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ENGROSSED SENATE
BILL NO. 1369 By: Haste of the Senate
and
McEntire of the House
[ health information – Oklahoma Healthcare
Transparency Initiative Act of 2022 - Office of the
State Coordinator for Health Information Exchange -
health information exchange legislative intent –
definitions - Oklahoma Healthcare Transparency
Initiative – submission of claims data – disclosure
of data – penalty schedule – Oklahoma Open Records
Act - codification - effective date –
emergency ]
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Secti on 1-134.1 of Title 63, unless
there is created a duplication in numbering, reads as follows :
Sections 4 through 10 of this act shall be known and may be
cited as the "Oklahoma Healthcare Transparency Initiative Act of
2022".
SECTION 2. NEW LAW A new sect ion of law to be codified
in the Oklahoma Statutes as Section 1-132.1 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. There is hereby created the Office of the State Coor dinator
for Health Information Exchange within the Oklahoma Health Care
Authority.
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B. The Office shall have the power and duty to:
1. a. Serve as the state designated entity for health
information exchange, if the State of Oklahoma serves
as the state designated entity for healt h information
exchange under Section 1-133 of Title 63 of the
Oklahoma Statutes, or
b. Oversee the state designated entity for health
information exchange, if the State of Oklahoma
designates a state designated entity for health
information exchange under Section 1-133 of Title 63
of the Oklahoma Statutes ; and
2. Implement and govern the Oklahom a Healthcare Transparency
Initiative created under Sections 4 through 10 of this act.
C. The Office shall consist of the State Coordinator for Health
Information Exchange, who shall be appointed by and serve at the
pleasure of the Administrator of the Aut hority, and such other
employees of the Authority as the Administrator may assign to the
Office.
SECTION 3. AMENDATORY 63 O.S. 2021, Section 1-133, is
amended to read as follows:
Section 1-133. A. As used in this section:
1. "Health care entity" means:
a. a health plan that, either as an individual or group,
provides for, or pays the cost of, medical care,
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b. a health care provider that o ffers or renders medica l
or health services, or
c. any further individual or association defined as a
covered entity under 45 C.F.R., Section 160.103; and
2. "Health information exchange " means the electronic movement
of health-related information among o rganizations according to
nationally recognized standards for purpos es including, but not
limited to, payment, treatment, and administration;
2. "Health information exchange organization " means an entity
whose primary business act ivity is health informati on exchange; and
3. "Oklahoma State Health I nformation Network and Exchange" or
"OKSHINE" means a health information exchange organization charged
with facilitating the exchange of health information to and from
authorized individuals and health care organizations in this state
and.
B. The State of Oklahoma shall serve as or shall designate the
state-designated state designated entity for health information
exchange.
B. The Oklahoma Health Care Authority (OHCA) shall establish a
health information exchan ge certification with i nput from
stakeholders. Such certific ation shall be required in order for a
health information exchange organization to qualify as an Oklahoma
Statewide Health Information Exchange (OKHIE). Until such time a s
the health information exchange certification is established by
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OHCA, an OKHIE shall mean either OKSHINE or a health information
exchange organization that was previously certified by the Oklahoma
Health Information Exchange Trust.
C. The Oklahoma State Health Information Netw ork and Exchange
(OKSHINE) shall be organized for the purpose of improving the health
of residents of this state by:
1. Promoting efficient and effective communication among
multiple health care providers including, but not limited to,
hospitals, physicians, payers, employers, pharmacies, laboratories,
and other health care entities or health information exchange
networks and organizations;
2. Creating efficiencies in health care costs by eliminating
redundancy in data capture and storage and reducing adm inistrative,
billing, and data collection costs;
3. Creating the ability to monitor community health status; and
4. Providing reliable information to health care consumers and
purchasers regarding the quality of health care.
C. Beginning July 1, 2023, a ll health care entities licensed by
and located in this state shall report data to and utilize the state
designated entity. The Office of the State Coordinator for Health
Information Exchange may, as provided by rules promulgated by the
Oklahoma Health Care Authority Board, all ow exemptions from the
requirement provided by this subsection on the basis of financial
hardship, size, or technological capability of a health care entity
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or such other bases as may be provided by rules promulgated by the
Board.
D. 1. A person who participates in the services or information
provided by OKSHINE or an OKHIE the state designated entity shall
not be liable in any action for damages or costs of any nature that
result solely from the person's use or failure to use either an
OKHIE or OKSHINE information or data from the state designated
entity that was entered or retrieved under relevant state or federal
privacy laws, rules, regulations, or policies including , but not
limited to, the Health Insurance Portability and Accountability Act
of 1996.
2. A person shall not be subject to antitrust or unfair
competition liability based on participation in OKSHINE or an OKHIE
with the state designated entity as long as the participation
provides an essential governmental function fo r the public health
and safety and enjoys state action immunity.
3. Participating in an OKH IE shall qualify as meeting any
requirement to send data to OKSHINE.
E. 1. A person who provides information and data to OKSHINE
the state designated entity retains a property right in the
information or data, but grants to the other participants or
subscribers a nonexclusive license to retrieve and use that
information or data under relevant state or federal privacy laws,
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rules, regulations, or policies including , but not limited to, the
Health Insurance Portability and Accountability Act of 1996.
2. All processes or software developed, designed, or purchased
by OKSHINE shall remain the property of OKSHINE subject to use by
participants or subscribers.
F. Patient-specific protected health information shall only be
disclosed in accordance with the patient's authorization or in
compliance with releva nt state or federal privacy laws, rules,
regulations, or policies including , but not limited to, the Health
Insurance Portability and Acco untability Act of 1996.
G. The Oklahoma Health Care Authority Board shall promulgate
rules to implement the provision s of this section.
SECTION 4. NEW LAW A new sectio n of law to be codif ied
in the Oklahoma Statutes as Section 1-134.2 of Title 63, unless
there is created a duplication in numbering, rea ds as follows:
A. It is the intent of the Legislature to create and maintain
an informative source of healthcare information to support
consumers, researchers, and policymakers in healthcare decisions
within this state.
B. The purpose of the Oklahoma Healthcare Transparency
Initiative Act is to:
1. Create the Oklahoma Healthcare Transparency Initiative;
2. Establish governance of the Oklahoma Healthcare Transparency
Initiative;
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3. Provide authority to collect healthcare information from
insurance carriers and other entities; and
4. Establish appropriate methods for collecting, maintaining,
and reporting healthcare information including privacy and security
safeguards.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-134.3 of Title 63, unless
there is created a duplication in numbering, reads as follows:
As used in the Oklahoma Healthcare Transparency Initiative Act
of 2022:
1. "Board" means the Oklahoma Health Care Authority Board;
2. "Claims data" means information included in an
institutional, professional, or pharmacy claim or equivalent
information transaction for a covered individual including the
amount paid to a provider of healthcare services plus any amount
owed by the covered individual;
3. "Covered individual" means a natural person who is a
resident of this state and is eligible to receive medical, dental,
or pharmaceutical benefits under any policy, contract, certificate,
evidence of coverage, rider, binder, or endorsement that provides
for or describes coverage;
4. "Direct personal identifiers" means information relating to
a covered individual that contains primary or obvious identifiers,
such as the individual's name, street address, e-mail address,
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telephone number, or Social Security number. Direct personal
identifiers shall not include geographic or demographic information
that would not allow the identification of a covered individual;
5. "Enrollment data" means demographic information and other
identifying information relating to covered individuals including
direct personal identifiers;
6. "Office" means the Office of the State Coordinator for
Health Information Exchange;
7. "Oklahoma Healthcare Transparency Initiative" means an
initiative to create a database including ongoing all-payer claims
database projects that receive and store data from a submitting
entity relating to medical, dental, pharmaceutical, and other
insurance claims information, unique identifiers, and geographic and
demographic information for covered individuals as permitted in the
Oklahoma Healthcare Transparency Initiative Act, and provider files,
for the purposes of the Oklahoma Healthcare Transparency Initiative
Act;
8. "Protected health information" means health information as
protected by the Health Insurance Portability and Accountability Act
of 1996, Pub. L. No. 104-191;
9. "Provider" means an individual or entity licensed by the
state to provide healthcare services;
10. a. "Submitting entity" means:
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(1) an entity that provides health or dental
insurance or a health or dental benefit plan in
the state including but not limited to an
insurance company, medical services plan, managed
care organization, hospital plan, hospital
medical service corporation, health maintenance
organization, or fraternal benefit society,
provided that the entity has covered individuals
and the entity had at least two thousand covered
individuals in the previous calendar year,
(2) a health benefit plan offered or administered by
or on behalf of the state or an agency or
instrumentality of the state including but not
limited to benefits administered by a managed
care organization, notwithstanding the number of
covered individuals in the previous year,
(3) a health benefit plan offered or administered by
or on behalf of the federal government with the
agreement of the federal government,
(4) the Workers' Compensation Commission,
(5) any other entity providing a plan of health
insurance or health benefits subject to state
insurance regulation, a third-party
administrator, or a pharmacy benefits manager;
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provided, that the entity has covered individuals
and the entity had at least two thousand covered
individuals in the previous calendar year,
(6) a health benefit plan subject to the Employee
Retirement Income Security Act of 1974, Pub. L.
No. 93-406, and that is fully insured,
(7) a risk-based provider organization licensed by
the Insurance Department, and
(8) any entity that contracts with the Department of
Corrections to provide medical, dental, or
pharmaceutical care to inmates.
b. A submitting entity shall not include:
(1) an entity that provides health insurance or a
health benefit plan that is accident-only,
specified disease, hospital indemnity, long-term
care, disability income, or other supplemental
benefit coverage,
(2) an employee of a welfare benefit plan as defined
by federal law that is also a trust established
pursuant to collective bargaining subject to the
Labor Management Relations Act of 1947, Pub. L.
No. 80-101, or
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(3) a health benefit plan subject to the Employee
Retirement Income Security Act of 1974, Pub. L.
No. 93-406, that is self-funded; and
11. "Unique identifier" means any identifier that is guaranteed
to be unique among all identifiers for covered individuals but does
not include direct personal identifiers.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-134.4 of Title 63, unless
there is created a duplication in numbering, rea ds as follows:
A. There is hereby created the Oklahoma Healthcare Transparency
Initiative, which shall be governed by the Office of the State
Coordinator for Health Information Exchange.
B. The Office shall be the administrator of the Oklahoma
Healthcare Transparency Initiative and shall, in collaboration with
the state designated entity for health information exchange, be
responsible for development and implementation of a sustainability
plan subject to data use and disclosure requirements of the Oklahoma
Healthcare Transparency Initiative Act and any rules promulgated by
the Oklahoma Health Care Authority Board under the Oklahoma
Healthcare Transparency Initiative Act.
C. The Office shall have the power and duty to:
1. Collect, validate, analyze, and pre sent health data
including claims data;
2. Assess penalties for noncompliance with this section;
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3. Establish policies and procedures necessary for the
administration and oversight of the Oklahoma Healthcare Transparency
Initiative including procedures for the collection, processing,
storage, analysis, use, and release of data;
4. Identify and explore the key healthcare issues, questions,
and problems that may be improv ed through more transparent
information including but not limited to data required to be
disclosed to patients related to provider relationships or
affiliations with payers and providers, financial interests in
healthcare businesses, and payments or items of any value given to
providers from pharmaceutical or medical device manufacturers or
agents thereof; and
5. Provide a biennial r eport to the Legislature on the
operations of the Oklahoma Healthcare Transparency Initiative.
SECTION 7. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-134.5 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. No later than July 1, 2023, and thereafter in a frequency
specified in rules promulgated by the Oklahoma Health Car e Authority
Board, a submitting entity s hall submit claims data, unique
identifiers, and geographic and demographic information for covered
individuals as permitted in the Oklahoma Healthcare Transparency
Initiative Act, and provider files to the Oklahoma Healthcare
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Transparency Initiative in ac cordance with standards and procedures
promulgated by the Board.
B. Data submitted under this section shall be treated as
confidential and shall be exempt from disclosure as a record under
the Oklahoma Open Records Act as defined pursuant to Section 24A.3
of Title 51 of the Oklahoma Statutes and are not subject to subpoena
except to the extent provided in the Oklahoma Insurance Code.
C. The collection, storage, and release of data and other
information under this se ction is subject to applicable state and
federal data privacy and security law.
SECTION 8. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Sectio n 1-134.6 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. Data in the Oklahoma Healthcare Transparency Initiative
shall, to the extent authorized by rules promulgated by the Oklahoma
Health Care Authority Board, be available:
1. When disclosed in a form and manner that ensures the privacy
and security of protected health information as required by state
and federal laws, as a resource to insurers, employers, purchasers
of health care, researchers, state agencies, and healthcare
providers to allow for assessment of healthcare utilization,
expenditures, and performance in this state including but not
limited to as a resource for hospital community health needs
assessments; and
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2. To state programs regarding healthcare quality and costs for
use in improving health care in the state, subject to rules
prescribed by the Board conforming to state and federal privacy laws
or limiting access to limited-use data sets.
B. Data in the Oklahoma Healthcare Transparency Initiative
shall not be used to disclose trade secrets of submitting entities,
and shall be used or disclosed only in compliance with applicable
state and federal data privacy and security law and in compliance
with the policies established by the Board.
C. Notwithstanding any other section of law, the Oklahoma
Healthcare Transparency Initiative shall not publicly disclose any
data that contains direct personal identifiers.
SECTION 9. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-134.7 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. Except for state or federal agencies that are submitting
entities, a submitting entity that fails to submit data as required
by the Oklahoma Healthcare Transparency Initiative Act or the rules
promulgated by the Oklahoma Health Care Authority Board may be
subject to a penalty.
B. The Board shall adopt a schedule of penalties not to exceed
One Thousand Dollars ($1,000.00) per day for each day the violation
occurs, determined by the severity of the violation.
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C. A penalty imposed under this section may be remitted or
mitigated upon such terms and conditions as the Board considers
proper and consistent with the public health and safety.
D. A penalty remitted under this section shall be used to fund
operations of the Oklahoma Healthcare Transparency Initiative.
SECTION 10. NEW LAW A new section of law to be codi fied
in the Oklahoma Statutes as Sec tion 1-134.8 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. The State Department of Health shall submit all public
health data and vital statistics data collected by the Department to
the Oklahoma Healthcare Transparency Initiative for integration into
the Initiative database created under Section 6 of this act
including but not limited to data collected regarding hospital
discharge and emergency department records for the uninsured, birth
and death records, and disease registry data under Sections 1-115 et
seq., 1-323 et seq., 1-541, and 1-551.1 of Title 63 of the Oklahoma
Statutes.
B. The data submitted under subsection A of this section shall
be assigned a unique identifier and may be used in accordance with
the purposes of the Oklahoma Healthcare Transparency Initiative and
the rules promulgated pursuant to the Oklahoma Healthcare
Transparency Initiative Act.
SECTION 11. AMENDATORY 51 O.S. 2021, Section 24A.3, is
amended to read as follows:
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Section 24A.3. As used in the Oklahoma Open Records Act:
1. "Record" means all documents, including, but not limited to,
any book, paper, photograph, microfilm, data files created by or
used with computer software, computer tape, disk, record , sound
recording, film recording, video record or other material regardless
of physical form or chara cteristic, created by, received by, under
the authority of, or coming into the custody, cont rol or possession
of public officials, public bodies, or their representatives in
connection with the transaction of public business, the exp enditure
of public funds or the administering of public property. "Record"
Record does not mean:
a. computer software,
b. nongovernment personal effects,
c. unless public disclosure is required by other laws or
regulations, vehicle movement records of the Oklahoma
Transportation Authority obtained in connection with
the Authority's electronic toll collection system,
d. personal financial information, credit reports or
other financial data obtained by or submitted to a
public body for the purpose of evaluat ing credit
worthiness, obtaining a license, permit, or for the
purpose of becoming qualified to contract with a
public body,
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e. any digital audio/video recordings of the toll
collection and safeguarding activities of the Oklahoma
Transportation Authority,
f. any personal informa tion provided by a guest at any
facility owned or operated by the Oklahoma Tourism and
Recreation Department or the Board of Trustees of the
Quartz Mountain Arts and Conference Center and Nature
Park to obtain any service at the faci lity or by a
purchaser of a product sold by or through the Oklahoma
Tourism and Recreation Department or the Quartz
Mountain Arts and Conference Center and Nature Park,
g. a Department of Defense Form 214 (DD Form 214) filed
with a county clerk, including any DD Form 214 filed
before July 1, 2002, or
h. except as provided for in Section 2-110 of Title 47 of
the Oklahoma Statutes,
(1) any record in connection with a Motor Vehicle
Report issued by the Department of Public Safety,
as prescribed in Section 6 -117 of Title 47 of the
Oklahoma Statutes, or
(2) personal information within driver records, as
defined by the Driver 's Privacy Protection Act,
18 United States Code, Sections 2721 thr ough
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2725, which are stored and maintained by the
Department of Public Saf ety, or
i. data submitted under the Oklahoma Healthcare
Transparency Initiative Act of 2022;
2. "Public body" shall include, but not be limited to, any
office, department, board, bureau, commission, agency, trusteeship,
authority, council, committee, trust or any enti ty created by a
trust, county, city, village, town, township, district, school
district, fair board, c ourt, executive office, advisory group, task
force, study group, or any subdivision thereof, supported in whole
or in part by public funds or entrusted wi th the expenditure of
public funds or administering or operating public property, and all
committees, or subcommittees thereof. Except for the records
required by Section 24A.4 of this title, "public body" public body
does not mean judges, justices, the C ouncil on Judicial Complaints,
the Legislature, or legislators;
3. "Public office" means the physical location where public
bodies conduct business or keep records ;
4. "Public official" means any official or employee of an y
public body as defined herein; and
5. "Law enforcement agency" means any public body charged with
enforcing state or local criminal laws and initiating criminal
prosecutions, including, but not limited to, police departments,
county sheriffs, the Depart ment of Public Safety, the Oklah oma State
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Bureau of Narcotics and Dangerous Drugs Control, the Alcoholic
Beverage Laws Enforcement Com mission, and the Oklahoma State Bureau
of Investigation.
SECTION 12. This act shall become effecti ve July 1, 2022.
SECTION 13. It being immediately necessary for the preservation
of the public peace, health or safety, an emergency is hereby
declared to exist, by reason whereof this act shall take effect and
be in full force from and aft er its passage and approval.
Passed the Senate the 23rd day of March, 2022.
Presiding Officer of the Senate
Passed the House of Represe ntatives the ____ day of __________,
2022.
Presiding Officer of the House
of Representatives