§ 2816 — Statewide planning and research cooperative system

* § 2816. Statewide planning and research cooperative system. 1. (a)\nThe statewide planning and research cooperative system in the department\nis continued, as provided in and subject to this section, within amounts\nappropriated for that purpose. The system shall be developed and\noperated by the commissioner in consultation with the council, as may be\nspecified by regulation of the commissioner. Any component or components\nof the system may be operated under a different name or names, and may\nbe structured as separate systems. In making regulations under this\nsection, subsequent to April first, two thousand eleven, the\ncommissioner shall consult with the superintendent of financial services\nor the head of any agency that succeeds the department of financial\nservices, health care providers, third-party health care payers, and\nadvocates representing patients; protect the confidentiality of\npatient-identifiable information; promote the accuracy and completeness\nof reporting; and minimize the burden on institutional and\nnon-institutional health care providers and third-party health care\npayers.\n (b) As used in this section, unless the context clearly requires\notherwise:\n (i) "Health care" means any services, supplies, equipment, or\nprescription drugs referred to in subdivision two of this section.\n (ii) "Health care provider" includes, in addition to its common\nmeanings, a clinical laboratory, a pharmacy, an entity that is an\nintegrated organization of health care providers, and an accountable\ncare organization of health care providers.\n (iii) "System" means the statewide planning and research cooperative\nsystem under this section, and any separate system under this\nsubdivision.\n (iv) "Third-party health care payer" includes, but is not limited to,\nan insurer, organization or corporation licensed or certified pursuant\nto article thirty-two, forty-three or forty-seven of the insurance law,\nor article forty-four of the public health law; or an entity such as a\npharmacy benefits manager, fiscal administrator, or administrative\nservices provider that participates in the administration of a\nthird-party health care payer system.\n (v) "Covered person" is a person covered under a third-party health\ncare payer contract, agreement, or arrangement.\n 2. Notwithstanding any provision of law to the contrary, regulations\ngoverning the system shall include, but not be limited to, the\nfollowing:\n (a) Specification of patient, covered person, claims, and other data\nelements and format which shall be reported including data related to:\n (i) inpatient hospitalization data from general hospitals;\n (ii) ambulatory surgery data from hospital-based ambulatory surgery\nservices and all other ambulatory surgery facilities licensed under this\narticle;\n (iii) emergency department data from general hospitals;\n (iv) outpatient, clinical laboratory, and prescription data, including\nbut not limited to data from or relating to services, supplies,\nequipment, and prescription drugs provided or ordered by general\nhospitals and diagnostic and treatment centers licensed under this\narticle, pharmacies, clinical laboratories, and other health care\nproviders;\n (v) covered person and claims data; and\n (vi) the data specified in this paragraph shall include the\nidentification of patients transferred, admitted or treated subsequent\nto a medical, surgical or diagnostic procedure by a licensed health care\nprofessional or at a health care site or facility.\n (b) Standards to assure the protection of patient privacy in data\ncollected, published, released, used and accessed under this section,\nincluding compliance with applicable federal law.\n (c) Standards for the publication, release, and use of and access to\ndata reported in accordance with this section, including fees to be\ncharged.\n (d) Provisions requiring specified health care providers and\nthird-party health care payers to report data to the system, with\nspecifications of the data, circumstances, format, time and method of\nreporting.\n (e) Provisions to acquire data relating to health care provided (i) to\npatients for whom there is no third-party health care payer and (ii)\nunder arrangements that do not involve fee-for-service payment.\n (f) Phased-in implementation of the system.\n 3. The commissioner may provide that the system may participate in or\ncooperate with a similar system operated by, or receive information from\nor provide information to, a regional or national entity or another\njurisdiction, including making appropriate agreements and applying for\napprovals, provided that the protections for health care providers,\npatients, and third-party health care payers in this section are\npreserved and comparable provisions are included in the other system.\n 4. The commissioner may provide for access to data in the system by a\nhealth care provider relating to a patient being treated by the health\ncare provider, subject to this section and applicable state and federal\nlaw.\n 5. In operating the system, the commissioner shall consider national\nstandards, including but not limited to those approved by the National\nUniform Billing Committee (NUBC) or required under national electronic\ndata interchange (EDI) standards for health care transactions. The\ncommissioner shall also consider the use of the Statewide Health\nInformation Network for New York in relation to the system.\n 6. Notwithstanding any inconsistent provision of law to the contrary,\nincluding but not limited to section one hundred two of the executive\nlaw, such rules and regulations may describe data elements by reference\nto information reasonably available to regulated parties, as such\nmaterial may be amended in the future, even though such material cannot\nbe precisely identified to the extent that it is amended in the future;\nprovided, however, that the commissioner shall precisely identify and\npublish such data elements.\n 7. The commissioner may contract with one or more entities to operate\nany part of the system subject to this section.\n 8. The commissioner may accept grants and enter into contracts as may\nbe necessary to provide funding for the system.\n 9. The commissioner shall publish an annual report relating to health\ncare utilization, cost, quality, and safety, including data on health\ndisparities.\n * NB Effective until March 31, 2026\n * § 2816. Statewide planning and research cooperative system. 1. The\nstatewide planning and research cooperative system in the department is\ncontinued, as provided in this section. The statewide planning and\nresearch cooperative system shall be developed and operated by the\ncommissioner in consultation with the council, and shall be comprised of\nsuch data elements as may be specified by regulation.\n 2. Regulations governing the statewide planning and research\ncooperative system shall include, but not be limited to, the following:\n (a) Specification of patient and other data elements and format to be\nreported including data related to:\n (i) inpatient hospitalization data from general hospitals;\n (ii) ambulatory surgery data from hospital-based ambulatory surgery\nservices and all other ambulatory surgery facilities licensed under this\narticle;\n (iii) emergency department data from general hospitals;\n (iv) outpatient clinic data from general hospitals and diagnostic and\ntreatment centers licensed under this article, provided, however, that\nnotwithstanding subdivision one of this section the commissioner, in\nconsultation with the health care industry, is authorized to promulgate\nor adopt any rules or regulations necessary to implement the collection\nof data pursuant to this subparagraph; and\n (v) the data specified in this paragraph shall include the\nidentification of patients transferred, admitted or treated subsequent\nto a medical, surgical or diagnostic procedure by a licensed health care\nprofessional at a site or facility other than those specified in\nsubparagraph (i), (ii), (iii) or (iv) of this paragraph.\n (b) Standards to assure the protection of patient privacy in data\ncollected and released under this section.\n (c) Standards for the publication and release of data reported in\naccordance with this section.\n * NB Effective March 31, 2026\n