reglab/statecodes huggingface dataset:
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 10 - DETERMINATION OF ASSESSMENTS › Section 590-10-4 - Compliance

Current through 2024-29, July 17, 2024
Failure to pay an assessment in accordance with the
				  provisions of this Chapter may be considered a violation under Title
				   22 M.R.S.A.
				  §8705-A.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 50 - PRICES FOR DATA SETS, FEES FOR PROGRAMMING AND REPORT GENERATION, DUPLICATION RATES › Section 590-50-2 - PROCESSING FEE

Current through 2024-29, July 17, 2024
A non-refundable processing fee of $25 is to be paid with all
				  requests for data sets, files, reports, or tables as set forth in sections
				  3 and
				  4 of these rules.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 50 - PRICES FOR DATA SETS, FEES FOR PROGRAMMING AND REPORT GENERATION, DUPLICATION RATES › Section 590-50-3 - CLINICAL DATA SET PRICES

Current through 2024-29, July 17, 2024
A.
Maine
Hospital
Data Sets.
The price
				schedules and data availability for individual record level data sets derived
				from data submitted by all Maine-licensed hospitals are as follows:
1. Unrestricted Data Sets.
Entity Requesting Data
Commercial
Assessed
Non-Profit/Educational
Redistributor
First Year
Per
Per
Per
Per
Per
Per
Per
Per
Data Set
Available
Quarter
Year
Quarter
Year
Quarter
Year
Quarter
Year
Inpatient
1980
$375
$1,300
$202
$697
$185
$650
$1,250
$4,325
Outpatient
1998
$750
$2,600
$337
$1,170
$310
$1,100
$2,065
$7,140
Emergency Dept.
2000
$750
$2,600
$337
$1,170
$310
$1,100
$2,065
$7,140
2.
				Restricted Data Sets.
Entity Requesting Data
Commercial
Assessed
Non-Profit/Educational
Redistributor
First Year
Per
Per
Per
Per
Per
Per
Per
Per
Data Set
Available
Quarter
Year
Quarter
Year
Quarter
Year
Quarter
Year
Inpatient
1980
$430
$1,500
$234
$810
$215
$750
$1,445
$5,000
Outpatient
1998
$860
$3,000
$387
$1,350
$360
$1,250
$2,385
$8,250
Emergency Dept.
2000
$860
$3,000
$387
$1,350
$360
$1,250
$2,385
$8,250
Practitioner Identifiers
2000
-
$1,500
-
$675
-
$625
-
$4,125
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 50 - PRICES FOR DATA SETS, FEES FOR PROGRAMMING AND REPORT GENERATION, DUPLICATION RATES › Section 590-50-4 - REQUESTS FOR OTHER DATA FILES, REPORTS, OR TABLES

Current through 2024-29, July 17, 2024
Data files, reports, or tables not listed under section
				  3 shall be generated at a cost of $80 /
				  hour, with a one hour minimum charge applied. Those entities requesting the
				  data or information shall be provided a written estimate of the total cost
				  prior to the request being fulfilled by the MHDO staff.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 50 - PRICES FOR DATA SETS, FEES FOR PROGRAMMING AND REPORT GENERATION, DUPLICATION RATES › Section 590-50-5 - DUPLICATE RATES

Current through 2024-29, July 17, 2024
The price for copying or duplicating existing hard copy
				  material is $0.15 per page.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 50 - PRICES FOR DATA SETS, FEES FOR PROGRAMMING AND REPORT GENERATION, DUPLICATION RATES › Section 590-50-6 - PAYMENTS

Current through 2024-29, July 17, 2024
Payments are due in full from the requesting party within
				  thirty days of receipt of MHDO data sets, files, reports, or tables. If, after
				  thirty days have elapsed, the MHDO does not receive full payment from the
				  requesting party, the provisions of
				   22 M.R.S.A.
				  Section8705-A and the Maine Health Data
				  Organization Enforcement Rule (90-590 C.M.R. Chapter 100) shall be
				  invoked.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 50 - PRICES FOR DATA SETS, FEES FOR PROGRAMMING AND REPORT GENERATION, DUPLICATION RATES › Section 590-50-7 - WAIVER PROVISIONS

Current through 2024-29, July 17, 2024
The Maine Health Data Organization Board may reduce or waive
				  the fees established in sections
				  3 and
				  4 in the event it determines that the
				  entity requesting data has demonstrated either or both of the following:
A. Inability to pay. An inability to pay for
				data due to extenuating circumstances; or
B. Information/analysis publicly accessible.
				The requested data are to be used to improve the health of Maine residents and
				the resulting information, reports, and/or analytical products are to be in the
				public domain without charge and can be easily accessed within the time frame
				approved by the Maine Health Data Organization Board.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 100 - ENFORCEMENT PROCEDURES › Section 590-100-1 - APPLICABILITY

Current through 2024-29, July 17, 2024
This rule is applicable to all activities and processes
				  described under 22 M.R.S. Chapter 1683 including but not limited to the
				  activities required of health care providers, payors, other persons and/or data
				  users in the filing, acquisition, and use of Maine Health Data Organization
				  data.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 100 - ENFORCEMENT PROCEDURES › Section 590-100-3 - PENALTIES; FINES

Current through 2024-29, July 17, 2024
The MHDO Board may assess fines pursuant to
				  22 M.R.S.
				  §
										8705-A in accordance with the
				  following schedules:
A. A hospital
				that fails to file inpatient and outpatient service data and/or to meet the
				standards for data and the provisions for compliance as set forth in 90-590
				C.M.R Chapter 241 is considered in civil violation under
				22 M.R.S.
				§8705-A for which fines may be adjudged
				as follows:
1. $100 per day for the first week
				of non-compliance;
2. $250 per day
				for the second week of non-compliance;
3. $500 per day for the third week of
				non-compliance; and
4. $1,000 per
				day for the fourth week of non-compliance and each week thereafter, not to
				exceed a maximum of $25,000 per any one occurrence.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 100 - ENFORCEMENT PROCEDURES › Section 590-100-4 - ADDITIONAL DISCIPLINARY ACTION.

Current through 2024-29, July 17, 2024
Upon a finding that a person or entity has failed to comply
				  with the requirements of 22 M.R.S., Chapter 1683 and any rules adopted by the
				  MHDO Board, the Board may undertake any or all of the following:
A. Refer the matter to the department or
				board that issued a license to the provider for such action as the department
				or board considers appropriate.
B.
				Refer the matter to the Department of Professional and Financial Regulation,
				Bureau of Insurance for such action against the payor as the bureau considers
				appropriate.
C. File a complaint
				with the Superior Court in the county in which the person resides or the entity
				is located, or in Kennebec County, seeking an order to require that person or
				entity in non-compliance to comply with the requirements for which adjudication
				is being sought, and for the enforcement of any fine determined by the Board or
				for other relief from the court.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 100 - ENFORCEMENT PROCEDURES › Section 590-100-5 - INJUNCTIVE RELIEF

Current through 2024-29, July 17, 2024
In the event of any violation of 22 M.R.S., Chapter 1683 and
				  any rules adopted by the MHDO Board, the Attorney General may seek to enjoin a
				  further violation and seek any other appropriate remedy provided by this
				  Chapter.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 100 - ENFORCEMENT PROCEDURES › Section 590-100-6 - PETITION FOR REVIEW; FAIR HEARING; JUDICIAL REVIEW

Current through 2024-29, July 17, 2024
Any person affected by any determination made under this rule
				  by the MHDO may petition the MHDO Board for review of the decision. The
				  petition must be filed within fifteen business days, in accordance with 5
				  M.R.S. Chapter 375.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-1 - GENERAL PURPOSE

Current through 2024-29, July 17, 2024
The Maine Health Data Organization (MHDO) is charged with
				  collecting health care data. This Chapter governs the release of data submitted
				  to the MHDO. The purpose of this rule is to specify the permissible uses of the
				  data; Level I, II, and III Data file types; the process for which data requests
				  will be reviewed and data released; public notice of data requests; the MHDO
				  Data Use Agreement (MHDO DUA), MHDO internal use of the data, and the security
				  and protection of the MHDO Data.
1.
				Authority and Purpose
MHDO Data are obtained to fulfill MHDO's legislative mandate
				  to create and maintain a useful, objective, reliable and comprehensive health
				  information database that is used to improve the health of Maine citizens and
				  to issue reports promoting public transparency of health care quality,
				  outcomes, and costs. The MHDO will make data publicly available and accessible
				  to the broadest extent consistent with the laws protecting individual privacy,
				  and proprietary information.
The primary use of the MHDO Data is to produce meaningful
				  analysis in pursuit of improved health, health equity, and health care quality
				  for Maine people. Acceptable uses of MHDO Data include, but are not limited to,
				  study of health care disparities, health care costs, utilization, and outcomes;
				  benchmarking; quality analysis; longitudinal research; other research; and
				  administrative or planning purposes.
2. Transition
Data released under the prior rule Chapter 120 shall continue
				  to be subject to those rules and agreements signed pursuant to those rules.
				  Those agreements regarding use of MHDO Data shall remain effective until they
				  end, are terminated by the MHDO Executive Director, or are replaced with
				  updated MHDO DUA's. MHDO data released under prior rule chapter 120 shall
				  remain the property of MHDO.
3. Constitutionality Clause
Should any section, paragraph, sentence, clause, or phrase of
				  these rules be declared unconstitutional or invalid for any reason, the
				  remainder of said rule will not be affected thereby.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-2 - DEFINITIONS

Current through 2024-29, July 17, 2024
Unless the context indicates otherwise, the following words
				  and phrases shall have the following meanings:
1. APCD. "APCD" means the All Payer Claims
				Database.
2. APCD Data. "APCD Data
				is Health Care Claims Data consisting of, or derived directly from, member
				eligibility, medical claims which includes identifiable practitioner data
				elements, pharmacy claims, and/or dental claims files submitted by health care
				claims processors pursuant to Chapter 243 of the MHDO's rules, Uniform
				Reporting System for Health Care Claims Data Sets.
3. Applicant. An "Applicant" is an individual
				or organization that requests Data in accordance with this rule.
4. Breach. A "Breach" is an impermissible use
				or disclosure under this rule that compromises the security or privacy of
				Protected Health Information (PHI). An impermissible use or disclosure of PHI
				is presumed to be a breach unless the MHDO demonstrates that there is a low
				probability that the PHI has been compromised based on a risk assessment of at
				least the following factors:
A. The nature
				and extent of the PHI involved, including the types of identifiers and the
				likelihood of re-identification;
B.
				The unauthorized person who used the PHI or to whom the disclosure was
				made;
C. Whether the PHI was
				actually acquired or viewed; and
D. The extent to which the risk to the PHI
				has been mitigated.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-3 - GENERAL PROVISIONS APPLICABLE TO ALL MHDO DATA

Current through 2024-29, July 17, 2024
1. Confidentiality of Data
A. MHDO data may be released only in
				accordance with this chapter and rules. MHDO may designate certain reports or
				data as open to public inspection by publishing them on the MHDO public website
				(Public Data).
B. MHDO Data and
				records or documents containing PHI are confidential, may not be open to public
				inspection, are not public records for purposes of any state or federal freedom
				of access laws and may not be examined in any judicial, executive, legislative,
				administrative or other proceeding as to the existence or content of any
				individual's identifying health information , except that an individual's
				identifying health information may be used to the extent necessary to prosecute
				civil or criminal violations regarding information in the MHDO
				database.
C. Decisions of the MHDO
				or employees and subcommittees of MHDO denying or limiting data release are not
				reviewable externally.
D. Data
				elements related to health care facility or practitioner charges (total
				charges, line-item charges, charge amount) for services rendered shall only be
				released by MHDO in the average or aggregate in a manner which will prevent a
				charge/paid ratio to be computed for each type of service rendered for any
				individual health care claims processor, health care facility, or health care
				practitioner. All other data related to
payment
of claims
				contained in the appendices is publicly available contingent upon MHDO approval
				of the data request.
E. Any data
				that directly identifies or would lead to the indirect identification of
				practitioners performing abortions as defined by 22 M.R.S. § 1596,
				including a practitioner's tax identification number, or a practitioner's Drug
				Enforcement Administration (DEA) registration number, or National Provider
				Identifier (NPI) are deemed to be confidential and shall not be
				released.
F. HIV Tests and status.
				Level III Data shall not be released, nor shall any data released by MHDO be
				used, to individually identify any person's HIV status, including the results
				of an HIV test, except to the Maine Center for Disease Control on appropriate
				application and with a MHDO DUA, to fulfill its statutory duties under 22
				M.R.S.A. Chapters 250 and 251. 5 M.R.S. §§ 19203 & 19203-
				D.
G. Psychiatric treatment
				records. Level III Data shall not be released, nor shall any MHDO Data be used
				to individually identify any patient receiving mental health services including
				treatment from licensed psychiatric in-patient treatment facilities. 34-B
				M.R.S. § 1207.
H. Substance
				abuse treatment. Level III Data shall not be released, nor shall any MHDO Data
				be used to individually identify any patient regarding receipt of substance
				abuse treatment by a licensed substance abuse treatment provider. 42 CFR §
				2.13(2015).
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-5 - MHDO DATA SETS AND DATA RELEASE TYPES

Current through 2024-29, July 17, 2024
1. MHDO Data
				Sets available for Public Access:
A. APCD
				Data-Available in three Levels: Level I, Level II and Level III Data
				sets
B.  Hospital Encounter Data-
				Available in three Levels: Level I, Level II and Level III Data sets
C. Hospital Financial Data- Considered Level
				II Data
D. Provider Database -
				Considered Level I Data
E. Hospital
				Quality Data-Considered Level I Data
F. Supplemental Data-Available with any of
				the three Levels: Level I, Level II and Level III Data Sets
G. Cancer-Incidence Registry Data - Available
				in Level II and Level III Data Sets
H. Vital Statistics Birth Data - Available in
				Level II and Level III Data Sets
I.
				Vital Statistics Death Data - Available in Level II and Level III Data
				Sets
J. Non-Claims-Based Payments
				Data - Available in Level I
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-6 - DATA REQUESTS FOR LEVEL I DATA

Current through 2024-29, July 17, 2024
1. MHDO Level I Data
				Elements
The data elements available in the MHDO Level I Data Sets are
				  listed in Appendices A and C.
2. Process for Requesting Level I Data
A. Requests for Level I Data shall be made in
				writing by filing an application with the MHDO in a form specified by the MHDO
				as provided on the MHDO Public Website. Data in APPENDIX C must be specifically
				requested.
B. Data requests for
				purposes of commercial redistribution that are aggregate level reporting,
				including online tools, are only eligible for Level I data elements.
C. The MHDO shall fulfill requests for Level
				I Data based upon an application that establishes to the MHDO's satisfaction
				that the purpose of the data request is consistent with the permissible use of
				the MHDO Level I De-Identified data.
D. MHDO Level I Data requests require review
				and approval by the Executive Director or staff delegate.
E. The Executive Director may take Level I
				Data requests to the MHDO Data Release Subcommittee for advice.
F. The Executive Director or designee has
				discretion to deny a request for Level I Data if they determine that the use of
				the data is not consistent with the permissible uses and/or that applicant does
				not meet requirements regarding security and privacy protections.
G. The Executive Director may add any
				restrictions to the MHDO DUA.
H.
				The data applicant and or the data provider may request a review of the
				decision(s) made by the MHDO Executive Director as described in Section
				11.
I. Prior to releasing the MHDO Data the
				authorized entity or individual must enter into a MHDO DUA.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-7 - DATA REQUESTS FOR LEVEL II DATA

Current through 2024-29, July 17, 2024
1. MHDO Level II
				Data Elements:
The data elements available in the MHDO Level II Data include
				  those available at Level I and those listed in Appendix B.
Process for Requesting Level II Data
A. Requests for Level II Data shall be made
				in writing by filing an application with the MHDO in a form specified by the
				MHDO as provided on the MHDO Public Website. Data in APPENDIX C must be
				specifically requested.
B. The
				Executive Director shall fulfill requests for Level II Data based upon an
				application that establishes to their satisfaction that the data request and
				use of the data meets the defined purposes and permissible uses of the MHDO
				Level II Limited Data Sets.
C. MHDO
				Level II Data requests will be reviewed by the Executive Director or staff
				delegate.
D. The Executive Director
				may take Level II Data requests to the MHDO Data Release Subcommittee for
				advice.
E. The Executive Director
				may deny a request for Level II Data if it is determined the use of the data is
				not consistent with the permissible uses and or requirements regarding security
				and privacy protections.
F. The
				Executive Director may add any restrictions to the MHDO DUA.
G. The data applicant and or the data
				provider may request a review of the decision(s) made by the MHDO Executive
				Director as described in Section
				11.
H. Prior to releasing the MHDO Data the
				authorized entity or individual must enter into a MHDO DUA.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-8 - DATA REQUESTS FROM COVERED ENTITIES WHO ARE DATA PROVIDERS FOR LEVEL III DATA

Current through 2024-29, July 17, 2024
1. MHDO Level III Data Elements:
The data elements available in the MHDO Level III Data
				  include elements available at Level I Data and Level II Data, and additional
				  elements in APPENDIX D. Data in APPENDIX C must be specifically
				  requested.
2. Process for
				Requesting Level III Data
A. Requests for
				Level III Data shall be made in writing by filing an application with the MHDO
				in a form specified by the MHDO as provided on its Website.
B. Level III Data may be requested by a
				covered entity that is a Data Provider or the Covered Entity's Business
				Associate for the purposes of Treatment, Payment and Health Plan Operations and
				which meet the permissible uses for MHDO Data releases.
C. Level III Data may also be used for Health
				Care Improvement Studies involving patients with whom the study entity has a
				treatment or payor relationship.
D.
				MHDO may release Level III Data to a covered entity's data applicant or to the
				covered entity's business associates, provided the business associates are
				listed on, and bound by, the MHDO DUA.
E. The Executive Director shall convene the
				MHDO Data Release Subcommittee to review and consider all Level III
				applications as provided for in Section
				12.
F. The Executive Director shall bring to the
				MHDO Data Release Subcommittee all comments received regarding the data
				release, including any claims of proprietary data.
G. An applicant receiving Level III Data may
				use the data only to the minimum extent necessary to accomplish the purposes
				stated in the application for which approval was granted and for no other
				purpose. The MHDO Data Release Subcommittee may add any restrictions to the
				MHDO DUA.
H. The decision of the
				MHDO Data Release Subcommittee to release Level III Data is final, unless a
				timely appeal to the Board of Directors is filed in accordance with Section
				11 and
				12.
I. Prior to releasing the MHDO Data the
				applicant must enter into a MHDO DUA.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-9 - PUBLIC HEALTH AUTHORITIES PERMITTED USE AND RELEASE OF LEVEL III DATA

Current through 2024-29, July 17, 2024
1. The MHDO may release Level III Data to a
				Public Health Authority for public health purposes authorized or mandated by
				state and or federal law.
2. The
				public health authority shall complete an MHDO application. The application
				shall include descriptions of the public health investigation or research;
				professional qualifications and affiliations of the staff; background of the
				study; research questions; research design or specify other permissible
				use.
3. After receipt of a data
				request from a Public Health Authority, the MHDO shall publish the request and
				notify each affected data provider. The notice will include a copy of the
				proposed protocol and will summarize the nature of the proposed investigation
				or research.
4. Data providers or
				other interested parties may submit comments to the Executive Director related
				to Level III Data requests.
5. The
				Executive Director shall convene the MHDO Data Release Subcommittee to review
				and consider all Level III applications as provided for in Section
				12.
6. An applicant receiving Level III Data may
				use the data only to the minimum extent necessary to accomplish the purposes
				stated in the application for which approval was granted and for no other
				purpose. The MHDO Data Release Subcommittee may add any restrictions to the
				MHDO DUA.
7. The decision of the
				MHDO Data Release Subcommittee to release Level III Data is reviewable as
				provided in Sections
				11 and
				12.
8. Prior to releasing the MHDO Data the
				applicant must enter into a MHDO DUA.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-10 - PUBLIC NOTICE OF ALL DATA REQUESTS INCLUDING NOTICE TO DATA PROVIDERS AND COMMENT PERIODS

Current through 2024-29, July 17, 2024
1. The MHDO shall
				create a page on its web site that lists the identity and address of all
				parties requesting MHDO Data. The MHDO will include the level of data requested
				and the purpose of the request.
2.
				MHDO shall add new data requests to the public site on the first business day
				of every week.
3. MHDO will send an
				electronic notification to the data providers that are responsible for the
				submission of the data to the MHDO, and other interested parties notifying them
				of new data requests on the first business day of the week.
4. For all data requests the data providers
				or other interested parties may submit to the Executive Director comments
				related to the data request. To be considered, comments must be received by the
				Executive Director in writing or electronic notification no later than thirty
				business days after the initial posting of the data request on the MHDO web
				site. If the Executive Director determines that (a) the comments received are
				of significant enough importance to delay the release of Data and/or (b)
				additional information is required from the requesting party to address the
				comments; then the data shall not be released until the additional information
				has been received from the requesting party and an additional review is
				conducted by the Executive Director or the MHDO Data Release Subcommittee, as
				applicable, to ensure that the requesting party conforms to all applicable
				requirements of this chapter.
5.
				The Executive Director will bring all comments received from the data providers
				and or other interested parties for the release of Level III Data to the MHDO
				Data Release Subcommittee for consideration.
6. MHDO will publish notice of the Level III
				Data requests in, at a minimum, three major news publications.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-11 - DECISIONS OF THE EXECUTIVE DIRECTOR AND THE DATA RELEASE SUBCOMMITTEE AND THE MHDO BOARD OF DIRECTORS

Current through 2024-29, July 17, 2024
1. Decisions of the
				Executive Director which either allow or deny a data applicant's data request
				for Level I or Level II data, or any elements of a data request for Level I or
				Level II data, or that add additional requirements to a related MHDO Data Use
				MOU, may be appealed by either the data applicant or data provider to the Data
				Release Subcommittee, and then to the MHDO Board of Directors pursuant to
				Section 11 and
				12.
2. Decisions of the Data Release Subcommittee
				regarding release of Level III Data that deny or allow a data applicant's data
				request or any elements of a data request, or that add additional requirements
				to a MHDO DUA, are reviewable. The data applicant or data provider may appeal
				the decision(s) of the Data Release Subcommittee to the MHDO Board of
				Directors.
A. Decisions of the Executive
				Director or Data Release Subcommittee or MHDO Board of Directors shall be
				provided by electronic notification to data providers who submitted comment to
				the Executive Director and to data applicants.
B. The data shall be released as approved no
				less than ten business days after the electronic notification and provided that
				the data applicant meets the requirements of these rules.
C. Level I and Level II Data approved by the
				MHDO Executive Director, and Level III Data approved by Data Release
				Subcommittee, shall be released as approved unless a data provider or data
				applicant takes action within ten business days of the electronic notification
				by submitting in writing to the attention of the MHDO Executive Director a
				request for review to the next higher authority. The request shall clearly
				state the basis for the review or requested action.
D. There shall be no further review,
				administrative or judicial, from a decision of the MHDO Board of Directors
				regarding release of MHDO Data.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-12 - ROLE AND RESPONSIBILITIES OF THE MHDO DATA RELEASE SUBCOMMITTEE AND THE MHDO BOARD OF DIRECTORS

Current through 2024-29, July 17, 2024
1. The MHDO Board of
				Directors shall establish a Data Release Subcommittee. This committee will
				review and consider all data applications that include the request for Level
				III Data. This subcommittee will review and consider all data applicant and or
				data providers' requests for review of the decisions of the MHDO executive
				director regarding Level I and Level II data as described above in Section
				11(1).
2. This subcommittee may also provide
				advisory reviews of other data applications and or requests at the discretion
				of the Executive Director.
3. The
				Data Release Subcommittee shall include 6 members of the MHDO Board of
				Directors. The Chair and Vice Chair of the board shall appoint the members of
				the subcommittee with the approval of the board. The composition of the
				committee is: one member representing health care plans, one member
				representing health care providers, one member representing hospitals, one
				member representing employers, one member representing consumers and one member
				representing government. The Executive Director shall staff the Data Release
				Subcommittee meetings.
4. The Data
				Release Subcommittee requires four votes in the affirmative to take
				action.
5. The Executive Director
				shall convene the Data Release Subcommittee no later than sixty business days
				after the initial posting of the data request on the MHDO web site to review
				and consider Level III applications for data.
6. If a review is requested, the Executive
				Director shall convene the Data Release Subcommittee no later than sixty
				business days after the initial decision made by the executive director to
				allow or deny a data release as described in Section
				11(1).
7. The Data Release Subcommittee shall review
				applications for Data as provided for in these rules and will determine whether
				the data applicant has met the MHDO criteria for release and may take any other
				action provided for in these rules.
8. The MHDO Board of Directors requires a
				majority vote in the affirmative to take action.
9. The Data Release Subcommittee may meet via
				electronic means, as long as a record is made of the meetings, and they provide
				for public participation.
10. The
				MHDO will post information about the Data Release Subcommittee's membership,
				scheduled meetings, and agendas on its Website.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-13 - INDIVIDUAL CHOICE, PROCESS TO FILE COMPLAINTS

Current through 2024-29, July 17, 2024
1. Individual Choice
A. Choice regarding disclosure of
				information: The MHDO shall provide the opportunity for any person to choose to
				opt out and have their direct identifiers excluded from all subsequent Level
				III Data releases.
B. An
				individual that decides to opt out or opt back in is responsible for completing
				the MHDO Choice Disclosure Form available on the MHDO Public Website or by
				calling the MHDO and filling the form out telephonically. Individuals who opt
				out of a specific study will remain opted out of Level III Data releases unless
				they opt back in.
C. The MHDO will
				post all Level III Data requests on its publicly accessible website.
				Individuals who want to opt out of a specific Level III Data release may do so
				by completing the MHDO Choice Disclosure Form no later than thirty business
				days after the initial posting of the data request on the MHDO web site.
				Individuals that do this will remain opted out of all subsequent Level III Data
				releases by MHDO unless they choose to opt back in.
D. A person who has chosen to have their
				direct identifiers excluded from Level III Data releases may choose to opt back
				in at any time.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-14 - DATA BREACH

Current through 2024-29, July 17, 2024
1. Breach of PHI. An
				impermissible use or disclosure of PHI is presumed to be a breach unless the
				MHDO concludes based on demonstrable evidence that there is a low probability
				that the PHI has been compromised.
2. Any person may report, and employees,
				vendors, board and subcommittee members shall report, to the Executive Director
				of MHDO when they believe a potential breach of PHI has occurred or may occur.
				When a potential breach of PHI is reported or made known to the MHDO Executive
				Director, a risk assessment shall be conducted by the Executive Director or the
				Staff Delegate immediately and shall consider at least the following factors:
A. The nature and extent of the PHI involved,
				including the types of identifiers and the likelihood of
				re-identification;
B. the
				unauthorized person who used the PHI or to whom the disclosure was
				made;
C. whether the PHI was
				actually acquired or viewed; and,
D. the extent to which the risk to the PHI
				has been mitigated.
E. Whether and
				how the data was secured, including encryption.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Section 590-120-15 - DATA GOVERNANCE, DATA USE AND STEWARDSHIP BY MHDO

Current through 2024-29, July 17, 2024
1. Internal MHDO Use of Data: The MHDO will
				use the data it collects as described in 90-590 C.M.R. Chapters 241, 243, 270,
				300 and 630 to:
A. Fulfill its
				responsibilities as described in Title 22 Chapter 1683;
B. Link APCD data with hospital encounter
				data or other MHDO data; and, if authorized in the data application, link
				external data sets to the MHDO Data set provided that the data are released to
				the Data Recipient de-identified;
C. Produce customized reports as requested by
				the Governor's office, other government agencies, the Maine State Legislature
				and other external parties;
D.
				Authenticate and ensure the integrity of data filed with MHDO;
E. Produce MHDO generated numbers to allow
				for the distinguishing of and longitudinal tracing of individuals, without
				individually identifying the individuals; and
F. Identify and exclude data entitled to
				special confidentiality protections as provided in this
				rule.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Appendix 590-120-C - SUPPLEMENTAL DATA ELEMENTS FOR LEVEL I, II AND III DATA REQUESTS

Current through 2024-29, July 17, 2024
C. 1. Group ID Data Elements - Level I, II and III APCD data
				  requests may include the following additional Group ID Data Element:
Payer Assigned Group ID Number
C. 2. Practitioner Identifiable Data Elements
Level I, II and III APCD data requests may include the
				  following additional Practitioner Identifiable Data Elements:
Provider First Name
									Provider Middle Initial or Name
									Provider Last Name
									Service Provider Suffix
									Provider NPI
									Billing Provider Last/Organization Name
									Billing Provider NPI
Level I, II and III Inpatient, Outpatient and Emergency
				  Department Hospital Encounter data requests may include the following
				  additional Practitioner Identifiable Data Elements:
Attending Practitioner First Name
									Attending Practitioner Middle Initial
									Attending Practitioner Last Name
									Attending Provider NPI
									Operating Practitioner First Name
									Operating Practitioner Middle Initial
									Operating Practitioner Last Name
									Operating Practitioner NPI
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 120 - RELEASE OF DATA TO THE PUBLIC › Appendix 590-120-D - DATA ELEMENTS RELEASED IN LEVEL III FILE- DIRECT IDENTIFIERS

Current through 2024-29, July 17, 2024
Level III Limited Data includes the data listed in APPENDIX A
				  and B, including Supplemental Data if requested, plus the following direct
				  identifiers:
Patient/Member/Registrant: First Name, Middle initial,
					 and Last Name
									Self-Pay Name (Individuals who are payers in the
					 hospital data)
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 125 - HEALTH CARE INFORMATION THAT DIRECTLY IDENTIFIES AN INDIVIDUAL › Section 590-125-1 - Applicability

Current through 2024-29, July 17, 2024
This rule is applicable to all activities and processes
				  described under
				   22 M.R.S.A.
				  §1711-C, Confidentiality of health care
				  information.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 125 - HEALTH CARE INFORMATION THAT DIRECTLY IDENTIFIES AN INDIVIDUAL › Section 590-125-2 - Definitions

Current through 2024-29, July 17, 2024
A.
Address
. "Address" includes
				street addresses, post office box numbers, apartment numbers, E-911 addresses,
				E-mail addresses, web universal resource locator (URL) and Internet protocol
				(IP) address number.
B.
Bank
				Account
. "Bank account" means any checking, savings, certificate of
				deposit, or any account utilized for the payment of third parties.
C.
Direct Identifier
. "Direct
				identifier" means any information that discloses the identity of an individual.
				A case or code number used to create anonymous or encrypted medical data for
				research purposes is not a direct identifier.
D.
Family
. "Family" means
				spouse, children, parents, siblings, and legal guardian.
E.
Insured
. "Insured" means an
				individual in whose name an insurance policy is carried.
F.
Operator
. "Operator" means an
				individual who uses a vehicle.
G.
Vehicle
. "Vehicle" means a piece of mechanized equipment for
				transporting passengers or goods including, but not limited to: automobiles,
				trucks, motorcycles, all-terrain-vehicles, snowmobiles, aircraft, and water
				craft.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 125 - HEALTH CARE INFORMATION THAT DIRECTLY IDENTIFIES AN INDIVIDUAL › Section 590-125-3 - Identifying Information

Current through 2024-29, July 17, 2024
Data elements determined to be direct identifiers of
				  individuals include the following:
A.
				Patient's Name;
B. Names of
				Patient's Family Members;
C.
				Insured's Name;
D. Patient's or
				Insured's Address;
E. Patient's or
				Insured's Telephone or FAX Numbers. Includes both home and work
				numbers;
F. Patient Control Number.
				A unique alphanumeric number assigned by a health care provider to facilitate
				retrieval of individual financial records and posting of payment;
G. Medical Record Number. A number assigned
				to the patient's medical/health record by the provider;
H. Patient's Account Number. A unique number
				used by a health care provider or supplier to identify an individual's case
				records and for posting payment;
I.
				Patient's or Insured's Social Security Number;
J. Insured's Unique Health Insurance
				Identification Number;
K. Insured's
				Unique Health Insurance Certificate Number;
L. Patient's Medicare/Medicaid Health
				Insurance Identification Number;
M.
				Patient's Federal Employees Compensation Act Number;
N. Patient's or Insured's Credit Card
				Number;
O. Patient's or Insured's
				Bank Account Number;
P. Patient's
				or Insured's Operator's License Number;
Q. Patient's or Insured's Vehicle
				Registration Number;
R. Patient's
				or Insured's Vehicle License Plate Number;
S. Patient's or Insured's Vehicle
				Identification Number;
T. Patient's
				or Insured's Finger or Voice Prints;
U. Patient's or Insured's Photographic
				Images;
V. Patient's Pilot Medical
				Certificate Number;
W. Patient's
				Maine Department of Corrections Inmate Identification Number;
X. Patient's or Insured's Medical Device
				Identifiers and Serial Numbers; and
Y. Any other unique number, characteristic,
				code or information that is a direct identifier.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 241 - UNIFORM REPORTING SYSTEM FOR HOSPITAL INPATIENT DATA SETS AND HOSPITAL OUTPATIENT DATA SETS › Section 590-241-2 - Hospital Inpatient and Outpatient Service Data Sets Filing Description

Current through 2024-29, July 17, 2024
Each hospital shall file with the MHDO or its designee a
				  completed hospital inpatient data set and a completed hospital outpatient data
				  set for every service provided to each patient. A completed hospital data set
				  includes professional and facility services as defined in the
				  appendices.
A.
General
				Requirements
(1)
Codes
(a)
Code Sources
. The code
				sources listed and described in Appendix A are to be utilized with the
				inpatient and outpatient data file submissions.
(b)
Specific and Unique Coding
.
				Except for location of service codes and provider number, specific or unique
				coding systems shall not be permitted as part of the inpatient and outpatient
				data submissions.
(c)
External Cause Codes
. External Cause Codes shall be assigned for
				all initial treatments of an injury, poisoning, or adverse effect of drugs. If
				a patient is transferred to another facility for continued treatment, this
				facility shall also assign the appropriate External Cause Code.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 241 - UNIFORM REPORTING SYSTEM FOR HOSPITAL INPATIENT DATA SETS AND HOSPITAL OUTPATIENT DATA SETS › Section 590-241-3 - Submission Requirements

Current through 2024-29, July 17, 2024
A.
File
				Format
. The inpatient file and the outpatient file(s) are to be
				submitted to the MHDO or it designee as separate ASCII files with fixed length
				records. Each record shall be terminated with a carriage return line feed
				(ASCII 13, ASCII 10).
B.
Filing Method
. All data files must be encrypted using 256-bit AES
				(AES-256) encryption, prior to submission/uploading. This can be accomplished
				using various commercially available software packages. Data files shall be
				submitted via electronic transmission using the Secure Hypertext Transfer
				Protocol (HTTPS). E-mail attachments shall not be accepted.
C.
File Editing
. All data files
				must be processed through the MHDO designee's system. Corrections must be
				applied to the data files before the data are transmitted.
D.
Filing Specifications
. Each
				hospital shall file all applicable data sets to the MHDO in accordance with the
				electronic specifications for submission of claims to Maine's designated
				Medicare intermediary.
E.
Filing Periods
. Each inpatient discharge or outpatient service
				record must be filed no later than 90 days following the calendar quarter in
				which the discharge or service occurred.
F.
Replacement of Data Files
. No
				hospital may amend its data submission more than one year after the end of the
				quarter in which the discharge or outpatient service occurred unless it can be
				established by the hospital that exceptional circumstances occurred. Any
				resubmission of data after the elapse of the one year period must be approved
				by the MHDO.
G.
Rejection of
				Files
. Failure to conform to the requirements of subsections A, B, C or
				D of this section shall result in the rejection of the data file(s). Rejected
				files must be resubmitted in the appropriate corrected form to the MHDO within
				15 days of notification.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 241 - UNIFORM REPORTING SYSTEM FOR HOSPITAL INPATIENT DATA SETS AND HOSPITAL OUTPATIENT DATA SETS › Section 590-241-4 - Standards for Data; Notification; Response

Current through 2024-29, July 17, 2024
A.
Standards
. The MHDO shall
				evaluate each inpatient file and each outpatient file submission in accordance
				with the following standards:
(1) The code
				for each data element identified in Appendices B-1 and C-1 shall be included
				within eligible values for the field;
(2) Coding values indicating "data not
				available" "data unknown" or the equivalent shall not be used for individual
				data elements unless specified as an eligible value for the field;
(3) Outpatient data sets shall have Current
				Procedural Terminology (CPT) Codes and Health Care Common Procedural Coding
				System (HCPCS) codes reported for specific revenue centers. The list of revenue
				centers requiring CPT and HCPCS codes shall be provided via the MHDO's
				designee; and
(4) CPT and HCPCS
				codes shall be assigned to the correct revenue centers.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 241 - UNIFORM REPORTING SYSTEM FOR HOSPITAL INPATIENT DATA SETS AND HOSPITAL OUTPATIENT DATA SETS › Section 590-241-5 - Public Access

Current through 2024-29, July 17, 2024
Information collected, processed and/or analyzed under this
				  rule shall be subject to release to the public or retained as confidential
				  information in accordance with
				  22 M.R.S.A.
				  Sec.8707 and Code of Maine Rules 90-590,
				  Chapter 120:
Release of Information to the Public
, unless
				  prohibited by state or federal law.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 241 - UNIFORM REPORTING SYSTEM FOR HOSPITAL INPATIENT DATA SETS AND HOSPITAL OUTPATIENT DATA SETS › Section 590-241-6 - Extension or Waiver to Data Submission Requirements

Current through 2024-29, July 17, 2024
If a hospital, due to circumstances beyond its control, is
				  temporarily unable to meet the terms and conditions of this chapter, a written
				  request must be made to the Compliance Officer of the MHDO as soon as it is
				  practicable after the hospital has determined that an extension or waiver is
				  required. The written request shall include: the specific requirement to be
				  extended or waived; an explanation of the cause; the methodology proposed to
				  eliminate the necessity of the extension or waiver; and the time frame required
				  to come into compliance. If the Compliance Officer does not approve the
				  requested extension or waiver, the hospital making the request may submit a
				  written request appealing the decision to the MHDO Board. The appeal shall be
				  heard by the MHDO Board at the next regularly scheduled meeting following
				  receipt of the request at the MHDO.
Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 590 - MAINE HEALTH DATA ORGANIZATION › Chapter 241 - UNIFORM REPORTING SYSTEM FOR HOSPITAL INPATIENT DATA SETS AND HOSPITAL OUTPATIENT DATA SETS › Section 590-241-7 - Compliance

Current through 2024-29, July 17, 2024
Failure to file, report, or correct in accordance with the
				  provisions of this chapter may be considered a violation under
				  22 M.R.S.A. Sec.
				  8705-A and Code of Maine Rules 90-590,
				  Chapter 100:
Enforcement Procedures
.