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90-590
Maine Health Data Organization

2004-2005 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 2004-2005 RULE-MAKING ACTIVITY:

CHAPTER 10: Determination of Assessments
STATUTORY AUTHORITY: 22 M.R.S.A., §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 non-hospital health care providers. The process for determining the assessments that each entity will be required to pay may also be altered.
ANTICIPATED SCHEDULE: January 2005 - June 2005
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 M.R.S.A., §8704, sub-§4 and §8706, sub-§2A and §8707, sub-§1.
PURPOSE: The rules may be amended to revise the schedule of fees to purchase health data available from the MHDO.
ANTICIPATED SCHEDULE: March 2005 - June 2005
AFFECTED PARTIES: All parties who request, access, and utilize data from the MHDO

CHAPTER 100: Enforcement and Forfeiture Schedule (Major Substantive)
STATUTORY AUTHORITY: 22 M.R.S.A., §8704, sub-§4 and §8705, sub-§1and 2.
PURPOSE: As a result of the enactment of LD 1884 - An Act to Strengthen the Enforcement Provisions of the Maine Health Data Organization (PL 2003 Chapter 659), the rules will be amended to incorporate the changes in statute related to the misuse of data acquired from the MHDO. PL 2003 Chapter 659 designated these rules as major substantive.
ANTICIPATED SCHEDULE: November 2004 - June 2005
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 M.R.S.A., §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: November 2004 - June 2005
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 M.R.S.A., §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: September 2004 - December 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 M.R.S.A., §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 2005 - June 2005
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 M.R.S.A., §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 2005 - June 2005
AFFECTED PARTIES: All Maine non-hospital health care providers that submit or may be required to submit health related data to the MHDO

CHAPTER 250: List of Ambulatory Services for Which Data Set Reporting is Required
STATUTORY AUTHORITY: 22 M.R.S.A., §8704, sub-§4 and §8708, sub-§4-A.
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 2005 - June 2005
AFFECTED PARTIES: All Maine health care providers that deliver those services in an ambulatory setting

CHAPTER 270: Uniform Reporting System For Health Care Quality Data Sets (Major Substantive)
STATUTORY AUTHORITY: 22 M.R.S.A., §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 M.R.S.A., §8708-A, the rules must be developed with the Maine Quality Forum and the Maine Quality Forum Advisory Council.
ANTICIPATED SCHEDULE: November 2004 - June 2005
AFFECTED PARTIES: All health care providers, 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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