900 KAR 7:040. Release of public data sets for health care discharge data

Link to law: http://www.lrc.ky.gov/kar/900/007/040.htm
Published: 2015

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      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.)