1| SENATE FLOOR VERSION |
| April 12, 2023 |
2| |
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3|COMMITTEE SUBSTITUTE |
|FOR ENGROSSED |
4|HOUSE BILL NO. 1688 By: McEntire of the House |
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5| and |
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6| Haste of the Senate |
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7| |
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8| |
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9| [ health information - Office of the State |
| Coordinator for Health Information Exchange - powers |
10| and duties - state-designated entity - time period - |
| exemptions - Oklahoma Health Care Transparency |
11| Initiative - voluntary submission - requirements - |
| public health data - penalties - proceeds - funds - |
12| Oklahoma Open Records Act - emergency ] |
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13| |
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14| |
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15|BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: |
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16| SECTION 1. NEW LAW A new section of law to be codified |
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17|in the Oklahoma Statutes as Section 1-134.1 of Title 63, unless |
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18|there is created a duplication in numbering, reads as follows: |
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19| Sections 4 through 7 of this act shall be known and may be cited |
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20|as the "Oklahoma Health Care Transparency Initiative Act of 2023". |
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21| SECTION 2. AMENDATORY Section 1, Chapter 250, O.S.L. |
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22|2022 (63 O.S. Supp. 2022, Section 1-132.1), is amended to read as |
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23|follows: |
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24| |
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1| Section 1-132.1 A. There is hereby created the Office of the |
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2|State Coordinator for Health Information Exchange within the |
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3|Oklahoma Health Care Authority. |
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4| B. The Office shall have the power and duty to oversee: |
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5| 1. Oversee the state-designated entity for health information |
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6|exchange, as described under Section 1-133 of Title 63 of the |
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7|Oklahoma Statutes this title; and |
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8| 2. Oversee the Oklahoma Health Care Transparency Initiative. |
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9| C. The Office shall consist of the State Coordinator for Health |
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10|Information Exchange, who shall be appointed by and serve at the |
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11|pleasure of the Administrator of the Authority, and such other |
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12|employees of the Authority as the Administrator may assign to the |
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13|Office. |
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14| SECTION 3. AMENDATORY 63 O.S. 2021, Section 1-133, as |
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15|amended by Section 2, Chapter 250, O.S.L. 2022 (63 O.S. Supp. 2022, |
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16|Section 1-133), is amended to read as follows: |
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17| Section 1-133. A. As used in this section: |
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18| 1. "Health information exchange" means the electronic movement |
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19|of health-related information among organizations according to |
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20|nationally recognized standards for purposes including, but not |
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21|limited to, payment, treatment, and administration; and |
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22| 2. "Health information exchange organization" means an entity |
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23|whose primary business activity is health information exchange and |
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24|which is governed by its stakeholders. |
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1| B. The State of Oklahoma: |
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2| 1. Shall designate a health information exchange organization |
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3|as the state-designated entity for health information exchange; |
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4| 2. Shall establish a transition plan to ensure continued |
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5|operation of the health information exchange; and |
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6| 3. May temporarily serve as the state-designated entity as part |
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7|of the transition plan described in paragraph 2 of this subsection. |
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8| C. Beginning July 1, 2023, all 1. All health care providers as |
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9|defined by the rules promulgated by the Oklahoma Health Care |
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10|Authority Board and who are licensed by and located in this state |
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11|shall report data to and utilize the state-designated entity. The |
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12|Office of the State Coordinator for Health Information Exchange |
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13|shall begin implementation of this requirement on or before July 1, |
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14|2023. |
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15| 2. The Office of the State Coordinator for Health Information |
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16|Exchange may, as provided by rules promulgated by the Board, allow |
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17|exemptions from the requirement provided by paragraph 1 of this |
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18|subsection on the basis of: |
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19| a. financial hardship, |
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20| b. size of the practice, or |
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21| c. technological capability of a, |
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22| d. type of health care provider, or |
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23| e. such other bases as may be provided by rules |
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24| promulgated by the Board. |
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1| D. 1. A person who participates in the services or information |
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2|provided by the state-designated entity shall not be liable in any |
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3|action for damages or costs of any nature that result solely from |
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4|the person's use or failure to use information or data from the |
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5|state-designated entity that was entered or retrieved under relevant |
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6|state or federal privacy laws, rules, regulations, or policies |
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7|including, but not limited to, the Health Insurance Portability and |
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8|Accountability Act of 1996. |
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9| 2. A person shall not be subject to antitrust or unfair |
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10|competition liability based on participation with the |
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11|state-designated entity as long as the participation provides an |
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12|essential governmental function for the public health and safety and |
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13|enjoys state action immunity. |
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14| E. A person who provides information and data to the |
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15|state-designated entity retains a property right in the information |
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16|or data, but grants to the other participants or subscribers a |
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17|nonexclusive license to retrieve and use that information or data |
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18|under relevant state or federal privacy laws, rules, regulations, or |
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19|policies including, but not limited to, the Health Insurance |
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20|Portability and Accountability Act of 1996. |
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21| F. Patient-specific protected health information shall only be |
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22|disclosed in compliance with relevant state or federal privacy laws, |
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23|rules, regulations, or policies including, but not limited to, the |
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24|Health Insurance Portability and Accountability Act of 1996. |
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1| G. The Oklahoma Health Care Authority Board shall promulgate |
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2|rules to implement the provisions of this section. |
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3| SECTION 4. NEW LAW A new section of law to be codified |
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4|in the Oklahoma Statutes as Section 1-134.2 of Title 63, unless |
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5|there is created a duplication in numbering, reads as follows: |
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6| As used in the Oklahoma Health Care Transparency Initiative Act |
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7|of 2023: |
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8| 1. "Board" means the Oklahoma Health Care Authority Board; |
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9| 2. "Claims data" means information included in an |
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10|institutional, professional, or pharmacy claim or equivalent |
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11|information transaction for a covered individual including the |
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12|amount paid to a provider of health care services plus any amount |
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13|owed by the covered individual; |
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14| 3. "Covered individual" means a natural person who is a |
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15|resident of this state and is eligible to receive medical, dental, |
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16|or pharmaceutical benefits under any policy, contract, certificate, |
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17|evidence of coverage, rider, binder, or endorsement that provides |
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18|for or describes coverage; |
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19| 4. "Direct personal identifiers" means information relating to |
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20|a covered individual that contains primary or obvious identifiers, |
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21|such as the individual's name, street address, email address, |
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22|telephone number, or Social Security number. Direct personal |
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23|identifiers shall not include geographic or demographic information |
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24|that would not allow the identification of a covered individual; |
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1| 5. "Enrollment data" means demographic information and other |
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2|identifying information relating to covered individuals including |
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3|direct personal identifiers; |
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4| 6. "Office" means the Office of the State Coordinator for |
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5|Health Information Exchange created under Section 1-132.1 of Title |
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6|63 of the Oklahoma Statutes; |
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7| 7. "Oklahoma Health Care Transparency Initiative" means an |
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8|initiative to create a database including ongoing all-payer claims |
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9|database projects that receive and store data from a submitting |
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10|entity relating to medical, dental, pharmaceutical, and other |
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11|insurance claims information, unique identifiers, and geographic and |
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12|demographic information for covered individuals as permitted in the |
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13|Oklahoma Health Care Transparency Initiative Act of 2023, and |
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14|provider files, for the purpose of implementing the Oklahoma Health |
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15|Care Transparency Initiative Act of 2023; |
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16| 8. "Protected health information" means health information as |
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17|protected by the Health Insurance Portability and Accountability Act |
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18|of 1996, Pub. L. No. 104-191; |
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19| 9. "Provider" means an individual or entity licensed by the |
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20|state to provide health care services; |
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21| 10. "State-designated entity for health information exchange" |
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22|or "state-designated entity" means the health information exchange |
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23|organization designated by the State of Oklahoma as the |
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24| |
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1|state-designated entity for health information exchange under |
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2|Section 1-133 of Title 63 of the Oklahoma Statutes; |
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3| 11. a. "Submitting entity" means: |
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4| (1) an entity that provides health or dental |
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5| insurance or a health or dental benefit plan in |
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6| the state including but not limited to an |
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7| insurance company, medical services plan, managed |
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8| care organization, hospital plan, hospital |
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9| medical service corporation, health maintenance |
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10| organization, or fraternal benefit society, |
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11| provided that the entity has covered individuals |
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12| and the entity had at least two thousand (2,000) |
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13| covered individuals in the previous calendar |
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14| year, |
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15| (2) a health benefit plan offered or administered by |
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16| or on behalf of the state or an agency or |
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17| instrumentality of the state including but not |
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18| limited to benefits administered by a managed |
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19| care organization, notwithstanding the number of |
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20| covered individuals in the previous year, |
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21| (3) a health benefit plan offered or administered by |
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22| or on behalf of the federal government with the |
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23| agreement of the federal government, |
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24| (4) the Workers' Compensation Commission, |
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1| (5) any other entity providing a plan of health |
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2| insurance or health benefits subject to state |
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3| insurance regulation, or a third-party |
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4| administrator; provided, that the entity has |
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5| covered individuals and the entity had at least |
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6| two thousand (2,000) covered individuals in the |
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7| previous calendar year, |
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8| (6) a health benefit plan subject to the Employee |
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9| Retirement Income Security Act of 1974, Pub. L. |
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10| No. 93-406, and that is fully insured, |
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11| (7) a risk-based provider organization licensed by |
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12| the Insurance Department, and |
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13| (8) any entity that contracts with the Department of |
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14| Corrections to provide medical, dental, or |
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15| pharmaceutical care to inmates. |
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16| b. A submitting entity shall not include: |
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17| (1) an entity that provides health insurance or a |
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18| health benefit plan that is accident-only, |
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19| specified disease, hospital indemnity, long-term |
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20| care, disability income, or other supplemental |
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21| benefit coverage, |
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22| (2) an employee of a welfare benefit plan as defined |
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23| by federal law that is also a trust established |
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24| |
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1| pursuant to collective bargaining subject to the |
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2| Labor Management Relations Act of 1947, Pub. L. |
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3| No. 80-101, |
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4| (3) a health benefit plan subject to the Employee |
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5| Retirement Income Security Act of 1974, Pub. L. |
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6| No. 93-406, that is self-funded, |
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7| (4) a Medicare supplemental policy as defined by 42 |
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8| C.F.R., Section 403.205, or |
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9| (5) a pharmacy benefits manager; and |
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10| 12. "Unique identifier" means any identifier that is guaranteed |
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11|to be unique among all identifiers for covered individuals but does |
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12|not include direct personal identifiers. |
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13| SECTION 5. NEW LAW A new section of law to be codified |
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14|in the Oklahoma Statutes as Section 1-134.3 of Title 63, unless |
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15|there is created a duplication in numbering, reads as follows: |
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16| A. Beginning July 1, 2024, there is hereby created the Oklahoma |
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17|Health Care Transparency Initiative. The initiative shall be |
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18|governed by the state-designated entity for health information |
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19|exchange and overseen by the Office of the State Coordinator for |
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20|Health Information Exchange. |
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21| B. Beginning on a date determined by the Oklahoma Health Care |
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22|Authority Board, and thereafter in a frequency specified in rules |
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23|promulgated by the Board, a submitting entity shall submit claims |
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24|data, unique identifiers, and geographic and demographic information |
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1|for covered individuals as permitted in the Oklahoma Health Care |
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2|Transparency Initiative Act of 2023, and provider files to the |
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3|state-designated entity for health information exchange in |
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4|accordance with standards and procedures promulgated by the Board. |
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5|The Office shall begin implementation of the requirements of this |
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6|subsection on or before July 1, 2024. |
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7| C. 1. A health benefit plan, person, or entity excluded from |
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8|the definition of submitting entity as provided by Section 4 of this |
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9|act shall not be subject to the requirements of subsection B of this |
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10|section, but may voluntarily submit claims data, unique identifiers, |
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11|and geographic and demographic information for covered individuals |
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12|as permitted in the Oklahoma Health Care Transparency Initiative Act |
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13|of 2023, and provider files to the state-designated entity in |
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14|accordance with standards and procedures promulgated by the Board. |
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15| 2. To the extent the excluded health benefit plan, person, or |
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16|entity voluntarily submits data described in this subsection to the |
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17|state-designated entity, the health benefit plan, person, or entity |
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18|shall comply with all requirements of the Oklahoma Health Care |
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19|Transparency Initiative Act of 2023, other than subsection B of this |
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20|section, including, but not limited to, compliance with applicable |
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21|state and federal data privacy and security laws. |
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22| D. 1. The State Department of Health shall submit all public |
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23|health data and vital statistics data collected by the Department |
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24|under Title 63 of the Oklahoma Statutes to the state-designated |
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1|entity for integration into the Oklahoma Health Care Transparency |
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2|Initiative database created under this section including, but not |
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3|limited to, data collected regarding hospital discharge and |
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4|emergency department records for the uninsured, birth and death |
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5|records, and disease registry data. |
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6| 2. The data submitted under paragraph 1 of this subsection |
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7|shall be assigned a unique identifier and may be used in accordance |
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8|with the Oklahoma Health Care Transparency Initiative Act of 2023 |
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9|and the rules promulgated under the Oklahoma Health Care |
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10|Transparency Initiative Act of 2023. |
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11| SECTION 6. NEW LAW A new section of law to be codified |
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12|in the Oklahoma Statutes as Section 1-134.4 of Title 63, unless |
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13|there is created a duplication in numbering, reads as follows: |
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14| A. Data and other information submitted under Section 5 of this |
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15|act shall be treated as confidential and shall be exempt from |
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16|disclosure as a record under the Oklahoma Open Records Act as |
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17|defined in Section 24A.3 of Title 51 of the Oklahoma Statutes and |
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18|are not subject to subpoena except to the extent provided in the |
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19|Oklahoma Insurance Code. |
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20| B. Data and other information submitted under Section 5 of this |
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21|act may only be collected, stored, used, disclosed, or released in |
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22|compliance with applicable state and federal data privacy and |
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23|security law, rules promulgated by the Oklahoma Health Care |
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24| |
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1|Authority Board, and data governance policies established by the |
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2|state-designated entity for health information exchange. |
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3| C. Data and other information in the Oklahoma Health Care |
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4|Transparency Initiative shall, to the extent authorized by rules |
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5|promulgated by the Board, be available: |
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6| 1. When disclosed in a form and manner that ensures the privacy |
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7|and security of protected health information as required by state |
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8|and federal laws, as a resource to insurers, employers, purchasers |
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9|of health care, researchers, state agencies, and health care |
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10|providers to allow for assessment of health care utilization, |
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11|expenditures, and performance in this state including, but not |
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12|limited to, as a resource for hospital community health needs |
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13|assessments; and |
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14| 2. To state programs regarding health care quality and costs |
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15|for use in improving health care in the state, subject to rules |
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16|prescribed by the Board conforming to state and federal privacy laws |
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17|or limiting access to limited-use data sets. |
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18| D. Data and other information in the Oklahoma Health Care |
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19|Transparency Initiative shall not be used to disclose trade secrets |
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20|of submitting entities. |
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21| E. Notwithstanding any other section of law, the Oklahoma |
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22|Health Care Transparency Initiative shall not publicly disclose any |
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23|data or other information that contains direct personal identifiers. |
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24| |
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1| F. The Oklahoma Health Care Transparency Initiative Act of 2023 |
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2|shall not be construed to supersede, limit, amend, or abrogate any |
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3|data privacy or security law, rule, or policy. |
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4| SECTION 7. NEW LAW A new section of law to be codified |
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5|in the Oklahoma Statutes as Section 1-134.5 of Title 63, unless |
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6|there is created a duplication in numbering, reads as follows: |
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7| A. Except for state or federal agencies that are submitting |
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8|entities, a submitting entity that fails to submit data as required |
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9|by the Oklahoma Health Care Transparency Initiative Act of 2023 or |
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10|the rules promulgated by the Oklahoma Health Care Authority Board |
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11|may be subject to a fine assessed by the Insurance Department. |
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12| B. The Insurance Commissioner shall adopt a schedule of fines |
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13|not to exceed One Thousand Dollars ($1,000.00) per day for each day |
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14|the violation occurs, to be determined by the severity of the |
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15|violation. |
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16| C. A fine assessed under this section may be remitted or |
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17|mitigated upon such terms and conditions as the Insurance |
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18|Commissioner considers proper and consistent with public health and |
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19|safety. |
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20| D. Of the proceeds from fines remitted under this section, the |
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21|Insurance Department shall retain a portion of such proceeds |
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22|necessary to cover the cost to the Department of administering the |
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23|assessment and collection of such fines, and the Department shall |
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24|remit the remainder of the proceeds to the Oklahoma Health Care |
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1|Authority. The Authority may only use proceeds from fines assessed |
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2|under this section to fund operations of the Oklahoma Health Care |
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3|Transparency Initiative. |
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4| SECTION 8. AMENDATORY 51 O.S. 2021, Section 24A.3, as |
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5|amended by Section 1, Chapter 402, O.S.L. 2022 (51 O.S. Supp. 2022, |
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6|Section 24A.3), is amended to read as follows: |
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7| Section 24A.3 As used in the Oklahoma Open Records Act: |
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8| 1. "Record" means all documents including, but not limited to, |
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9|any book, paper, photograph, microfilm, data files created by or |
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10|used with computer software, computer tape, disk, record, sound |
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11|recording, film recording, video record or other material regardless |
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12|of physical form or characteristic, created by, received by, under |
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13|the authority of, or coming into the custody, control or possession |
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14|of public officials, public bodies or their representatives in |
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15|connection with the transaction of public business, the expenditure |
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16|of public funds or the administering of public property. "Record" |
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17|does not mean: |
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18| a. computer software, |
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19| b. nongovernment personal effects, |
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20| c. unless public disclosure is required by other laws or |
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21| regulations, vehicle movement records of the Oklahoma |
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22| Transportation Authority obtained in connection with |
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23| the Authority's electronic toll collection system, |
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24| |
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1| d. personal financial information, credit reports or |
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2| other financial data obtained by or submitted to a |
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3| public body for the purpose of evaluating credit |
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4| worthiness, obtaining a license, permit or for the |
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5| purpose of becoming qualified to contract with a |
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6| public body, |
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7| e. any digital audio/video recordings of the toll |
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8| collection and safeguarding activities of the Oklahoma |
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9| Transportation Authority, |
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10| f. any personal information provided by a guest at any |
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11| facility owned or operated by the Oklahoma Tourism and |
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12| Recreation Department to obtain any service at the |
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13| facility or by a purchaser of a product sold by or |
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14| through the Oklahoma Tourism and Recreation |
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15| Department, |
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16| g. a Department of Defense Form 214 (DD Form 214) filed |
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17| with a county clerk including any DD Form 214 filed |
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18| before July 1, 2002, |
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19| h. except as provided for in Section 2-110 of Title 47 |
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20| of the Oklahoma Statutes,: |
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21| (1) any record in connection with a Motor Vehicle |
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22| Report issued by the Department of Public Safety, |
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23| as prescribed in Section 6-117 of Title 47 of the |
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24| Oklahoma Statutes, or |
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1| (2) personal information within driver records, as |
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2| defined by the Driver's Privacy Protection Act, |
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3| 18 United States Code, Sections 2721 through |
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4| 2725, which are stored and maintained by the |
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5| Department of Public Safety, or |
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6| i. any portion of any document or information provided |
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7| to an agency or entity of the state or a political |
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8| subdivision to obtain licensure under the laws of this |
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9| state or a political subdivision that contains an |
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10| applicant's personal address, personal phone number, |
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11| personal electronic mail address or other contact |
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12| information. Provided, however, lists of persons |
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13| licensed, the existence of a license of a person, or a |
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14| business or commercial address, or other business or |
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15| commercial information disclosable under state law |
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16| submitted with an application for licensure shall be |
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17| public record, or |
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18| j. data or other information submitted to the |
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19| state-designated entity for health information |
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20| exchange under Section 1-133 of Title 63 of the |
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21| Oklahoma Statutes or under the Oklahoma Health Care |
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22| Transparency Initiative Act of 2023; |
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23| 2. "Public body" shall include, but not be limited to, any |
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24|office, department, board, bureau, commission, agency, trusteeship, |
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1|authority, council, committee, trust or any entity created by a |
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2|trust, county, city, village, town, township, district, school |
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3|district, fair board, court, executive office, advisory group, task |
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4|force, study group or any subdivision thereof, supported in whole or |
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5|in part by public funds or entrusted with the expenditure of public |
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6|funds or administering or operating public property, and all |
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7|committees, or subcommittees thereof. Except for the records |
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8|required by Section 24A.4 of this title, "public body" does not mean |
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9|judges, justices, the Council on Judicial Complaints, the |
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10|Legislature or legislators. "Public body" shall not include an |
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11|organization that is exempt from federal income tax under Section |
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12|501(c)(3) of the Internal Revenue Code of 1986, as amended, and |
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13|whose sole beneficiary is a college or university, or an affiliated |
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14|entity of the college or university, that is a member of The |
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15|Oklahoma State System of Higher Education. Such organization shall |
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16|not receive direct appropriations from the Oklahoma Legislature. |
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17|The following persons shall not be eligible to serve as a voting |
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18|member of the governing board of the organization: |
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19| a. a member, officer, or employee of the Oklahoma State |
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20| Regents for Higher Education, |
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21| b. a member of the board of regents or other governing |
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22| board of the college or university that is the sole |
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23| beneficiary of the organization, or |
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1| c. an officer or employee of the college or university |
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2| that is the sole beneficiary of the organization; |
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3| 3. "Public office" means the physical location where public |
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4|bodies conduct business or keep records; |
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5| 4. "Public official" means any official or employee of any |
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6|public body as defined herein; and |
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7| 5. "Law enforcement agency" means any public body charged with |
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8|enforcing state or local criminal laws and initiating criminal |
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9|prosecutions including, but not limited to, police departments, |
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10|county sheriffs, the Department of Public Safety, the Oklahoma State |
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11|Bureau of Narcotics and Dangerous Drugs Control, the Alcoholic |
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12|Beverage Laws Enforcement Commission, and the Oklahoma State Bureau |
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13|of Investigation. |
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14| SECTION 9. It being immediately necessary for the preservation |
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15|of the public peace, health or safety, an emergency is hereby |
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16|declared to exist, by reason whereof this act shall take effect and |
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17|be in full force from and after its passage and approval. |
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18|COMMITTEE REPORT BY: COMMITTEE ON APPROPRIATIONS |
|April 12, 2023 - DO PASS AS AMENDED BY CS |
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arsid2778092 SENATE FLOOR VERSION - HB1688 SFLR Page 18
