2572-S2.E AMS BECK NEED 061

E2SHB 2572 - S AMD TO S-5045.3 684

By Senator Becker

ADOPTED 03/13/2014

    On page 4, line 11 of the amendment, after "requirements." Insert the following:

    "(6) The authority may adopt rules necessary to implement this section, but may not adopt rules, policies, or procedures beyond the scope of the authority granted in this section."   

    On page 6, line 11 of the amendment, after "inform" insert "and set benchmarks for"

and after "decisions" strike "and set benchmarks"

    On page 7, line 35 of the amendment, after "includes" strike ", but is not limited to," and insert ": (a)"

    On page 8, line 3 of the amendment, after "program" insert "; and (b) Claims data voluntarily provided by other data suppliers, including carriers and self-funded employers"

    On page 9, line 26 of the amendment, after "dollars" insert "unless otherwise negotiated"

    On page 10, line 11 of the amendment, after "release: strike ", at no additional cost,"

    On page 12, line 31 of the amendment, after "patients;" strike "or" and on line 34 after "payer" insert the following: "; or (c) Compares performance in a report generated for the general public that includes any provider in a practice with fewer than five providers"

EFFECT:

· HCA may adopt rules for the community grants program, but the rules may not exceed the authority provided in this section

· Agencies must use the measure set developed by the performance measure committee to inform and set benchmarks for purchasing decisions rather than inform purchasing decisions and set benchmarks

· Limits the definition of claims data to those items specifically listed

· Allows flexibility with regard to the fees for the database (which are not to exceed $5,000) "unless otherwise negotiated"

· Adds clarification that claims data can be voluntarily provided by carriers and self-funded employers (consistent with another section that allows voluntary participation in the database)

· Removes the limitation for the third-party administrator to provide data "at no additional cost" if an entity chooses to participate in the database

· Prevents the publication of a report that compares performance that includes any provider in a practice with fewer than five providers

--- END ---