192.667. Health care providers, financial data, submission of data on nosocomial infections to be collected, rules, recommendation--federal system may be implemented--use of data by department of heal - Missouri Statutes

Health care providers, financial data, submission of data onnosocomial infections to be collected, rules, recommendation--federalsystem may be implemented--use of data by department of health andsenior services, duties, restrictions, penalty--publication ofinformation, when--failure to provide information, effect--publicreports required, when, requirements--rulemaking authority.

192.667. 1. All health care providers shall at least annually provideto the department charge data as required by the department. All hospitalsshall at least annually provide patient abstract data and financial data asrequired by the department. Hospitals as defined in section 197.020, RSMo,shall report patient abstract data for outpatients and inpatients. Within oneyear of August 28, 1992, ambulatory surgical centers as defined in section197.200, RSMo, shall provide patient abstract data to the department. Thedepartment shall specify by rule the types of information which shall besubmitted and the method of submission.

2. The department shall collect data on required nosocomial infectionincidence rates from hospitals, ambulatory surgical centers, and otherfacilities as necessary to generate the reports required by this section.Hospitals, ambulatory surgical centers, and other facilities shall providesuch data in compliance with this section.

3. No later than July 1, 2005, the department shall promulgate rulesspecifying the standards and procedures for the collection, analysis, riskadjustment, and reporting of nosocomial infection incidence rates and thetypes of infections and procedures to be monitored pursuant to subsection 12of this section. In promulgating such rules, the department shall:

(1) Use methodologies and systems for data collection established by thefederal Centers for Disease Control and Prevention National NosocomialInfection Surveillance System, or its successor; and

(2) Consider the findings and recommendations of the infection controladvisory panel established pursuant to section 197.165, RSMo.

4. The infection control advisory panel created by section 197.165,RSMo, shall make a recommendation to the department regarding theappropriateness of implementing all or part of the nosocomial infection datacollection, analysis, and public reporting requirements of this act* byauthorizing hospitals, ambulatory surgical centers, and other facilities toparticipate in the federal Centers for Disease Control and Prevention'sNational Nosocomial Infection Surveillance System, or its successor. Theadvisory panel shall consider the following factors in developing itsrecommendation:

(1) Whether the public is afforded the same or greater access tofacility-specific infection control indicators and rates than would beprovided under subsections 2, 3, and 6 to 12 of this section;

(2) Whether the data provided to the public are subject to the same orgreater accuracy of risk adjustment than would be provided under subsections2, 3, and 6 to 12 of this section;

(3) Whether the public is provided with the same or greater specificityof reporting of infections by type of facility infections and procedures thanwould be provided under subsections 2, 3, and 6 to 12 of this section;

(4) Whether the data are subject to the same or greater level ofconfidentiality of the identity of an individual patient than would beprovided under subsections 2, 3, and 6 to 12 of this section;

(5) Whether the National Nosocomial Infection Surveillance System, orits successor, has the capacity to receive, analyze, and report the requireddata for all facilities;

(6) Whether the cost to implement the nosocomial infection datacollection and reporting system is the same or less than under subsections 2,3, and 6 to 12 of this section.

5. Based on the affirmative recommendation of the infection controladvisory panel, and provided that the requirements of subsection 12 of thissection can be met, the department may or may not implement the federalCenters for Disease Control and Prevention Nosocomial Infection Surveillance**System, or its successor, as an alternative means of complying with therequirements of subsections 2, 3, and 6 to 12 of this section. If thedepartment chooses to implement the use of the federal Centers for DiseaseControl Prevention Nosocomial Infection Surveillance** System, or itssuccessor, as an alternative means of complying with the requirements ofsubsections 2, 3, and 6 to 12 of this section, it shall be a condition oflicensure for hospitals and ambulatory surgical centers which opt toparticipate in the federal program to permit the federal program to disclosefacility-specific data to the department as necessary to provide the publicreports required by the department. Any hospital or ambulatory surgicalcenter which does not voluntarily participate in the National NosocomialInfection Surveillance System, or its successor, shall be required to abide byall of the requirements of subsections 2, 3, and 6 to 12 of this section.

6. The department shall not require the resubmission of data which hasbeen submitted to the department of health and senior services or thedepartment of social services under any other provision of law. Thedepartment of health and senior services shall accept data submitted byassociations or related organizations on behalf of health care providers byentering into binding agreements negotiated with such associations or relatedorganizations to obtain data required pursuant to section 192.665 and thissection. A health care provider shall submit the required information to thedepartment of health and senior services:

(1) If the provider does not submit the required data through suchassociations or related organizations;

(2) If no binding agreement has been reached within ninety days ofAugust 28, 1992, between the department of health and senior services and suchassociations or related organizations; or

(3) If a binding agreement has expired for more than ninety days.

7. Information obtained by the department under the provisions ofsection 192.665 and this section shall not be public information. Reports andstudies prepared by the department based upon such information shall be publicinformation and may identify individual health care providers. The departmentof health and senior services may authorize the use of the data by otherresearch organizations pursuant to the provisions of section 192.067. Thedepartment shall not use or release any information provided under section192.665 and this section which would enable any person to determine any healthcare provider's negotiated discounts with specific preferred providerorganizations or other managed care organizations. The department shall notrelease data in a form which could be used to identify a patient. Anyviolation of this subsection is a class A misdemeanor.

8. The department shall undertake a reasonable number of studies andpublish information, including at least an annual consumer guide, incollaboration with health care providers, business coalitions and consumersbased upon the information obtained pursuant to the provisions of section192.665 and this section. The department shall allow all health careproviders and associations and related organizations who have submitted datawhich will be used in any report to review and comment on the report prior toits publication or release for general use. The department shall include anycomments of a health care provider, at the option of the provider, andassociations and related organizations in the publication if the departmentdoes not change the publication based upon those comments. The report shallbe made available to the public for a reasonable charge.

9. Any health care provider which continually and substantially, asthese terms are defined by rule, fails to comply with the provisions of thissection shall not be allowed to participate in any program administered by thestate or to receive any moneys from the state.

10. A hospital, as defined in section 197.020, RSMo, aggrieved by thedepartment's determination of ineligibility for state moneys pursuant tosubsection 9 of this section may appeal as provided in section 197.071, RSMo.An ambulatory surgical center as defined in section 197.200, RSMo, aggrievedby the department's determination of ineligibility for state moneys pursuantto subsection 9 of this section may appeal as provided in section 197.221,RSMo.

11. The department of health may promulgate rules providing forcollection of data and publication of nosocomial infection incidence rates forother types of health facilities determined to be sources of infections;except that, physicians' offices shall be exempt from reporting and disclosureof infection incidence rates.

12. In consultation with the infection control advisory panelestablished pursuant to section 197.165, RSMo, the department shall developand disseminate to the public reports based on data compiled for a period oftwelve months. Such reports shall be updated quarterly and shall show foreach hospital, ambulatory surgical center, and other facility a risk-adjustednosocomial infection incidence rate for the following types of infection:

(1) Class I surgical site infections;

(2) Ventilator-associated pneumonia;

(3) Central line-related bloodstream infections;

(4) Other categories of infections that may be established by rule bythe department.

The department, in consultation with the advisory panel, shall be authorizedto collect and report data on subsets of each type of infection described inthis subsection.

13. In the event the provisions of this act* are implemented byrequiring hospitals, ambulatory surgical centers, and other facilities toparticipate in the federal Centers for Disease Control and Prevention NationalNosocomial Infection Surveillance System, or its successor, the types ofinfections to be publicly reported shall be determined by the department byrule and shall be consistent with the infections tracked by the NationalNosocomial Infection Surveillance System, or its successor.

14. Reports published pursuant to subsection 12 of this section shall bepublished on the department's Internet web site. The initial report shall beissued by the department not later than December 31, 2006. The reports shallbe distributed at least annually to the governor and members of the generalassembly.

15. The Hospital Industry Data Institute shall publish a report ofMissouri hospitals' and ambulatory surgical centers' compliance withstandardized quality of care measures established by the federal Centers forMedicare and Medicaid Services for prevention of infections related tosurgical procedures. If the Hospital Industry Data Institute fails to do soby July 31, 2008, and annually thereafter, the department shall be authorizedto collect information from the Centers for Medicare and Medicaid Services orfrom hospitals and ambulatory surgical centers and publish such information inaccordance with subsection 14 of this section.

16. The data collected or published pursuant to this section shall beavailable to the department for purposes of licensing hospitals and ambulatorysurgical centers pursuant to chapter 197, RSMo.

17. The department shall promulgate rules to implement the provisions ofsection 192.131 and sections 197.150 to 197.160, RSMo. Any rule or portion ofa rule, as that term is defined in section 536.010, RSMo, that is createdunder the authority delegated in this section shall become effective only ifit complies with and is subject to all of the provisions of chapter 536, RSMo,and, if applicable, section 536.028, RSMo. This section and chapter 536,RSMo, are nonseverable and if any of the powers vested with the generalassembly pursuant to chapter 536, RSMo, to review, to delay the effectivedate, or to disapprove and annul a rule are subsequently heldunconstitutional, then the grant of rulemaking authority and any rule proposedor adopted after August 28, 2004, shall be invalid and void.

(L. 1992 H.B. 1574 § 6 and S.B. 721 § 2 merged with S.B. 796 § 15, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3, A.L. 2004 S.B. 1279)

*"This act" (S.B. 1279, 2004) contained numerous sections. Consult Disposition of Sections table for a definitive listing.

**Word "Surveillance" does not appear in original rolls.