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Regular Session, 2014
SENATE BILL NO. 647
BY SENATOR HEITMEIER
MEDICAID. Provides relative to Medicaid managed care and health information
exchanges. (8/1/14)
AN ACT1
To enact Subpart C of Part XIII of Chapter 3 of Title 46 of the Louisiana Revised Statutes2
of 1950, to be comprised of R.S. 46:460.81, relative to Medicaid; to provide relative3
to health information exchanges; to provide relative to legislative findings; to4
provide for reporting and coordination; to provide relative to confidentiality; and to5
provide for related matters.6
Be it enacted by the Legislature of Louisiana:7
Section 1. Subpart C of Part XIII of Chapter 3 of Title 46 of the Louisiana Revised8
Statutes of 1950, comprised of R.S. 46:460.81, is hereby enacted to read as follows:9
SUBPART C. HEALTH INFORMATION EXCHANGES10
ยง460.81. Health information exchanges; legislative findings; requirements for11
Medicaid managed care; reporting; coordination; confidentiality12
A. The legislature finds health information exchanges facilitate informed13
clinical decisions, improve continuity and coordination of patient care, enhance14
health care quality and outcomes, reduce costs, improve efficiency, reduce15
avoidable interventions and services, and simplify and streamline16
administrative payor-provider communications. Furthermore, the legislature17 SB NO. 647
SLS 14RS-1677 ORIGINAL
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
finds that it will benefit the state of Louisiana, the individuals with Medicaid1
benefits who participate in managed care plans that contract with the2
Department of Health and Hospitals, and the Medicaid managed care plans if3
such an individual's data is reported to a health information exchange.4
B. The Department of Health and Hospitals shall require a Medicaid5
managed care plan to ensure:6
(1) Hospitals that are providers for a Medicaid managed care plan shall7
report each enrolled individual's hospital admission, discharge, and transfer8
data to the appropriate health information exchange for its parish as identified9
in Subsection (E) of this Section.10
(2) A notification system shall be developed in collaboration with the11
health information exchanges by which such information is promptly reported12
to each enrolled individual's primary care providers and managed care plan to13
improve continuity and coordination of patient care.14
C.(1) An enrolled individual's hospital admission, discharge, and15
transfer data shall be reported to the appropriate health information exchange16
in a uniform manner proscribed by the department through rules and17
regulations promulgated pursuant to the Administrative Procedure Act.18
(2) The enrolled individual's primary care provider shall be promptly19
notified of such admission, discharge, and transfer data.20
D.(1) The department shall maximize all available federal financial21
assistance to cover the cost of the reporting and notification required by this22
Section.23
(2) If there is insufficient funding to cover the costs of the health24
information exchanges, the Medicaid managed care plans shall pay a charge to25
the health information exchanges to offset unfunded costs that are associated26
with the reporting and notification of the enrolled individuals' admission,27
discharge, and transfer data as required by this Section.28
E. To implement a statewide system of reporting and notification, the29 SB NO. 647
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words in boldface type and underscored are additions.
health information exchanges located within the state receiving funding from1
the Office of the National Coordinator for Health Information Technology,2
United States Department of Health and Human Services, the Greater New3
Orleans Health Information Exchange, and the Louisiana Health Information4
Exchange shall provide services to its respective parishes.5
(1) The Greater New Orleans Health Information Exchange shall6
provide services in the greater New Orleans area, consisting of the parishes of7
Orleans, Jefferson, Plaquemines, St. Bernard, St. Charles, and St. Tammany.8
(2) The Louisiana Health Information Exchange shall provide services9
in the other parishes of the state.10
F.(1) The health information exchanges shall coordinate with each other11
for the implementation of the reporting and notifications required by this12
Section.13
(2) A health information exchange shall report to the department on a14
quarterly basis regarding its implementation of the reporting and notification15
requirements of this Section.16
G. A health information exchange shall maintain the confidentiality of17
the hospital admission, discharge, and transfer data and shall only provide such18
data to the managed care plan and primary care providers of the enrolled19
individual who is the subject of the report, unless otherwise instructed by the20
enrolled individual.21
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Christopher D. Adams.
DIGEST
Heitmeier (SB 647)
Proposed law provides for the use of health insurance exchanges by Medicaid managed care
plans.
Proposed law provides for legislative findings.
Proposed law provides the Department of Health and Hospitals shall require a Medicaid
managed care plan to ensure:
(1) Hospitals that are providers for a Medicaid managed care plan shall report each SB NO. 647
SLS 14RS-1677 ORIGINAL
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
enrolled individual's hospital admission, discharge, and transfer data to the
appropriate health information exchange for its parish.
(2) A notification system shall be developed in collaboration with the health information
exchanges by which such information is promptly reported to each enrolled
individual's primary care providers and managed care plan to improve continuity and
coordination of patient care.
Proposed law provides an enrolled individual's hospital admission, discharge, and transfer
data shall be reported to the appropriate health information exchange in a uniform manner
proscribed by the department through rules and regulations promulgated pursuant to the
Administrative Procedure Act.
Proposed law provides the department shall maximize all available federal financial
assistance to cover the cost of the reporting and notification required by proposed law.
Furthermore, if there is insufficient funding to cover the costs of the health information
exchanges, the Medicaid managed care plans shall pay a charge to the health information
exchanges to offset unfunded costs that are associated with the reporting and notification of
the enrolled individuals' admission, discharge, and transfer data as required by proposed law.
Proposed law provides the department implement a statewide system of reporting and
notification, the health information exchanges located within the state receiving funding
from the Office of the National Coordinator for Health Information Technology, United
States Department of Health and Human Services, the Greater New Orleans Health
Information Exchange, and the Louisiana Health Information Exchange shall provide
services to its respective parishes.
(1) The Greater New Orleans Health Information Exchange shall provide services in the
greater New Orleans area, consisting of the parishes of Orleans, Jefferson,
Plaquemines, St. Bernard, St. Charles, and St. Tammany.
(2) The Louisiana Health Information Exchange shall provide services in the other
parishes of the state.
Proposed law provides the health information exchanges shall coordinate with each other for
the implementation of the reporting and notifications.
Proposed law provides a health information exchange shall report to the department on a
quarterly basis regarding its implementation of the reporting and notification requirements.
Proposed law provides a health information exchange shall maintain the confidentiality of
the hospital admission, discharge, and transfer data and shall only provide such data to the
managed care plan and primary care providers of the enrolled individual who is the subject
of the report, unless otherwise instructed by the enrolled individual.
Effective August 1, 2014.
(Adds R.S. 46:460.81)