy occurs in the membership for any reason, the replacement shall be appointed for the unexpired term.

(16)  Committee members shall annually elect a chair of the committee from among the committee’s membership. The chair shall report to the executive director.

(17) 

(a)  The committee shall meet at least once during each calendar quarter. Meeting dates shall be set by the chair upon 10 working days’ notice to the other members, or upon written request by at least four committee members with at least 10 working days’ notice to other committee members.

(b)  Eight committee members constitute a quorum for the transaction of business. Action may not be taken except upon the affirmative vote of a majority of a quorum of the committee.

(c)  All meetings of the committee shall be open to the public, except that the committee may hold a closed meeting if the requirements of Sections 52-4-204, 52-4-205, and 52-4-206 are met.

(18)  A member:

(a)  may not receive compensation or benefits for the member’s service, but may receive per diem and travel expenses in accordance with:

(i)  Section 63A-3-106;

(ii)  Section 63A-3-107; and

(iii)  rules made by the Division of Finance pursuant to Sections 63A-3-106 and 63A-3-107; and

(b)  shall comply with the conflict of interest provisions described in 3.

Renumbered and Amended by Chapter 305, 2023 General Session

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