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H. 4582
STATUS INFORMATION
General Bill
Sponsors: Rep. Tripp
Document Path: l:\council\bills\nbd\12014ac04.doc
Introduced in the House on January 21, 2004
Currently residing in the House Committee on Medical, Military, Public and Municipal Affairs
Summary: DHEC Data Oversight Council; meetings and reports, provisions
HISTORY OF LEGISLATIVE ACTIONS
Date Body Action Description with journal page number
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1/21/2004 House Introduced and read first time HJ-9
1/21/2004 House Referred to Committee on Medical, Military, Public and
Municipal Affairs HJ-10
View the latest legislative information at the LPITS web site
VERSIONS OF THIS BILL
TO AMEND SECTION 44-6-170, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE ESTABLISHMENT, COMPOSITION, AND DUTIES OF THE DATA OVERSIGHT COUNCIL UNDER THE OFFICE OF RESEARCH AND STATISTICS IN THE BUDGET AND CONTROL BOARD, SO AS TO REQUIRE THE COUNCIL TO PREPARE AND ISSUE REPORTS TO THE GENERAL ASSEMBLY AND THE PUBLIC CONCERNING, AMONG OTHER THINGS, INPATIENT AND OUTPATIENT HEALTH SERVICES, PROVIDER QUALITY AND SERVICE EFFECTIVENESS, DIFFERENCES IN MORTALITY RATES AND OTHER COMPARATIVE OUTCOME MEASURES, THE INCIDENCE RATE OF SELECTED MEDICAL OR SURGICAL PROCEDURES; TO REQUIRE ALL MEETINGS OF THE COUNCIL TO BE OPEN TO THE PUBLIC; AND TO MAKE TECHNICAL CORRECTIONS.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Section 44-6-170(A), (C), and (D) of the 1976 Code is amended to read:
"(A) As used in this section:
(1) 'Office' means the Office of Research and Statistics of the Budget and Control Board.
(2) 'Council' means the Data Oversight Council.
(3) 'Committee' means the Joint Legislative Health Care Planning and Oversight Committee.
(C) The duties of the council are to:
(1) make periodic recommendations to the committee and the General Assembly and the general public concerning the collection and release of health care-related data by the State which the council considers necessary to assist in the formation of health care policy in the State;
(2) convene expert panels as necessary to assist in developing recommendations for the collection and release of health care-related data;
(3) approve all regulations for the collection and release of health care-related data to be promulgated by the office;
(4) approve release of health care-related data consistent with regulations promulgated by the office;
(5) recommend to the office appropriate dissemination of health care-related data reports, training of personnel, and use of health care-related data. ;
(6) conduct examinations and investigations, to conduct audits, and to hear testimony and take proof, under oath or affirmation, at public or private hearings, on any matter necessary to its duties. The council has the right to independently audit all information required to be submitted by data sources as needed to corroborate the accuracy of the submitted data, pursuant to the following:
(a) audits of information submitted by providers or health care insurers must be performed on a sample and issue-specific basis, as needed by the council. All health care insurers and providers are required to make those books, records of accounts, and any other data needed by the auditors available to the council at a convenient location within thirty days of a written notification by the council.
(b) audits of information submitted by purchasers must be performed on a sample basis, unless there exists reasonable cause to audit specific purchasers, but the council does not have the power to audit financial statements of any purchasers.
(c) all audits performed by the council must be performed at the expense of the council;
(7) the council shall prepare and issue reports to the General Assembly and to the general public, according to the following:
(a) the council shall, for every provider of both inpatient and outpatient services within this State, prepare and issue reports on provider quality and service effectiveness on diseases or procedures that, when ranked by volume, cost, payment and high variation in outcome, represent the best opportunity to improve overall provider quality, improve patient safety, and provide opportunities for cost reduction. These reports must provide comparative information on:
(i) differences in mortality rates; differences in length of stay; differences in complication rates; differences in readmission rates; differences in infection rates; and other comparative outcome measures the council may develop that will allow purchasers, providers, and consumers to make purchasing and quality improvement decisions based upon quality patient care and to restrain costs;
(ii) the incidence rate of selected medical or surgical procedures, the quality and service effectiveness, and the payments received for those providers, identified by the name and type of specialty, for which these elements vary significantly from the norms for all providers;
(b) in preparing its reports under subitem (a) the council shall explain factors which have the effect of either reducing provider revenue or increasing provider costs and other factors beyond a provider's control which reduce provider competitiveness in the marketplace. The council shall also note any clarifications and dissents submitted by individual providers in any reports that include release of data on that individual provider.
(D) The office, with the approval of the council, shall promulgate regulations in accordance with the Administrative Procedures Act regarding the collection of inpatient and outpatient information. No data may be released by the office except in a format recommended by the council and consistent with regulations. Before the office releases provider identifiable data the office must determine that the data to be released is for purposes consistent with the regulations as promulgated by the office and the release must be approved by the council and the committee. Provided, however, committee approval of the release is not necessary if the data elements and format in the release are substantially similar to releases or standardized reports previously approved by the committee. The council shall make periodic recommendations to the committee and the General Assembly concerning the collection and release of health care-related data by the State. Regulations promulgated by the office mandating the collection of inpatient or outpatient data apply to every provider or insurer affected by the regulation regardless of how the data is collected by the provider or insurer. Every effort must be made to utilize existing data sources."
SECTION 2. Section 44-6-170 of the 1976 Code is amended by adding at the end:
"(J) All meetings of the council are open to the public, unless otherwise provided in this section."
SECTION 3. This act takes effect upon approval by the Governor.
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