Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H1238 Compare Versions

Only one version of the bill is available at this time.

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1	1	1 of 1
2	2	HOUSE DOCKET, NO. 2828 FILED ON: 1/19/2023
3	3	HOUSE . . . . . . . . . . . . . . . No. 1238
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Daniel J. Ryan
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act to improve patient care through integrated electronic health records.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Daniel J. Ryan2nd Suffolk1/19/2023 1 of 8
16	16	HOUSE DOCKET, NO. 2828 FILED ON: 1/19/2023
17	17	HOUSE . . . . . . . . . . . . . . . No. 1238
18	18	By Representative Ryan of Boston, a petition (accompanied by bill, House, No. 1238) of Daniel
19	19	J. Ryan for legislation to establish integrated electronic health records. Health Care Financing.
20	20	The Commonwealth of Massachusetts
21	21	_______________
22	22	In the One Hundred and Ninety-Third General Court
23	23	(2023-2024)
24	24	_______________
25	25	An Act to improve patient care through integrated electronic health records.
26	26	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
27	27	of the same, as follows:
28	28	1 Section 118I of the General Laws is hereby amended by striking out the chapter and
29	29	2inserting in place thereof the following chapter:.
30	30	3 Chapter 118I
31	31	4 HEALTH INFORMATION EXCHANGE
32	32	5 Section 1. As used in this chapter, the following words shall, unless the context clearly
33	33	6requires otherwise, have the following meanings:
34	34	7 “Council”, the health information technology council established under section 2.
35	35	8 “Electronic health record”, an electronic record of patient health information generated
36	36	9by 1 or more encounters in any care delivery setting.
37	37	10 “Executive office”, the executive office of health and human services.
38	38	11 “Health care entity”, a payer, health care provider or provider organization. 2 of 8
39	39	12 “Health care provider”, a provider of medical or health services or any other person or
40	40	13organization that furnishes, bills or is paid for health care service delivery in the normal course
41	41	14of business.
42	42	15 “Health information exchange”, transmission of health care-related data among health
43	43	16care entities of personal health records aligning with national standards; the reliable and secure
44	44	17transfer of data among diverse systems and access to and retrieval of data.
45	45	18 “Office of the National Coordinator” or “ONC”, the Office of the National Coordinator
46	46	19for Health Information Technology within the United States Department of Health and Human
47	47	20Services.
48	48	21 “Payer”, any entity, other than an individual, that pays providers for the provision of
49	49	22health care services; provided, that “payer” shall include both governmental and private entities;
50	50	23provided further, that “payer” shall not include ERISA plans.
51	51	24 “Provider organization”, any corporation, partnership, business trust, association or
52	52	25organized group of persons, which is in the business of health care delivery or management,
53	53	26whether incorporated or not that represents 1 or more health care providers in contracting with
54	54	27carriers for the payments of health care services; provided, that “provider organization” shall
55	55	28include, but not be limited to, physician organizations, physician-hospital organizations,
56	56	29independent practice associations, provider networks, accountable care organizations and any
57	57	30other organization that contracts with carriers for payment for health care services.
58	58	31 “Statewide health information exchange”, health information exchange established,
59	59	32operated, facilitated or funded by a governmental entity or entities in the commonwealth. 3 of 8
60	60	33 Section 2. (a) There shall be a health information technology council within the executive
61	61	34office of health and human services. The council shall advise the executive office on design,
62	62	35implementation, operation and use of statewide health information exchange.
63	63	36 (b) The council shall consist of the following 21 members: the secretary of health and
64	64	37human services or a designee, who shall serve as the chair; the secretary of administration and
65	65	38finance or designee; the executive director of the health policy commission or a designee; the
66	66	39executive director of the center for health information analysis or a designee; the director of the
67	67	40Massachusetts eHealth Institute or a designee; the director of the office of Medicaid or a
68	68	41designee; and 14 members who shall be appointed by the governor, of whom at least 1 shall be
69	69	42an expert in health information technology; 1 shall be an expert in law and health policy; 1 shall
70	70	43be an expert in health information privacy and security; 1 shall be from an academic medical
71	71	44center; 1 shall be from a community hospital; 1 shall be from a community health center; 1 shall
72	72	45be from a long term care facility; 1 shall be a from large physician group practice; 1 shall be
73	73	46from a small physician group practice; 1 shall be a registered nurse; 1 shall be from a behavioral
74	74	47health, substance abuse disorder or mental health services organization; 1 shall be from the
75	75	48Massachusetts Association of Health Plans or a designee, 1 shall be from Blue Cross Blue Shield
76	76	49of Massachusetts, 1 shall be from a business group; and 2 additional members shall have
77	77	50experience or expertise in health information technology. The council may consult with all
78	78	51relevant parties, public or private, in exercising its duties under this section, including persons
79	79	52with expertise and experience in the development and dissemination of electronic health records
80	80	53systems, and the implementation of electronic health record systems by small physician groups
81	81	54or ambulatory care providers, as well as persons representing organizations within the
82	82	55commonwealth interested in and affected by the development of networks and electronic health 4 of 8
83	83	56records systems, including, but not limited to, persons representing local public health agencies,
84	84	57licensed hospitals and other licensed facilities and providers, private purchasers, the medical and
85	85	58nursing professions, physicians and health insurers, the state quality improvement organization,
86	86	59academic and research institutions, consumer advisory organizations with expertise in health
87	87	60information technology and other stakeholders as identified by the secretary of health and human
88	88	61services. Appointed members of the council shall serve for terms of 2 years or until a successor
89	89	62is appointed. Members shall be eligible to be reappointed and shall serve without compensation.
90	90	63 (c) Chapter 268A shall apply to all council members, except that the council may
91	91	64purchase from, sell to, borrow from, contract with or otherwise deal with any organization in
92	92	65which any council member is in anyway interested or involved; provided, however, that such
93	93	66interest or involvement shall be disclosed in advance to the council and recorded in the minutes
94	94	67of the proceedings of the council; and provided, further, that no member shall be considered to
95	95	68have violated section 4 of said chapter 268A because of the member’s receipt of usual and
96	96	69regular compensation from such member’s employer during the time in which the member
97	97	70participates in the activities of the council.
98	98	71 Section 3. (a) The executive office shall establish, operate, facilitate, or fund statewide
99	99	72health information exchange among health care entities, including, but not limited to, improving
100	100	73interoperability among health care entities and requiring the exchange of minimum standardized
101	101	74health data requirements.
102	102	75 (b) The executive office may: 5 of 8
103	103	76 (i) conduct procurements and enter into contracts for the purchase, dissemination,
104	104	77development of hardware and software, in connection with the implementation of statewide
105	105	78health information exchange; and
106	106	79 (ii) in consultation with the council, oversee the development, dissemination,
107	107	80implementation and operation of statewide health information exchange including any modules,
108	108	81applications, interfaces or other technology infrastructure for statewide health information
109	109	82exchange.
110	110	83 (c) In carrying out this chapter, the executive office may undertake any activities
111	111	84necessary to implement the powers and duties under this chapter, which may include issuing
112	112	85implementing regulations and the adoption of policies consistent with those adopted by the
113	113	86Office of the National Coordinator for Health Information Technology of the United States
114	114	87Department of Health and Human Services; provided, however, that nothing herein shall be
115	115	88construed to limit the executive office’s ability to advance interoperability and other health
116	116	89information technology beyond such federal standards, including without limitation any
117	117	90applicable meaningful use standards.
118	118	91 Section 4. Every patient shall have electronic access to such patient’s health records. The
119	119	92executive office shall ensure that each patient will have secure electronic access to such patient’s
120	120	93electronic health records with each of such patient’s health care providers.
121	121	94 Section 5. All health care entities in the commonwealth shall participate in statewide
122	122	95health information exchange; provided that all health care providers shall implement fully
123	123	96interoperable electronic records systems necessary to participate in statewide health information
124	124	97exchange activities, as defined by the executive office. The executive office shall issue 6 of 8
125	125	98regulations requiring that statewide health information exchange, the associated electronic
126	126	99records systems, comply with all state and federal privacy requirements, including those imposed
127	127	100by the Health Insurance Portability and Accountability Act of 1996, P.L. 104–191, the American
128	128	101Recovery and Reinvestment Act of 2009, P.L. 111–5, 42 C.F.R. §§ 2.11 et seq. and 45 C.F.R. §§
129	129	102160, 162 and 164.
130	130	103 Section 6. The executive office shall prescribe by regulation penalties for non-compliance
131	131	104by health care entities with the requirements of this chapter provided, however, that the executive
132	132	105office may waive penalties for good cause. Penalties collected under this section shall be
133	133	106deposited into the Health Information Technology Trust Fund, established in section 10 of
134	134	107chapter 35RR.
135	135	108 Section 7. In the event of an unauthorized access to or disclosure of individually
136	136	109identifiable patient health information by or through a health care entity or a vendor contracted
137	137	110through services of a health care entity as participants of statewide health information exchange,
138	138	111the health care entity or vendor shall comply with the requirements of chapter 93H and in any
139	139	112event shall: (i) report the conditions of such unauthorized access or disclosure as required by the
140	140	113executive office; and (ii) provide notice, as defined in section 1 of chapter 93H, as soon as
141	141	114practicable, but not later than 10 business days after such unauthorized access or disclosure, to
142	142	115any person whose patient health information may have been compromised as a result of such
143	143	116unauthorized access or disclosure, and shall report the conditions of such unauthorized access or
144	144	117disclosure, and further shall concurrently provide a copy of such report to the executive office.
145	145	118Any unauthorized access or disclosures shall be punishable by the civil penalties under section
146	146	11910. 7 of 8
147	147	120 Section 8. Patients shall have the choice to opt-out of having their health data disclosed
148	148	121for electronic health information exchange activities that are owned and operated or contracted
149	149	122by the Commonwealth.
150	150	123 Section 9. The executive office shall pursue and maximize all opportunities to qualify for
151	151	124federal financial participation.
152	152	125 Section 10. The executive office may require participant fees from health care entities
153	153	126that use health information exchange services. Participant fees collected under this section shall
154	154	127be deposited into the Health Information Technology Trust Fund, as established by section 35RR
155	155	128of chapter 10, or its successor trust fund. Nonpayment or late payment of fees may subject health
156	156	129care entities to fines or penalties as determined by the executive office. The executive office shall
157	157	130promulgate regulations to assess fair and reasonable fines or penalties.
158	158	131 Section 11. The council shall file an annual report, not later than April 1, with the joint
159	159	132committee on health care financing, the joint committee on economic development and emerging
160	160	133technologies, the house and senate committees on ways and means and the clerks of the house
161	161	134and senate concerning the activities of the council in general and, in particular, describing the
162	162	135progress to date in developing statewide health information exchange and recommending such
163	163	136further legislative action as it deems appropriate.
164	164	137 Section 12. Unauthorized access to or disclosure of individually identifiable patient
165	165	138health information shall be subject to fines or penalties as determined by the executive office.
166	166	139The executive office shall promulgate regulations to assess fair and reasonable fines or penalties. 8 of 8
167	167	140 Section 13. Cybersecurity-based documentation, including but not limited to security
168	168	141audit reports, provided to the executive office shall be exempt from disclosure under clause
169	169	142Twenty-sixth of section 7 of chapter 4 and chapter 66.