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Home > Agendas > 2006-2007 > Maine Health Data Organization

2006-2007 Regulatory Agendas

90-590
Maine Health Data Organization

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, alan.m.prysunka@maine.gov

EMERGENCY RULES ADOPTED SINCE THE LAST REGULATORY AGENDA: None

EXPECTED 2006-2007 RULE-MAKING ACTIVITY:

CHAPTER 10: Determination of Assessments (Routine Technical)
STATUTORY BASIS: 22 M.R.S.A., 8704, sub-4 and 8706, sub-2.
PURPOSE: These 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 selection criteria and methodologies that identify non-hospital health care providers may be revised. Also, the process for determining the assessments that each entity will be required to pay may change.
SCHEDULE FOR ADOPTION: Prior to October 2007
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: Prices for Data Sets, Fees For Programming and Report Generation, Duplication Rates
(Routine Technical)
STATUTORY BASIS: 22 M.R.S.A., 8704, sub-4; 8706, sub-2A and 2B; and 8707, sub-1.
PURPOSE: These rules may be amended to revise the schedule of fees to purchase health data that is available from the MHDO.
SCHEDULE FOR ADOPTION: Fall 2006
AFFECTED PARTIES: All parties who request, access, and utilize data from the MHDO.

CHAPTER 100: Enforcement Procedures (Major Substantive)
STATUTORY BASIS: 22 M.R.S.A., 8704, sub-4 and 8705-A, sub-3-B
PURPOSE: These rules may be amended to increase fines that may be adjudged to any person or entity that receives data or information and intentionally or knowingly uses, sells or transfers the data in violation of the rules for commercial advantage, pecuniary gain, personal gain, or malicious harm.
SCHEDULE FOR ADOPTION: Spring 2007
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 BASIS: 22 M.R.S.A., 8704, sub-4 and 8707
PURPOSE: These 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 restrict the release of individually identifiable practitioner data to be made available to the public.
SCHEDULE FOR ADOPTION: Prior to June 2007
AFFECTED PARTIES: All parties who request, access, and utilize data from the MHDO and all parties who submit data to the MHDO.

CHAPTER 125: Health Care Information that Directly Identifies an Individual (Routine Technical)
STATUTORY BASIS: 22 M.R.S.A., 1711-C, sub-1-E and 8704, sub-4
PURPOSE: These rules may be amended to define or list additional health care information deemed to be direct identifiers of individuals.
SCHEDULE FOR ADOPTION: Prior to October 2007
AFFECTED PARTIES: All parties who have access and utilize data from the MHDO and all parties who submit data to the MHDO.

CHAPTER 241: Uniform Reporting System For Hospital Inpatient Data Sets and Hospital Outpatient
Data Sets (Routine Technical)
STATUTORY BASIS: 22 M.R.S.A., 8704, sub-1 and 4 and 8708
PURPOSE: These rules may be amended to add additional data elements and reflect new modes of reporting the required data sets. Timelines, record formats and submittal requirements may also be modified.
SCHEDULE FOR ADOPTION: Prior to October 2007
AFFECTED PARTIES: All Maine hospitals that submit health-related data to the MHDO.

CHAPTER 243: Uniform Reporting System For Health Care Claims Data Sets (Routine Technical)
STATUTORY BASIS: 22 M.R.S.A., 8704, sub-1 and 4, and 8708
PURPOSE: These rules may be amended to correct errors in the technical appendices and to add new data elements.
SCHEDULE FOR ADOPTION: Prior to October 2007
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 270: Uniform Reporting System For Health Care Quality Data Sets (Major Substantive)
STATUTORY BASIS: 22 M.R.S.A., 8704, sub-4 and 8708-A
PURPOSE: These rules may be amended to specify the content, form, frequency of submittal, and those parties required to submit additional health care quality data. In accordance with the provisions of 22 M.R.S.A, 8708-A, the modification of the rules must be coordinated between the Maine Quality Forum and the Maine Quality Forum Advisory Council.
SCHEDULE FOR ADOPTION: Prior to June 2007
AFFECTED PARTIES: All health care providers.

CHAPTER 300: Uniform Reporting System for Hospital Financial Data (Routine Technical)
STATUTORY BASIS: 22 M.R.S.A., 8704, sub-4, 8709, sub-1-A, and 8711
PURPOSE: These rules may be amended to revise the standardized accounting template and/or amend other financial data requirements submitted to the Maine Health Data Organization.
SCHEDULE FOR ADOPTION: Prior to October 2007
AFFECTED PARTIES: All Maine hospitals.

CHAPTER 630: Uniform System for Reporting Baseline Information and Restructuring Occurrences
Relevant to the Delivery and Financing of Health Care in Maine (Routine Technical)
STATUTORY BASIS: 22 M.R.S.A., 8704, sub-4 and 8710
PURPOSE: These rules may be amended to revise the provisions for filing and specifies the information to be submitted to the Maine Health Data Organization regarding baseline information and major structural changes relevant to the restructuring of hospitals and their parent entities in Maine.
SCHEDULE FOR ADOPTION: Fall 2006
AFFECTED PARTIES: All Maine hospitals and their parent entities

CHAPTER 700: Criteria and Standards For Price Lists at Hospitals and Ambulatory Surgical Facilities (Routine Technical)
STATUTORY BASIS: 22 M.R.S.A., 1718 and 8704, sub-4
PURPOSE: These rules may be modified if it is determined that the process of listing prices is determined to be flawed.
SCHEDULE FOR ADOPTION: Prior to October 2007
AFFECTED PARTIES: All hospitals, ambulatory surgical centers, and consumers of health care.