No. 42728 (Amendment): Rule R428-1. Health Data Plan and Incorporated Documents

(Amendment)

DAR File No.: 42728
Filed: 03/29/2018 11:27:01 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rule change reports that the Data Submittal Guide, as corrected on 03/15/2018, should be used by submitters to Utah's All Payer Claims Database (APCD).

Summary of the rule or change:

The rule change makes one technical change as explained; clarifies version of APCD Data Submittal Guide, as corrected on 03/15/2018, that should be used by all APCD submitters for data submissions required on or after 03/01/2018. Original description in DSG (APCD Element MC055) Professional Procedure Code -- Procedure code for professional services. HCPCS, including CPT codes of the American Medical Association, are valid entries. Corrected description in DSG HCPCS/CPT Procedure Code -- Healthcare Common Procedural Coding System (HCPCS). This includes the CPT codes maintained by the American Medical Association.

Statutory or constitutional authorization for this rule:

• Section 26-33a-109

Anticipated cost or savings to:

the state budget:

This rule change is not expected to have any fiscal impact on state government revenues or expenditures because it only clarifies the version of Data Submitter Guide expected for use by data submitters to Utah's APCD. 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 with the existing budget.

local governments:

This rule change is not expected to have any fiscal impact on local governments revenues or expenditures because they are not directly affected by this rule; nor are local governments indirectly impacted because thid rule does not create a situation requiring services from local governments.

small businesses:

This rule change is not expected to have any fiscal impact on small businesses' revenues or expenditures because all potentially impacted businesses have more than 50 employees. As a result, this rule will have no effect on small business budgets for costs or savings.

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

This rule change is not expected to have any fiscal impact on other individuals� revenues or expenditures because this change only clarifies a prior expectation.

Compliance costs for affected persons:

Affected persons are as follows: state government and non-small businesses (APCD suppliers). However, no compliance costs are anticipated as a result of this technical change in Rule R428-1.

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

After conducting a thorough analysis, it was determined that this proposed change will not result in a fiscal impact to businesses.

Joseph K. 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:

• 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:

05/15/2018

This rule may become effective on:

05/22/2018

Authorized by:

Joseph Miner, Executive Director

RULE TEXT

Appendix 1: Regulatory Impact Summary Table*

Fiscal Costs

FY 2018

FY 2019

FY 2020

State Government

$0

$0

$0

Local Government

$0

$0

$0

Small Businesses

$0

$0

$0

Non-Small Businesses

$0

$0

$0

Other Person

$0

$0

$0

Total Fiscal Costs:

$0

$0

$0

Fiscal Benefits

State Government

$0

$0

$0

Local Government

$0

$0

$0

Small Businesses

$0

$0

$0

Non-Small Businesses

$0

$0

$0

Other Persons

$0

$0

$0

Total Fiscal Benefits:

$0

$0

$0

Net Fiscal Benefits:

$0

$0

$0

 

*This table only includes fiscal impacts that could be measured. If there are inestimable fiscal impacts, they will not be included in this table. Inestimable impacts for State Government, Local Government, Small Businesses and Other Persons are described above. Inestimable impacts for Non - Small Businesses are described below.

 

Appendix 2: Regulatory Impact to Non - Small Businesses

There are 41 non-small businesses in the industry in question with each covering 2,500 or more Utah residents. These businesses will likely not experience a fiscal impact because the proposed change is a correction to previously-approved rule text.

 

Joseph Miner, MD, Executive Director for the Utah Department of Health, has reviewed and approved this fiscal analysis.

 

 

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 3.0 for data submissions required before March 1, 2018, and

(b) Utah All-Payer Claims Database Data Submission Guide Version 3.1 (as corrected on March 15, 2018) for data submissions required on or after March 1, 2018.

 

KEY: health, health policy, health planning, APCD

Date of Enactment or Last Substantive Amendment: [December 12, 2017]2018

Notice of Continuation: November 10, 2016

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

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