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This entry was published on 2020-04-17
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SECTION 2816
Statewide planning and research cooperative system
Public Health (PBH) CHAPTER 45, ARTICLE 28
* § 2816. Statewide planning and research cooperative system. 1. (a)
The statewide planning and research cooperative system in the department
is continued, as provided in and subject to this section, within amounts
appropriated for that purpose. The system shall be developed and
operated by the commissioner in consultation with the council, as may be
specified by regulation of the commissioner. Any component or components
of the system may be operated under a different name or names, and may
be structured as separate systems. In making regulations under this
section, subsequent to April first, two thousand eleven, the
commissioner shall consult with the superintendent of financial services
or the head of any agency that succeeds the department of financial
services, health care providers, third-party health care payers, and
advocates representing patients; protect the confidentiality of
patient-identifiable information; promote the accuracy and completeness
of reporting; and minimize the burden on institutional and
non-institutional health care providers and third-party health care
payers.

(b) As used in this section, unless the context clearly requires
otherwise:

(i) "Health care" means any services, supplies, equipment, or
prescription drugs referred to in subdivision two of this section.

(ii) "Health care provider" includes, in addition to its common
meanings, a clinical laboratory, a pharmacy, an entity that is an
integrated organization of health care providers, and an accountable
care organization of health care providers.

(iii) "System" means the statewide planning and research cooperative
system under this section, and any separate system under this
subdivision.

(iv) "Third-party health care payer" includes, but is not limited to,
an insurer, organization or corporation licensed or certified pursuant
to article thirty-two, forty-three or forty-seven of the insurance law,
or article forty-four of the public health law; or an entity such as a
pharmacy benefits manager, fiscal administrator, or administrative
services provider that participates in the administration of a
third-party health care payer system.

(v) "Covered person" is a person covered under a third-party health
care payer contract, agreement, or arrangement.

2. Notwithstanding any provision of law to the contrary, regulations
governing the system shall include, but not be limited to, the
following:

(a) Specification of patient, covered person, claims, and other data
elements and format which shall be reported including data related to:

(i) inpatient hospitalization data from general hospitals;

(ii) ambulatory surgery data from hospital-based ambulatory surgery
services and all other ambulatory surgery facilities licensed under this
article;

(iii) emergency department data from general hospitals;

(iv) outpatient, clinical laboratory, and prescription data, including
but not limited to data from or relating to services, supplies,
equipment, and prescription drugs provided or ordered by general
hospitals and diagnostic and treatment centers licensed under this
article, pharmacies, clinical laboratories, and other health care
providers;

(v) covered person and claims data; and

(vi) the data specified in this paragraph shall include the
identification of patients transferred, admitted or treated subsequent
to a medical, surgical or diagnostic procedure by a licensed health care
professional or at a health care site or facility.

(b) Standards to assure the protection of patient privacy in data
collected, published, released, used and accessed under this section,
including compliance with applicable federal law.

(c) Standards for the publication, release, and use of and access to
data reported in accordance with this section, including fees to be
charged.

(d) Provisions requiring specified health care providers and
third-party health care payers to report data to the system, with
specifications of the data, circumstances, format, time and method of
reporting.

(e) Provisions to acquire data relating to health care provided (i) to
patients for whom there is no third-party health care payer and (ii)
under arrangements that do not involve fee-for-service payment.

(f) Phased-in implementation of the system.

3. The commissioner may provide that the system may participate in or
cooperate with a similar system operated by, or receive information from
or provide information to, a regional or national entity or another
jurisdiction, including making appropriate agreements and applying for
approvals, provided that the protections for health care providers,
patients, and third-party health care payers in this section are
preserved and comparable provisions are included in the other system.

4. The commissioner may provide for access to data in the system by a
health care provider relating to a patient being treated by the health
care provider, subject to this section and applicable state and federal
law.

5. In operating the system, the commissioner shall consider national
standards, including but not limited to those approved by the National
Uniform Billing Committee (NUBC) or required under national electronic
data interchange (EDI) standards for health care transactions. The
commissioner shall also consider the use of the Statewide Health
Information Network for New York in relation to the system.

6. Notwithstanding any inconsistent provision of law to the contrary,
including but not limited to section one hundred two of the executive
law, such rules and regulations may describe data elements by reference
to information reasonably available to regulated parties, as such
material may be amended in the future, even though such material cannot
be precisely identified to the extent that it is amended in the future;
provided, however, that the commissioner shall precisely identify and
publish such data elements.

7. The commissioner may contract with one or more entities to operate
any part of the system subject to this section.

8. The commissioner may accept grants and enter into contracts as may
be necessary to provide funding for the system.

9. The commissioner shall publish an annual report relating to health
care utilization, cost, quality, and safety, including data on health
disparities.

* NB Effective until March 31, 2023

* § 2816. Statewide planning and research cooperative system. 1. The
statewide planning and research cooperative system in the department is
continued, as provided in this section. The statewide planning and
research cooperative system shall be developed and operated by the
commissioner in consultation with the council, and shall be comprised of
such data elements as may be specified by regulation.

2. Regulations governing the statewide planning and research
cooperative system shall include, but not be limited to, the following:

(a) Specification of patient and other data elements and format to be
reported including data related to:

(i) inpatient hospitalization data from general hospitals;

(ii) ambulatory surgery data from hospital-based ambulatory surgery
services and all other ambulatory surgery facilities licensed under this
article;

(iii) emergency department data from general hospitals;

(iv) outpatient clinic data from general hospitals and diagnostic and
treatment centers licensed under this article, provided, however, that
notwithstanding subdivision one of this section the commissioner, in
consultation with the health care industry, is authorized to promulgate
or adopt any rules or regulations necessary to implement the collection
of data pursuant to this subparagraph; and

(v) the data specified in this paragraph shall include the
identification of patients transferred, admitted or treated subsequent
to a medical, surgical or diagnostic procedure by a licensed health care
professional at a site or facility other than those specified in
subparagraph (i), (ii), (iii) or (iv) of this paragraph.

(b) Standards to assure the protection of patient privacy in data
collected and released under this section.

(c) Standards for the publication and release of data reported in
accordance with this section.

* NB Effective March 31, 2023