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§ 449.7. Data dissemination and publication

Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 35 P.S. Health and SafetyEffective: June 29, 2008

Purdon's Pennsylvania Statutes and Consolidated Statutes
Title 35 P.S. Health and Safety (Refs & Annos)
Chapter 1D. Health Care Cost Containment Act (Refs & Annos)
Effective: June 29, 2008
35 P.S. § 449.7
§ 449.7. Data dissemination and publication
(a) Public reports.--Subject to the restrictions on access to council data set forth in section 101 and utilizing the data collected under section 62 as well as other data, records and matters of record available to it, the council shall prepare and issue reports to the General Assembly and to the general public according to the following provisions:
(1) The council shall, for every provider of both inpatient and outpatient services within this Commonwealth and within appropriate regions and subregions, 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 shall provide comparative information on the following:
(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 or specialty, for which these elements vary significantly from the norms for all providers.
(2) In preparing its reports under paragraph (1), the council shall ensure that 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 are explained in the reports. The council shall also ensure that any clarifications and dissents submitted by individual providers under section 6(g) are noted in any reports that include release of data on that individual provider.
(b) Raw data reports and computer access to council data.--The council shall provide special reports derived from raw data and a means for computer-to-computer access to its raw data to any purchaser, pursuant to section 10(f). The council shall provide such reports and computer-to-computer access, at its discretion, to other parties, pursuant to section 10(g). The council shall provide these special reports and computer-to-computer access in as timely a fashion as the council's responsibilities to publish the public reports required in this section will allow. Any such provision of special reports or computer-to-computer access by the council shall be made only subject to the restrictions on access to raw data set forth in section 10(b) and only after payment for costs of preparation or duplication pursuant to section 10(f) or (g).

Credits

1986, July 8, P.L. 408, No. 89, § 7, imd. effective. Reenacted and amended 1993, June 28, P.L. 146, No. 34, § 1, imd. effective; 2003, July 17, P.L. 31, No. 14, § 2, imd. effective. Reenacted 2009, June 10, P.L. 10, No. 3, § 3, retroactive effective June 29, 2008.
EXPIRATION
<See 35 P.S. § 449.19 for expiration of this act.>
HISTORICAL AND STATUTORY NOTES
Act 1993-34 legislation
The 1993 amendment in subd. (a)(1) deleted “quarterly” following “issue”, rewrote subd. (a)(3), which prior thereto read:
“(3) The council shall, for all providers within the Commonwealth and within appropriate regions and subregions within the Commonwealth, prepare and issue quarterly reports that at least provide information on the following:
“(i) The number of physicians, by speciality, on the staff of each hospital or ambulatory service facility and those physicians on the staff that accept Medicare assignment as full payment and that accept Medical Assistance patients.
“(ii) The status of hospitals respecting accreditation and licensure.”
; and in subd. (a)(4) inserted “annually”.
Act 2003-14 legislation
Act 2003-14, § 2, rewrote subsec. (a), which prior thereto read:
“(a) Public reports.--Subject to the restrictions on access to council data set forth in section 10 and utilizing the data collected under section 6 as well as other data, records and matters of record available to it, the council shall prepare and issue reports to the General Assembly and to the general public, according to the following provisions:
“(1) The council shall, for every provider within the Commonwealth and within appropriate regions and subregions within the Commonwealth and for those inpatient and outpatient services which, when ranked by order of frequency, account for at least 65% of all covered services and which, when ranked by order of total payments, account for at least 65% of total payments, prepare and issue reports that at least provide information on the following:
“(i) Comparisons among all providers of payments received, charges, population-based admission or incidence rates, and provider service effectiveness, such comparisons to be grouped according to diagnosis and severity, and to identify each provider by name and type or specialty.
“(ii) Comparisons among all providers, except physicians, of inpatient and outpatient charges and payments for room and board, ancillary services, drugs, equipment and supplies and total services, such comparisons to be grouped according to provider quality and provider service effectiveness and according to diagnosis and severity, and to identify each health care facility by name and type.
“(iii) Until and unless a methodology to measure provider quality and provider service effectiveness pursuant to sections 5(d)(4) and 6(c) and (d) is available to the council, comparisons among all providers, grouped according to diagnosis, procedure and severity, which identify facilities by name and type and physicians by name and specialty, of charges and payments received, readmission rates, mortality rates, morbidity rates and infection rates. Following adoption of the methodology specified in sections 5(d)(4) and 6(c) and (d), the council may, at its discretion, discontinue publication of this component of the report.
“(iv) The incidence rate of selected medical or surgical procedures, the provider service effectiveness and the payments received for those providers, identified by the name and type or specialty, for which these elements vary significantly from the norms for all providers.
“(2) In preparing its reports under paragraph (1), the council shall ensure that 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 market place, are explained in the reports. It shall also ensure that any clarifications and dissents submitted by individual providers under section 6(g) are noted in any reports that include release of data on that individual provider.
“(3) The council shall, for all providers within the Commonwealth and within appropriate regions and subregions within the Commonwealth, prepare and issue quarterly reports that at least provide information on the number of physicians, by speciality, on the staff of each hospital or ambulatory service facility and those physicians on the staff that accept Medicare assignment as full payment and that accept Medical Assistance patients.
“(4) The council shall publish all reports required in this section in the Pennsylvania Bulletin and shall publish, in at least one newspaper of general circulation in each subregion within the Commonwealth, reports on the providers in that subregion and subregions adjacent to it. In addition, the council shall advertise annually the availability of these reports and the charge for duplication in the Pennsylvania Bulletin and in at least one newspaper of general circulation in each subregion within the Commonwealth at least once in each calendar quarter.”
Section 10 of 2003, July 17, P.L. 31, No. 14, imd. effective, provides that “[t]his act shall apply retroactively to June 29, 2003.”

Footnotes

35 P.S. § 449.10.
35 P.S. § 449.6.
35 P.S. § 449.7, PA ST 35 P.S. § 449.7
Current through 2018 Regular Session Acts 1 to 47, 51, 52, 54, 65, 66, 71 and 72
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