Utah Code 26B-8-513. Identifying potential overuse of non-evidence-based health care

26B-8-513. Identifying potential overuse of non-evidence-based health care.

(1)

The department shall, in accordance with Title 63G, Chapter 6a, Utah Procurement Code, contract with an entity to provide a nationally-recognized health waste calculator that:

Committee: means the Health Data Committee created in Section 26B-1-413. See Utah Code 26B-8-501
Contract: A legal written agreement that becomes binding when signed.
Organization: means any corporation, association, partnership, agency, department, unit, or other legally constituted institution or entity, or part thereof. See Utah Code 26B-8-501
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

(a)	uses principles such as the principles of the Choosing Wisely initiative of the American Board of Internal Medicine Foundation; and

(b)	is approved by the committee.

(2)

The department shall use the calculator described in Subsection (1) to:

(a)	analyze the data in the state‘s All Payer Claims Database; and

(b)	flag data entries that the calculator identifies as potential overuse of non- evidence-based health care.

(3)

The department, or a third party organization that the department contracts with in accordance with Title 63G, Chapter 6a, Utah Procurement Code, shall:

(a)	analyze the data described in Subsection (2)(b);

(b)	review current scientific literature about medical services that are best practice;

(c)	review current scientific literature about eliminating duplication in health care;

(d)	solicit input from Utah health care providers, health systems, insurers, and other stakeholders regarding duplicative health care quality initiatives and instances of non-alignment in metrics used to measure health care quality that are required by different health systems;

(e)	solicit input from Utah health care providers, health systems, insurers, and other stakeholders on methods to avoid overuse of non-evidence-based health care; and

(f)	present the results of the analysis, research, and input described in Subsections (3)(a) through (e) to the committee.

(4)

The committee shall:

(a)	make recommendations for action and opportunities for improvement based on the results described in Subsection (3)(f);

(b)	make recommendations on methods to bring into alignment the various health care quality metrics different entities in the state use; and

(c)	identify priority issues and recommendations to include in an annual report.

(5)

The department, or the third party organization described in Subsection (3) shall:

(a)	compile the report described in Subsection (4)(c); and

(b)	submit the report to the committee for approval.

(6)	Beginning in 2021, on or before November 1 each year, the department shall submit the report approved in Subsection (5)(b) to the Health and Human Services Interim Committee.

Renumbered and Amended by Chapter 306, 2023 General Session