Connecticut Seal

General Assembly

 

Substitute Bill No. 812

January Session, 2015

 

*_____SB00812PH____033115____*

AN ACT CONCERNING ELECTRONIC HEALTH RECORDS AND HEALTH INFORMATION EXCHANGE.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. (NEW) (Effective from passage) All patient health records, including electronic health records, belong to the patient who is the subject of the records and shall, to the fullest extent practicable, be accessible to the patient and any authorized representative or health care provider of the patient's choice regardless of such health care provider's location or affiliation.

Sec. 2. (NEW) (Effective from passage) (a) For purposes of this section:

(1) "Health care provider" means any individual, corporation, facility or institution licensed by this state to provide health care services; and

(2) "Certified electronic health record system" means a health care provider's health records system that meets the criteria for certification by the federal Office of the National Coordinator for Health Information Technology.

(b) There is established a State-wide Health Information Exchange to empower health care consumers in making decisions relating to their health care, promote patient-centered care, improve the quality, safety and value of health care, reduce waste and duplication of services and support clinical decision-making.

(c) The State-wide Health Information Exchange shall: (1) Allow real-time, secure access to patient health information across all health care provider settings; (2) provide patients with secure electronic access to their health information; (3) allow voluntary participation by patients at no cost to them; (4) meet all state and federal privacy and security requirements; and (5) support public health reporting and academic research.

(d) (1) The Commissioner of Public Health shall issue a request for proposals to eligible nonprofit organizations for the development, management and operation of the State-wide Health Information Exchange.

(2) An eligible nonprofit organization responding to the request for proposal shall: (A) Have experience in not less than one other state in operating a state-wide health information exchange as an official state-designated entity that (i) enables the seamless exchange of patient health information among health care providers, health plans and other authorized users without regard to geographic region, source of payment or technology, (ii) includes, with proper consent, behavioral health and substance abuse treatment information, (iii) supports transitions of care and care coordination through real-time health care provider alerts and access to clinical information, (iv) allows health information to follow each patient, (v) allows patients to access and manage their health data, and (vi) has demonstrated success in reducing costs associated with preventable readmissions, duplicative testing and medical errors; (B) be committed to, and demonstrate, a high level of transparency in its governance, decision-making and operations; and (C) have sufficient staff and appropriate expertise and experience to carry out the administrative, operational and financial responsibilities of the State-wide Health Information Exchange.

(e) Such request shall require: (1) Broad local governance that (A) includes all stakeholders, including, but not limited to, hospitals, physicians, behavioral health providers, long-term care providers, health insurers, employers, patients and state officials, and (B) is committed to the successful development and implementation of the State-wide Health Information Exchange; (2) provision of a health information exchange plan that (A) builds upon existing infrastructure and is coordinated with existing programs, (B) ensures the privacy and security of patient information at all levels and, at a minimum, complies with all applicable state and federal privacy and security laws, (C) focuses on efforts to maximize utility with minimal cost and burden on stakeholders, (D) promotes the highest level of interoperability and utilization of national information technology standards, and (E) is consistent with the statewide health information technology plan developed pursuant to section 19a-25d of the general statutes; and (3) provision of a business plan that includes (A) a collaborative process engaging all stakeholders in the development of recommended funding streams sufficient to support the annual operating expenses of the State-wide Health Information Exchange, and (B) the development of services and products to support the long-term sustainability of the State-wide Health Information Exchange.

(f) (1) Not later than six months after commencement of the operation of the State-wide Health Information Exchange, each health care provider with a certified electronic health record system shall connect to, and participate in, the State-wide Health Information Exchange.

(2) Not later than three years after commencement of the operation of the State-wide Health Information Exchange, each health care provider shall maintain a certified electronic health records system and connect to, and participate in, the State-wide Health Information Exchange.

Sec. 3. (Effective July 1, 2015) (a) For the purposes described in subsection (b) of this section, the State Bond Commission shall have the power from time to time to authorize the issuance of bonds of the state in one or more series and in principal amounts not exceeding in the aggregate fifty million dollars, provided fifteen million dollars of said authorization shall be effective July 1, 2016, ten million dollars of said authorization shall be effective July 1, 2017, and ten million dollars shall be effective July 1, 2018.

(b) The proceeds of the sale of such bonds, to the extent of the amount stated in subsection (a) of this section, shall be used by the Department of Public Health for the development and maintenance of the State-wide Health Information Exchange, established pursuant to section 2 of this act, including the purchase of software and related equipment.

(c) All provisions of section 3-20 of the general statutes, or the exercise of any right or power granted thereby, that are not inconsistent with the provisions of this section are hereby adopted and shall apply to all bonds authorized by the State Bond Commission pursuant to this section. Temporary notes in anticipation of the money to be derived from the sale of any such bonds so authorized may be issued in accordance with section 3-20 of the general statutes and from time to time renewed. Such bonds shall mature at such time or times not exceeding twenty years from their respective dates as may be provided in or pursuant to the resolution or resolutions of the State Bond Commission authorizing such bonds. None of such bonds shall be authorized except upon a finding by the State Bond Commission that there has been filed with it a request for such authorization that is signed by or on behalf of the Secretary of the Office of Policy and Management and states such terms and conditions as said commission, in its discretion, may require. Such bonds issued pursuant to this section shall be general obligations of the state and the full faith and credit of the state of Connecticut are pledged for the payment of the principal of and interest on such bonds as the same become due, and accordingly and as part of the contract of the state with the holders of such bonds, appropriation of all amounts necessary for punctual payment of such principal and interest is hereby made, and the State Treasurer shall pay such principal and interest as the same become due.

Sec. 4. (NEW) (Effective from passage) There is established an account to be known as the "State-wide Health Information Exchange account" which shall be a separate, nonlapsing account within the General Fund. The account shall contain any moneys required by law to be deposited in the account. Moneys in the account shall be expended by the Commissioner of Public Health for the purposes of the development and maintenance of the State-wide Health Information Exchange, established pursuant to section 2 of this act.

Sec. 5. (NEW) (Effective from passage) (a) For the purposes of this section: (1) "Certified electronic health record system" means a health care provider's health records system that meets the criteria for certification by the federal Office of the National Coordinator for Health Information Technology, (2) "hospital" has the same meaning as provided in section 19a-490 of the general statutes, and (3) "health care provider" means any individual, corporation, facility or institution licensed by this state to provide health care services.

(b) Each hospital shall, as a condition of its license, (1) maintain a certified electronic health records system, and (2) enable bidirectional connectivity for the secure exchange of patient health records between the hospital and other licensed health care providers that maintain a certified electronic health records system that is technologically capable of accepting such records, including at least the following: (A) Laboratory and diagnostic tests; (B) radiological and other diagnostic imaging; (C) continuity of care documents; (D) discharge notifications and documents; and (E) patient care referrals.

(c) Each hospital shall implement the use of any hardware, software or other functionality or program settings existing and available within its electronic health records system that would support the exchange of information as described in subsection (b) of this section.

(d) Except as required by federal law, no hospital shall (1) require any health care provider to pay for any hardware, software or other internal cost associated with the hospital's implementation or maintenance of the hospital's electronic health records system, or (2) charge any fee to connect to, or exchange information through, the hospital's electronic health records system.

(e) To the extent the exchange of patient health records, as described in subsection (b) of this section, requires the installation of an interface or the purchase of additional software, information technology, services or equipment, a hospital may donate such items, to the extent authorized by federal law, to a health care provider. Such health care provider may make a request for such donation in writing to the hospital. The hospital shall respond, in writing, to such request not later than thirty days after receipt of the request and submit a copy of the health care provider's request and the hospital's response to the request, not later than fifteen days after the date of such response, to the Commissioner of Public Health and the Commissioner of Consumer Protection. Any such donation shall be eligible for a tax credit equal to the actual cost to the hospital of the donated items against the tax imposed pursuant to chapter 211a of the general statutes, as provided in section 6 of this act.

(f) It shall be an unfair trade practice pursuant to section 42-110b of the general statutes for any hospital to (1) fail to take all reasonable actions necessary to comply with subsections (b) and (c) of this section or to otherwise unreasonably fail to facilitate the timely electronic exchange of patient health information, or (2) take any action in violation of subsection (d) of this section.

(g) If the Commissioner of Consumer Protection finds that a hospital has intentionally violated the provisions of this section, the commissioner shall forward such findings, to the Attorney General. The Attorney General may investigate such complaint to determine whether any action on the part of the hospital constitutes a violation of the provisions of chapter 624 of the general statutes, to the extent such action constitutes a restraint of trade or an attempt to monopolize or otherwise result in a lessening of competition by dividing patients among health care providers, inducing patients to refuse to obtain services from certain health care providers or lessening competition among health care providers.

Sec. 6. (NEW) (Effective July 1, 2015, and applicable to income years commencing on or after January 1, 2015) (a) For the income years commencing January 1, 2015, and ending December 31, 2020, there shall be allowed as a credit against the tax imposed by section 12-263b of the general statutes for items donated by a hospital to a health care provider. The amount of credit allowed shall be equal to the actual cost to a hospital of items donated to a health care provider, as described in subsection (e) of section 5 of this act.

(b) The amount of credit allowed any taxpayer under this section for any income year may not exceed the amount of tax due from such taxpayer under section 12-263b of the general statutes with respect to such income year.

Sec. 7. (NEW) (Effective from passage and applicable to taxable or income years, as appropriate, commencing on or after January 1, 2015) (a) There shall be allowed as a credit against the tax imposed by chapter 208, 211a or 229 of the general statutes for health care providers implementing or upgrading an electronic health records system. The amount of credit allowed shall be equal to the actual cost to health care providers of the implementation of a certified electronic health records system or upgrade of an existing health records system to a certified electronic health records system. As used in this subsection, "certified electronic health records system" means a health care provider's health records system that meets the criteria for certification by the federal Office of the National Coordinator for Health Information Technology.

(b) The amount of credit allowed any taxpayer under this section for any income or taxable year, as appropriate, may not exceed the amount of tax due from such taxpayer under chapter 208, 211a or 229 of the general statutes with respect to such income or taxable year, as appropriate.

(c) No credit shall be allowed pursuant to this section for income or taxable years, as appropriate, commencing on and after January 1, 2021.

This act shall take effect as follows and shall amend the following sections:

Section 1

from passage

New section

Sec. 2

from passage

New section

Sec. 3

July 1, 2015

New section

Sec. 4

from passage

New section

Sec. 5

from passage

New section

Sec. 6

July 1, 2015, and applicable to income years commencing on or after January 1, 2015

New section

Sec. 7

from passage and applicable to taxable or income years, as appropriate, commencing on or after January 1, 2015

New section

Statement of Legislative Commissioners:

In Section 2(b), "shall be established" was changed to "is established", for conformity with statutory format; in Section 2(c), a colon was placed before "(1)" and "Allow" was capitalized, for conformity with statutory format; and in Section 5(e), "as provided in section 6 of this act" was added for clarity.

PH

Joint Favorable Subst. -LCO