F.S.A. § 408.061

Data collection; uniform systems of financial reporting; information relating to physician charges; confidential information; immunity

The Agency for Health Care Administration must require health care facilities, providers, and health insurers to submit certain data, such as case-mix data, patient admission and discharge data, hospital emergency department data, data on hospital-acquired infections, data on complications, readmissions data with specific patient identifiers included, actual charge data by diagnostic group, financial data, accounting data, operating expenses, charity care expenses, and demographic data.  The Agency must adopt nationally recognized risk adjustment methodologies, such as those used by the Agency for Healthcare Research and Quality.  Data may be acquired from a number of documents, such as leases, contracts, debt instruments, itemized patient bills, medical record abstracts, and related diagnostic information.  These data elements must be reported electronically. 

Data to be submitted by health care providers may include professional and specialty board affiliations, Medicare/Medicaid participation, types of services offered, revenue and expenses, and other data needed to study utilization patterns. 

Data to be submitted by health insurers may include claims, premium, financial, and  administration information. 

Health facilities, providers and insurers are not required to submit specific provider contract reimbursement information, but that information must be available for inspection onsite by the Agency.  The Agency must establish rules for uniform system of reporting of financial data by facility type.  As part of this system, the Agency may require the reporting of physician cost and consumer charge of services provided. 

Within 120 after the end of the fiscal year, each health care facility except for continuing care facilities and nursing homes, must file with the Agency its actual financial experience for the year, including expenditures, revenues, and statistical measures.   This data may be based on internal financial reports.  Nursing homes must submit a statistical profile of its residents to the Agency.  The Agency with the Department of Elderly Affairs and Department of Health will review the profiles and make recommendations for the placement of residents into other settings.  Nursing homes are also required to track each resident’s admission, discharge, if converted to Medicaid, health and functional status, plan of care, and other information. 

Any part of patient medical records that contains patient identifying information must remain confidential.  The identity of health care providers, health facilities, and health insurers that submit data that is proprietary must remain confidential.  The law specifically outlines what constitutes proprietary business information under the law.  Health care providers, facilities or insurers may not be held liable for reporting patient data to the Agency or the release of data by the Agency. 

The Agency for Health Care Administration is the primary source of health care data collection and dissemination.  Other state agencies may not collect data from providers without first determining whether the Agency is already collecting the data.  Health care data collection throughout the state must be coordinated so that data collection and public dissemination is done by a single source.  Confidential information may be released to other governmental agencies to perform their functions, but the receiving agency must retain the confidentiality of the information.  The Agency must coordinate with local and state agencies in efforts to establish an integrated health care database.  The following items must not be deducted from a facility’s operating costs in order to encourage philanthropic support of health care services:

• An unrestricted gift or grant or income from such that is not available to be used as operating expenses due to the Board’s designation;
• Grant or other payment made by a governmental entity that cannot be used as operating expenses;
• The sale or mortgage of real estate or capital assets of the health facility acquired through a gift or grant not available to be used as operating expenses.