Current through Register Vol. 54, No. 44, November 2, 2024
(a)
Confidentiality
principle. The Council, under the mandates of and authority provided
in the act will assure the confidentiality of information received as a result
of the enactment and implementation of the act. This chapter establishes
policies and procedures to protect and maintain the confidentiality of
individual patient information which is submitted to the Council. These
policies and procedures assure that information and data will not be released
or be accessible if the release of the information or data could reasonably be
expected to reveal the identity of an individual patient. If conflicts between
patient confidentiality and release of data arise, patient confidentiality will
take priority.
(b) Other
principles.
(1) The Council will facilitate
the continuing provision of quality, cost-effective health services throughout
this Commonwealth by providing data and information to the purchasers and
consumers of health care on the cost and quality of health care
services.
(2) The Council will
assure that information and data received by the Council will be utilized by
the Council for the benefit of the public.
(3) The Council will assure that data will
not be released or be accessible that does not simultaneously disclose charge
or payment as well as provider quality and provider service
effectiveness.
(4) The Council will
assure that data will not be released or be accessible which could reasonably
be expected to reveal the identity of a purchaser, other than a purchaser
requesting data on its own group or an entity entitled to the purchaser's data
under the act.
(5) The Council will
assure that data will not be released or be accessible which relates to actual
payments to an identified provider made by a purchaser, except that this does
not apply to a purchaser requesting data on the group for which it purchases or
otherwise provides covered services or access to that same data by an entity
entitled to the purchaser's data under the act.
(6) The Council will assure that data which
discloses discounts or differentials between payments accepted by providers for
services and their billed charges obtained by identified payors from identified
providers will not be released or accessible unless comparable data on other
payors is also released and the Council determines that the release of the
information is not prejudicial or inequitable to an individual payor or
provider or group thereof.
(7) The
Council will assure that access to data, as defined in this chapter, by a
party, including, but not limited to, purchasers, collective bargaining
representatives, general public and Council members, will be in accordance with
the procedures contained in this chapter.
(8) The Council is required to uphold the act
and to prohibit the unauthorized use of Council data as set forth in the
act.
(9) The Council will be very
restrictive with regard to the release of data. Requests for data will be
reviewed in accordance with the confidentiality protections, as enumerated in
§§
915.21-915.25 (relating to
confidentiality protections). If the Council determines that the request
violates the Council's confidentiality protections, the Council may seek to
amend cell sizes, propose alternative ways to examine data, propose alternative
ways to look at specific issues and otherwise amend the scope of the report or
deny the request.
