LAWRENCE J. HOGAN, JR., Governor Ch. 296 – 1 – Chapter 296 (House Bill 1127) AN ACT concerning Public Health – State Designated Exchange – Health Data Utility FOR the purpose of requiring the State designated exchange to operate as a health data utility for the State for certain purposes; requiring the Maryland Department of Health, dispensers, and certain nursing homes and electronic health networks dispensers to provide certain data to the State designated exchange; requiring dispensers to submit certain prescription information to the State designated exchange; requiring the State designated exchange to establish a certain consumer advisory council; and generally relating to the State designated exchange operating as a health data utility. BY adding to Article – Health – General Section 19–145 Annotated Code of Maryland (2019 Replacement Volume and 2021 Supplement) SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, That the Laws of Maryland read as follows: Article – Health – General 19–145. (A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS INDICATED. (2) “DISPENSER” MEANS A PERSON AUTHO RIZED BY LAW TO DISPENSE, AS DEFINED IN § 12–101 OF THE HEALTH OCCUPATIONS ARTICLE, A PRESCRIPTION DRUG TO A PATIENT OR THE PAT IENT’S AGENT IN THE STATE. (3) “NONCONTROLLED PRESCRI PTION DRUG ” MEANS A PRESCRIPTION DRUG , AS DEFINED IN § 21–201 OF THIS TITLE, THAT IS NOT A CONTROLLED DAN GEROUS SUBSTANCE DES IGNATED UNDER TITLE 5, SUBTITLE 4 OF THE CRIMINAL LAW ARTICLE. (3) (4) “STATE DESIGNATED EXCH ANGE” HAS THE MEANING STATED IN § 4–302.3 OF THIS ARTICLE. Ch. 296 2022 LAWS OF MARYLAND – 2 – (B) THE STATE DESIGNATED EXCH ANGE SHALL OPERATE A S A HEALTH DATA UTILITY FOR THE STATE. (C) THE PURPOSES OF THE H EALTH DATA UTILITY I NCLUDE THE: (1) THE COLLECTION , AGGREGATION , AND ANALYSIS OF CLIN ICAL INFORMATION , PUBLIC HEALTH DATA , AND HEALTH ADMINISTR ATIVE AND OPERATIONS DATA TO A SSIST HEALTH CARE AND PUBL IC HEALTH LEADER S THE DEPARTMENT , LOCAL HEALTH DEPARTM ENTS, THE COMMISSION, AND THE HEALTH SERVICES COST REVIEW COMMISSION IN THE EVALUATION OF PUBLIC HEALTH INTERVENTIONS AND HEALTH EQUITY ; (2) THE COMMUNICATION OF DATA FROM BETWEEN PUBLIC HEALTH OFFICIALS AND HEALTH CARE PROVIDERS TO AD VANCE DISEASE CONTRO L AND HEALTH EQUITY ; AND (3) THE ENHANCEMENT AND A CCELERATION OF THE INTEROPERABILITY OF HEALTH INFORMATION T HROUGHOUT THE STATE. (D) THE FOLLOWING ENTITIE S DISPENSERS SHALL PROVIDE DATA TO THE STATE DESIGNATED EXCH ANGE: (1) THE DEPARTMENT ; (2) NURSING HOMES REQUIRE D TO PROVIDE DATA UN DER § 4–302.3 OF THIS ARTICLE; (3) ELECTRONIC HEALTH NET WORKS REQUIRED TO PR OVIDE DATA UNDER § 4–302.3 OF THIS ARTICLE; AND (4) DISPENSERS. (E) (1) THE PURPOSE OF THIS S UBSECTION IS TO: (I) AUTHORIZE INDIVIDUALS AND ORGANIZATIONS IN VOLVED IN THE TREATMENT AND CARE COORDINATION OF PATIENTS TO ACCESS , AS LEGALLY AUTHORIZED , A PATIENT ’S MEDICATION HISTORY , INCLUDING MEDICATIONS PRESCRIBED FOR THE P ATIENT; AND (II) ASSIST HEALTH CARE PR OVIDERS, CARE MANAGERS , THE DEPARTMENT , AND PUBLIC HEALTH OFFICI ALS LOCAL HEALTH DEPARTM ENTS TO LAWRENCE J. HOGAN, JR., Governor Ch. 296 – 3 – UNDERSTAND AND PROMO TE MATTERS OF HEALTH EQUITY AND TREATMENT EFFICACY. (2) AFTER DISPENSING A NONCONTROLLED PRESCRIPTION DRUG , A DISPENSER SHALL SUBM IT PRESCRIPTION INFO RMATION TO THE STATE DESIGNATED EXCHANGE . (3) THE PRESCRIPTION INFO RMATION SHALL BE SUB MITTED: (I) BY ELECTRONIC MEANS ; (II) WITHOUT UNDULY INCREA SING THE WORKLOAD AN D EXPENSE ON A DISPENS ER; (III) IN A MANNER THAT MINIMIZES BURDE N AND DUPLICATION BY BEING AS COMPATIBLE AS POS SIBLE WITH EXISTING FEDERAL STANDARDS FO R DATA SUBMISSION PRAC TICES, INCLUDING TECHNOLOGY SOFTWARE OF DISPENSERS; AND (IV) AS OTHERWISE REQUIRED BY REGULATIONS ADOPT ED BY THE COMMISSION. (4) THE STATE DESIGNATED EXCH ANGE MAY NOT IMPOSE ANY FEES OR OTHER ASSESSMENTS ON DISPENSERS TO SUP PORT THE OPERATION O F THE EXCHANGE. (5) THE STATE DESIGNATED EXCH ANGE SHALL MAKE PRES CRIPTION INFORMATION SUBMITTE D UNDER THIS SUBSECT ION AVAILABLE FOR PU RPOSES OF TREATMENT AND CARE C OORDINATION OF A PAT IENT. (F) THE STATE DESIGNATED EXCH ANGE SHALL MAY PROVIDE DATA , AS ALLOWED BY LAW , TO INDIVIDUALS AND O RGANIZATIONS INVOLVE D IN THE TREATMENT AND CARE COOR DINATION OF PATIENTS AND TO PUBLIC HEALTH OFFICIALS TO SUPPORT PUBLIC HEALTH GOALS , FOR PUBLIC HEALTH PU RPOSES THAT MAY INCLUDE : (1) UNDERSTANDING AND PRO MOTING THE EQUITABLE AVAILABILITY TO PATI ENTS OF IMPROVING HEALTH EQUI TY THROUG H ACCESS TO PRESCRIPTION MEDICAT IONS, INCLUDING FOR THE TR EATMENT OF INFECTIOU S DISEASE; (2) ASSISTING PROGRAMS LED BY HEALTH CARE PROVIDER S, CARE MANAGERS, AND PUBLIC HEALTH OFFICI ALS IN IDENTIFYING THE DEPARTMENT , Ch. 296 2022 LAWS OF MARYLAND – 4 – LOCAL HEALTH DEPARTM ENTS, THE COMMISSION, AND THE HEALTH SERVICES COST REVIEW COMMISSION TO IDENTIF Y OPPORTUNITIES TO USE TREATMENTS MORE EFFECTIVELY , FOR QUALITY IMPROVEM ENT, INCLUDING FOR STEWAR DSHIP OF ANTIBIOTIC MEDICA TIONS; AND (3) ANY ADDITIONAL PATIEN T INTERVENTIONS AND ACTIVITIES, INCLUDING CASE INVES TIGATION CONDUCTING CASE INVES TIGATIONS AND RELATED ACTIVITIES . (G) INFORMATION SUBMITTED TO THE STATE INFORMATION EXC HANGE OR PROVIDED BY THE STATE INFORMATION EXC HANGE UNDER THIS SEC TION SHALL BE SUBMITTED OR PROVIDE D, TO THE EXTENT PRACTICABLE , IN AS NEAR TO REAL T IME AS POSSIBLE. (G) (H) (1) THE COMMISSION, IN CONSULTATION WITH APPROPRIATE STAKEHOLDERS , SHALL ADOPT REGULATI ONS TO CARRY OUT THI S SECTION. (2) THE REGULATIONS SHALL TAKE INTO ACCOUNT CO NSUMER PERSPECTIVE A ND INCLUDE: (I) THE SPECIFIC DATA REQ UIRED TO BE PROVIDED UNDER SUBSECTION (D) OF THIS SECTION; (II) THE SPECIFIC PRESCRIP TION INFORMATION REQ UIRED TO BE SUBMITTED UNDER S UBSECTION (E) OF THIS SECTION; (III) THE TIME FRAME FOR SU BMITTING PRESCRIPTION INFORMATION UNDER SU BSECTION (E) OF THIS SECTION; (IV) THE ELECTRONIC MEANS AND MANNER BY WHICH PRESCRIPTION INFORMA TION IS TO BE SUBMIT TED UNDER SUBSECTION (E) OF THIS SECTION; AND (V) PRESCRIPTION INFORMAT ION SUBMISSION REQUIREMENTS THAT ALIGN WITH THE DATA SUBMISSION REQU IREMENTS ON DISPENSERS OF MONITO RED PRESCRIPTION DRU GS UNDER TITLE 21, SUBTITLE 2A OF THIS ARTICLE; AND (VI) IDENTIFICATION AND NE CESSARY SUPPRESSION OF INFORMATION RELATED TO PROVIDERS OR MEDI CATIONS THAT ARE DE TERMINED TO HAVE SIGNIFICANT POTENTIAL TO CAUSE H ARM. LAWRENCE J. HOGAN, JR., Governor Ch. 296 – 5 – (I) (1) THE STATE DESIGNATED EXCH ANGE SHALL ESTABLISH A CONSUMER ADVISORY CO UNCIL TO BRING THE P ERSPECTIVES OF INDIV IDUALS AND ORGANIZATIONS WITH A N INTEREST IN PROTEC TING CONSUMERS INTO THE DELIVERY OF SERVICES PROVIDED BY THE STATE DESIGNATED EXCH ANGE. (2) IN SELECTING MEMBERS , THE STATE DESIGNATED EXCH ANGE SHALL CONSIDER DIVER SITY OF EXPERIENCE . (3) THE CONSUMER ADVISORY COUNCIL ESTABLISHED UNDER PARAGRAPH (1) OF THIS SUBSECTION S HALL: (I) CONSIST OF A MINIMUM OF SIX MEMBERS , INCLUDING AT LEAST FOUR CONSUMER REPRESENTATIVES AND TWO STAFF REPRESENTA TIVES, AND MAINTAIN A RATIO OF CONSUMER REPRESEN TATIVES TO NONCONSUM ER REPRESENTATIVES OF A T LEAST TWO TO ONE ; (II) IDENTIFY AND REPORT C ONSUMER PRIVACY CONCERNS TO SENIOR LEADERSHIP OF THE STATE DESIGNATED EXCH ANGE; (III) ADVISE ON EFFORTS TO EDUCATE CONSUMERS ON DATA EXCHANGE POLICIES , INCLUDING OPTIONS FO R CONSUMERS TO OPT O UT OF DISCLOSURE OF PROTEC TED HEALTH INFORMATI ON; (IV) MEET AT LEAST 3 TIMES EACH YEAR ; AND (V) ADOPT AND MAINTAIN A CHARTER TO BE POSTED ONLINE THAT INCLUDES THE PU RPOSE, MEMBERS, AND MEETING SCHEDULE OF THE CONSUMER ADVISORY CO UNCIL. SECTION 2. AND BE IT FURTHER ENACTED, That on or before January 1, 2024, the Maryland Department of Health, the Maryland Health Care Commission, and the State designated exchange shall submit a report to the General Assembly, in accordance with § 2–1257 of the State Government Article, that identifies ongoing revenue sources to fund the activities required under § 19–145 of the Health – General Article, as enacted by Section 1 of this Act. SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect October 1, 2022. Approved by the Governor, May 12, 2022.