2023 New York Laws › PBH - Public Health › Article 28 - Hospitals › 2816 - Statewide Planning and Research Cooperative System.

* §  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, 2026
* §  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, 2026