SENATE BILL NO. 385

INTRODUCED BY D. GRIMES

A BILL FOR AN ACT ENTITLED: "AN ACT DIRECTING THE DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES TO RESEARCH HEALTH CARE ECONOMICS AND THE DEVELOPMENT OF A HEALTH CARE ENDOWMENT PROGRAM TO PROVIDE INCENTIVES TO ENTITIES IN THE HEALTH CARE AND LONG-TERM CARE SYSTEMS TO REDUCE THE EFFECTS OF COST SHIFTING AND SPIRALING HEALTH CARE COSTS; PROVIDING FOR ESTABLISHMENT OF A HEALTH INFORMATION NETWORK; AND REQUIRING REPORTS TO THE LEGISLATURE, INCLUDING BIENNIAL PROPOSALS FOR DISTRIBUTION OF ENDOWMENT PROCEEDS."

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:

NEW SECTION. Section 1. Study -- health care economics and endowment program. The department of public health and human services shall research health care economics to develop criteria that encompass the purposes in [section 2] and the development of a health care endowment program to guide the legislature [in the allocation of funds from the interest and earnings from the Montana health and long-term care trust fund created in [House Bill No. 131] for the purposes set forth in [section 2]].

NEW SECTION. Section 2. Purposes. The purpose of the research of health economics and the development of a health care endowment program is to assist entities in the Montana health care industry or public sector programs that affect health care economics in Montana by:

(1) reducing the impacts of cost shifting in private sector health care to the rest of Montanans in an effort to minimize the rising cost of health care;

(2) leveraging additional federal and other funds in both the general health care system and the long-term care system for targeted areas of need;

(3) supporting long-term affordable health care in the state;

(4) providing incentives that encourage providers to care for uninsured and underinsured individuals in the most cost-effective manner;

(5) minimizing entitlements or other long-term encumbrances that fail to recognize changes within the health care and long-term care systems;

(6) protecting future generations from undue health care cost increases caused by inappropriate policy decisions;

(7) applying incentives to adjust health care systems for demonstrable trends and systemic changes that threaten, in the following order of priority, the provision of, access to, and quality of health care;

(8) responding to systemic emergencies that are immediate and catastrophic and that may threaten the lives of large numbers of Montanans; and

(9) responding to programmatic or economic factors.

NEW SECTION. Section 3. Administration -- rulemaking authority. As a part of the research provided for in [section 1], the department of public health and human services shall develop a procedure to evaluate quarterly health care data, including any information collected or reported as provided in [section 4]. The procedure must include a process for developing a list of proposals for the legislature that will have the most favorable economic impacts on cost shifting and health care costs that can be ascertained. The proposals may be accompanied by impact notes regarding quality of care, access, and other significant issues. The department shall also incorporate proposals on preventative health care by agency and nonprofit health care concerns and any other proposals by appropriate legislative permanent and interim committees that would have favorable economic impacts on reducing cost shifting and the costs of health care.

NEW SECTION. Section 4. Health information network. (1) The department of public health and human services may establish a health information network. The purpose of the network is to analyze, coordinate, and distribute health information in order to increase access to health care services, promote cost containment and efficiency, avoid reporting duplication, and maintain quality of care. The functions of the network include but are not limited to:

(a) identifying, cataloging, and maintaining current information on health data sources and other health-related information;

(b) monitoring health policy decisions to determine the impact of the policies on the health of Montanans by comparing baseline and postimplementation data;

(c) developing volunteer standards for uniformity of health data collection and reporting;

(d) establishing voluntary agreements with health data sources to gain access to health data and providing technical expertise and assistance to link health data from a variety of sources;

(e) encouraging standards for uniformity of health data and supporting electronic data transfer; and

(f) identifying gaps in the availability of needed health information and recommending strategies for filling the gaps.

(2) If the department of public health and human services establishes a health information network, the department shall work with consumers, health care providers, health insurers, health payors, managed care organizations, health care facilities, private entities, and state and local governments to determine the information necessary to fulfill the purposes of the network as provided in subsection (1).

(3) The department of public health and human services or its agent may make recommendations regarding the establishment of fees to be charged to users of the health information network in order to offset the costs of the network. Any fee structure must be designed to be commensurate with the costs of using and maintaining the network and to assist in the creation of a permanent network that will be self-supporting.

(4) The department of public health and human services shall prepare a report to the legislature, in the manner provided by 5-11-210, explaining the department's decision regarding and any progress in establishing a health information network.

(5) The department of public health and human services may implement subsections (1) through (4) by contract and may pursue grant funding for the implementation or contracting.

(6) The department of public health and human services shall adopt by rule a confidentiality code to ensure that information received by the network is maintained and used according to state law governing confidential health care information.

NEW SECTION. Section 5. Reporting. (1) The department of public health and human services shall develop, maintain, and disseminate a biennial report that contains the data elements available from health data sources that may be used as a policy resource for establishing proposals to the legislature [for the purposes of allocating funds from the Montana health and long-term care trust fund created in [House Bill No. 131] for the purposes set forth in [section 2]].

(2) The department of public health and human services shall provide periodic reports to the legislature that include the impact of any incremental health care reform measures that have been implemented to increase access to health care services or health benefits coverage, promote cost containment, or maintain quality of care in accordance with the requirements of 50-4-502.

NEW SECTION. Section 6. Codification instruction. [Sections 1 through 5] are intended to be codified as an integral part of Title 50, chapter 4, and the provisions of Title 50, chapter 4, apply to [sections 1 through 5].

NEW SECTION. Section 7. Coordination instruction. If House Bill No. 131 is not passed and approved, the bracketed language in [sections 1 and 5] regarding the Montana health and long-term care trust fund is void.

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