Original Content (c) MultiState Associates Inc.

 

 

Association of Health Information Outsourcing Services

10/20/2005 - 10/26/2005

 

New Legislative Entries

 

Maine L.R. 2764

 

Full Text Link:

http://www.multistate.com/SMART.nsf/billdetail?openform&billid=ME+L.R.+2764

 

Category:

Medical Records Privacy

 

Last Action:

10/18/2005 FILED.

 

Synopsis:

Preserves patient records.

 

Additional Information:

Not available.

 

Status:

 

10/18/2005 FILED.

 

Sponsor Information:

William J. Smith (D-Majority).

 

Sponsor:

Smith W

 

 

 

Michigan H.B. 5336

 

Full Text Link:

http://www.multistate.com/SMART.nsf/billdetail?openform&billid=MI+H.B.+5336

 

Category:

Medical Records Privacy

 

Last Action:

10/19/2005 To HOUSE Committee on HEALTH POLICY.

 

Synopsis:

Creates Health Information Technology Commission.

 

Additional Information:

Language as Introduced on October 19, 2005:

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

PART 25 HEALTH INFORMATION TECHNOLOGY

 

SEC. 2501. AS USED IN THIS PART:

 

(A) "COMMISSION" MEANS THE HEALTH INFORMATION TECHNOLOGY COMMISSION CREATED UNDER SECTION 2503.

 

(B) "DEPARTMENT" MEANS THE DEPARTMENT OF COMMUNITY HEALTH.

 

SEC. 2503. (1) THE HEALTH INFORMATION TECHNOLOGY COMMISSION IS CREATED WITHIN THE DEPARTMENT TO PROMOTE THE DESIGN, IMPLEMENTATION, OPERATION, AND MAINTENANCE OF FACILITIES FOR PUBLIC AND PRIVATE USE OF HEALTH CARE INFORMATION IN THIS STATE.

 

SEC. 2505. THE COMMISSION'S POWERS AND DUTIES SHALL INCLUDE EACH OF THE FOLLOWING:

 

(A) THE DEVELOPMENT OF A COMMUNITY-BASED HEALTH INFORMATION NETWORK TO FACILITATE COMMUNICATION OF PATIENT CLINICAL AND FINANCIAL INFORMATION THAT IS DESIGNED TO DO ALL OF THE FOLLOWING:

 

(I) PROMOTE MORE EFFICIENT AND EFFECTIVE COMMUNICATION AMONG MULTIPLE HEALTH CARE PROVIDERS, INCLUDING, BUT NOT LIMITED TO, HOSPITALS, PHYSICIANS, PAYERS, EMPLOYERS, PHARMACIES, LABORATORIES, AND ANY OTHER HEALTH CARE ENTITY.

 

(II) CREATE EFFICIENCIES IN HEALTH CARE COSTS BY ELIMINATING REDUNDANCY IN DATA CAPTURE AND STORAGE AND REDUCING ADMINISTRATIVE, BILLING, AND DATA COLLECTION COSTS.

 

(III) CREATE THE ABILITY TO MONITOR COMMUNITY HEALTH STATUS.

 

(IV) PROVIDE RELIABLE INFORMATION TO HEALTH CARE CONSUMERS AND PURCHASERS REGARDING THE QUALITY AND COST -EFFECTIVENESS OF HEALTH CARE, HEALTH PLANS, AND HEALTH CARE PROVIDERS.

 

(V) ENSURE THE CONFIDENTIALITY OF PROTECTED HEALTH INFORMATION, INCLUDING, BUT NOT LIMITED TO, PATIENT IDENTIFIERS.

 

(B) THE DEVELOPMENT OR DESIGN OF ANY OTHER INITIATIVES IN FURTHERANCE OF THE COMMISSION'S PURPOSE.

 

(C) ANNUALLY, REPORT AND MAKE RECOMMENDATIONS TO THE CHAIRPERSONS OF THE STANDING COMMITTEES OF THE HOUSE OF REPRESENTATIVES AND SENATE WITH JURISDICTION OVER ISSUES PERTAINING TO COMMUNITY HEALTH AND INFORMATION TECHNOLOGY, THE HOUSE OF REPRESENTATIVES AND SENATE APPROPRIATIONS SUBCOMMITTEES ON COMMUNITY HEALTH AND INFORMATION TECHNOLOGY, AND THE SENATE AND HOUSE FISCAL AGENCIES.

 

(D) PERFORM ANY AND ALL OTHER ACTIVITIES IN FURTHERANCE OF THE ABOVE OR AS DIRECTED BY THE DEPARTMENT OR THE DEPARTMENT OF INFORMATION TECHNOLOGY, OR BOTH.

 

Status:

 

10/19/2005 INTRODUCED.

10/19/2005 To HOUSE Committee on HEALTH POLICY.

 

Sponsor Information:

Gary Newell (R-Majority).

 

Sponsor:

Newell

 

 


 

Movement Legislative Entries

 

 

Massachusetts H.B. 2654

 

Full Text Link:

http://www.multistate.com/SMART.nsf/billdetail?openform&billid=MA+H.B.+2654

 

Category:

Pricing

 

Last Action:

10/19/2005 In JOINT Committee on PUBLIC HEALTH: Heard. Eligible for Executive Session.

 

Synopsis:

Relative to the fees for records of hospital patients.

 

Additional Information:

Language as Introduced on January 5, 2005:

 

SECTION 1. Section 12CC of Chapter 112 of the General Laws, as appearing in the 2002 Official Edition, is hereby amended by adding at the end thereof the following sentence:-

 

For the purpose of this section the word " reasonable fee " shall mean a fee of not more that twenty five cents per page of records, and not more than twenty dollars per hour for clerical and administrative expenses.

 

SECTION 2. Section 70 of Chapter 111 of the General Laws, as appearing in the 1998 Official Edition is hereby amended by adding at the end thereof the following sentence:-

 

For the purpose of this section the word " reasonable fee " shall mean a fee of not more that twenty-five cents per page of records, and not more that twenty dollars per hour of clerical and administrative expenses.

 

Status:

 

01/05/2005 INTRODUCED.

01/05/2005 To JOINT Committee on PUBLIC HEALTH.

01/05/2005 Filed as House Docket 1307

10/19/2005 In JOINT Committee on PUBLIC HEALTH: Heard. Eligible for Executive Session.

 

Sponsor Information:

Eugene 'Gene' L. O'Flaherty (D-Majority)

 

Sponsor:

O'Flaherty

 

 

 

Massachusetts S.B. 1292

 

Full Text Link:

http://www.multistate.com/SMART.nsf/billdetail?openform&billid=MA+S.B.+1292

 

Category:

Medical Records Privacy

 

Last Action:

10/19/2005 In JOINT Committee on PUBLIC HEALTH: Heard. Eligible for Executive Session.

 

Synopsis:

Regards medical record retention requirements.

 

Additional Information:

Language as Introduced on January 5, 2005:

 

SECTION 1. Section 70 of chapter 111 of the General Laws, as appearing in the 2002 Official Edition, is hereby amended by deleting the second and third sentence in the first paragraph in their entirety and inserting in place thereof the following two new sentences-

 

Such records may be made in handwriting, in print, by typewriting, in electronic digital media or conversion to electronic digital media as originally created by such hospital or clinic, by the photographic or microphotographic process, or any combination of the same. Such hospital or clinic, may only destroy said records after the applicable retention period has elapsed upon notifying the department of public health that the applicable retention period has elapsed and the records will be destroyed. Such Hospital or Clinic shall further provide information through applicable provisions contained in the hospital or clinic notice of privacy practices or through mailing a notice to the patient's last known address that records will be terminated after the applicable retention period has elapsed since the last date of service.

 

SECTION 2: Section 70 of chapter 111 of the General Laws, as so appearing, is hereby amended by deleting the word "thirty" in the last sentence of the first paragraph and inserting in place thereof the word "fifteen"

 

SECTION 3: Section 36 of Chapter 123 of the General Laws, as so appearing, is hereby amended by adding at the end thereof the following new sentences-

 

Each facility, subject to provisions of this chapter and Section 19 of Chapter 19 who provide mental health care and treatment shall maintain records of individual patients', records are so defined under section 70 of chapter 111, for at least fifteen years after closing of the record due to discharge, death, or last contact. Such facility may destroy said records after the applicable retention period has elapsed upon notifying the department that the applicable retention period has elapsed and the records will be destroyed. Said facility shall further provide information through applicable provisions in the hospital or clinic notice of privacy practices or through mailing a notice to the patient's last known address that records will be terminated after the applicable retention period has elapsed since the last date of service.

 

SECTION 4: Application of this Act

 

(a) The Department of Public Health and the Department of Mental Health shall consult with the Massachusetts Hospital Association, the Massachusetts Medical Society, and the Massachusetts Association of Behavioral Health Systems prior to developing regulations required under this Act. Promulgation or amendment of said regulations shall occur within 120 days of the effective date of this Act.

 

Status:

 

01/05/2005 INTRODUCED.

01/05/2005 To JOINT Committee on PUBLIC HEALTH.

01/05/2005 Filed as Senate Docket 152.

10/19/2005 In JOINT Committee on PUBLIC HEALTH: Heard. Eligible for Executive Session.

 

Sponsor Information:

Richard T. Moore (D-Majority)

 

Sponsor:

Moore

 

 

 

Michigan H.B. 4606

 

Full Text Link:

http://www.multistate.com/SMART.nsf/billdetail?openform&billid=MI+H.B.+4606

 

Category:

Medical Records Privacy

 

Last Action:

10/25/2005 Expected in HJ 91 substitute H-1 adopted; Expected in HJ 91 placed on third reading

 

Synopsis:

Allows year-round posting of school session signage.

 

Additional Information:

Language as Introduced on April 13, 2005:

 

Sec. 20201. (1) A health facility or agency that provides services directly to patients or residents and is licensed under this article shall adopt a policy describing the rights and responsibilities of patients or residents admitted to the health facility or agency. Except for a licensed health maintenance organization which shall comply with chapter 35 of the insurance code of 1956, 1956 PA 218, MCL 500.3501 to 500.3580, the policy shall be posted at a public place in the health facility or agency and shall be provided to each member of the health facility or agency staff. Patients or residents shall be treated in accordance with the policy.

 

(2) The policy describing the rights and responsibilities of patients or residents required under subsection (1) shall include, as a minimum, all of the following:

 

(a) A patient or resident shall not be denied appropriate care on the basis of race, religion, color, national origin, sex, age, disability, marital status, sexual preference, or source of payment.

 

(b) An individual who is or has been a patient or resident is entitled to inspect, or receive for a reasonable fee, a copy of his or her medical record upon request. A EXCEPT AS OTHERWISE PERMITTED UNDER THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996, PUBLIC LAW 104-191, OR REGULATIONS PROMULGATED UNDER THAT ACT, 45 CFR PARTS 160 AND 164, A third party shall not be given a copy of the patient's or resident's medical record without prior authorization of the patient or resident.

 

(c) A patient or resident is entitled to confidential treatment of personal and medical records, and may refuse their release to a person outside the health facility or agency except as required because of a transfer to another health care facility, or as required by law or third party payment contract , OR AS PERMITTED UNDER THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996, PUBLIC LAW 104-191, OR REGULATIONS PROMULGATED UNDER THAT ACT, 45 CFR PARTS 160 AND 164 .

 

Status:

04/13/2005 In House; referred to Committee on Health Policy

10/18/2005 In House; reported with recommendation with substitute H-1; referred to second reading

10/25/2005 Expected in HJ 91 substitute H-1 adopted; Expected in HJ 91 placed on third reading

 

Sponsor Information:

John P. Stakoe (R-Majority)

 

Sponsor:

Stakoe

 

 


 

Regulatory Report

 

 

 

MISSOURI

Title:

Orders of Rulemaking

 

Agency:

Department of Social Services

 

Summary:

Conditions of Provider Participation, Reimbursement and Procedure of General Applicability.

 

Summary Comments:

13 CSR 70-3.030 Sanctions for False or Fraudulent Claims for Title XIX

Services

 

(1) Administration. The Missouri Medicaid program shall be administered by

the Department of Social Services, Division of Medical Services. The services

covered and not covered, the limitations under which services are covered, and

the maximum allowable fees for all covered services shall be determined by the

division and shall be included in the Medicaid provider manuals, which are

incorporated by reference and made a part of this rule as published by the

Department of Social Services, Division of Medical Services, 615 Howerton Court,

Jefferson City, MO 65102, at its website www.dss.mo.gov/dms, June 15, 2005. This

rule does not incorporate any subsequent amendments or additions.

 

(2) The following definitions will be used in administering this rule: (A)

Adequate documentation means documentation from which services rendered and the

amount of reimbursement received by a provider can be readily discerned and

verified with reasonable certainty. Adequate medical records are records which

are of the type and in a form from which symptoms, conditions, diagnosis,

treatments, prognosis and the identity of the patient to which these things

relate can be readily discerned and verified with reasonable certainty. All

documentation must be made available at the same site at which the service was

rendered. An adequate and complete patient record is a record which is

legible, which is made contemporaneously with the delivery of the service, which

addresses the patient/ client specifics, which include, at a minimum,

individualized statements that support the assessment or treatment encounter,

and shall include documentation of the following information:

 

1. First name, and last name, and either middle initial or date of birth of

the Medicaid recipient;

 

2. An accurate, complete, and legible description of each services) provided;

 

3. Name, title, and signature of the Missouri Medicaid enrolled provider

delivering the service. Inpatient hospital services must have signed and dated

physician or psychologist orders within the patient's medical record for the

admission and for services billed to Missouri Medicaid. For patients

registered on hospital records as outpatient, the patient's medical record

must contain signed and dated physician orders for services billed to Missouri

Medicaid. Services provided by an individual under the direction or supervision

are not reimbursed by Missouri Medicaid. Services provided by a person not

enrolled with Missouri Medicaid are not reimbursed by Missouri Medicaid;

 

4. The name of the referring entity, when applicable;

 

5. The date of service (month/day/year);

 

6. For those Medicaid programs and services that are reimbursed according to

the amount of time spent in delivering or rendering a service(s) (except for

services as specified under 13 CSR 70-91.010 Personal Care Program (4)(A)) the

actual begin and end time taken to deliver the service (for example, 4:00-4:30

p.m.) must be documented;

 

7. The setting in which the service was rendered;

 

8. The plan of treatment, evaluation(s), test(s), findings, results, and

prescription(s) as necessary. Where a hospital acts as an independent laboratory

or independent radiology service for persons considered by the hospital as

"nonhospital" patients, the hospital must have a written request or requisition

slip ordering the tests or procedures;

 

9. The need for the service(s) in relationship to the Medicaid recipient's

treatment plan;

 

10. The Medicaid recipient's progress toward the goals stated in the

treatment plan (progress notes);

 

11. Long-term care facilities shall be exempt from the seventytwo-72)-hour

documentation requirements rules applying to paragraphs (2)(A)9. and (2)(A)10.

However, applicable documentation should be contained and available in the

entirety of the medical record; and

 

12. For applicable programs it is necessary to have adequate invoices, trip

tickets/reports, activity log sheets, employee records (excluding health

records) , and training records of staff; (I) Participation means the

ability and authority to provide services or merchandise to eligible Medicaid

recipients and to receive payment from the Medicaid program for those services

or merchandise;

 

(3) Program Violations.

 

(A) Sanctions may be imposed by the Medicaid agency against a provider for

any one (1) or more of the following reasons:

 

1. Presenting, or causing to be presented, for payment any false or

fraudulent claim for services or merchandise in the course of business related

to Medicaid;

 

2. Submitting, or causing to be submitted, false information for the purpose

of obtaining greater compensation than that to which the provider is entitled

under applicable Medicaid program policies or rules, including, but not limited

to, the billing or coding of services which results in payments in excess of the

fee schedule for the service actually provided or billing or coding of services

which results in payments in excess of the provider's charges to the general

public for the same services or billing for higher level of service or increased

number of units from those actually ordered or performed or both, or altering or

falsifying medical records to obtain or verify a greater payment than

authorized by a fee schedule or reimbursement plan;

 

3. Submitting, or causing to be submitted, false information for the purpose

of meeting prior authorization requirements or for the purpose of obtaining

payments in order to avoid the effect of those changes;

 

4. Failing to make available, and disclosing to the Medicaid agency or its

authorized agents, all records relating to services provided to Medicaid

recipients or records relating to Medicaid payments, whether or not the records

are commingled with non-Title XIX (Medicaid) records. All records must be kept a

minimum of five (5) years from the date of service unless a more specific

provider regulation applies. The minimum five (5)-year retention of records

requirement continues to apply in the event of a change of ownership or

discontinuing enrollment in Medicaid. Services billed to the Medicaid agency

that are not adequately documented in the patient's medical records or for

which there is no record that services were performed shall be considered a

violation of this section. Copies of records must be provided upon request of

the Medicaid agency or its authorized agents, regardless of the media in which

they are kept. Failure to make these records available on a timely basis at

the same site at which the services were rendered or at the provider's address

of record with the Medicaid agency, or failure to provide copies as requested,

or failure to keep and make available adequate records which adequately document

the services and payments shall constitute a violation of this section and shall

be a reason for sanction . Failure to send records, which have been requested

via mail, within the specified time frame shall constitute a violation of this

section and shall be a reason for sanction;

 

28. Billing for services , through an agent , which were upgraded-from those

actually ordered, performed; or billing or coding services, either directly or

through an agent, in a manner that services are paid for as separate procedures

when, in fact, the services were performed concurrently or sequentially and

should have been billed or coded as integral components of a total service as

prescribed in Medicaid policy for payment in a total payment less than the

aggregate of the improperly separated services; or billing a higher level of

service than is documented in the patient/ client record; or unbundling

procedure codes;

 

33. For providers other than long-term care facilities, failing to retain in

legible form for at least five (5) years from the date of service, worksheets,

financial records, appointment books, appointment calendars (for those

providers who schedule patient/ client appointments), adequate documentation of

the service, and other documents and records verifying data transmitted to a

billing intermediary, whether the intermediary is owned by the provider or not.

For longterm care providers, failing to retain in legible form, for at least

seven (7) years from the date of service, worksheets, financial records,

adequate documentation for the service(s), and other documents and records

verifying data transmitted to a billing intermediary, whether the intermediary

is owned by the provider or not. The documentation must be maintained so as to

protect it from damage or loss by fire, water, computer failure, theft, or any

other cause;

 

Agency Contact:

Department of Social Services, Division of Medical Services, 615 Howerton Court, Jefferson City, MO 65109

 

Citation:

13 CSR 70-3

 

Status:

02/17/2004 Proposed

 

Comment Deadline:

06/15/2005 Notice

10/17/2005 Orders of Rulemaking

 

Effective Date:

30 Days after publication in the Code of State Regulations.

 

NEW JERSEY

Title:

Rule Adoptions

 

Agency:

Department of Human Services

 

Summary:

The Intoxicated Driving Program, and Intoxicated Driver Resource Centers,

under N.J.A.C. 10:162, are subject to, but do not exceed the requirements of 42

CFR Part 2, Confidentiality of Alcohol and Drug Abuse Patient Records,

authorized by 42 U.S.C. #167;#167; 290dd-3 and 290ee-3. These Federal

regulations prohibit unauthorized disclosure or use of patient records

unless permitted in certain circumstances by the regulations. No other Federal

standards are applicable to the subject matter of these rules. Therefore, a

Federal standards analysis is not required.

 

Citation:

8:66A, 10:162

 

Status:

07/18/2005 Proposed.

09/19/2005 Adopted by James M. Davy, Commissioner, Department of Human Services.

09/22/2005 Filed with substantive and technical changes not requiring additional public notice and comment (see N.J.A.C. 1:30-6.3).

09/22/2005 Effective Date for Readoption.

10/17/2005 Effective Date for Amendments, New Rules and Recodification.

09/22/2010 Expiration Date.

 

Effective Date:

09/22/2005

 

 

 

NEW MEXICO

Title:

Notices of Rule Making and Proposed Rules

 

Agency:

New Mexico Medical Board

 

Summary:

Changes to the physician licensing requirements will make permanent emergency rules facilitating the licensure of physicians from Federal disaster areas.Complaint procedures will be amended to eliminate the requirement for a notarized complaint. Changes to Part 13 will provide further clarification of the requirements for procedures performed by medical assistants under the supervision of a physician. Changes to the physician assistant rule will make permanent emergency rules that facilitate licensing of applicants from a Federal disaster area and add provisions for physician assistant practice during an emergency or disaster. The new rule will establish requirements for the management of medical records.

 

Summary Comments:

The New Mexico Medical Board will convene a Public Rule hearing on Monday,

October 31, 2005 at 4:30 p.m. in the Conference Room, 2055 S. Pacheco, Building

400, Santa Fe, New Mexico, before a hearing officer. A decision will be made on

the proposed rules at a Regular board meeting on Thursday, November 10, 2005.

 

The purpose of the Rule Hearing is to consider amending 16.10.2 NMAC

(Physicians: Licensure Requirements), 16.10.6 (Complaint Procedures and

Institution of Disciplinary Action), 16.10.13 NMAC (Use of Devices & Procedures

by Unlicensed Personnel), 16.10.15 NMAC (Physician Assistants: Licensure &

Practice Requirements), and to add 16.10.17 NMAC (Management of Medical

Records) .

 

Changes to the physician licensing requirements will make permanent emergency

rules facilitating the licensure of physicians from Federal disaster areas.

Complaint procedures will be amended to eliminate the requirement for a

notarized complaint. Changes to Part 13 will provide further clarification of

the requirements for procedures performed by medical assistants under the

supervision of a physician. Changes to the physician assistant rule will make

permanent emergency rules that facilitate licensing of applicants from a Federal

disaster area and add provisions for physician assistant practice during an

emergency or disaster. The new rule will establish requirements for the

management of medical records.

Copies of the proposed rules will be available on September 30th on

request from the Board office at the address listed above, by phone (505)

476-7220, or on the Internet at www.nmmb@state.nm.us.

 

Persons desiring to present their views on the proposed amendments may appear

in person at said time and place or may submit written comments no later than

5:00 p.m., October 24, 2005, to the board office, 2055 S. Pacheco, Building 400,

Santa Fe, NM, 87505.

 

If you are an individual with a disability who is in need of a reader,

amplifier, qualified sign language interpreter, or any other form of auxiliary

aid or service in order to attend or participate in the hearing, please contact

Lynnelle Tipton, Administrative Assistant at 2055 S. Pacheco, Building 400,

Santa Fe, NM at least one week prior to the meeting. Public documents, including

the agenda and minutes, can be provided in various accessible formats.

 

Agency Contact:

Lynnelle Tipton, Administrative Assistant at 2055 S. Pacheco, Building 400,

Santa Fe, NM

 

Citation:

16.10 NMAC

 

Status:

10/17/2005 Notices of Rule Making and Proposed Rules

10/31/2005 Hearing

11/10/2005 Board Meeting

 

Comment Deadline:

10/24/2005