Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 421 - HEALTH CARE INFORMATION › Subchapter D - COLLECTION AND RELEASE OF OUTPATIENT SURGICAL AND RADIOLOGICAL PROCEDURES AT HOSPITALS AND AMBULATORY SURGICAL CENTERS › Section 421.66 - Certification of Compiled Event Data

Current through Reg. 49, No. 28; July 12, 2024
(a) Within 5 months after the end of each reporting quarter, DSHS shall
											  establish a process to compile one or more electronic data files for each facility using the event claims
											  received from each facility. The certification file shall have one record for each patient event during the
											  reporting quarter and one record for any patient event occurring during one prior reporting quarter for which
											  additional event claims have been received. The data files, including reports returned to the facilities,
											  allow the facility to provide physicians and other health professionals the opportunity to review, request
											  correction of, and comment on patients for whom an event occurred under the jurisdiction of the facilities
											  and they are indicated as "attending" or "operating or other." DSHS shall determine the format and medium in
											  which the quarterly file will be delivered to facilities.
(b) The
											  chief executive officer or chief executive officer's designated agent of each facility shall mark the
											  appropriate box on the form provided indicating whether the facility is certifying or not certifying the
											  event data and reports in the certification file specified in subsection (a) of this section. The chief
											  executive officer or chief executive officer's designated agent shall sign and return the form to DSHS by fax
											  or mail. A person designated by the chief executive officer and acting as the officer's agent may sign the
											  certification form. Designation of an agent does not relieve the chief executive officer of personal
											  responsibility for the certification. If the chief executive officer or chief executive officer's designated
											  agent does not believe the quarterly file is accurate, the officer shall provide DSHS with detailed comments
											  regarding the errors or submit a written request (on a form supplied by DSHS) and provide the data, processes
											  and resources necessary to correct any inaccuracy and certify the certification file subject to those
											  corrections being made prior to the deadlines specified in this subsection. Corrections to certification
											  event data shall be submitted on or prior to the following schedule: Quarter 1- October 1; Quarter 2- January
											  1; Quarter 3- April 1; and Quarter 4- July 1. Chief Executive Officers or designees that elect not to certify
											  shall submit a reasoned justification explaining their decision to not certify their discharge encounter data
											  and attach the justification to the certification form. Election to not certify data does not prevent
											  certification file data from appearing in the public use data file. Data that is not corrected and submitted
											  by the deadline may appear in the public use data file.
(c) The
											  signed certification form shall represent that:
(1) policies and procedures
											  are in place within the facility's processes to validate and assure the accuracy of the event data and any
											  corrections submitted; and
(2) all errors and omissions known to
											  the facility have been corrected or the facility has submitted comments describing the errors and the reasons
											  why they could not be corrected; and
(3) to the best of their
											  knowledge and belief, the data submitted accurately represents the facility's administrative status of
											  patients for which the services covered by the revenue codes or surgical and radiological categories
											  identified in §
											421.67(f)
											  or §
											421.67(g)
											  of this title (relating to Event File--Records, Data Fields and Codes) were provided for the reporting
											  quarter; and
(4) the facility has provided physicians and other
											  health professionals a reasonable opportunity to review and comment on the event data of patients for which
											  they were reported in one of the available physician number and name fields provided on the acceptable
											  formats specified in §
											421.67 of this title
											  (for example, "attending physician" or "operating or other physician" as applicable). The physicians or other
											  health professionals may write comments and have errors brought to the attention of the chief executive
											  officer or the chief executive officer's designated agent who shall address any comments by the physicians or
											  other health professionals; or
(5) if the chief executive officer
											  or the officer's designee elects not to certify the event data file for a specific quarter, a written
											  justification of any unresolved data issues concerning the accuracy and completeness of the data at the time
											  of the certification shall be included on the certification form. Event claim data that has been audited,
											  returned to the facility and is not certified, may be released and published in the public use data file and
											  used by DSHS for analysis.