No. 42209 (Amendment): Rule R428-1. Health Data Plan and Incorporated Documents

(Amendment)

DAR File No.: 42209
Filed: 10/13/2017 11:46:41 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

This change updates the versions of required documents for compliance in 2017 and 2018.

Summary of the rule or change:

The changes update materials incorporated by reference to reflect technical requirements expected for compliance; also clarify effective dates for Healthcare Facility Database (HFD) Data Submission Guides (Version 1 and Version 2), HEDIS Volume 3 Specifications for Survey Measures; HEDIS Volume 5 Compliance Audit, Standards, Policies and Procedures; and for the All Payer Claims Database (APCD) Data Submission Guides (Version 3.0 and Version 3.1).

Statutory or constitutional authorization for this rule:

• Section 26-33a-104

This rule or change incorporates by reference the following material:

• Removes All-Payer Claims Database Submission Guide, published by Utah Department of Health, Office of Health Care Statistics, 09/15/2016
• Adds Utah All-Payer Claims Database Submission Guide, published by Utah Department of Health, Office of Health Care Statistics, 09/26/2017
• Adds Healthcare Facility Database Submission Guide, published by Utah Department of Health, Office of Health Care Statistics, 09/12/2017

Anticipated cost or savings to:

the state budget:

This rule change iterates forward to the current versions of documents. The Utah Department of Health (UDOH) determines enactment of the amended version will not create any cost or savings impact to the state budget or UDOH's budget, since the change will not increase workload and can be carried out within the existing budget.

local governments:

This filing does not create any direct cost or savings impact to local governments since they are not directly affected by the rule; nor are local governments indirectly impacted because the rule does not create a situation requiring services from local governments.

small businesses:

None--Small businesses are not impacted by this rule change, all potentially impacted businesses have more than 50 employees. As a result, the rule change will have no effect on small business for costs or savings.

persons other than small businesses, businesses, or local governmental entities:

Some data suppliers will need to program changes in their system in order to be consistent with the updated guidelines. According to our research with APCD data carriers, some suppliers may incur cost while others report $0 as an estimate for compliance. Overall, UDOH estimates a one-time compliance cost of $2,000 per carrier (approximately 24 man hours x DTS approved Tier 3 rate of $88 per hour) to comply with proposed APCD DSG 3.1. According to our research of submitting healthcare facilities such as hospitals, ambulatory surgery centers and emergency departments, the compliance costs will be $0 per facility to comply with proposed HFD DSG Version 2, in part due to changes being absorbed by existing maintenance contracts between the facility and its vendor.

Compliance costs for affected persons:

UDOH anticipates that some APCD carriers will need to make programming changes to implement the additional flexibility and clarifications. By agreement with the APCD data suppliers, changes to the APCD DSG are limited to once per calendar year, so they should anticipate these changes as part of their normal business process in preparation for next year. The burden of these changes is consistent with that understanding. Based on figures reported in Box 7D and current APCD submission roster, UDOH estimates an industry cost of $84,000 (42 active carriers x $2,000) to comply with proposed APCD DSG 3.1. For healthcare facilities, consistent with the per-facility figure presented in Box 7D and current HFD submission roster, UDOH estimates an industry cost of $0 (93 active facilities x $0) to comply with proposed HFD DSG Version 2.

Comments by the department head on the fiscal impact the rule may have on businesses:

Some businesses will be impacted with a portion of a one time industry cost of $84,000 while other business will have no cost.

Joseph Miner, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Health
Center for Health Data, Health Care Statistics
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Mike Martin at the above address, by phone at 801-538-9205, by FAX at 801-538-9916, or by Internet E-mail at [e-mail]
• Norman Thurston at the above address, by phone at 801-538-7052, by FAX at 801-237-0787, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

12/01/2017

This rule may become effective on:

12/08/2017

Authorized by:

Joseph Miner, Executive Director

RULE TEXT

R428. Health, Center for Health Data, Health Care Statistics.

R428-1. Health Data Plan and Incorporated Documents.

R428-1-1. Legal Authority.

This rule is promulgated in accordance with Title 26, Chapter 33a.

 

R428-1-2. Purpose.

This rule adopts and incorporates documents related to the collection, analysis, and dissemination of data covered in this title.

 

R428-1-3. Health Data Plan Adoption.

As required by Section 26-33a-104, the Health Data Committee adopts by rule the health data plan dated October 3, 1991.

 

R428-1-4. Incorporation by Reference.

The following documents are adopted and incorporated by reference:

(1) "Utah Healthcare Facility Data Submission Guide" means:

(a) Utah Healthcare Facility Data Submission Guide, Version 1, January 15, 2016 for data submissions required before February 16, 2018, and

(b) Utah Healthcare Facility Data Submission Guide, Version 2 for data submissions required on or after February 16, 2018;

(2) "NCQA Survey Specifications" means:

(a) HEDIS 2017, Volume 3: Specifications for Survey Measures, published by NCQA for data submissions required before January 1, 2018, and

(b) HEDIS 2018, Volume 3: Specifications for Survey Measures, published by NCQA for data submissions required on or after January 1, 2018;

(3) "NCQA HEDIS Specifications" means:

(a) HEDIS 2017, Volume 5: HEDIS Compliance Audit: Standards, Policies, and Procedures, published by NCQA for data submissions required before January 1, 2018, and

(b) HEDIS 2018, Volume 5: HEDIS Compliance Audit: Standards, Policies, and Procedures, published by NCQA for data submissions required on or after January 1, 2018;

(4) "Data Submission Guide for Claims Data" means:

(a) Utah All-Payer Claims Database Data Submission Guide Version [2.2.1]3.0 for data submissions required before March 1, 2018, and

(b)[(5)] Utah All-Payer Claims Database Data Submission Guide Version [3.0]3.1 for data submissions required on or after March 1, 2018.

 

KEY: health, health policy, health planning

Date of Enactment or Last Substantive Amendment: [November 28, 2016]2017

Notice of Continuation: November 10, 2016

Authorizing, and Implemented or Interpreted Law: 26-33a-104

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