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To amend sections 3727.12, 3727.15, and 3727.16; to | 1 |
amend for the purpose of adopting new section | 2 |
numbers as indicated in parentheses sections | 3 |
3727.12 (3727.43), 3727.121 (3727.45), 3727.15 | 4 |
(3727.41), and 3727.16 (3727.48); to enact | 5 |
sections 3727.30, 3727.31, 3727.32, 3727.33, | 6 |
3727.34, 3727.35, 3727.36, 3727.37, 3727.38, | 7 |
3727.39, 3727.40, 3727.42, 3727.44, 3727.46, and | 8 |
3727.47; and to repeal sections 3727.11, 3727.13, | 9 |
and 3727.14 of the Revised Code to revise the law | 10 |
governing information hospitals are to provide to | 11 |
the Department of Health and the public. | 12 |
Section 1. That sections 3727.12, 3727.15, and 3727.16 be | 13 |
amended; sections 3727.12 (3727.43), 3727.121 (3727.45), 3727.15 | 14 |
(3727.41), and 3727.16 (3727.48) be amended for the purpose of | 15 |
adopting new section numbers as indicated in parentheses; and | 16 |
sections 3727.30, 3727.31, 3727.32, 3727.33, 3727.34, 3727.35, | 17 |
3727.36, 3727.37, 3727.38, 3727.39, 3727.40, 3727.42, 3727.44, | 18 |
3727.46, and 3727.47 of the Revised Code be enacted to read as | 19 |
follows: | 20 |
Sec. 3727.30. As used in sections 3727.30 to 3727.42 of the | 21 |
Revised Code: | 22 |
(A) "Case mix" means the distribution of patients into | 23 |
categories reflecting the differences in severity of illness or | 24 |
resource consumption. | 25 |
(B) "Complication rate" means the percentage of patients who | 26 |
experience a medical complication or a new medical problem while | 27 |
admitted as a patient in a hospital. | 28 |
(C) "Infection data" means data related to nosocomial | 29 |
infections in accordance with the national nosocomial infections | 30 |
surveillance (NNIS) system of the surgical infection prevention | 31 |
(SIP) measures. | 32 |
(D) "Mortality rate" means the number of patients who die | 33 |
while admitted as a patient in a hospital. | 34 |
(E) "Patient billing data" means all of the following | 35 |
information with respect to an individual patient: | 36 |
(1) Gender; | 37 |
(2) Age; | 38 |
(3) Zip code of primary residence; | 39 |
(4) Date of hospital admission; | 40 |
(5) Date of hospital discharge; | 41 |
(6) Type of hospital admission; | 42 |
(7) The uniform identifier of the physician or dentist who | 43 |
admits the patient to the hospital in accordance with section | 44 |
3727.06 of the Revised Code; | 45 |
(8) Diagnosis codes applicable at the time of hospital | 46 |
admission; | 47 |
(9) Patient status at time of discharge from the hospital; | 48 |
(10) Diagnosis codes applicable at the time of discharge from | 49 |
the hospital; | 50 |
(11) Codes of the procedures performed in the hospital and | 51 |
the dates of such procedures; | 52 |
(l2) Uniform hospital identifier; | 53 |
(13) Zip code of the hospital; | 54 |
(14) Uniform identifier of the attending physician or | 55 |
dentist; | 56 |
(15) Uniform identifier of any physician or dentist who | 57 |
operates on the patient if the patient has surgery; | 58 |
(16) Total charges incurred by revenue or hospital department | 59 |
code; | 60 |
(17) Uniform primary insurer identifier; | 61 |
(18) Any other information required by rules adopted under | 62 |
section 3727.41 of the Revised Code. | 63 |
(F) "Price and performance data" means all of the following | 64 |
information regarding each of the sixty conditions and procedures | 65 |
specified in rules adopted under section 3727.42 of the Revised | 66 |
Code: | 67 |
(1) Number of cases; | 68 |
(2) Average billed charge; | 69 |
(3) Average length of patient stay in the hospital; | 70 |
(4) Readmission rate; | 71 |
(5) Complication rate; | 72 |
(6) Mortality rate; | 73 |
(7) Infection data; | 74 |
(8) Whether the hospital uses an electronic system to order | 75 |
drugs. | 76 |
(G) "Physician" means an individual authorized under Chapter | 77 |
4731. of the Revised Code to practice medicine and surgery, | 78 |
osteopathic medicine and surgery, or podiatric medicine and | 79 |
surgery. | 80 |
(H) "Readmission rate" means the percentage of patients who | 81 |
are readmitted to a hospital within thirty days following a | 82 |
previous admission. | 83 |
(I) "Severity of illness" means the measurable degree of the | 84 |
potential for failure of one or more vital organs. | 85 |
Sec. 3727.31. Not later than forty-five days after the end | 86 |
of each calendar quarter, each hospital shall disclose to the | 87 |
department of health patient billing data for each patient who was | 88 |
admitted to, or received outpatient services at, the hospital. The | 89 |
patient billing data shall be disclosed in a format specified in | 90 |
rules adopted under section 3727.42 of the Revised Code. | 91 |
Sec. 3727.32. The department of health shall permit a | 92 |
hospital to verify the accuracy of all patient billing data | 93 |
disclosed to the department under section 3727.31 of the Revised | 94 |
Code and provide corrections of the data in a timely manner. | 95 |
Sec. 3727.33. No hospital that discloses patient billing | 96 |
data to the department of health in accordance with section | 97 |
3727.31 of the Revised Code is liable for the misuse or improper | 98 |
release of data by any of the following: | 99 |
(A) The department of health; | 100 |
(B) A person with whom the department contracts under section | 101 |
3727.46 of the Revised Code; | 102 |
(C) A person whose misuse or improper release of the data is | 103 |
not done on behalf of the hospital. | 104 |
Sec. 3727.34. The department of health shall aggregate | 105 |
patient billing data by hospital in accordance with a procedure | 106 |
specified in rules adopted under section 3727.42 of the Revised | 107 |
Code. The department shall do both of the following with the | 108 |
aggregated patient billing data: | 109 |
(A) Make it available on the department's internet web site; | 110 |
(B) Permit persons to purchase electronic access to it. | 111 |
Sec. 3727.35. In addition to the patient billing data | 112 |
received under section 3727.31 of the Revised Code, the department | 113 |
of health may receive data reported voluntarily by hospitals, | 114 |
other health care providers, third-party payers, or other | 115 |
entities. | 116 |
Sec. 3727.36. Beginning not later than October 1, 2006, and | 117 |
using the patient billing data that the department of health | 118 |
aggregates under section 3727.34 of the Revised Code and other | 119 |
data reported to the department voluntarily under section 3727.35 | 120 |
of the Revised Code, the department shall make available on its | 121 |
internet web site price and performance data for each hospital in | 122 |
the state. The department shall risk adjust the price and | 123 |
performance data for case mix and severity of illness, if | 124 |
applicable, pursuant to a procedure specified in rules adopted | 125 |
under section 3727.42 of the Revised Code. The web site shall use | 126 |
an interactive query system that does all of the following with | 127 |
respect to price and performance data: | 128 |
(A) Allows a person to view and compare the data for each | 129 |
hospital; | 130 |
(B) Includes a map that allows a person to compare the data | 131 |
for hospitals within a county; | 132 |
(C) Includes a description of each condition and procedure to | 133 |
which the data pertains; | 134 |
(D) Includes an explanation of why the data may differ from | 135 |
hospital to hospital. | 136 |
Sec. 3727.37. Before the department of health makes price | 137 |
and performance data that identifies a hospital available on its | 138 |
web site pursuant to section 3727.36 of the Revised Code, the | 139 |
department shall allow the hospital thirty days to verify the | 140 |
accuracy of any hospital-specific data. After receiving comments | 141 |
from a hospital, the department shall correct any information the | 142 |
department agrees is in error. | 143 |
Sec. 3727.38. Price and performance data or any other | 144 |
information released by the department of health under section | 145 |
3727.36 of the Revised Code shall neither be used to establish or | 146 |
alter any professional standard of care nor be admissible as | 147 |
evidence in any civil, criminal, or administrative proceeding. | 148 |
Sec. 3727.39. The department of health shall update the | 149 |
price and performance data made available on its internet web site | 150 |
pursuant to section 3727.36 of the Revised Code each calendar | 151 |
quarter. | 152 |
Sec. 3727.40. Neither the name nor the social security | 153 |
number of a patient, physician, or dentist shall be included in | 154 |
either of the following: | 155 |
(A) Patient billing data disclosed to the department of | 156 |
health under section 3727.31 of the Revised Code; | 157 |
(B) Price and performance data the department makes available | 158 |
under section 3727.36 of the Revised Code. | 159 |
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The collection, compilation, analysis, and dissemination of | 172 |
information by the department of health or by any person under | 173 |
contract with the department shall be performed in a manner that | 174 |
protects the confidentiality of patients | 175 |
dentists and meets the requirements of Chapter 1347. of the | 176 |
Revised Code. | 177 |
pursuant to | 178 |
shall | 179 |
confidentiality of | 180 |
protect patient confidentiality in accordance with section 3701.17 | 181 |
of the Revised Code. | 182 |
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Sec. 3727.42. The public health council shall adopt rules in | 186 |
accordance with Chapter 119. of the Revised Code to specify or | 187 |
provide for all of the following: | 188 |
(A) For the purpose of division (E)(18) of section 3727.30 of | 189 |
the Revised Code, additional information hospitals shall disclose | 190 |
to the department of health as part of patient billing data; | 191 |
(B) For the purpose of section 3727.31 of the Revised Code, a | 192 |
format for disclosure of patient billing data that complies with | 193 |
the electronic transaction standards and code sets adopted by the | 194 |
United States secretary of health and human services under 42 | 195 |
U.S.C. 1320d-2; | 196 |
(C) For the purpose of section 3727.34 of the Revised Code, a | 197 |
procedure to aggregate patient billing data by hospital that | 198 |
complies with 45 C.F.R. 164.514; | 199 |
(D) A procedure by which the department is to risk adjust | 200 |
price and performance data under section 3727.36 of the Revised | 201 |
Code; | 202 |
(E) The sixty conditions and procedures for which the | 203 |
department is to make price and performance data available on its | 204 |
internet web site under section 3727.36 of the Revised Code; | 205 |
(F) Anything else that is necessary to carry out the purposes | 206 |
of sections 3727.30 to 3727.42 of the Revised Code. | 207 |
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make available for inspection by the public a price information | 209 |
list containing the
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division (B) of this section and shall | 211 |
update the list to maintain current information. The price | 212 |
information list shall be compiled and made available in a format | 213 |
that complies with the electronic transaction standards and code | 214 |
sets adopted by the United States secretary of health and human | 215 |
services under 42 U.S.C. 1320d-2. | 216 |
(B) Each price information list required by division (A) of | 217 |
this section shall contain all of the following information: | 218 |
(1) The usual and customary room and board charges for each | 219 |
level of care within the hospital, including but not limited to | 220 |
private rooms, semiprivate rooms, other multiple patient rooms, | 221 |
and intensive care and other specialty units; | 222 |
(2) Rates charged for nursing care, if the hospital charges | 223 |
separately for nursing care; | 224 |
(3) The usual and customary charges, stated separately for | 225 |
inpatients and outpatients if different charges are imposed, for | 226 |
any of the following services provided by the hospital: | 227 |
(a) The thirty most common x-ray and radiological procedures; | 228 |
(b) The thirty most common laboratory procedures; | 229 |
(c) Emergency room services; | 230 |
(d) Operating room services; | 231 |
(e) Delivery room services; | 232 |
(f) Physical, occupational, and pulmonary therapy services; | 233 |
(g) Any other services designated as high volume services by | 234 |
a rule which shall be adopted by the public health council. | 235 |
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whether the hospital charges interest on an amount not paid in | 238 |
full by any person or government entity and the interest rate | 239 |
charged; | 240 |
(5) Whether or not the charges listed include fees for the | 241 |
services of hospital-based anesthesiologists, radiologists, | 242 |
pathologists, and emergency room physicians | 243 |
charge does
not include such fees, | 244 |
such fee information can be obtained. | 245 |
(C) | 246 |
price information list required by this section: | 247 |
(1) At the time of admission, or as soon as practical | 248 |
thereafter, | 249 |
availability of the | 250 |
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of the list | 252 |
(2) On request, | 253 |
list to any person or governmental agency, subject to payment of a | 254 |
reasonable fee for copying and processing; | 255 |
(3) Make the list available free of charge on the hospital's | 256 |
web site to any person and post an announcement of the list's | 257 |
availability in each of the hospital's billing offices and | 258 |
admission, patient waiting, and reception areas. | 259 |
Sec. 3727.44. No hospital shall change the amount the | 260 |
hospital charges for room and board or any service for which the | 261 |
charge is included in the price information list required by | 262 |
section 3727.43 of the Revised Code until at least thirty days | 263 |
after the date the hospital does all of the following: | 264 |
(A) Creates a notice of the pending change that identifies | 265 |
the amount and percentage by which the charge is to be increased | 266 |
or decreased; | 267 |
(B) Makes the notice available free of charge to the public | 268 |
on the hospital's internet web site; | 269 |
(C) Posts in the hospital's billing offices and admission, | 270 |
patient waiting, and reception areas an announcement regarding the | 271 |
availability of the notice. | 272 |
| 273 |
disclosure of the provisions of section 3924.21 of the Revised | 274 |
Code to every beneficiary who receives services at the hospital. | 275 |
Sec. 3727.46. The department of health may contract with a | 276 |
person for the person to take the actions required by sections | 277 |
3727.34 to 3727.40 of the Revised Code. | 278 |
Sec. 3727.47. The public health council may adopt rules in | 279 |
accordance with Chapter 119. of the Revised Code to carry out the | 280 |
purpose of sections 3721.43 to 3721.45 of the Revised Code. | 281 |
| 282 |
the court of common pleas of the county in which a hospital is | 283 |
located for a temporary or permanent injunction restraining the | 284 |
hospital from failure to comply with sections
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3727.31 and 3727.43 of the Revised Code. | 286 |
Section 2. That existing sections 3727.12, 3727.121, 3727.15, | 287 |
and 3727.16 and sections 3727.11, 3727.13, and 3727.14 of the | 288 |
Revised Code are hereby repealed. | 289 |