Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 4
Subtitle 25 - MARYLAND HEALTH CARE COMMISSION
Chapter 10.25.05 - Small Group Market Data Collection
Section 10.25.05.02 - Definitions
Universal Citation: MD Code Reg 10.25.05.02
Current through Register Vol. 51, No. 19, September 20, 2024
A. In this chapter, the following terms have the meanings indicated.
B. Terms Defined.
(1) "All-payor claims database" or "APCD"
means a large-scale database that systematically collects and aggregates
enrollment, claims, and provider information from private and public payors in
a state.
(2) "Applicant" means a
person, governmental entity, or other entity that submits an application
requesting data from the Commission.
(3) "Application" means a written request for
data submitted in the form and manner specified by the Commission.
(4) "Commission" means the Maryland Health
Care Commission.
(5) "Data extract"
means a subset of information from the Maryland medical care database or other
data base maintained by the Commission based on criteria provided by an
applicant.
(6) "Data recipient"
means a person, governmental entity, or other entity whose application has been
approved and who is authorized to access and use data requested in an
application in accordance with a data use agreement.
(7) "Data release" means the process of
providing a data recipient with access and use of data requested in an
application in accordance with a data use agreement.
(8) "Data Release Advisory Committee" or
"DRAC" means a multi-stakeholder group of individuals appointed by the
Commission whose functions include but are not limited to that of privacy board
review as described in 45
CFR § 164.512, reviewing completed
applications, and making a written recommendation to the Executive Director
regarding whether an application should be approved, approved with conditions,
or disapproved.
(9) "Data set"
means a collection of separate data elements or variables that can be
manipulated as a unit.
(10) "Data
use agreement" means a written contractual document entered into between the
Commission and a data recipient that contains terms and conditions that govern
a data recipient's access to and use of data provided by the
Commission.
(11) "De-identified
data" means information that does not identify an individual and for which
there is no reasonable basis to believe that it can be used to identify an
individual.
(12) "Direct individual
identifier" means personal information such as name, Social Security number,
and date of birth that uniquely identifies an individual or that can be
combined with other readily available information to uniquely identify an
individual.
(13) "Disclose" means
the release, redisclosure, transfer, provision, access, transmission,
communication, or divulgence in any other manner of data release pursuant to
this chapter.
(14) Entity.
(a) "Entity" means a person, partnership,
firm, association, limited liability company, limited liability partnership, or
public or private corporation.
(b)
"Entity includes a county or municipality of Maryland or a governmental entity
of another state.
(15)
"Executive Director" means the Executive Director of the Maryland Health Care
Commission.
(16) "Funding source"
means any federal or state governmental entity, public or private corporation
or organization, educational or research institution or organization,
foundation, person, individual, or other entity that has committed to give or
grant, or has already given or granted, monetary funds to an applicant to cover
all or part of the costs of the proposed use of the data described in an
application submitted to the Commission.
(17) Governmental Entity.
(a) "Governmental entity" means any agency,
authority, board, commission, council, department, instrumentality, unit, or
other body of State government or the federal government that is established by
law.
(b) "Governmental entity" does
not include a county or municipality of Maryland or a governmental entity of
another state.
(18)
"HIPAA" means the United States Health Insurance Portability and Accountability
Act of 1996, P.L. 10491, as implemented and amended in federal regulations,
including the HIPAA Privacy and Security Rules, 45 CFR Parts 160 and 164, as
they may be amended, modified, or renumbered, including as amended by the
Health Information Technology for Economic and Clinical Health (HITECH)
Act.
(19) "Identifiable data" means
information that contains data elements that can be used to identify a specific
individual.
(20) "Indirect
individual identifier" means a data element that can be used to identify an
individual when combined with other information or data.
(21) "Institutional Review Board" or "IRB"
has the meaning stated in 45 CFR Part 46, and any subsequent revisions of those
regulations, as they may be amended, modified, or renumbered, regarding the
protection of human subject research.
(22) "Medicaid" means the Maryland Medical
Assistance Program.
(23) "Medical
Care Data Base" or "MCDB" means the data base established and maintained by the
Commission pursuant to Health-General Article, § 19-133, Annotated Code of
Maryland, that collects eligibility data, professional services claims,
institutional services claims, pharmacy claims, and provider data for Maryland
residents enrolled in private insurance, Medicaid, or Medicare. The MCDB is
Maryland's all-payer claims data base.
(24) "Person" means an individual, receiver,
trustee, guardian, personal representative, fiduciary, representative of any
kind, partnership, firm, association, corporation, or other entity.
(25) "Product" means any creation derived in
whole or part from data released pursuant to this chapter, including an
analysis, article, chart, compilation, display, finding, graph, information,
manuscript, map, presentation, publication, report, service, software, study,
subscription service, summary, table, or website.
(26) "Protected health information" or "PHI"
means individually identifiable health information as defined in the HIPAA
Privacy Rule at 45 CFR
§ 160.103, as it may be amended,
modified, or renumbered.
(27)
"State" means:
(a) When capitalized, the
State of Maryland; or
(b) When
lowercase, any state, possession, territory, or commonwealth of the United
States, or the District of Columbia.
Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.