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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>56739</law_id><section_number>32.1-276.4</section_number><catch_line>Agreements for certain data services</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>32.1-137.09</reference><reference>32.1-137.6</reference><reference>32.1-23.4</reference><reference>32.1-276.3</reference><reference>32.1-276.5</reference><reference>32.1-276.6</reference><reference>32.1-276.7</reference><reference>32.1-276.8</reference><reference>38.2-3438</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="32.1">Health</unit><unit label="chapter" level="2" order_by="1" identifier="7.2">Health Care Data Reporting</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> The <span class="dictionary">Commissioner</span> shall negotiate and enter into <span class="dictionary">contracts</span> or agreements with a <span class="dictionary">nonprofit organization</span> for the compilation, storage, analysis, and evaluation of data submitted by <span class="dictionary">health care providers</span> pursuant to this chapter; for the operation of the All-Payer Claims Database pursuant to &#xA7; <a class="law" title="All-Payer Claims Database created; purpose; reporting requirements" href="/32.1-276.7_1/">32.1-276.7:1</a>; and for the development and administration of a methodology for the measurement and review of the efficiency and productivity of <span class="dictionary">health care providers</span>. Such <span class="dictionary">nonprofit organization</span> shall be governed by a <span class="dictionary">board</span> of directors composed of representatives of state government, including the <span class="dictionary">Commissioner</span>, representatives of the <span class="dictionary">Department</span> of Medical Assistance Services and the Bureau of Insurance, health plans and health insurance issuers, and the <span class="dictionary">consumer</span>, <span class="dictionary">health care provider</span>, and business communities. Of the <span class="dictionary">health care provider</span> representatives, there shall be an equal number of hospital, nursing home, <span class="dictionary">physician</span>, and health plan representatives. The articles of incorporation of such <span class="dictionary">nonprofit organization</span> shall require the nomination of such <span class="dictionary">board</span> members by organizations and associations representing those categories of <span class="dictionary">persons</span> specified for representation on the <span class="dictionary">board</span> of directors. <a id="paragraph-207576" class="section-permalink" href="https://vacode.org/32.1-276.4/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> In addition to providing for the compilation, storage, analysis, and evaluation services described in subsection A, any <span class="dictionary">contract</span> or agreement with a nonprofit, tax-exempt health data organization made pursuant to this section shall require the <span class="dictionary">board</span> of directors of such organization to: <a id="paragraph-207577" class="section-permalink" href="https://vacode.org/32.1-276.4/#B"><i class="fa fa-link"/></a></p></section>
						<section id="B1" class="indent-1"><p><span class="prefix-number">1.</span> Develop and disseminate other health care quality and efficiency information designed to assist businesses and <span class="dictionary">consumers</span> in purchasing health care and long-term care services; <a id="paragraph-207578" class="section-permalink" href="https://vacode.org/32.1-276.4/#B1"><i class="fa fa-link"/></a></p></section>
						<section id="B2" class="indent-1"><p><span class="prefix-number">2.</span> Prepare and make public summaries, compilations, or other supplementary reports based on the data provided pursuant to this chapter; <a id="paragraph-207579" class="section-permalink" href="https://vacode.org/32.1-276.4/#B2"><i class="fa fa-link"/></a></p></section>
						<section id="B3" class="indent-1"><p><span class="prefix-number">3.</span> Collect, compile, and publish Health Employer Data and Information Set (HEDIS) information or reports or other quality of care or performance information sets approved by the <span class="dictionary">Board</span>, pursuant to &#xA7; <a class="law" title="Providers to submit data; civil penalty" href="/32.1-276.5/">32.1-276.5</a>, and submitted by <span class="dictionary">health maintenance organizations</span> or other health care plans; <a id="paragraph-207580" class="section-permalink" href="https://vacode.org/32.1-276.4/#B3"><i class="fa fa-link"/></a></p></section>
						<section id="B4" class="indent-1"><p><span class="prefix-number">4.</span> Jointly determine with the <span class="dictionary">Board</span> of Medicine any data concerning safety services and quality health care services rendered by <span class="dictionary">physicians</span> to Medicaid recipients that should be identified, collected, and disseminated. The <span class="dictionary">board</span> of directors shall further determine jointly with the <span class="dictionary">Board</span> of Medicine the costs of requiring <span class="dictionary">physicians</span> to identify, submit, or collect such information and identify sufficient funding sources to appropriate to <span class="dictionary">physicians</span> for the collection of the same. No <span class="dictionary">physician</span> shall be required to collect or submit safety and quality of health care services information that is already identified, collected, or submitted under this chapter; or for which funds for collection are not appropriated; <a id="paragraph-207581" class="section-permalink" href="https://vacode.org/32.1-276.4/#B4"><i class="fa fa-link"/></a></p></section>
						<section id="B5" class="indent-1"><p><span class="prefix-number">5.</span> Maintain the confidentiality and security of data as set forth in &#xA7;&#xA7; <a class="law" title="All-Payer Claims Database created; purpose; reporting requirements" href="/32.1-276.7_1/">32.1-276.7:1</a> and <a class="law" title="Confidentiality, subsequent release of data and relief from liability for reporting; penalty for wrongful disclosure; individual action for damages" href="/32.1-276.9/">32.1-276.9</a>; <a id="paragraph-207582" class="section-permalink" href="https://vacode.org/32.1-276.4/#B5"><i class="fa fa-link"/></a></p></section>
						<section id="B6" class="indent-1"><p><span class="prefix-number">6.</span> Submit a report to the <span class="dictionary">Board</span>, the Governor, and the General Assembly no later than October 1 of each year for the preceding fiscal year. Such report shall include a certified audit, including an analysis of the efficacy and value of the All-Payer Claims Database, and provide information on the accomplishments, priorities, and current and planned activities of the <span class="dictionary">nonprofit organization</span>; <a id="paragraph-207583" class="section-permalink" href="https://vacode.org/32.1-276.4/#B6"><i class="fa fa-link"/></a></p></section>
						<section id="B7" class="indent-1"><p><span class="prefix-number">7.</span> Submit, as appropriate, strategic plans to the <span class="dictionary">Board</span>, the Governor, and the General Assembly recommending specific data projects to be undertaken and specifying data elements for collection under this chapter. In developing strategic plans, the <span class="dictionary">nonprofit organization</span> shall incorporate similar activities of other public and private entities to maximize the quality of data projects and to minimize the cost and duplication of data projects. In its strategic plans, the <span class="dictionary">nonprofit organization</span> shall also evaluate the continued need for and efficacy of current data initiatives, including the use of patient level data for public health purposes. The approval of the General Assembly shall be required prior to the implementation of any recommendations set forth in a strategic plan submitted pursuant to this section; <a id="paragraph-207584" class="section-permalink" href="https://vacode.org/32.1-276.4/#B7"><i class="fa fa-link"/></a></p></section>
						<section id="B8" class="indent-1"><p><span class="prefix-number">8.</span> Competitively bid or competitively negotiate all aspects of all data projects, if feasible; and <a id="paragraph-207585" class="section-permalink" href="https://vacode.org/32.1-276.4/#B8"><i class="fa fa-link"/></a></p></section>
						<section id="B9" class="indent-1"><p><span class="prefix-number">9.</span> Fulfill all funded requirements set forth for the <span class="dictionary">nonprofit organization</span> in this chapter. <a id="paragraph-207586" class="section-permalink" href="https://vacode.org/32.1-276.4/#B9"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> The <span class="dictionary">Department</span> shall take steps to increase public awareness of the data and information available through the <span class="dictionary">nonprofit organization</span>&#x2019;s website and how <span class="dictionary">consumers</span> can use the data and information when making decisions about <span class="dictionary">health care providers</span> and services. <a id="paragraph-207587" class="section-permalink" href="https://vacode.org/32.1-276.4/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> Except as provided in subdivision A 2 of &#xA7; <a class="law" title="Exemptions from competitive sealed bidding and competitive negotiation for certain transactions; limitations" href="/2.2-4345/">2.2-4345</a>, the provisions of the Virginia Public Procurement Act (&#xA7; <a class="law" title="Short title; purpose; declaration of intent" href="/2.2-4300/">2.2-4300</a> et seq.) shall not apply to the activities of the <span class="dictionary">Commissioner</span> authorized by this section. Funding for services provided pursuant to any such <span class="dictionary">contract</span> or agreement shall come from general appropriations and from fees determined pursuant to &#xA7; <a class="law" title="Fees for processing, verification, and dissemination of data" href="/32.1-276.8/">32.1-276.8</a> and from such fees and other public and private funding sources as may be authorized by this chapter. <a id="paragraph-207588" class="section-permalink" href="https://vacode.org/32.1-276.4/#D"><i class="fa fa-link"/></a></p></section></text><history>1996, c. 902; 2000, c. 897; 2006, c. 426; 2010, c. 416; 2012, cc. 693, 709.</history><metadata></metadata></law>
