Pennsylvania Code
Title 28 - HEALTH AND SAFETY
Part VI - Health Care Cost Containment Council
Chapter 915 - DATA ACCESS CRITERIA AND PROCEDURE
PROCEDURES FOR ACCESSING COUNCIL DATA
Section 915.31 - Procedure for requesting access to Council data

Universal Citation: 28 PA Code ยง 915.31

Current through Register Vol. 54, No. 44, November 2, 2024

(a) A request for access to data, including computer-to-computer access, shall be made in writing to the Executive Director of the Council on a form prescribed by the Council. This form will require:

(1) The name of the party requesting the data.

(2) The name, title, address and telephone number of the contact person for the request.

(3) A description of the information to which access is requested, including a description of the desired tape format and list of data elements.

(4) Information on the purpose or intended use of the data.

(b) The request form will contain a statement prohibiting the recipient of the data, other than a recipient who is a purchaser, from selling, exchanging or publishing the data without the express written consent of and under the terms and conditions developed and approved by the Council. The statement will also prohibit the recipient of the data from using the data to attempt to identify an individual or to use the data for purposes of disciplining, discharging or penalizing an employe of the recipient. In addition, the statement will indicate that a recipient is prohibited from further releasing data which:

(1) Could reasonably be expected to reveal the identity of an individual patient.

(2) Does not simultaneously disclose payment, as well as provider quality and provider service effectiveness.

(3) Could reasonably be expected to reveal the identity of a purchaser, except if the recipient is a purchaser receiving data on its own group and then that purchaser may reveal his own identity.

(4) Relates to actual payments to an identified provider made by a purchaser.

(5) Discloses discounts or differentials between payments accepted by providers for their billed charges obtained by identified payors from identified providers.

(c) Requesters of data will be required to sign the form to indicate that they have read and understood the prohibitions contained in subsection (b). In addition, a requester who is a purchaser will be required to provide notice to employes that information has been requested on the health care services which they, or dependents who are covered under the purchaser's health care insurance, have received. This notice shall be required to be posted in prominent location where other similar employe notices are posted.

Disclaimer: These regulations may not be the most recent version. Pennsylvania 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.
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