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90-590 - Maine Health Data Organization
2001-2002 Regulatory Agenda

UMBRELLA-UNIT NUMBER: 90-590
AGENCY NAME: Maine Health Data Organization

CONTACT PERSON: Alan M. Prysunka, Executive Director, Gardiner Annex - 122 Northern Avenue, 102 State House Station, Augusta, ME 04333-0102. Tel: (207) 624-8655

EMERGENCY RULES ADOPTED SINCE THE LAST REGULATORY AGENDA: None

EXPECTED 2001-2002 RULE-MAKING ACTIVITY:

CHAPTER 10: Determination of Assessments
STATUTORY AUTHORITY: 22 MRSA, 8704, sub-4 and 8706, sub-2.
PURPOSE: The rules identify those health care providers, insurers, health maintenance organizations, and third-party administrators required to pay annual assessments for the operation of the MHDO. The rules will be amended to include selection criteria and methodologies to identify additional health care providers, third-party administrators, and carriers that provide only administrative services for plan sponsors that will be required to pay assessments. The processes for determining the assessments that each entity will be required to pay will also be altered.
ANTICIPATED SCHEDULE: October 2001 - March 2002
AFFECTED PARTIES: All Maine health care providers and all non-profit hospital and medical service organizations, ambulatory services and surgery facilities, health insurance carriers, health maintenance organizations and third-party administrators of health benefits plans administered for employers.

CHAPTER 100: Enforcement and Forfeiture Schedule
STATUTORY AUTHORITY: 22 MRSA, 8704, sub-4 and 8705, sub-1and 2.
PURPOSE: The rules will be amended to reflect changes in the Maine Health Data Organization's statute and will equalize the fee schedule of forfeitures for failure to file data and failure to protect the disclosure of confidential or privileged data.
ANTICIPATED SCHEDULE: January 2002 - October 2002
AFFECTED PARTIES: All non-profit hospital and medical service organizations, ambulatory services and surgery facilities, health insurance carriers, health maintenance organizations and third-party administrators of health benefits plans administered for employers, and carriers that provide only administrative services for plan sponsors.

CHAPTER 120: Release of Information to the Public (Major Substantive)
STATUTORY AUTHORITY: 22 MRSA, 8704, sub-4 and 8707.
PURPOSE: The rules define privileged medical information and confidential commercial information and establish the conditions for release, publication, and use of the health data (including derived analyses, reports or compilations) made available by the MHDO. The rules will be modified to reflect the changes made to the Maine Health Data Organization's statute and to its data submittal rules (Chapters 241, 243 (proposed), 245, 300, and 630).
ANTICIPATED SCHEDULE: October 2001 - February 2002
AFFECTED PARTIES: All parties who request, access, and utilize data from the MHDO.

CHAPTER 125: Health Care Information that Directly Identifies an Individual
STATUTORY AUTHORITY: 22 MRSA, 1711-C, sub-1(E).
PURPOSE: These rules define health care information that may directly identify individuals. The definitions are utilized in the implementation of certain aspects of PL 1997, Ch.793 - An Act to Provide for Confidentiality of Health Care Information and may need to be amended.
ANTICIPATED SCHEDULE: October 2001 - February 2002
AFFECTED PARTIES: Health care providers, payers, and recipients; and all parties who access and utilize confidential health related data.

CHAPTER 241: Uniform Reporting System For Hospital Inpatient Data Sets and Hospital Outpatient Data Sets
STATUTORY AUTHORITY: 22 MRSA, 8704, sub-4 and 8708
PURPOSE: The rules must be amended to reflect new modes of reporting the required data sets. Timelines, record formats and submittal requirements may need to be modified.
ANTICIPATED SCHEDULE: March 2002- October 2002
AFFECTED PARTIES: All Maine hospitals that submit health-related data to the MHDO.

CHAPTER 243: Uniform Reporting System For Health Care Claims Data Sets
STATUTORY AUTHORITY: 22 MRSA, 8704, sub-1 sub-4 and 8708
PURPOSE: These rules will contain the provision for filing health care claims data sets from all third-party payers, third-party administrators, and carriers that provide only administrative services for a plan sponsor.
ANTICIPATED SCHEDULE: October 2001- March 2002
AFFECTED PARTIES: All Maine health insurance carriers, health maintenance organizations, and carriers that provide only administrative services for plan sponsors. and third-party administrators of health benefits plans administered for employers or a plan sponsor, and all ambulatory services and surgery facilities.

CHAPTER 245: Uniform Reporting System For Non-Hospital Ambulatory Service Data Sets STATUTORY AUTHORITY: 22 MRSA, 8704, sub-4 and 8708
PURPOSE: The rules must be amended to reflect the elimination of reporting data sets related to specific procedures and identify those providers required to submit all data. Timelines, record formats and submittal requirements may need to be modified.
ANTICIPATED SCHEDULE: March 2002 - October 2002
AFFECTED PARTIES: All Maine non-hospital health care providers that submit or may be required to submit health related data to the MHDO.



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