                                 CODE OF VIRGINIA

AGREEMENTS FOR CERTAIN DATA SERVICES (§ 32.1-276.4)

A. The Commissioner shall negotiate and enter into contracts or agreements with
a nonprofit organization for the compilation, storage, analysis, and evaluation
of data submitted by health care providers pursuant to this chapter; for the
operation of the All-Payer Claims Database pursuant to &#xA7; 32.1-276.7:1; and
for the development and administration of a methodology for the measurement and
review of the efficiency and productivity of health care providers. Such
nonprofit organization shall be governed by a board of directors composed of
representatives of state government, including the Commissioner, representatives
of the Department of Medical Assistance Services and the Bureau of Insurance,
health plans and health insurance issuers, and the consumer, health care
provider, and business communities. Of the health care provider representatives,
there shall be an equal number of hospital, nursing home, physician, and health
plan representatives. The articles of incorporation of such nonprofit
organization shall require the nomination of such board members by organizations
and associations representing those categories of persons specified for
representation on the board of directors.

B. In addition to providing for the compilation, storage, analysis, and
evaluation services described in subsection A, any contract or agreement with a
nonprofit, tax-exempt health data organization made pursuant to this section
shall require the board of directors of such organization to:

   1. Develop and disseminate other health care quality and efficiency
   information designed to assist businesses and consumers in purchasing health
   care and long-term care services;

   2. Prepare and make public summaries, compilations, or other supplementary
   reports based on the data provided pursuant to this chapter;

   3. 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 Board, pursuant to &#xA7; 32.1-276.5, and
   submitted by health maintenance organizations or other health care plans;

   4. Jointly determine with the Board of Medicine any data concerning safety
   services and quality health care services rendered by physicians to Medicaid
   recipients that should be identified, collected, and disseminated. The board
   of directors shall further determine jointly with the Board of Medicine the
   costs of requiring physicians to identify, submit, or collect such information
   and identify sufficient funding sources to appropriate to physicians for the
   collection of the same. No physician 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;

   5. Maintain the confidentiality and security of data as set forth in
   &#xA7;&#xA7; 32.1-276.7:1 and 32.1-276.9;

   6. Submit a report to the Board, 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
   nonprofit organization;

   7. Submit, as appropriate, strategic plans to the Board, 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 nonprofit organization 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 nonprofit organization 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;

   8. Competitively bid or competitively negotiate all aspects of all data
   projects, if feasible; and

   9. Fulfill all funded requirements set forth for the nonprofit organization in
   this chapter.

C. The Department shall take steps to increase public awareness of the data and
information available through the nonprofit organization&#8217;s website and how
consumers can use the data and information when making decisions about health
care providers and services.

D. Except as provided in subdivision A 2 of &#xA7; 2.2-4345, the provisions of
the Virginia Public Procurement Act (&#xA7; 2.2-4300 et seq.) shall not apply to
the activities of the Commissioner authorized by this section. Funding for
services provided pursuant to any such contract or agreement shall come from
general appropriations and from fees determined pursuant to &#xA7; 32.1-276.8
and from such fees and other public and private funding sources as may be
authorized by this chapter.

HISTORY: 1996, c. 902; 2000, c. 897; 2006, c. 426; 2010, c. 416; 2012, cc. 693,
709.