26-33a-106.1 - Health care cost and reimbursement data.
26-33a-106.1. Health care cost and reimbursement data.
(1) (a) The committee shall, as funding is available, establish an advisory panel to advisethe committee on the development of a plan for the collection and use of health care datapursuant to Subsection 26-33a-104(6) and this section.
(b) The advisory panel shall include:
(i) the chairman of the Utah Hospital Association;
(ii) a representative of a rural hospital as designated by the Utah Hospital Association;
(iii) a representative of the Utah Medical Association;
(iv) a physician from a small group practice as designated by the Utah MedicalAssociation;
(v) two representatives who are health insurers, appointed by the committee;
(vi) a representative from the Department of Health as designated by the executivedirector of the department;
(vii) a representative from the committee;
(viii) a consumer advocate appointed by the committee;
(ix) a member of the House of Representatives appointed by the speaker of the House;and
(x) a member of the Senate appointed by the president of the Senate.
(c) The advisory panel shall elect a chair from among its members, and shall be staffedby the committee.
(2) (a) The committee shall, as funding is available:
(i) establish a plan for collecting data from data suppliers, as defined in Section26-33a-102, to determine measurements of cost and reimbursements for risk adjusted episodes ofhealth care;
(ii) assist the demonstration projects implemented by the Insurance Department pursuantto Section 31A-22-614.6, with access to cost data, reimbursement data, care process data, andprovider service data necessary for the demonstration projects' research, statistical analysis, andquality improvement activities:
(A) notwithstanding Subsection 26-33a-108(1) and Section 26-33a-109;
(B) contingent upon approval by the committee; and
(C) subject to a contract between the department and the entity providing analysis for thedemonstration project;
(iii) share data regarding insurance claims with insurers participating in the definedcontribution market created in Title 31A, Chapter 30, Part 2, Defined ContributionArrangements, only to the extent necessary for:
(A) renewals of policies in the defined contribution arrangement market; and
(B) risk adjusting in the defined contribution arrangement market; and
(iv) assist the Legislature and the public with awareness of, and the promotion of,transparency in the health care market by reporting on:
(A) geographic variances in medical care and costs as demonstrated by data available tothe committee; and
(B) rate and price increases by health care providers:
(I) that exceed the Consumer Price Index - Medical as provided by the United StatesBureau of Labor statistics;
(II) as calculated yearly from June to June; and
(III) as demonstrated by data available to the committee.
(b) The plan adopted under this Subsection (2) shall include:
(i) the type of data that will be collected;
(ii) how the data will be evaluated;
(iii) how the data will be used;
(iv) the extent to which, and how the data will be protected; and
(v) who will have access to the data.
Amended by Chapter 68, 2010 General Session