HEALTH INFORMATION EXCHANGE, the official text

Enrolled SB 272 
 Relating to the electronic health information exchange system; and providing for an effective 
 date. 
 _______________ 
 * Section 1. AS 18.23.300(a) is amended to read: 
 (a) The department shall establish and implement a statewide electronic health 
 information exchange system and ensure the interoperability and compliance of the 
 system with state and federal specifications and protocols for exchanging health 
 records and related data. 
 * Sec. 2. AS 18.23.300(b) is repealed and reenacted to read: 
 (b) The commissioner shall designate a qualified entity or combination of 
 qualified entities in the state to perform the tasks described in this subsection. The 
 designee must have an advisory or governing body made up of health system 
 stakeholders that include members identified under (d) of this section. The designee 
 shall

(1) develop a statewide program to support the system connecting 
 electronic health records to the health information exchange infrastructure, including 
 (A) support for installation and training on the use of the 
 system; 
 (B) a plan to encourage eligible participants to use electronic 
 exchange of records over a sustained period; 
 (C) support to system participants for workflow redesign and 
 quality improvement; 
 (D) a plan to provide for participation by all identified 
 stakeholders in the planning and implementation of the system; 
 (E) measures for periodic evaluation and improvement of the 
 system; 
 (F) oversight and technical assistance needed for planning and 
 implementing the system; 
 (2) submit an annual budget for the program described in (1) of this 
 subsection for approval to the designee's governing body; 
 (3) comply with state nondiscrimination and conflict of interest 
 policies; 
 (4) comply with federal and state health information privacy laws, 
 policies, and standards applicable to the exchange of individually identifiable 
 information to ensure the privacy and security of the information that is part of the 
 system; 
 (5) provide an estimate of costs of the hardware, software, services, 
 and support needed to implement and maintain the technical infrastructure of the 
 system; and 
 (6) provide cost and cost saving data associated with the development 
 and use of the system to the department. 
 * Sec. 3. AS 18.23.300(c) is amended to read: 
 (c) The department and the designee may [ENTER INTO CONTRACTS,] 
 seek and accept available public [FEDERAL] and private funds and equipment. The 
 department may enter into contracts [,] and adopt regulations necessary to carry out

the purposes of this section. 
 * Sec. 4. AS 18.23.300(d) is amended to read: 
 (d) The designee [UNDER (b)(1)(A) OF THIS SECTION] may be a private 
 for-profit or nonprofit entity or entities under contract with the state. The advisory or 
 governing body of the designee must include 
 (1) the commissioner; 
 (2) nine [EIGHT] other individuals, each of whom represents one of 
 the following interests: 
 (A) hospitals and nursing home facilities; 
 (B) private medical care providers; 
 (C) community-based primary care providers; 
 (D) federal health care providers; 
 (E) Alaska tribal health organizations; 
 (F) health insurers; 
 (G) health care consumers; 
 (H) employers or businesses; 
 (I) behavioral health providers; and 
 (3) a [TWO] nonvoting liaison member [MEMBERS] who shall serve 
 to enhance communication and collaboration between the designee and [BOTH] the 
 Board of Regents of the University of Alaska; and 
 (4) at least one nonvoting liaison member chosen by the governing 
 body to represent other stakeholders and community interest related to the 
 system [THE COMMISSION ESTABLISHED IN THE GOVERNOR'S OFFICE TO 
 REVIEW HEALTH CARE POLICY]. 
 * Sec. 5. AS 18.23.305 is amended to read: 
 Sec. 18.23.305. Department; duties. In carrying out its duties under 
 AS 18.23.300, the department shall 
 (1) in accordance with federal recommendations and in consultation 
 with the designee, determine the manner in which the system is developed and 
 operated; 
 (2) [PROVIDE OVERSIGHT AND TECHNICAL ASSISTANCE

NEEDED FOR PLANNING AND IMPLEMENTING THE SYSTEM; 
 (3) AUTHORIZE AND] facilitate applications for any [AVAILABLE 
 FEDERAL] funding available for planning and implementing the system; 
 (3) [(4) ENSURE COMPLIANCE WITH APPLICABLE FEDERAL 
 AND STATE HEALTH INFORMATION POLICIES AND STANDARDS; 
 (5) ENSURE COMPLIANCE WITH FEDERAL AND STATE LAW 
 AND STANDARDS THAT SAFEGUARD THE PRIVACY AND SECURITY OF 
 HEALTH INFORMATION; 
 (6)] ensure that the [HEALTH INFORMATION EXCHANGE] system 
 becomes self-sustaining through a combination of user fees, which may include user 
 fees charged to the department or other government entities, and other private and 
 public funding sources. 
 * Sec. 6. AS 18.23.310 is amended to read: 
 Sec. 18.23.310. Confidentiality and security of information. (a) The 
 department shall ensure the designee establishes [ESTABLISH] appropriate privacy 
 and security standards to protect the disclosure, transmission, and receipt of 
 individually identifiable information contained in the system established under 
 AS 18.23.300. The standards must 
 (1) include controls over access to and collection, organization, and 
 maintenance of records and data that protect the confidentiality of the individual who 
 is the subject of the [A HEALTH] record in accordance with applicable state and 
 federal law; 
 (2) include a secure and traceable electronic audit system for 
 identifying access points and trails; 
 (3) meet the most stringent applicable federal or state privacy law 
 governing the protection of the information contained in the system. 
 (b) A person may not release or publish individually identifying [HEALTH] 
 information from the system except for the following purposes: 
 (1) treatment of a patient who is the subject of the information; 
 (2) to facilitate payment for services received by a patient who is 
 the subject of the information;

(3) limited health care operations of a participant; 
 (4) public health activities; or 
 (5) uses or disclosures authorized by the individual who is the 
 subject of the information [FOR PURPOSES UNRELATED TO THE 
 TREATMENT OR BILLING OF THE PATIENT WHO IS THE SUBJECT OF THE 
 INFORMATION. USE OR DISTRIBUTION OF THE INFORMATION FOR A 
 MARKETING PURPOSE IS STRICTLY PROHIBITED]. 
 (c) The designee [DEPARTMENT] shall establish procedures for a patient 
 who is the subject of a health record contained in the system 
 (1) to opt out of the system; 
 (2) to authorize [CONSENT TO] the distribution of the patient's 
 records contained in the system, if additional authorization is necessary under 
 applicable privacy and security laws; 
 (3) to be notified of a violation of the confidentiality provisions 
 required under this section; 
 (4) on request to the designee [DEPARTMENT], to view an audit 
 report created under this section for the purpose of monitoring access to the patient's 
 records. 
 * Sec. 7. AS 18.23.315 is amended to read: 
 Sec. 18.23.315. Health information exchange system report to the 
 legislature. The department shall provide to the legislature, on or before December 31 
 of each year, an annual report on the progress of the health information exchange 
 system in the state, including rates of participation by providers in the system, the 
 number of health records exchanged, identification of any gaps in, or obstacles 
 to, provider participation, such as issues with connecting to the system, and a 
 specific set of recommendations for long-term participation and financial support by 
 the state. 
 * Sec. 8. AS 18.23.325(3) is amended to read: 
 (3) "system" means the statewide electronic health information 
 exchange system established under AS 18.23.300, but does not include technical 
 infrastructure, software, or information that is owned or managed by

participants in the system. 
 * Sec. 9. AS 18.23.325 is amended by adding a new paragraph to read: 
 (4) "designee" means the entity or entities designated under 
 AS 18.23.300(b). 
 * Sec. 10. This Act takes effect immediately under AS 01.10.070(c).