130th Ohio General Assembly
The online versions of legislation provided on this website are not official. Enrolled bills are the final version passed by the Ohio General Assembly and presented to the Governor for signature. The official version of acts signed by the Governor are available from the Secretary of State's Office in the Continental Plaza, 180 East Broad St., Columbus.

Sub. H. B. No. 197  As Reported by the House Health Committee
As Reported by the House Health 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 



A BILL
To amend sections 3727.11, 3727.12, 3727.14, and 3727.16, to amend for the purpose of adopting new section numbers as indicated in parentheses sections 3727.11 (3727.34), 3727.12 (3727.42), 3727.121 (3727.43), 3727.14 (3727.36), and 3727.16 (3727.45), to enact sections 3727.30, 3727.301, 3727.302, 3727.303, 3727.304, 3727.305, 3727.31, 3727.32, 3727.33, 3727.331, 3727.332, 3727.35, 3727.37, 3727.38, 3727.39, 3727.40, 3727.41, and 3727.44, and to repeal sections 3727.13 and 3727.15 of the Revised Code concerning hospitals submitting information about performance measures and disclosing price data.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 3727.11, 3727.12, 3727.14, and 3727.16 be amended, sections 3727.11 (3727.34), 3727.12 (3727.42), 3727.121 (3727.43), 3727.14 (3727.36), and 3727.16 (3727.45) be amended for the purpose of adopting new section numbers as indicated in parentheses, and sections 3727.30, 3727.301, 3727.302, 3727.303, 3727.304, 3727.305, 3727.31, 3727.32, 3727.33, 3727.331, 3727.332, 3727.35, 3727.37, 3727.38, 3727.39, 3727.40, 3727.41, and 3727.44 of the Revised Code be enacted to read as follows:
Sec. 3727.30.  There is hereby created the hospital performance measures advisory council. The council shall consist of the following members:
(A) The director of health;
(B) The superintendent of insurance;
(C) Two members of the house of representatives, from different political parties, appointed by the speaker of the house of representatives;
(D) Two members of the senate, from different political parties, appointed by the president of the senate;
(E) One representative of each of the following appointed by the speaker of the house of representatives:
(1) Health insurers;
(2) Small employers;
(3) Organized labor;
(4) Physicians in general practice;
(5) Childrens' hospitals.
(F) One representative of each of the following appointed by the president of the senate:
(1) Physicians specializing in public health;
(2) Hospitals;
(3) Health services researchers;
(4) Health care consumers;
(5) Large employers.
Sec. 3727.301.  All of the following shall apply to members of the hospital performance measures advisory council:
(A) They shall serve at the pleasure of their appointing authority.
(B) They shall serve without remuneration, except to the extent that serving on the council is considered a part of their regular employment duties.
(C) They shall not be reimbursed for expenses incurred in the performance of their duties on the council.
Sec. 3727.302.  The director of health shall serve as chair of the hospital performance measures advisory council.
Sec. 3727.303.  The department of health shall provide meeting space and staff and other administrative support for the hospital performance measures advisory council.
Sec. 3727.304.  The hospital performance measures advisory council shall do all of the following:
(A) Study the issue of hospitals reporting information regarding performance measures for hospital inpatient and outpatient services, including how such reports are made in other states;
(B) Not later than one year after the date the last of the initial members of the council is appointed to the council, issue a report to the director of health with recommendations for all of the following:
(1) Collecting information from hospitals that shows the hospitals' records in meeting the performance measures;
(2) The audits performed under section 3727.332 of the Revised Code;
(3) Disseminating hospitals' records in meeting the performance measures, including effective means of displaying information on the internet web site established under section 3727.39 of the Revised Code;
(4) Explaining to the public how to use the information about the hospitals' records in meeting the performance measures, including explanations about the limitations of the information.
(C) Provide the director of health ongoing advice on the issue of hospitals reporting information regarding performance measures for hospital inpatient and outpatient services, disseminating the information so reported by hospitals, and making improvements to the reports and dissemination of information.
Sec. 3727.305. The director of health may consider, but is not required to follow, the recommendations and on-going advice provided to the director by the hospital performance measures advisory council under section 3727.304 of the Revised Code when implementing sections 3727.33 to 3727.40 of the Revised Code and adopting rules under section 3727.41 of the Revised Code.
Sec. 3727.31.  (A) The director of health shall convene a group of experts in data collection and analysis or a related field to do all of the following:
(1) Select, not later than thirty days after the date the last of the initial members of the hospital performance measures advisory council is appointed to the council, either the refined-diagnostic related group or all patients refined-diagnostic related group method by which a hospital may adjust information pursuant to division (B)(4) of section 3727.33 of the Revised Code;
(2) Issue, not later than one year after the date the last of the initial members of the hospital performance measures advisory council is appointed to the council, a report to the director that advises the director on how to provide for the internet web site established under section 3727.39 of the Revised Code to include a report on each hospital's overall record in meeting the performance measures established by the entities specified in division (A) of section 3727.33 of the Revised Code;
(3) Submit to the director guidelines to be used to determine whether a hospital's record in meeting a specific performance measure should be excluded from the web site established under section 3727.39 of the Revised Code because the hospital's caseload for the diagnosis or procedure that the performance measure concerns is insufficient to make the hospital's record a reliable indicator of its ability to treat the diagnosis or provide the procedure in a quality manner;
(B) In addition to convening a group of experts in data collection and analysis or a related field for the purposes of division (A) of this section, the director of health may convene such a group at other times the director determines necessary to assist the hospital performance measures advisory council with its duties, including assistance regarding the following:
(1) Determining the validity of performance measures for hospital inpatient and outpatient services;
(2) Determining the reliability of information hospitals submit to the director under section 3727.33 of the Revised Code, including how the factor of caseloads affects reliability;
(3) Audits conducted pursuant to section 3727.332 of the Revised Code.
(C) Each member of the hospital performance measures advisory council shall appoint an individual to serve on a group convened under this section. A member of the council who is an expert in data collection and analysis or a related field may appoint himself or herself to the group rather than appoint another individual. Individuals appointed to the group shall serve without remuneration, except to the extent that serving in the group is considered a part of their regular employment duties, and shall not be reimbursed for expenses incurred in the performance of their duties in the group.
Sec. 3727.32.  At times the director of health determines necessary, the director shall convene a group of health care consumers, nurses, and experts in infection control to provide the hospital performance measures advisory council information about infection issues that the council needs to be able to perform its duties. The director shall make the appointments to a group convened under this section. Individuals appointed to the group shall serve without remuneration, except to the extent that serving in the group is considered a part of their regular employment duties, and shall not be reimbursed for expenses incurred in the performance of their duties in the group.
Sec. 3727.33.  (A) Beginning not later than thirty days after the group convened under section 3727.31 of the Revised Code completes its duty under division (A)(1) of that section, each hospital shall semiannually submit information to the director of health that shows the hospital's record in meeting each of the performance measures for hospital inpatient and outpatient services established by each of the following:
(1) The agency for health care research and quality;
(2) The national quality forum;
(3) The United States centers for medicare and medicaid services;
(4) The national committee for quality assurance;
(5) The joint commission on accreditation of healthcare organizations.
(B) In submitting information under division (A) of this section, each hospital shall do all of the following:
(1) Submit the information for the hospital's inpatient and outpatient services regardless of who pays the charges incurred for the services;
(2) Use the diagnosis and procedure codes for either or both of the following as appropriate:
(a) The version of the international classification of diseases, clinical modification, that is current at the time the information is submitted;
(b) The version of the current procedural terminology (CPT) published by the American medical association that is current at the time the information is submitted.
(3) Include data about all of the following with the information:
(a) The hospital's caseloads for treating diagnoses and providing procedures;
(b) Adjusted length of stays;
(c) Complication rates, including complications from infections;
(d) Mortality rates.
(4) If the hospital determines that any of the information is misleading unless adjusted to reflect patients' risk factors, adjust the information to reflect the risk factors in accordance with the method selected by the group convened under section 3727.31 of the Revised Code;
(5) Provide for the information to reflect the performance measures in effect on the date the information is submitted;
(6) Beginning with the first submission of information made after the initial rules governing the submission of the information that are adopted under section 3727.41 of the Revised Code go into effect, follow those rules.
Sec. 3727.331.  A hospital may provide for a third party to determine whether any information to be submitted to the director of health under section 3727.33 of the Revised Code should be adjusted for risk pursuant to division (B)(4) of that section.
Sec. 3727.332.  The director of health may audit any information submitted to the director under section 3727.33 of the Revised Code, including information adjusted for risk pursuant to division (B)(4) of that section.
Sec. 3727.11 3727.34 (A) As used in this section, "nongovernmental patient" means any patient other than a patient for whom primary charges are paid under Title XVIII or XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended, or by the bureau for children with medical handicaps under sections 3701.023 to 3701.028 of the Revised Code.
(B) On or before the first day of May each year, every hospital shall disclose to the department director of health the following data for nongovernmental all patients, regardless of who pays the charges incurred, in each of the one hundred sixty diagnosis related groups as defined pursuant to 42 C.F.R. 412 most frequently treated on an inpatient basis in the hospital as represented by inpatient discharges during the previous calendar year and in each of the sixty diagnosis related groups as defined pursuant to 42 C.F.R. 412 most frequently treated on an outpatient basis in the hospital as represented by outpatient discharges during the previous calendar year:
(1) The total number of patients discharged;
(2) The mean, median, and range of total hospital charges;
(3) The mean, median, and range of length of stay;
(4) The number of admissions from each of the following:
(a) Emergency room;
(b) Transfer from another hospital;
(c) Other sources of admission.
(5) The number of nongovernmental patients falling within diagnosis related group numbers 468, 469, and 470 as defined pursuant to 42 C.F.R. part 412.
This section does not require disclosure of data for any diagnosis related group for which the hospital treated fewer than ten nongovernmental patients during the year.
Each hospital may include with data disclosed under this section commentary concerning reasons for major deviations in the range of data for any diagnosis related group. All reports or other releases of information by the department director identifying a hospital shall include the commentary provided by the hospital. The department director shall maintain the information disclosed under division (B)(A) of this section as a public record in accordance with section 149.43 of the Revised Code.
(C)(B) Every hospital shall make the information it reports under division (B)(A) of this section available for inspection by any member of the public at any reasonable time. On request, the hospital shall make copies available for a reasonable fee, and the hospital shall advise the requesting person that the information is available from the department director of health. If a hospital has information available on the average prices of diagnosis related groups or specific procedures not required to be disclosed under this section, it shall make such information available at the request of any member of the public.
If the federal government adopts a severity of illness classification system under Title XVIII of the "Social Security Act," such system shall be used by all hospitals in reporting their diagnosis related group prices effective with hospital fiscal years beginning on or after said action, and if the federal government fails to act by July 1, 1988, the public health council shall adopt rules under Chapter 119. of the Revised Code requiring the use of one or more severity of illness classification systems effective with hospital fiscal years beginning on or after January 1, 1989.
Sec. 3727.35.  The director of health shall permit a hospital to verify the accuracy of all information submitted to the director under section 3727.33 and data disclosed under section 3727.34 of the Revised Code and provide corrections of the information and data in a timely manner.
Sec. 3727.14 3727.36 Under no circumstances shall the name or social security number of a patient or, physician, or dentist be included in the information submitted under section 3727.33 or data disclosed under sections 3727.11 and 3727.13 section 3727.34 of the Revised Code.
The health care information data base collected by the department of health under section 3727.13 of the Revised Code and any analysis of such information shall be maintained as a public record within the meaning of section 149.43 of the Revised Code. No data collected by the department pursuant to this section shall be released to the public except on an aggregate basis by geographic area, by institution, or by other aggregation.
No hospital that discloses data under section 3727.11 or 3727.13 of the Revised Code is liable for misuse or improper release of the data by the department or by any other person.
Sec. 3727.37.  No hospital that submits information under section 3727.33 or discloses data under section 3727.34 of the Revised Code is liable for the misuse or improper release of the information or data by any of the following:
(A) The department of health;
(B) A person with whom the department contracts under section 3727.40 of the Revised Code;
(C) A person whose misuse or improper release of the information or data is not done on behalf of the hospital.
Sec. 3727.38.  Neither information submitted under section 3727.33 nor data disclosed under section 3727.34 of the Revised Code shall be used to establish or alter any professional standard of care or be admissible as evidence in any civil, criminal, or administrative proceeding.
Sec. 3727.39.  (A) The director of health shall make the information submitted to the director by hospitals under section 3727.33 of the Revised Code and the data disclosed by hospitals under section 3727.34 of the Revised Code available on an internet web site available to the public. In making the information and data available on a web site, the director shall do all of the following:
(1) Provide for the web site to be organized in a manner that enables the public to use it easily;
(2) Exclude from the web site any information that compromises patient privacy;
(3) Include links to hospitals' internet web sites to enable the public to obtain additional information about hospitals, including hospitals' programs designed to enhance quality and safety;
(4) Allow other internet web sites to link to the web site for the purposes of increasing the web site's availability and encouraging ongoing improvement;
(5) Update the web site as hospitals submit new information under section 3727.33 of the Revised Code, disclose new data under section 3727.34 of the Revised Code, and as needed to correct errors.
(B) The information submitted under section 3727.33 of the Revised Code shall be presented on the web site in a manner that enables the public to compare hospitals' records in meeting the performance measures for hospital inpatient and outpatient services established by the entities specified in division (A) of section 3727.33 of the Revised Code. In making the information available on a web site, the director shall do all of the following:
(1) Enable the public to compare hospitals' records in meeting the performance measures for specific diagnoses and procedures;
(2) Enable the public to make the comparisons by different geographic regions, such as by county or zip code;
(3) Based on the report issued to the director pursuant to division (A)(2) of section 3727.31 of the Revised Code, include a report of each hospital's overall record in meeting the performance measures;
(4) To the extent possible, include state and federal benchmarks for the performance measures;
(5) Include contextual information and explanations that the public can easily understand, including contextual information that explains why differences in different hospital's records in meeting the performance measures may be misleading;
(6) Exclude from the web site a hospital's record in meeting a specific performance measure if the hospital's caseload for the diagnosis or procedure that the performance measure concerns is insufficient, as determined in accordance with the guidelines submitted to the director under division (A)(3) of section 3727.31 of the Revised Code, to make the hospital's record for the diagnosis or procedure a reliable indicator of its ability to treat the diagnosis or provide the procedure in a quality manner;
(7) Clearly identify the sources of data used in the web site and explain the analytical methods used in determining hospitals' records in meeting performance measures.
Sec. 3727.40.  The director of health may contract with a person for the person to perform the director's duties under sections 3727.33 to 3727.39 of the Revised Code.
Sec. 3727.41.  The director of health shall adopt rules in accordance with Chapter 119. of the Revised Code that govern hospitals' submission of information and disclosure of data to the director of health under sections 3727.33 and 3727.34 of the Revised Code.
Sec. 3727.12 3727.42 (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. 3727.121 3727.43 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. 3727.44.  The director of health may adopt rules in accordance with Chapter 119. of the Revised Code to carry out the purpose of sections 3727.42 and 3727.43 of the Revised Code.
Sec. 3727.16 3727.45 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 3727.33, 3727.34, and 3727.12 3727.42 of the Revised Code.
Section 2. That existing sections 3727.11, 3727.12, 3727.121, 3727.14, and 3727.16 and sections 3727.13 and 3727.15 of the Revised Code are hereby repealed.
Please send questions and comments to the Webmaster.
© 2019 Legislative Information Systems | Disclaimer