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90-590
Maine Health Data Organization

2003-2004 Regulatory Agenda

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

CONTACT PERSON: Alan M. Prysunka, Executive Director, 151 Capitol Street - 102 State House Station, Augusta, ME 04333-0102. Tel: (207) 287-6722

EMERGENCY RULES ADOPTED SINCE THE LAST REGULATORY AGENDA: None

EXPECTED 2003-2004 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 may be amended with respect to the selection criteria and methodologies that identify health care providers, third-party administrators, and carriers that provide only administrative services for plan sponsors that will be required to pay assessments. The process for determining the assessments that each entity will be required to pay may also be altered.
ANTICIPATED SCHEDULE: January 2004 - June 2004
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 50: Rules for Fees for Data Processing, Report Compilation and Copying Services
STATUTORY AUTHORITY: 22 MRSA, §8704, sub-§4 and §8706, sub-§2A and §8707, sub-§1.
PURPOSE: The rules will be amended to update the schedule of user fees for the right to access and use the health data available from the MHDO and for report generation, publishing and duplicating costs incurred in responding to requests.
ANTICIPATED SCHEDULE: November 2003 - June 2004
AFFECTED PARTIES: All parties who request, access, and utilize data from the MHDO

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: December 2003 - June 2004
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, carriers that provide only administrative services for plan sponsors, and recipients of data.

CHAPTER 120: Release of Information to the Public (Major Substantive)
STATUTORY AUTHORITY: 22 MRSA, §8704, sub-§4 and §8707.
PURPOSE: These major substantive 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 may be modified to reflect the changes made to the Maine Health Data Organization's data submittal rules (Chapters 241, 243, (245, 300, and 630).
ANTICIPATED SCHEDULE: February 2004 - June 2004
AFFECTED PARTIES: All parties who request, access, and utilize data from the MHDO.

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 will 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: February 2004 - July 2004
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 may be amended to alter the provisions 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. Timelines and submittal requirements may need to be modified.
ANTICIPATED SCHEDULE: January 2004 - June 2004
AFFECTED PARTIES: All Maine licensed 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 that pay claims for Maine residents.

CHAPTER 245: Uniform Reporting System For Non-Hospital Ambulatory Service Data Sets STATUTORY AUTHORITY: 22 MRSA, §8704, sub-§4 and §8708
PURPOSE: The rules may be eliminated in their entirety if the new database created under the authority of 90-590 CMR Chapter 243 includes data from federal and state governmental payers.
ANTICIPATED SCHEDULE: March 2004 - June 2004
AFFECTED PARTIES: All Maine non-hospital health care providers that submit or may be required to submit health related data to the MHDO.

CHAPTER 247: Uniform Reporting System For Health Care Quality Data Sets
STATUTORY AUTHORITY: 22 MRSA, §8708-A
PURPOSE: These major substantive rules shall specify the content, form, frequency of submittal, and those parties required to submit health care quality data. In accordance with the provisions of 22 MRSA, §8708-A, the rules must be developed with the Maine Quality Forum and the Maine Quality Forum Advisory Council.
ANTICIPATED SCHEDULE: November 2003 - March 2004
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.


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