130th Ohio General Assembly
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H. B. No. 197  As Introduced
As Introduced

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


Representatives Raussen, Gibbs, McGregor, Carmichael, C. Evans, Flowers, D. Evans, Faber, Ujvagi, Koziura, Schaffer, Blasdel 



A BILL
To amend sections 3727.12, 3727.15, and 3727.16; to amend for the purpose of adopting new section numbers as indicated in parentheses sections 3727.12 (3727.43), 3727.121 (3727.45), 3727.15 (3727.41), and 3727.16 (3727.48); to enact sections 3727.30, 3727.31, 3727.32, 3727.33, 3727.34, 3727.35, 3727.36, 3727.37, 3727.38, 3727.39, 3727.40, 3727.42, 3727.44, 3727.46, and 3727.47; and to repeal sections 3727.11, 3727.13, and 3727.14 of the Revised Code to revise the law governing information hospitals are to provide to the Department of Health and the public.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 3727.12, 3727.15, and 3727.16 be amended; sections 3727.12 (3727.43), 3727.121 (3727.45), 3727.15 (3727.41), and 3727.16 (3727.48) be amended for the purpose of adopting new section numbers as indicated in parentheses; and sections 3727.30, 3727.31, 3727.32, 3727.33, 3727.34, 3727.35, 3727.36, 3727.37, 3727.38, 3727.39, 3727.40, 3727.42, 3727.44, 3727.46, and 3727.47 of the Revised Code be enacted to read as follows:
Sec. 3727.30.  As used in sections 3727.30 to 3727.42 of the Revised Code:
(A) "Case mix" means the distribution of patients into categories reflecting the differences in severity of illness or resource consumption.
(B) "Complication rate" means the percentage of patients who experience a medical complication or a new medical problem while admitted as a patient in a hospital.
(C) "Infection data" means data related to nosocomial infections in accordance with the national nosocomial infections surveillance (NNIS) system of the surgical infection prevention (SIP) measures.
(D) "Mortality rate" means the number of patients who die while admitted as a patient in a hospital.
(E) "Patient billing data" means all of the following information with respect to an individual patient:
(1) Gender;
(2) Age;
(3) Zip code of primary residence;
(4) Date of hospital admission;
(5) Date of hospital discharge;
(6) Type of hospital admission;
(7) The uniform identifier of the physician or dentist who admits the patient to the hospital in accordance with section 3727.06 of the Revised Code;
(8) Diagnosis codes applicable at the time of hospital admission;
(9) Patient status at time of discharge from the hospital;
(10) Diagnosis codes applicable at the time of discharge from the hospital;
(11) Codes of the procedures performed in the hospital and the dates of such procedures;
(l2) Uniform hospital identifier;
(13) Zip code of the hospital;
(14) Uniform identifier of the attending physician or dentist;
(15) Uniform identifier of any physician or dentist who operates on the patient if the patient has surgery;
(16) Total charges incurred by revenue or hospital department code;
(17) Uniform primary insurer identifier;
(18) Any other information required by rules adopted under section 3727.41 of the Revised Code.
(F) "Price and performance data" means all of the following information regarding each of the sixty conditions and procedures specified in rules adopted under section 3727.42 of the Revised Code:
(1) Number of cases;
(2) Average billed charge;
(3) Average length of patient stay in the hospital;
(4) Readmission rate;
(5) Complication rate;
(6) Mortality rate;
(7) Infection data;
(8) Whether the hospital uses an electronic system to order drugs.
(G) "Physician" means an individual authorized under Chapter 4731. of the Revised Code to practice medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery.
(H) "Readmission rate" means the percentage of patients who are readmitted to a hospital within thirty days following a previous admission.
(I) "Severity of illness" means the measurable degree of the potential for failure of one or more vital organs.
Sec. 3727.31.  Not later than forty-five days after the end of each calendar quarter, each hospital shall disclose to the department of health patient billing data for each patient who was admitted to, or received outpatient services at, the hospital. The patient billing data shall be disclosed in a format specified in rules adopted under section 3727.42 of the Revised Code.
Sec. 3727.32.  The department of health shall permit a hospital to verify the accuracy of all patient billing data disclosed to the department under section 3727.31 of the Revised Code and provide corrections of the data in a timely manner.
Sec. 3727.33.  No hospital that discloses patient billing data to the department of health in accordance with section 3727.31 of the Revised Code is liable for the misuse or improper release of data by any of the following:
(A) The department of health;
(B) A person with whom the department contracts under section 3727.46 of the Revised Code;
(C) A person whose misuse or improper release of the data is not done on behalf of the hospital.
Sec. 3727.34.  The department of health shall aggregate patient billing data by hospital in accordance with a procedure specified in rules adopted under section 3727.42 of the Revised Code. The department shall do both of the following with the aggregated patient billing data:
(A) Make it available on the department's internet web site;
(B) Permit persons to purchase electronic access to it.
Sec. 3727.35.  In addition to the patient billing data received under section 3727.31 of the Revised Code, the department of health may receive data reported voluntarily by hospitals, other health care providers, third-party payers, or other entities.
Sec. 3727.36.  Beginning not later than October 1, 2006, and using the patient billing data that the department of health aggregates under section 3727.34 of the Revised Code and other data reported to the department voluntarily under section 3727.35 of the Revised Code, the department shall make available on its internet web site price and performance data for each hospital in the state. The department shall risk adjust the price and performance data for case mix and severity of illness, if applicable, pursuant to a procedure specified in rules adopted under section 3727.42 of the Revised Code. The web site shall use an interactive query system that does all of the following with respect to price and performance data:
(A) Allows a person to view and compare the data for each hospital;
(B) Includes a map that allows a person to compare the data for hospitals within a county;
(C) Includes a description of each condition and procedure to which the data pertains;
(D) Includes an explanation of why the data may differ from hospital to hospital.
Sec. 3727.37.  Before the department of health makes price and performance data that identifies a hospital available on its web site pursuant to section 3727.36 of the Revised Code, the department shall allow the hospital thirty days to verify the accuracy of any hospital-specific data. After receiving comments from a hospital, the department shall correct any information the department agrees is in error.
Sec. 3727.38. Price and performance data or any other information released by the department of health under section 3727.36 of the Revised Code shall neither be used to establish or alter any professional standard of care nor be admissible as evidence in any civil, criminal, or administrative proceeding.
Sec. 3727.39.  The department of health shall update the price and performance data made available on its internet web site pursuant to section 3727.36 of the Revised Code each calendar quarter.
Sec. 3727.40.  Neither the name nor the social security number of a patient, physician, or dentist shall be included in either of the following:
(A) Patient billing data disclosed to the department of health under section 3727.31 of the Revised Code;
(B) Price and performance data the department makes available under section 3727.36 of the Revised Code.
Sec. 3727.15 3727.41 The department of health may issue reports concerning information reported or received under sections 3727.11 and 3727.13 of the Revised Code. Prior to releasing any reports which identify a hospital, the department shall allow the hospital thirty days to verify the accuracy of any hospital-specific data that has not been provided for hospital review previously under sections 3727.11 to 3727.16 of the Revised Code. After receiving comments from a hospital, the department shall correct any information the department agrees is in error. The department shall include in the reports commentary from the hospitals concerning major deviations in the range of data for any of the diagnosis related groups for which information is reported.
The collection, compilation, analysis, and dissemination of information by the department of health or by any person under contract with the department shall be performed in a manner that protects the confidentiality of patients and, physicians, and dentists and meets the requirements of Chapter 1347. of the Revised Code. No report prepared Data released by the department pursuant to this section 3727.34 or 3727.36 of the Revised Code shall include exclude any information that violates the confidentiality of patients and physicians or dentists and shall protect patient confidentiality in accordance with section 3701.17 of the Revised Code.
The public health council may adopt rules, pursuant to Chapter 119. of the Revised Code, to carry out the purposes of sections 3727.11 to 3727.16 of the Revised Code.
Sec. 3727.42.  The public health council shall adopt rules in accordance with Chapter 119. of the Revised Code to specify or provide for all of the following:
(A) For the purpose of division (E)(18) of section 3727.30 of the Revised Code, additional information hospitals shall disclose to the department of health as part of patient billing data;
(B) For the purpose of section 3727.31 of the Revised Code, a format for disclosure of patient billing data that complies with the electronic transaction standards and code sets adopted by the United States secretary of health and human services under 42 U.S.C. 1320d-2;
(C) For the purpose of section 3727.34 of the Revised Code, a procedure to aggregate patient billing data by hospital that complies with 45 C.F.R. 164.514;
(D) A procedure by which the department is to risk adjust price and performance data under section 3727.36 of the Revised Code;
(E) The sixty conditions and procedures for which the department is to make price and performance data available on its internet web site under section 3727.36 of the Revised Code;
(F) Anything else that is necessary to carry out the purposes of sections 3727.30 to 3727.42 of the Revised Code.
Sec. 3727.12 3727.43 (A) Every hospital shall compile and make available for inspection by the public a price information list containing the following information, which specified in division (B) of this section and shall be updated periodically update the list to maintain current information. The price information list shall be compiled and made available in a format that complies with the electronic transaction standards and code sets adopted by the United States secretary of health and human services under 42 U.S.C. 1320d-2.
(B) Each price information list required by division (A) of this section shall contain all of the following information:
(1) The usual and customary room and board charges for each level of care within the hospital, including but not limited to private rooms, semiprivate rooms, other multiple patient rooms, and intensive care and other specialty units;
(2) Rates charged for nursing care, if the hospital charges separately for nursing care;
(3) The usual and customary charges, stated separately for inpatients and outpatients if different charges are imposed, for any of the following services provided by the hospital:
(a) The thirty most common x-ray and radiological procedures;
(b) The thirty most common laboratory procedures;
(c) Emergency room services;
(d) Operating room services;
(e) Delivery room services;
(f) Physical, occupational, and pulmonary therapy services;
(g) Any other services designated as high volume services by a rule which shall be adopted by the public health council.
(B) The list required by division (A) of this section shall specify whether (4) The hospital's billing policies, including whether the hospital charges interest on an amount not paid in full by any person or government entity and the interest rate charged;
(5) Whether or not the charges listed include fees for the services of hospital-based anesthesiologists, radiologists, pathologists, and emergency room physicians. If the and, if a charge does not include such fees, the listing shall specify how such fee information can be obtained.
(C) At Every hospital shall do all of the following with the price information list required by this section:
(1) At the time of admission, or as soon as practical thereafter, the hospital shall inform each patient of the availability of the price information list required by this section and on request shall provide the patient with a free copy of the list. On;
(2) On request, a hospital shall provide a paper copy of the list to any person or governmental agency, subject to payment of a reasonable fee for copying and processing;
(3) Make the list available free of charge on the hospital's web site to any person and post an announcement of the list's availability in each of the hospital's billing offices and admission, patient waiting, and reception areas.
Sec. 3727.44.  No hospital shall change the amount the hospital charges for room and board or any service for which the charge is included in the price information list required by section 3727.43 of the Revised Code until at least thirty days after the date the hospital does all of the following:
(A) Creates a notice of the pending change that identifies the amount and percentage by which the charge is to be increased or decreased;
(B) Makes the notice available free of charge to the public on the hospital's internet web site;
(C) Posts in the hospital's billing offices and admission, patient waiting, and reception areas an announcement regarding the availability of the notice.
Sec. 3727.121 3727.45 Each hospital shall provide a full disclosure of the provisions of section 3924.21 of the Revised Code to every beneficiary who receives services at the hospital.
Sec. 3727.46. The department of health may contract with a person for the person to take the actions required by sections 3727.34 to 3727.40 of the Revised Code.
Sec. 3727.47.  The public health council may adopt rules in accordance with Chapter 119. of the Revised Code to carry out the purpose of sections 3721.43 to 3721.45 of the Revised Code.
Sec. 3727.16 3727.48 The director of health may apply to the court of common pleas of the county in which a hospital is located for a temporary or permanent injunction restraining the hospital from failure to comply with sections 3727.11 and 3727.12 3727.31 and 3727.43 of the Revised Code.
Section 2. That existing sections 3727.12, 3727.121, 3727.15, and 3727.16 and sections 3727.11, 3727.13, and 3727.14 of the Revised Code are hereby repealed.
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