A BILL FOR AN ACT ENTITLED: "AN ACT REQUIRING STATE-RELATED HEALTH BENEFIT PROGRAMS TO PARTICIPATE IN A SECURE statewide HEALTH information EXCHANGE; ENABLING STATE AGENCIES TO PRIVATELY AND SECURELY SHARE INFORMATION WITH THE EXCHANGE; and AMENDING SECTIONS 2-18-811, 20-25-1303, AND 20-25-1403, MCA."
WHEREAS, Montana has established a network that provides for the secure exchange of and access to health data so health care providers and systems may receive and utilize real-time and comprehensive patient-specific data to improve clinical care and patient decisionmaking.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
NEW SECTION. Section 1. Department to participate in health information exchange -- sharing of data. (1) The department shall provide eligibility information and clinically relevant data from claims for the following programs to a secure system established to allow for the statewide electronic exchange of information among health care providers, facilities, and payers:
(a) the healthy Montana kids plan provided for in Title 53, chapter 4, part 11; and
(b) the medicaid program provided for in Title 53, chapter 6.
(a) share information under this section only with an electronic system that is able to ensure the privacy and security of the data reported to the system; and
(b) enter into any contract or agreement necessary for participating in the electronic exchange of information.
Section 2. Section 2-18-811, MCA, is amended to read:
"2-18-811. General duties of department. The department shall:
(1) adopt rules for the conduct of its business under this part and to carry out the purposes of this part;
(2) negotiate and administer contracts for state employee group benefit plans for a period not to exceed 10 years;
(3) design state employee group benefit plans, establish specifications for bids, and make recommendations for acceptance or rejection of bids;
(4) prepare an annual report that describes the state employee group benefit plans being administered, details the historical and projected program costs and the status of reserve funds, and makes recommendations, if any, for change in existing state employee group benefit plans;
(5) provide eligibility information and clinically relevant data from claims related to the group benefits plans to a system established in this state that is:
(a) designed to allow for the statewide electronic exchange of information among health care providers, facilities, and payers; and
(b) able to ensure the privacy and security of data reported to the system;
(5)(6) prior to each legislative session, perform or obtain an analysis of rate adequacy of all state employee group benefit plans administered under this part; and
(6)(7) submit the report required in
this section to the office of budget and program planning as a part of the information required by 17-7-111."
Section 3. Section 20-25-1303, MCA, is amended to read:
"20-25-1303. Duties of commissioner -- group benefits plans and employee premium levels not mandatory subjects for collective bargaining. (1) The commissioner shall:
(a) design group benefits plans and establish premium levels for employees;
(b) establish specifications for bids and accept or reject bids for administering group benefits plans;
(c) negotiate and administer contracts for group benefits plans;
(d) prepare an annual report that:
(i) describes the group benefits plans being administered; and
(ii) details the historical and projected program costs and the status of reserve funds; and
(e) adopt policies for the conduct of business of the advisory committee and to carry out the provisions of this part.
(2) The provisions of Title 33 do not apply to the commissioner when exercising the duties provided for in this part.
(3) The design or modification of group benefits plans and the establishment of employee premium levels are not mandatory subjects for collective bargaining under Title 39, chapter 31.
(4) The commissioner shall provide or arrange to provide eligibility information and clinically relevant data from claims related to the group benefits plans to a system established in this state that is:
(a) designed to allow for the statewide electronic exchange of information among health care providers, facilities, and payers; and
(b) able to ensure the privacy and security of data reported to the system."
Section 4. Section 20-25-1403, MCA, is amended to read:
"20-25-1403. Authorization to establish self-insured health plan for students -- requirements -- exemption. (1) The commissioner may establish a self-insured student health plan for enrolled students of the system and their dependents, including students of a community college district. In developing a self-insured student health plan, the commissioner shall:
(a) maintain the plan on an actuarially sound basis;
(b) maintain reserves sufficient to liquidate the unrevealed claims liability and other liabilities of the plan; and
(c) deposit all reserve funds, contributions and payments, interest earnings, and premiums paid to the plan. The deposits must be expended for claims under the plan and for the costs of administering the plan, including but not limited to the costs of hiring staff, consultants, actuaries, and auditors, purchasing necessary reinsurance, and repaying debts.
(2) Prior to the implementation of a self-insured student health plan, the commissioner shall consult with affected parties, including but not limited to the board of regents and representatives of enrolled students of the system.
(3) The commissioner shall provide or arrange to provide eligibility information and clinically relevant data from claims related to a self-insured student health plan to a system established in this state that is:
(a) designed to allow for the statewide electronic exchange of information among health care providers, facilities, and payers; and
(b) able to ensure the privacy and security of data reported to the system.
(3)(4) A self-insured student health plan developed under this part is not responsible for and may not cover any services or pay any expenses for which payment has been made or is due under an automobile, premises, or other private or public medical payment coverage plan or provision or under a workers' compensation plan or program, except when the other payor is required by federal law to be a payor of last resort. The term "services" includes but is not limited to all medical services, procedures, supplies, medications, or other items or services provided to treat an injury or medical condition sustained by a member of the plan.
(4)(5) The provisions of 20-25-1315 through 20-25-1320 apply to any self-insured student health plan developed under this part.
(5)(6) The provisions of Title 33 do not apply to the commissioner when exercising the duties provided for in this part."
NEW SECTION. Section 5. Codification instruction. [Section 1] is intended to be codified as an integral part of Title 53, chapter 2, part 2, and the provisions of Title 53, chapter 2, part 2, apply to [section 1].