DAR File No. 40850

Health, Center for Health Data, Health Care Statistics

Rule R428-1

Health Data Plan and Incorporated Documents

Notice of Proposed Rule

(Amendment)

DAR File No.: 40850
Filed: 09/30/2016 03:25:59 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

This change updates versions of required documents for compliance in 2017.

Summary of the rule or change:

This change updates the Data Submission Guide to the next version and indicates that CAHPS surveys should use the current version.

Statutory or constitutional authorization for this rule:

• Section 26-33a-104

This rule or change incorporates by reference the following material:

• Updates HEDIS 2017, Volume 5: HEDIS Compliance Audit: Standards, Policies, and Procedures, published by National Committee on Quality Assurance, Volume 5
• Updates HEDIS 2017, Volume 3: Specifications for Survey Measures, published by National Committee on Quality Assurance, Volume 3
• Updates Utah All-Payer Claims Database Data Submission Guide , published by , 11/21/2016

Anticipated cost or savings to:

the state budget:

This rule iterates forward to the current versions of documents. The Utah Department of Health (UDOH) determines enactment of the amended version will not create any cost or savings impact to the state budget or UDOH's budget since the change will not increase workload and can be carried out with existing budget.

local governments:

This filing does not create any direct cost or savings impact to local governments since they are not directly affected by the rule; nor are local governments indirectly impacted because the rule does not create a situation requiring services from local governments.

small businesses:

None--Small businesses are not impacted by this rule change, with all potentially impacted having more than 50 employees. As a result, the rule will have no affect on small business budgets for costs or savings.

persons other than small businesses, businesses, or local governmental entities:

UDOH anticipates that some carriers will need to make programming changes to implement the additional flexibility and clarifications. By agreement with the data suppliers, changes to the DSG are limited to once per calendar year, so they should anticipate these changes as part of their normal business process in preparation for next year. The burden of these changes is consistent with that understanding. Based on figures reported and current submission roster, UDOH estimates an industry cost of $57,500 (46 active carriers x $1,250) to comply with proposed APCD DSG 3.0.

Compliance costs for affected persons:

Some data suppliers will need to program changes to their system in order to be consistent with the updated guidelines. According to our research, some suppliers may incur cost while others report $0 as an estimate for compliance. Overall, UDOH estimates a one-time compliance cost of $1,250 per carrier (approximately 16 man hours x DTS approved rate of $77 per hour) to comply with proposed APCD DSG 3.0.

Comments by the department head on the fiscal impact the rule may have on businesses:

The proposed amendment updates the rule to adopt the current changes in the DSG. There will be some fiscal impact to some business that may need to program system changes in order to comply with the updated guidelines.

Joseph Miner, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Health
Center for Health Data, Health Care Statistics
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Mike Martin at the above address, by phone at 801-538-9205, by FAX at 801-538-9916, or by Internet E-mail at mikemartin@utah.gov
• Norman Thurston at the above address, by phone at 801-538-7052, by FAX at 801-237-0787, or by Internet E-mail at nthurston@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

11/14/2016

This rule may become effective on:

11/21/2016

Authorized by:

Joseph Miner, Executive Director

R428. Health, Center for Health Data, Health Care Statistics.

R428-1. Health Data Plan and Incorporated Documents.

R428-1-1. Legal Authority.

This rule is promulgated in accordance with Title 26, Chapter 33a.

 

R428-1-2. Purpose.

This rule adopts and incorporates documents related to the collection, analysis, and dissemination of data covered in this title.

 

R428-1-3. Health Data Plan Adoption.

As required by Section 26-33a-104, the Health Data Committee adopts by rule the health data plan dated October 3, 1991.

 

R428-1-4. Incorporation by Reference.

The following documents are adopted and incorporated by reference:

(1) Utah Healthcare Facility Data Submission Guide, Version 1, January 15, 2016

(2) HEDIS 2017[2014], Volume 3: Specifications for Survey Measures, published by NCQA

(3) HEDIS 2017[2014], Volume 5: HEDIS Compliance Audit: Standards, Policies, and Procedures, published by NCQA

(4) Utah All-Payer Claims Database Data Submission Guide Version 2.2.1[2.1]

(5) Utah All-Payer Claims Database Data Submission Guide Version 3.0[2.2.1]

 

KEY: health, health policy, health planning

Date of Enactment or Last Substantive Amendment: [March 25], 2016

Notice of Continuation: November 21, 2011

Authorizing, and Implemented or Interpreted Law: 26-33a-104