900 KAR 7:040. Release of public data sets for health care discharge
data.
RELATES TO: KRS 216.2920-216.2929
STATUTORY AUTHORITY KRS: 194A.050(1),
216.2923(2)(c), 216.2925(1), (2)
NECESSITY, FUNCTION, AND CONFORMITY: KRS
216.2923 requires the Cabinet for Health and Family Services to publish and
make available information relating to the health care delivery and finance
system that is in the public interest. KRS 216.2927 mandates that personally
identifying data collected by the Cabinet for Health and Family Services from
health care providers not be released to the general public nor be allowed
public inspection under KRS 61.870 to 61.884. This administrative regulation establishes
the guidelines for distribution and publication of data collected by the
cabinet pursuant to 900 KAR 7:030, while maintaining patient confidentiality
and further protecting personally identifying information.
Section 1. Definitions. (1)
"Cabinet" is defined by KRS 216.2920(2).
(2) "Data" means the
information collected pursuant to 900 KAR 7:030.
(3) "Encounter-level" means the
data record of a single instance of hospitalization, outpatient service, ambulatory
surgery, emergency department, or observation stay billing record contained in
a data file.(4) "Health care provider" is defined by KRS 216.2920(5).
(5) "Public" means a person or
group not directly responsible for the collection, maintenance, custody, or
dissemination of data for purposes of this administrative regulation.
(6) "Report" means a summary or
compilation of data disseminated to the public.
Section 2. Encounter-Level Data. Encounter-level
data shall be released in the following standard file format described in the
table below:
Encounter-Level
Standard File Format -
Data Element Contained
in the File if information is available
File Type
Provider ID
Quarter & Year of Discharge
Patient Gender
Patient Age Group
Patient Race/Ethnicity
Patient Resident County
Type of Admission
Source of Admission
Diagnosis 1 (Primary)
Diagnosis 2
Diagnosis 3
Diagnosis 4
Diagnosis 5
Diagnosis 6
Diagnosis 7
Diagnosis 8
Diagnosis 9
Diagnosis 10
Diagnosis 11
Diagnosis 12
Diagnosis 13
Diagnosis 14
Diagnosis 15
Diagnosis 16
Diagnosis 17
Diagnosis 18
Diagnosis 19
Diagnosis 20
Diagnosis 21
Diagnosis 22
Diagnosis 23
Diagnosis 24
Diagnosis 25
Procedure 1
Procedure 2
Procedure 3
Procedure 4
Procedure 5
Procedure 6
Procedure 7
Procedure 8
Procedure 9
Procedure 10
Procedure 11
Procedure 12
Procedure 13
Procedure 14
Procedure 15
Procedure 16
Procedure 17
Procedure 18
Procedure 19
Procedure 20
Procedure 21
Procedure 22
Procedure 23
Procedure 24
Procedure 25
Length of Stay
Total Charges
Discharge Status
Payer 1 (Primary)
Payer 2
Payer 3
Diagnostic related group
Medicare Severity - Diagnostic related group
Major Diagnostic Category
Diagnosis Version Qualifier
Event Code 1
Event Code 2
Do not resuscitate indicator
Diagnosis present on admission indicator
Section 3. Summary Data. (1) The cabinet
shall not release data if KRS 216.2927 prohibits its release.
(2) The cabinet may include the following
data elements, in any combination thereof, for encounter-level, aggregate, and
summary report formats:
(a) Diagnoses and procedures, primary,
and any other level;
(b) Diagnosis and procedure groupings,
including diagnostic related groups, major diagnostic categories, and agency
for health care policy and research clinical classification system;
(c) Patient gender;
(d) Age or age grouping;
(e) Discharge status;
(f) Payor category, all levels;
(g) Charge information, total and
ancillary;
(h) County of patient residence;
(i) County of provider;
(j) Ancillary department information;
(k) Length of stay, total, and average;
(l) External cause of injury;
(m) Race or ethnicity; or
(n) Mortality rate. Reports including
mortality rates shall be adjusted by severity of illness by reputable grouping
software, either on a contract basis or by the cabinet.
(3) Data shall not be withheld from the
public or another interested party based solely on an unfavorable profile of a
provider or group of providers, if the data is deemed reliable, accurate, and
sufficiently free of error, as determined by the cabinet and pursuant to 900
KAR 7:030.
Section 4. Release of Data. (1) A person
or agency shall, as a condition for receiving data from the cabinet, sign an
"Agreement for Use of Kentucky Health Claims Data". A person or
agency receiving data shall agree to adhere to the confidentiality requirements
established in subsection (2) of this section and KRS 216.2927.
(2) To protect patient confidentiality:
(a) A report or summary of data that
consists of five (5) or fewer records shall not be released or made public;
(b) A person or agency receiving data
shall not redistribute or sell data in the original format;
(c) Distribution of data received by the
cabinet shall be approved by the custodial agency prior to receipt of the data;
(d) The data collected pursuant to 900
KAR 7:030 shall be used only for the purpose of health statistical reporting
and analysis or as specified in the user's written request for the data; and
(e) A user shall not attempt to link the
public use data set with an individually identifiable record from another data
set.
Section 5. Fees. (1) The cabinet shall
charge $1,500 for the purchase of a single copy of an annual, public-use data
set.
(2) A public-use data set shall be
available for purchase no later than sixty (60) days after the end of the
facility reporting period as established in 900 KAR 7:030. Special requests for
data shall be prioritized and completed at the discretion of the custodial
agency.
Section 6. Incorporation by Reference.
(1) "Agreement for Use of Kentucky Health Claims Data", September
2008, is incorporated by reference.
(2) This material may be inspected,
copied, or obtained, subject to applicable copyright law, at the Cabinet for
Health and Family Services, Office of Health Policy, 275 East Main Street 4WE,
Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m. (27 Ky.R. 886; Am. 1263;
eff. 11-17-2000; Recodified from 902 KAR 17:050, 6-7-2004; 35 Ky.R. 1319; 1802;
eff. 2-6-2009; Recodified from 902 KAR 19:030, 4-2-2009; 38 Ky.R. 618; eff.
9-13-11.)
