N.J. Admin. Code § 10:79A-1.8 - Data analyses and annual project evaluation
(a) Pursuant to the Act, the Rutgers Center
for State Health Policy (the Center) shall make HIPAA-compliant data requests
to the Department and the Department of Health to support the Demonstration
Project.
(b) The Department, in
consultation with the Department of Health, shall review the Centers assessment
of the gainsharing plans in accordance with the Act.
(c) Certified ACOs shall execute a
HIPAA-required business associate agreement between the ACO and its
participating hospitals, primary care offices, and other members, as needed, to
permit sharing of protected health information. Certified ACOs shall perform
data analyses of patient utilization of local hospitals to improve care
coordination and monitor program performance. All such agreements shall require
that beneficiaries are to be notified by all such members or providers that the
ACO will obtain beneficiary-identifiable data, and that beneficiaries shall be
given the opportunity to decline such data sharing, in which case no such data
sharing shall occur.
(d) Certified
ACOs shall, upon direction from the Department, execute HIPAA-compliant data
use agreements for sharing of protected health information with the Rutgers
Center for State Health Policy, for use in the annual evaluation of the
Demonstration Project. The protected health information shall enable an
evaluation of patient care utilization over time without providing direct
patient identifiers.
Notes
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