THE GENERAL ASSEMBLY OF PENNSYLVANIA

SENATE BILL

INTRODUCED BY FOLMER, SCARNATI, PILEGGI, FARNESE, M. WHITE, GORDNER, BOSCOLA, D. WHITE, VANCE, ERICKSON, TARTAGLIONE, BLAKE AND STACK, FEBRUARY 13, 2012

REFERRED TO COMMUNICATIONS AND TECHNOLOGY, FEBRUARY 13, 2012  

AN ACT

Establishing the Pennsylvania Health Information Partnership

Authority and the Pennsylvania Health Information Partnership

Account; providing for consent and confidentiality of health

information; and establishing civil immunity under certain

circumstances.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

CHAPTER 1

PRELIMINARY PROVISIONS

Section 101.  Short title.

This act shall be known and may be cited as the Pennsylvania

Health Information Technology Act.

Section 102.  Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Account."  The Pennsylvania Health Information Partnership

Account.

"Authority."  The Pennsylvania Health Information Partnership

Authority.

"Board."  The board of directors of the Pennsylvania Health

Information Partnership Authority.

"Electronic health record."  A qualified electronic health

record that is certified under section 3001(c)(5) of the Public

Health Service Act (58 Stat. 682, 42 U.S.C. § 300jj-11(c)(5)) as

meeting standards adopted under section 3004 of the Public

Health Service Act (58 Stat. 682, 42 U.S.C. § 300jj-14) that are

applicable to the type of record involved and used by a health

care provider.

"Health care provider."  A person licensed by the

Commonwealth to provide health care or professional clinical

services.

"Health information."  Oral or recorded information in any

form or medium that meets all of the following:

(1)  Is created or received by a health care provider,

health care plan, employer, payer or public health authority.

(2)  Relates to:

(i)  the past, present or future physical or mental

health condition of an individual and is provided to the

individual; or

(ii)  the past, present or future payment for the

provision of health care to an individual.

"Health information exchange."  The electronic movement of

health information between various entities according to

nationally recognized standards.

"Health information technology."  Hardware, software,

integrated technologies or related licenses, intellectual

property, upgrades or packaged solutions sold as services that

are designed for or support the use by health care entities or

patients for the electronic creation, maintenance, access or

exchange of health information.

"Interoperability."  The ability for information technology

systems to employ federally recognized standards to exchange

data securely, accurately, effectively and in a manner that

maintains and preserves the clinical purpose of the data.

"Payer."  An entity that contracts or offers to contract to

provide, deliver, pay or reimburse any of the costs of health

care services, including an employer, the Federal Government,

the Commonwealth, a municipality, a labor union or an entity

licensed under any of the following:

(1)  The act of May 17, 1921 (P.L.682, No.284), known as

The Insurance Company Law of 1921.

(2)  The act of December 29, 1972 (P.L.1701, No.364),

known as the Health Maintenance Organization Act.

(3)  40 Pa.C.S. Ch. 61 (relating to hospital plan

corporations).

(4)  40 Pa.C.S. Ch. 63 (relating to professional health

services plan corporations).

"Protected health information."  Information under 45 CFR

Pts. 160 (relating to general administrative requirements) and

164 Subpts. A (relating to general provisions) and E (relating

to privacy of individually identifiable health information).

"Regional extension center."  A grantee of the office of the

National Coordinator for Health Information Technology meeting

the requirements of section 3012(c) of the Public Health Service

Act (58 Stat. 682, 42 U.S.C. § 300jj-32(c)).

CHAPTER 3

PENNSYLVANIA HEALTH INFORMATION PARTNERSHIP AUTHORITY

Section 301.  Scope of chapter.

This chapter relates to the Pennsylvania Health Information

Partnership Authority.

Section 302.  Pennsylvania Health Information Partnership

Authority.

(a)  Establishment.--There is hereby established a body

corporate and politic to be known as the Pennsylvania Health

Information Partnership Authority. The powers and duties of the

authority shall be vested in and exercised by a board of

directors.

(b)  Composition.--The board of the authority shall consist

of members, composed and appointed in accordance with the

following:

(1)  The Secretary of Health or a designee who is an

employee of the department.

(2)  The Secretary of Public Welfare or a designee who is

an employee of the department.

(3)  Two representatives of the health care community

focused on unserved and underserved rural and urban patient

populations, one of whom shall be appointed by the Minority

Leader of the Senate from a list of two individuals submitted

for consideration by a Statewide health education center and

the other of whom shall be appointed by the Minority Leader

of the House of Representatives from a list of two

individuals submitted by a Statewide association of community

health centers.

(4)  Five representatives of participating health

information exchange entities, one of whom shall be appointed

by the Governor to represent the Commonwealth's internal

agencies, one of whom shall be appointed by the President pro

tempore of the Senate, one of whom shall be appointed by the

Minority Leader of the Senate, one of whom shall be appointed

by the Speaker of the House of Representatives and one of

whom shall be appointed by the Minority Leader of the House

of Representatives, who shall serve terms coterminous with

their respective appointing authorities.

(5)  Two physicians who are residents of this

Commonwealth selected from a list of four individuals

submitted by the Pennsylvania Medical Society and the

Pennsylvania Osteopathic Medical Association, one of whom

shall be appointed by the President pro tempore of the Senate

and the other of whom shall be appointed by the Speaker of

the House of Representatives, who shall serve terms

coterminous with their respective appointing authorities.

(6)  Two hospital representatives who are residents of

this Commonwealth selected from a list of four individuals

submitted by the Hospital and Healthsystem Association of

Pennsylvania, one of whom shall be appointed by the President

pro tempore of the Senate, and the other of whom shall be

appointed by the Speaker of the House of Representatives, who

shall serve terms coterminous with their respective appointed

appointing authorities.

(7)  One representative of the Blue Cross and Blue Shield

Plans in Pennsylvania who shall be appointed by the Governor

and serve an initial term of three years.

(8)  One representative of a licensed insurer other than

a Blue Cross or Blue Shield Plan selected from a list of two

individuals submitted by a Statewide insurance federation who

shall be appointed by the Governor and serve an initial term

of two years.

(9)  Two representatives of consumers who are not

primarily involved in the provision of health care or health

care insurance who shall be appointed by the Governor and

serve an initial term of three years.

(10)  One representative of an assisted living residence,

personal care home, long-term care nursing facility or

continuing care facility who shall be appointed by the

Governor.

(11)  A resident of this Commonwealth who has expertise

in health care or health care information technology who

shall be appointed by the Governor.

(c)  Terms.--With the exception of subsection (b)(1), (2),

(3) and (4), members of the board shall serve for terms of three

years after completion of the initial terms designated in

subsection (b) and shall not be eligible to serve more than two

full consecutive terms.

(d)  Quorum.--A majority of the members of the board shall

constitute a quorum. Notwithstanding any other provision of law,

action may be taken by the board at a meeting upon a vote of the

majority of its members present in person or through the use of

amplified telephonic equipment if authorized by the bylaws of

the board.

(e)  Meetings.--The board shall meet at the call of the

chairperson or as may be provided in the bylaws of the board.

The board shall hold meetings at least quarterly, which shall be

subject to the requirements of 65 Pa.C.S. Ch. 7 (relating to

open meetings). Meetings of the board may be held anywhere

within this Commonwealth.

(f)  Chairperson.--The Governor shall appoint a chairman from

among the authority members.

(g)  Formation.--The authority shall be formed within 90 days

of the effective date of this section.

(h)  Initial appointment and vacancy.--Appointing authorities

shall appoint initial members to the board within 60 days of the

effective date of this section. If a vacancy occurs on the

board, the appointing authority shall appoint a successor member

within 60 days of the vacancy.

Section 303.  Powers and duties.

(a)  General rule.--The board shall:

(1)  Adopt bylaws necessary to carry out the provisions

of this chapter.

(2)  Establish a system to provide for the exchange of

health care information.

(3)  Make, execute and deliver contracts, grants and

other instruments.

(4)  Apply for, solicit, receive, establish priorities

for, allocate, disburse, contract for, administer and spend

funds made available to the board from a source consistent

with the purposes of this chapter.

(5)  Apply for and accept grants to carry out the purpose

of the authority that includes administering grants and loans

in accordance with the terms of the funding award.

(6)  Accept funds from outside sources, both public and

private, consistent with Federal and State law.

(7)  Develop and maintain a directory of provider contact

information to enable providers to share health information.

(8)  Certify regional health information networks to

ensure compliance with national standards.

(9)  Assure that security standards and procedures to

protect confidentiality of health information are adopted and

properly implemented.

(10)  Identify and adopt transaction, subscription and

other fees or donations to cover costs associated with

implementation and operation of the exchange or for other

services provided by the authority. Receipt of services

provided by or through the authority may be conditioned on

payment of fees. Participation in the exchange by any health

care provider, payer, consumer or any other person is

voluntary.

(11)  Create advisory groups with diverse membership

representing interested and affected groups and individuals,

including representatives of the following:

(i)  Health care practitioners.

(ii)  Health care insurers and managed care

organizations.

(iii)  Health care information systems.

(iv)  Hospitals and health systems.

(v)  Laboratory services.

(vi)  Pharmacies.

(vii)  Radiological services.

(viii)  Nursing homes.

(ix)  Community-based health care clinics.

(x)  Employers.

(xi)  Consumers.

(12)  Develop and conduct public information programs to

educate and inform consumers and patients on health

information.

(13)  Submit an annual report to the Governor, the

President pro tempore of the Senate and the Speaker of the

House of Representatives for distribution to appropriate

legislative committees on the activities of the authority for

the year, including a summary of the receipts and

expenditures, a list of contracts and a summary of any

security breaches that occurred and corrective actions that

were taken.

(b)  Audit.--

(1)  The accounts and books of the authority shall be

examined and audited annually by an independent certified

public accounting firm. The audit shall be public

information.

(2)  The authority shall, by December 31 of each year,

file a copy of the audit required under paragraph (1) with

the Secretary of the Senate and the Chief Clerk of the House

of Representatives.

(c)  Publication.--The authority shall submit annually to the

Legislative Reference Bureau a concise financial statement for

publication in the Pennsylvania Bulletin.

(d)  Cooperation.--Executive agencies shall cooperate with

and provide assistance to the authority without financial

reimbursement. The Governor shall assign staff who shall be

responsible for the day-to-day operations of the authority.

(e)  Existence and dissolution.--The authority shall expire

December 31, 2018.

(f)  Independent agency.--The authority shall be considered

an independent agency.

CHAPTER 5

PENNSYLVANIA HEALTH INFORMATION PARTNERSHIP ACCOUNT

Section 501.  Establishment.

There is established a separate account in the State Treasury

to be known as the Pennsylvania Health Information Partnership

Account. The account shall be administered by the authority.

Section 502.  Funds.

All moneys deposited into the account shall be held in trust

and shall not be considered general revenue of the Commonwealth

but shall be used only to effectuate the purposes of this act as

determined by the authority. All interest earned from the

investment or deposit of moneys accumulated in the account shall

be deposited in the account for the same use.

Section 503.  Dissolution.

In the event that the account is discontinued or the

authority is dissolved by operation of law, any balance

remaining in the account, after deducting administrative costs

of liquidation or subscription fees paid by participating users

of the network, shall be returned to the General Fund.

CHAPTER 7

CONSENT AND CONFIDENTIALITY OF HEALTH INFORMATION

Section 701.  Consent and confidentiality of health information.

(a)  Consent.--Nothing in this act shall be construed to

prohibit a provider from obtaining a patient's health

information from another provider without the patient's consent

if the health information is needed to provide health care

services to the patient, subject to the following:

(1)  A provider shall not disclose information in excess

of the information reasonably required for the purpose for

which it is disclosed.

(2)  A patient, or in the case of a minor, the minor's

parent or guardian, may deny release of the patient's health

information.

(3)  It shall be presumed that the patient does not

consent to the release of any information relating to HIV

status or alcohol or drug abuse treatment unless the patient

executes a release of such information, which release relates

only to that information.

(b)  Notice of patient's right to deny release of health

information.--The authority shall promulgate a form of notice of

a patient's right to deny release of health information under

subsection (a). The notice shall include, at a minimum and in

plain language, the following information:

(1)  Definition of a health information exchange.

(2)  Explanation of the benefits of participation in a

health information exchange.

(3)  Explanation of the patient's right to deny release

of health information to the health information exchange.

(c)  Notice to parents.--Upon implementation of this act, a

patient shall be provided by the patient's provider with notice

of a patient's right to deny release of health information. The

notice shall be signed, dated and witnessed by the patient, or

the patient's representative, should the patient choose to

execute a denial of release. Copies of the executed form shall

be kept by the provider and delivered to the patient within five

business days of the provider's receipt of the executed form.

(d)  Disclosure.--

(1)  Except as provided under paragraph (2), the

authority shall not disclose without prior written patient

consent any health information, including, but not limited

to, HIV status or alcohol or drug abuse treatment or any

personally identifying information that the authority or its

agents or contractors retain, or to which the authority or

its agents or contractors have access or any other records

maintained or accessible by the authority under this act, to

any person who is not an authorized employee, agent or

contractor of the authority.

(2)  Paragraph (1) shall not apply to a disclosure

permitted for exchange with a user authorized by the

authority, which user has executed a data use and reciprocal

sharing agreement or if the disclosure is necessary to carry

out the purposes of this act.

(e)  Burden of proof.--Information in the health information

exchange shall not be subject to section 708 of the act of

February 14, 2008 (P.L.6, No.3), known as the Right-to-Know Law.

CHAPTER 9

MISCELLANEOUS PROVISIONS

Section 901.  Immunity from civil liability.

A provider and the employees, agents and representatives of a

provider are immune from civil liability for libel or slander

arising from information or entries made in health information

and for the transfer of information to another provider, if the

health information, transfer of health information or entries

are made in good faith and without malice.

Section 902.  Effective date.

This act shall take effect immediately.