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Research in Pennsylvania

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        Under many circumstances, the state of Pennsylvania may allow medical records that otherwise are required to be kept confidential, to be shared for research purposes.  For instance, the Health Care Cost Containment Council actively encourages research and demonstrations to design and test improved methods of assessing provider quality, provider service effectiveness and efficiency by accessing the council’s raw data files1, particularly to study and analyze medically indigent populations.2  Additionally any state agency may study and issue public reports on the special medical needs and need for financing of health services for minority and underserved populations.3

        Other types of information that may be permitted to be disseminated for use in health care research includes vital statistics4, disease reports and responses thereto5, and managed care data.6

 

Footnotes

  • 1. 35 Pa. Stat. Ann § 449.13 (West 2008)
  • 2. 35 Pa. Stat. Ann. § 449.8 (West 2008)
  • 3. 35 Pa. Stat. Ann. § 449.11 (West 2012)
  • 4. 35 Pa. Stat. Ann. § 450.805 (West 2012)
  • 5. 35 Pa. Stat. Ann. § 521.15 (West 2012)
  • 6. 40 Pa. Stat. Ann. § 991.2131 (West 2012)

 

Research in Pennsylvania

Subtopic Statute/Regulation Description
Research Annual audited financial statements - 28 Pa. Code § 912.61 Hospitals and ambulatory service facilities must annually file audited and certified financial statements within 120 days after the close of the...
Confidentiality - 40 Pa. Stat. Ann. § 991.2131 Managed care plans and utilization review entities must ensure that all identifiable information regarding enrollee health, diagnosis and treatment...
Confidentiality of case reports - 28 Pa. Code § 27.5a Case reports submitted to the department of health or to a local morbidity reporting office (LMRO) related to diseases, conditions and infections are...
Confidentiality of reports and records - 35 Pa. Stat. Ann. § 521.15 State and local health authorities may disclose reports of diseases or records of actions taken in response to such reports under the following...
Department investigations - 28 Pa. Code § 9.605 The department of health may investigate plans to determine their compliance with regulations; the department may access enrollees’ medical...
Health care for the medically indigent - 35 Pa. Stat. Ann. § 449.8 As a condition of licensure, each provider must offer and provide medically necessary, lifesaving and emergency health care services to every person...
HMO external quality assurance assessment - 28 Pa. Code § 9.654 Within 18 months of enrollment, and every three years thereafter, an HMO must use an acceptable external quality review organization to conduct a...
Medicare cost reports and Medical Assistance Form 336 - 28 Pa. Code § 912.63 Hospitals and ambulatory care facilities must quarterly report summary utilization and financial reports to the council. 28 Pa. Code Chapter 912,...
Plan reporting requirements - 28 Pa. Code § 9.604 A plan must annually submit to the department of health a detailed report of its activities, including the following provisions: ...
Records; disclosure for research purposes - 35 Pa. Stat. Ann. § 450.805 The department of health may permit the use of vital statistics records or parts thereof for research; the department must strictly supervise such...
Reporting cases of cancer - 28 Pa. Code § 27.31 Each case of cancer must be reported in accordance with the following: To the cancer registry maintained by the department of health’s...
Required data elements - 28 Pa. Code § 912.21 Health care facilities must quarterly submit the following data elements:1         Those contained in health...
Research and demonstration projects - 35 Pa. Stat. Ann § 449.13 The health care cost containment council will actively encourage research and demonstrations to design and test improved methods of assessing...
Special studies and reports - 35 Pa. Stat. Ann. § 449.11 Any state agency may study and issue a report on the special medical needs, demographic characteristics, access or lack thereof to health care...
Click on the individual state law in the table above to see our summary of the individual law.


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