As Reported by the Senate Health, Human Services and Aging Committee

126th General Assembly
Regular Session
2005-2006
Sub. H. B. No. 197


Representatives Raussen, Gibbs, McGregor, J., Carmichael, Evans, C., Flowers, Evans, D., Faber, Ujvagi, Koziura, Schaffer, Blasdel, Martin, Beatty, Blessing, Cassell, Collier, DeBose, Distel, Dolan, Domenick, Fessler, Hagan, Hughes, Key, Law, Mason, Miller, Patton, S., Smith, S., Stewart, D., Sykes, Wagoner, White, Williams, Woodard, Yuko 

Senator Clancy 



A BILL
To amend sections 111.15, 3702.11, 3702.16, 3702.18, 1
3727.11, 3727.12, 3727.14, and 3727.16, to amend 2
for the purpose of adopting new section numbers as 3
indicated in parentheses sections 3727.11 4
(3727.34), 3727.12 (3727.42), 3727.121 (3727.43), 5
3727.14 (3727.36), and 3727.16 (3727.45), to enact 6
sections 3727.31, 3727.311, 3727.312, 3727.313, 7
3727.32, 3727.321, 3727.33, 3727.331, 3727.35, 8
3727.37, 3727.38, 3727.39, 3727.391, 3727.40, 9
3727.41, and 3727.44, and to repeal sections 10
3727.13 and 3727.15 of the Revised Code concerning 11
the submission of information by hospitals about 12
their performance in meeting certain measures and 13
their charges for services.14


BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

       Section 1. That sections 111.15, 3702.11, 3702.16, 3702.18, 15
3727.11, 3727.12, 3727.14, and 3727.16 be amended, sections 16
3727.11 (3727.34), 3727.12 (3727.42), 3727.121 (3727.43), 3727.14 17
(3727.36), and 3727.16 (3727.45) be amended for the purpose of 18
adopting new section numbers as indicated in parentheses, and 19
sections 3727.31, 3727.311, 3727.312, 3727.313, 3727.32, 3727.321, 20
3727.33, 3727.331, 3727.35, 3727.37, 3727.38, 3727.39, 3727.391, 21
3727.40, 3727.41, and 3727.44 of the Revised Code be enacted to 22
read as follows:23

       Sec. 111.15.  (A) As used in this section:24

       (1) "Rule" includes any rule, regulation, bylaw, or standard25
having a general and uniform operation adopted by an agency under26
the authority of the laws governing the agency; any appendix to a27
rule; and any internal management rule. "Rule" does not include28
any guideline adopted pursuant to section 3301.0714 of the Revised29
Code, any order respecting the duties of employees, any finding,30
any determination of a question of law or fact in a matter31
presented to an agency, or any rule promulgated pursuant to32
Chapter 119., section 4141.14, division (C)(1) or (2) of section33
5117.02, or section 5703.14 of the Revised Code. "Rule" includes34
any amendment or rescission of a rule.35

       (2) "Agency" means any governmental entity of the state and36
includes, but is not limited to, any board, department, division,37
commission, bureau, society, council, institution, state college38
or university, community college district, technical college39
district, or state community college. "Agency" does not include40
the general assembly, the controlling board, the adjutant41
general's department, or any court.42

       (3) "Internal management rule" means any rule, regulation,43
bylaw, or standard governing the day-to-day staff procedures and44
operations within an agency.45

       (4) "Substantive revision" has the same meaning as in46
division (J) of section 119.01 of the Revised Code.47

       (B)(1) Any rule, other than a rule of an emergency nature,48
adopted by any agency pursuant to this section shall be effective49
on the tenth day after the day on which the rule in final form and50
in compliance with division (B)(3) of this section is filed as51
follows:52

       (a) The rule shall be filed in electronic form with both the53
secretary of state and the director of the legislative service54
commission;55

       (b) The rule shall be filed in electronic form with the joint 56
committee on agency rule review. Division (B)(1)(b) of this57
section does not apply to any rule to which division (D) of this58
section does not apply.59

       An agency that adopts or amends a rule that is subject to60
division (D) of this section shall assign a review date to the61
rule that is not later than five years after its effective date. 62
If no review date is assigned to a rule, or if a review date63
assigned to a rule exceeds the five-year maximum, the review date64
for the rule is five years after its effective date. A rule with a 65
review date is subject to review under section 119.032 of the66
Revised Code. This paragraph does not apply to a rule of a state67
college or university, community college district, technical68
college district, or state community college.69

       If all filings are not completed on the same day, the rule70
shall be effective on the tenth day after the day on which the71
latest filing is completed. If an agency in adopting a rule72
designates an effective date that is later than the effective date73
provided for by division (B)(1) of this section, the rule if filed74
as required by such division shall become effective on the later75
date designated by the agency.76

       Any rule that is required to be filed under division (B)(1)77
of this section is also subject to division (D) of this section if78
not exempted by division (D)(1), (2), (3), (4), (5), (6), (7), or79
(8) of this section.80

       If a rule incorporates a text or other material by reference,81
the agency shall comply with sections 121.71 to 121.76 of the82
Revised Code.83

       (2) A rule of an emergency nature necessary for the immediate 84
preservation of the public peace, health, or safety shall state 85
the reasons for the necessity. The emergency rule, in final form 86
and in compliance with division (B)(3) of this section, shall be 87
filed in electronic form with the secretary of state, the director 88
of the legislative service commission, and the joint committee on 89
agency rule review. The emergency rule is effective immediately 90
upon completion of the latest filing, except that if the agency in 91
adopting the emergency rule designates an effective date, or date 92
and time of day, that is later than the effective date and time 93
provided for by division (B)(2) of this section, the emergency 94
rule if filed as required by such division shall become effective 95
at the later date, or later date and time of day, designated by 96
the agency.97

       An emergency rule becomes invalid at the end of the ninetieth98
day it is in effect. Prior to that date, the agency may file the99
emergency rule as a nonemergency rule in compliance with division100
(B)(1) of this section. The agency may not refile the emergency101
rule in compliance with division (B)(2) of this section so that,102
upon the emergency rule becoming invalid under such division, the103
emergency rule will continue in effect without interruption for104
another ninety-day period.105

       (3) An agency shall file a rule under division (B)(1) or (2)106
of this section in compliance with the following standards and107
procedures:108

       (a) The rule shall be numbered in accordance with the109
numbering system devised by the director for the Ohio110
administrative code.111

       (b) The rule shall be prepared and submitted in compliance112
with the rules of the legislative service commission.113

       (c) The rule shall clearly state the date on which it is to114
be effective and the date on which it will expire, if known.115

       (d) Each rule that amends or rescinds another rule shall116
clearly refer to the rule that is amended or rescinded. Each117
amendment shall fully restate the rule as amended.118

       If the director of the legislative service commission or the119
director's designee gives an agency notice pursuant to section120
103.05 of the Revised Code that a rule filed by the agency is not121
in compliance with the rules of the legislative service122
commission, the agency shall within thirty days after receipt of123
the notice conform the rule to the rules of the commission as124
directed in the notice.125

       (C) All rules filed pursuant to divisions (B)(1)(a) and (2)126
of this section shall be recorded by the secretary of state and127
the director under the title of the agency adopting the rule and128
shall be numbered according to the numbering system devised by the129
director. The secretary of state and the director shall preserve130
the rules in an accessible manner. Each such rule shall be a131
public record open to public inspection and may be transmitted to132
any law publishing company that wishes to reproduce it.133

       (D) At least sixty-five days before a board, commission,134
department, division, or bureau of the government of the state135
files a rule under division (B)(1) of this section, it shall file136
the full text of the proposed rule in electronic form with the137
joint committee on agency rule review, and the proposed rule is138
subject to legislative review and invalidation under division (I)139
of section 119.03 of the Revised Code. If a state board,140
commission, department, division, or bureau makes a substantive141
revision in a proposed rule after it is filed with the joint142
committee, the state board, commission, department, division, or143
bureau shall promptly file the full text of the proposed rule in144
its revised form in electronic form with the joint committee. The145
latest version of a proposed rule as filed with the joint146
committee supersedes each earlier version of the text of the same147
proposed rule. Except as provided in division (F) of this section, 148
a state board, commission, department, division, or bureau shall 149
also file the rule summary and fiscal analysis prepared under 150
section 121.24 or 127.18 of the Revised Code, or both, in 151
electronic form along with a proposed rule, and along with a 152
proposed rule in revised form, that is filed under this division.153

       As used in this division, "commission" includes the public154
utilities commission when adopting rules under a federal or state155
statute.156

       This division does not apply to any of the following:157

       (1) A proposed rule of an emergency nature;158

       (2) A rule proposed under section 1121.05, 1121.06, 1155.18, 159
1163.22, 1349.33, 1707.201, 1733.412, 4123.29, 4123.34, 4123.341, 160
4123.342, 4123.40, 4123.411, 4123.44, or 4123.442 of the Revised 161
Code;162

       (3) A rule proposed by an agency other than a board,163
commission, department, division, or bureau of the government of164
the state;165

       (4) A proposed internal management rule of a board,166
commission, department, division, or bureau of the government of167
the state;168

       (5) Any proposed rule that must be adopted verbatim by an169
agency pursuant to federal law or rule, to become effective within170
sixty days of adoption, in order to continue the operation of a171
federally reimbursed program in this state, so long as the172
proposed rule contains both of the following:173

       (a) A statement that it is proposed for the purpose of174
complying with a federal law or rule;175

       (b) A citation to the federal law or rule that requires176
verbatim compliance.177

       (6) An initial rule proposed by the director of health to178
impose safety standards,and quality-of-care standards, and179
quality-of-care data reporting requirements with respect to a180
health service specified in section 3702.11 of the Revised Code,181
or an initial rule proposed by the director to impose quality182
standards on a facility listed in division (A)(4) of section183
3702.30 of the Revised Code, if section 3702.12 of the Revised184
Code requires that the rule be adopted under this section;185

       (7) A rule of the state lottery commission pertaining to186
instant game rules.187

       If a rule is exempt from legislative review under division188
(D)(5) of this section, and if the federal law or rule pursuant to189
which the rule was adopted expires, is repealed or rescinded, or190
otherwise terminates, the rule is thereafter subject to191
legislative review under division (D) of this section.192

       (E) Whenever a state board, commission, department, division, 193
or bureau files a proposed rule or a proposed rule in revised form 194
under division (D) of this section, it shall also file the full 195
text of the same proposed rule or proposed rule in revised form in 196
electronic form with the secretary of state and the director of 197
the legislative service commission. Except as provided in division 198
(F) of this section, a state board, commission, department, 199
division, or bureau shall file the rule summary and fiscal 200
analysis prepared under section 121.24 or 127.18 of the Revised 201
Code, or both, in electronic form along with a proposed rule or 202
proposed rule in revised form that is filed with the secretary of 203
state or the director of the legislative service commission.204

       (F) Except as otherwise provided in this division, the205
auditor of state or the auditor of state's designee is not206
required to file a rule summary and fiscal analysis along with a207
proposed rule, or proposed rule in revised form, that the auditor208
of state proposes under section 117.12, 117.19, 117.38, or 117.43209
of the Revised Code and files under division (D) or (E) of this210
section. If, however, the auditor of state or the designee211
prepares a rule summary and fiscal analysis of the original212
version of such a proposed rule for purposes of complying with213
section 121.24 of the Revised Code, the auditor of state or214
designee shall file the rule summary and fiscal analysis in215
electronic form along with the original version of the proposed216
rule filed under division (D) or (E) of this section.217

       Sec. 3702.11.  The director of health shall adopt rules218
establishing safety standards,and quality-of-care standards, and219
quality-of-care data reporting requirements for each of the220
following:221

       (A) Solid organ and bone marrow transplantation;222

       (B) Stem cell harvesting and reinfusion;223

       (C) Cardiac catheterization;224

       (D) Open-heart surgery;225

       (E) Obstetric and newborn care;226

       (F) Pediatric intensive care;227

       (G) Operation of linear accelerators;228

       (H) Operation of cobalt radiation therapy units;229

       (I) Operation of gamma knives.230

       Sec. 3702.16.  The rules adopted under section 3702.11 of the 231
Revised Code at a minimum shall specify the following:232

       (A) A procedure that the director of health shall follow to 233
update and revise safety and quality-of-care standards to account 234
for technological advances;235

       (B) The responsibilities of the department of health and of 236
health care providers with respect to collection of data and237
monitoring and enforcing compliance with the safety and 238
quality-of-care standards established by the rules;239

       (C) The types of reports providers must submit, the types of 240
audits they must undergo, and the frequency with which they must 241
submit the reports and undergo the audits;242

       (D) The quality-of-care data that must be reported to the 243
department;244

       (E) A requirement that data be reported to the department no 245
less frequently than annually;246

       (F) A standardized data reporting format;247

       (G) A scale for determining the amount of penalties to be 248
imposed under section 3702.20 of the Revised Code based on the 249
severity of the violation.250

       Sec. 3702.18.  The director of health and any employee or 251
contractor of the department of health shall not make public any 252
quality-of-care data reported to the department pursuant to the253
rules adopted under section 3702.11 of the Revised Code, as that 254
section existed immediately prior to the effective date of this 255
amendment, or any record copied under section 3702.19 of the 256
Revised Code, that identifies or would tend to identify specific 257
patients.258

       The director and any employee or contractor of the department 259
shall not make public any data reported to the department pursuant 260
to the rulerules adopted under section 3702.11 of the Revised 261
Code, as that section existed immediately prior to the effective 262
date of this amendment, that requiresrequire reports on specific263
adverse events, bodily injuries, or complaints.264

       Sec. 3727.31.  There is hereby created the hospital measures 265
advisory council. The council shall consist of the following 266
members:267

       (A) The director of health;268

       (B) The superintendent of insurance;269

       (C) The executive director of the commission on minority 270
health or the executive director's designee;271

       (D) Two members of the house of representatives, from 272
different political parties, appointed by the speaker of the house 273
of representatives;274

       (E) Two members of the senate, from different political 275
parties, appointed by the president of the senate;276

       (F) One representative of each of the following appointed by 277
the speaker of the house of representatives:278

       (1) Health insurers;279

       (2) Small employers;280

       (3) Organized labor;281

       (4) Physicians in general practice;282

       (5) Childrens' hospitals.283

       (G) One representative of each of the following appointed by 284
the president of the senate:285

       (1) Physicians specializing in public health;286

       (2) Hospitals;287

       (3) Health services researchers;288

       (4) Health care consumers;289

       (5) Large employers.290

       Sec. 3727.311.  The director of health shall serve as chair 291
of the hospital measures advisory council. The department of 292
health shall provide meeting space and staff and other 293
administrative support for the council.294

       Sec. 3727.312.  The hospital measures advisory council shall 295
do all of the following:296

       (A) Study the issue of hospitals reporting information 297
regarding their performance in meeting measures for hospital 298
inpatient and outpatient services, including how such reports are 299
made in other states;300

       (B) Not later than one year after the date the last of the 301
initial council members is appointed, issue a report to the 302
director of health with recommendations for all of the following:303

       (1) Collecting, pursuant to section 3727.33 of the Revised 304
Code, information from hospitals that shows their performance in 305
meeting measures for hospital inpatient and outpatient services;306

       (2) The audits conducted pursuant to section 3727.331 of the 307
Revised Code;308

       (3) Disseminating information about the performance of 309
hospitals in meeting the measures, including effective methods of 310
displaying information on any internet web site established under 311
section 3727.39 of the Revised Code;312

       (4) Explaining to the public how to use the information about 313
the performance of hospitals in meeting the measures, including 314
explanations about the limitations of the information.315

       (C) Provide the director of health ongoing advice on all of 316
the following:317

       (1) The issue of hospitals reporting information regarding 318
their performance in meeting measures for hospital inpatient and 319
outpatient services;320

       (2) Disseminating the information reported by hospitals;321

       (3) Making improvements to the reports and dissemination of 322
information;323

       (4) Making changes to the information collection requirements 324
and dissemination methods.325

       (D) Convene a group of health care consumers, nurses, and 326
experts in infection control, the members of which shall be 327
appointed by the council according to a method selected by the 328
council, to provide information about infection issues to the 329
council as needed for the council to perform its duties.330

       Sec. 3727.313.  All of the following apply to members of the 331
hospital measures advisory council and the members of the group 332
convened by the council under division (D) of section 3727.312 of 333
the Revised Code:334

       (A) The members shall serve at the pleasure of their 335
appointing authority.336

       (B) The members shall serve without remuneration, except to 337
the extent that serving on the council or in the group is 338
considered a part of their regular employment duties.339

       (C) The members shall not be reimbursed for expenses incurred 340
in the performance of their duties on the council or in the group.341

       Sec. 3727.32.  (A) The director of health shall convene a 342
group of experts in data collection and analysis or a related 343
field to do all of the following:344

       (1) Develop, on an ongoing basis, recommendations regarding 345
measures for hospital inpatient and outpatient services and submit 346
the recommendations to the director for the director's 347
consideration when the director adopts rules under section 3727.41 348
of the Revised Code specifying the measures to be used by 349
hospitals in submitting information to the director under section 350
3727.33 of the Revised Code;351

       (2) Issue, not later than one year after the date the last of 352
the initial members of the hospital measures advisory council is 353
appointed, a report to the director that advises the director on 354
how to provide for any internet web site established under section 355
3727.39 of the Revised Code to include a report on each hospital's 356
overall performance in meeting the measures specified in rules 357
adopted under section 3727.41 of the Revised Code;358

       (3) Submit to the director guidelines to be used to determine 359
whether a hospital's performance in meeting a particular measure 360
should be excluded from any web site established under section 361
3727.39 of the Revised Code because the hospital's caseload for 362
the diagnosis or procedure that the measure concerns is 363
insufficient to make the hospital's performance a reliable 364
indicator of its ability to treat the diagnosis or perform the 365
procedure in a quality manner;366

       (4) Assist the hospital measures advisory council with the 367
part of the report required by division (B) of section 3727.312 of 368
the Revised Code that includes recommendations for the audits 369
conducted pursuant to section 3727.331 of the Revised Code and 370
provide the director ongoing advice on the issue of those audits.371

       (B) Each member of the hospital measures advisory council 372
shall appoint an individual to serve on a group convened under 373
this section, except that a member of the council who is an expert 374
in data collection and analysis or a related field may serve as a 375
member of the group rather than appoint another individual. The 376
director of health shall ensure that the group's membership 377
includes at least one representative of small and rural hospitals.378

       The members of the group shall serve without remuneration, 379
except to the extent that serving in the group is considered a 380
part of their regular employment duties. The members shall not be 381
reimbursed for expenses incurred in the performance of their 382
duties in the group.383

       Sec. 3727.321. (A) The group of experts convened under 384
section 3727.32 of the Revised Code may include in the 385
recommendations developed under division (A)(1) of that section 386
recommendations that the director of health's rules adopted under 387
section 3727.41 of the Revised Code include some or all of the 388
following measures:389

       (1) Hospital quality measures publicly reported by the 390
centers for medicare and medicaid services;391

       (2) Hospital quality measures publicly reported by the joint 392
commission on accreditation of healthcare organizations;393

       (3) Measures included in the patient safety indicators and 394
inpatient quality indicators developed by the agency for health 395
care research and quality;396

        (4) Measures included in the national voluntary consensus 397
standards for hospital care endorsed by the national quality 398
forum.399

        (B) In considering whether to recommend that the director 400
include a particular measure in the rules, the group of experts 401
shall consider whether there are any excessive administrative or 402
financial implications associated with the reporting of 403
information by hospitals regarding their performance in meeting 404
the measure.405

       Sec. 3727.33.  Beginning in 2007, not later than the first 406
day of each April and the first day of each October, each hospital 407
shall submit information to the director of health that shows the 408
hospital's performance in meeting each of the inpatient and 409
outpatient service measures specified in rules adopted under 410
section 3727.41 of the Revised Code.411

       In submitting information under this section, each hospital 412
shall do all of the following:413

       (A) Submit the information for the hospital's inpatient and 414
outpatient services regardless of who pays the charges incurred 415
for the services;416

       (B) For each measure for which the information is submitted, 417
use the form and specifications for the measure that the entity 418
that developed or endorsed the measure recommends be used for the 419
measure;420

        (C) Adjust for risk, as needed, the information for a 421
particular measure in accordance with the risk adjustment 422
methodology that the entity that developed or endorsed the measure 423
recommends be used for the measure;424

       (D) Provide for the information to reflect the hospital's 425
performance in meeting the measures over a twelve-month period;426

       (E) Follow the rules governing the submission of the 427
information that are adopted under section 3727.41 of the Revised 428
Code.429

       Sec. 3727.331.  The director of health may audit any 430
information submitted to the director under section 3727.33 of the 431
Revised Code, including information adjusted for risk pursuant to 432
division (C) of that section.433

       Sec. 3727.11.        Sec. 3727.34.  (A) As used in this section,434
"nongovernmental patient" means any patient other than a patient435
for whom primary charges are paid under Title XVIII or XIX of the436
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as437
amended, or by the bureau for children with medical handicaps 438
under sections 3701.023 to 3701.028 of the Revised Code.439

       (B) OnExcept as provided in division (C) of this section, on440
or before the first day of each May each year, everyeach hospital 441
shall disclosesubmit to the departmentdirector of health the 442
following datainformation pertaining to inpatient services, 443
regardless of who pays the charges incurred for the services, for 444
nongovernmental patients in each of the one hundredsixty445
diagnosis related groups as defined pursuant to 42 C.F.R. 412 most 446
frequently treated on an inpatient basis in the hospital as447
represented by inpatient discharges during the previous calendar 448
year:449

       (1) The total number of patients discharged;450

       (2) The mean, median, and range of total hospital charges;451

       (3) The mean, median, and range of length of stay;452

       (4) The number of admissions from each of the following:453

       (a) Emergency room;454

       (b) Transfer from another hospital;455

       (c) Other sources of admission.456

       (5) The number of nongovernmental patients falling within457
diagnosis related group numbers 468, 469, and 470 as defined458
pursuant to 42 C.F.R. part 412.459

       (B) On or before the first day of each May, each hospital 460
shall submit to the director of health the following information 461
pertaining to outpatient services, regardless of who pays the 462
charges incurred for the services, for patients in each of the 463
sixty categories of outpatient services most frequently provided 464
by the hospital as represented by outpatient discharges during the 465
previous calendar year:466

       (1) The mean and median of total hospital charges for the 467
services;468

       (2) For each of the sixty categories of services, the number 469
of patients for whom the hospital provided the services.470

        (C) This section does not require disclosurethe submission471
of datainformation for any diagnosis related group or outpatient 472
service category for which the hospital treated fewer than ten 473
nongovernmental patients during the year.474

       (D) Each hospital may include with data disclosedthe 475
information submitted under this section commentary concerning 476
reasons for major deviations in the range of datathe information477
for any diagnosis related group or outpatient service category. 478
All reports or other releases of information by the department479
director identifying a hospital shall include the commentary 480
provided by the hospital. The department481

       (E)(1) The director shall maintainmake the information 482
disclosedsubmitted under division (B) of this section as a public 483
recordavailable to the public in accordance with section 149.43484
sections 3727.39 and 3727.40 of the Revised Code.485

       (C)(2) Every hospital shall make the information it reports486
submits under division (B) of this section available for 487
inspection by any member of the public at any reasonable time. On 488
request, the hospital shall make copies available for a reasonable 489
fee, and the hospital shall advise the requesting person that the490
information is available from the departmentdirector of health, 491
as provided in sections 3727.39 and 3727.40 of the Revised Code. 492
If a hospital has information available on the average prices of493
diagnosis related groups, outpatient service categories, or 494
specific procedures not required to be disclosedsubmitted under 495
this section, it shall make such information available at the 496
request of any member of the public.497

       If the federal government adopts a severity of illness498
classification system under Title XVIII of the "Social Security499
Act," such system shall be used by all hospitals in reporting 500
their diagnosis related group prices effective with hospital 501
fiscal years beginning on or after said action, and if the federal 502
government fails to act by July 1, 1988, the public health council 503
shall adopt rules under Chapter 119. of the Revised Code requiring 504
the use of one or more severity of illness classification systems 505
effective with hospital fiscal years beginning on or after January 506
1, 1989.507

       Sec. 3727.35.  The director of health shall permit a hospital 508
to verify the accuracy of all information submitted to the 509
director under sections 3727.33 and 3727.34 of the Revised Code 510
and provide corrections of the information in a timely manner.511

       Sec. 3727.14.        Sec. 3727.36.  Under no circumstances shall the name 512
or social security number of a patient or, physician, or dentist513
be included in the data disclosedinformation submitted under 514
sections 3727.11 and 3727.13section 3727.33 or 3727.34 of the515
Revised Code.516

       The health care information data base collected by the517
department of health under section 3727.13 of the Revised Code and 518
any analysis of such information shall be maintained as a public 519
record within the meaning of section 149.43 of the Revised Code. 520
No data collected by the department pursuant to this section shall 521
be released to the public except on an aggregate basis by 522
geographic area, by institution, or by other aggregation.523

       No hospital that discloses data under section 3727.11 or524
3727.13 of the Revised Code is liable for misuse or improper525
release of the data by the department or by any other person.526

       Sec. 3727.37. A hospital that submits information under 527
section 3727.33 or 3727.34 of the Revised Code is not liable for 528
the misuse or improper release of the information by any of the 529
following:530

       (A) The department of health;531

       (B) A person with whom the director of health contracts under 532
section 3727.391 of the Revised Code;533

       (C) A person whose misuse or improper release of the 534
information is not done on behalf of the hospital.535

       Sec. 3727.38.  The information submitted under section 536
3727.33 or 3727.34 of the Revised Code shall not be used to 537
establish or alter any professional standard of care. The 538
information is not admissible as evidence in any civil, criminal, 539
or administrative proceeding.540

       Sec. 3727.39.  (A) The duties of the director of health under 541
this section are subject to section 3727.391 of the Revised Code.542

       (B) Not later than ninety days after a hospital submits 543
information to the director of health under section 3727.33 or 544
3727.34 of the Revised Code, the director shall make the submitted 545
information available on an internet web site. In making the 546
information available on a web site, the director shall do all of 547
the following:548

       (1) Make the web site available to the public without charge;549

       (2) Provide for the web site to be organized in a manner that 550
enables the public to use it easily;551

       (3) Exclude from the web site any information that 552
compromises patient privacy;553

       (4) Include links to hospital internet web sites to enable 554
the public to obtain additional information about hospitals, 555
including hospital programs designed to enhance quality and 556
safety;557

       (5) Allow other internet web sites to link to the web site 558
for purposes of increasing the web site's availability and 559
encouraging ongoing improvement;560

       (6) Update the web site as needed to include new information 561
and to correct errors.562

       (C) The information submitted under section 3727.33 of the 563
Revised Code shall be presented on the web site in a manner that 564
enables the public to compare the performance of hospitals in 565
meeting the measures for hospital inpatient and outpatient 566
services specified in rules adopted under section 3727.41 of the 567
Revised Code. In making the information available on a web site, 568
the director shall do all of the following:569

       (1) Enable the public to compare the performance of hospitals 570
in meeting the measures for specific diagnoses and procedures;571

       (2) Enable the public to make the comparisons by different 572
geographic regions, such as by county or zip code;573

       (3) Based on the report issued to the director pursuant to 574
division (A)(2) of section 3727.32 of the Revised Code, include a 575
report of each hospital's overall performance in meeting the 576
measures;577

       (4) To the extent possible, include state and federal 578
benchmarks for the measures;579

       (5) Include contextual information and explanations that the 580
public can easily understand, including contextual information 581
that explains why differences in the performance of hospitals in 582
meeting the measures may be misleading;583

       (6) Exclude from the web site a hospital's performance in 584
meeting a particular measure if the hospital's caseload for the 585
diagnosis or procedure that the measure concerns is insufficient, 586
as determined in accordance with the guidelines submitted to the 587
director under division (A)(3) of section 3727.32 of the Revised 588
Code, to make the hospital's performance for the diagnosis or 589
procedure a reliable indicator of its ability to treat the 590
diagnosis or provide the procedure in a quality manner;591

       (7) Clearly identify the sources of information used in the 592
web site and explain both of the following:593

       (a) The analytical methods used in determining the 594
performance of hospitals in meeting the measures;595

        (b) The risk adjustment methodologies that hospitals use to 596
adjust information submitted to the director pursuant to division 597
(C) of section 3727.33 of the Revised Code.598

       Sec. 3727.391. (A) The duties of the director of health under 599
section 3727.39 of the Revised Code apply only to the extent that 600
appropriations are made by the general assembly to make 601
performance of the duties possible.602

       (B) Subject to division (A) of this section, the director 603
shall enter into a contract with a person under which the 604
director's duties under section 3727.39 of the Revised Code are 605
performed by the person pursuant to the contract. The contract may 606
be entered into with any person selected by the director. For 607
purposes of section 3727.39 of the Revised Code, all references to 608
the director are references to the person who is under contract 609
with the director pursuant to this division.610

       The department of health may accept gifts, grants, 611
donations, and awards for purposes of paying the fees or other 612
costs incurred when a contract is entered into under this 613
division.614

       Sec. 3727.40. Not later than ninety days after a hospital 615
submits information to the director of health under section 616
3727.33 or 3727.34 of the Revised Code, the director shall make 617
the submitted information available for sale to any interested 618
person or government entity. When the director sells the 619
information, the fee charged shall not exceed a reasonable amount.620

       Sec. 3727.41. (A) The director of health shall adopt rules 621
governing hospitals in their submission of information to the 622
director under sections 3727.33 and 3727.34 of the Revised Code. 623
The rules shall be adopted in accordance with Chapter 119. of the 624
Revised Code.625

       (B)(1) The rules for submission of information under section 626
3727.33 of the Revised Code shall include rules specifying the 627
inpatient and outpatient service measures to be used by hospitals 628
in submitting the information. The rules may include any of the 629
measures recommended by the group of experts convened under 630
section 3727.32 of the Revised Code and shall include measures 631
from the following:632

       (a) Hospital quality measures publicly reported by the 633
centers for medicare and medicaid services;634

       (b) Hospital quality measures publicly reported by the joint 635
commission on accreditation of healthcare organizations;636

       (c) Measures that examine volume of cases, adjusted length of 637
stay, complications, infections, or mortality rates and are 638
developed by the agency for health care research and quality;639

       (d) Measures included in the national voluntary consensus 640
standards for hospital care endorsed by the national quality 641
forum.642

       (2) In adopting rules specifying the measures to be used by 643
hospitals in submitting the information, the director shall 644
consider both of the following:645

       (a) Whether hospitals have a sufficient caseload to make a 646
particular measure a reliable indicator of their ability to treat 647
a diagnosis or perform a procedure in a quality manner;648

       (b) Whether there are any excessive administrative or 649
financial implications associated with the reporting of 650
information by hospitals regarding their performance in meeting a 651
particular measure.652

       Sec. 3727.12.        Sec. 3727.42.  (A) Every hospital shall compile and 653
make available for inspection by the public a price information654
list containing the following information, whichspecified in 655
division (B) of this section and shall be updated periodically 656
update the list to maintain current information. The price 657
information list shall be compiled and made available in a format 658
that complies with the electronic transaction standards and code 659
sets adopted by the United States secretary of health and human 660
services under 42 U.S.C. 1320d-2.661

        (B) Each price information list required by division (A) of 662
this section shall contain all of the following information:663

       (1) The usual and customary room and board charges for each 664
level of care within the hospital, including but not limited to 665
private rooms, semiprivate rooms, other multiple patient rooms, 666
and intensive care and other specialty units;667

       (2) Rates charged for nursing care, if the hospital charges 668
separately for nursing care;669

       (3) The usual and customary charges, stated separately for670
inpatients and outpatients if different charges are imposed, for671
any of the following services provided by the hospital:672

       (a) The thirty most common x-ray and radiological procedures;673

       (b) The thirty most common laboratory procedures;674

       (c) Emergency room services;675

       (d) Operating room services;676

       (e) Delivery room services;677

       (f) Physical, occupational, and pulmonary therapy services;678

       (g) Any other services designated as high volume services by 679
a rule which shall be adopted by the public health council.680

       (B) The list required by division (A) of this section shall 681
specify whether(4) The hospital's billing policies, including 682
whether the hospital charges interest on an amount not paid in 683
full by any person or government entity and the interest rate 684
charged;685

        (5) Whether or not the charges listed include fees for the 686
services of hospital-based anesthesiologists, radiologists,687
pathologists, and emergency room physicians. If theand, if a688
charge does not include such fees, the listing shall specify how 689
such fee information can be obtained.690

       (C) AtEvery hospital shall do all of the following with the 691
price information list required by this section:692

       (1) At the time of admission, or as soon as practical693
thereafter, the hospital shall inform each patient of the694
availability of the price information list required by this695
section and on request shall provide the patient with a free copy696
of the list. On;697

       (2) On request, a hospital shall provide a paper copy of the698
list to any person or governmental agency, subject to payment of a 699
reasonable fee for copying and processing;700

       (3) Make the list available free of charge on the hospital's 701
internet web site.702

       Sec. 3727.121.        Sec. 3727.43.  Each hospital shall provide a full703
disclosure of the provisions of section 3924.21 of the Revised704
Code to every beneficiary who receives services at the hospital.705

       Sec. 3727.44.  The director of health may adopt rules to 706
carry out the purposes of sections 3727.42 and 3727.43 of the 707
Revised Code. All rules adopted pursuant to this section shall be 708
adopted in accordance with Chapter 119. of the Revised Code.709

       Sec. 3727.16.        Sec. 3727.45.  The director of health may apply to 710
the court of common pleas of the county in which a hospital is 711
located for a temporary or permanent injunction restraining the 712
hospital from failure to comply with sections 3727.113727.33, 713
3727.34, and 3727.123727.42 of the Revised Code.714

       Section 2. That existing sections 111.15, 3702.11, 3702.16, 715
3702.18, 3727.11, 3727.12, 3727.121, 3727.14, and 3727.16 and 716
sections 3727.13 and 3727.15 of the Revised Code are hereby 717
repealed.718