N.J. Admin. Code § 10:79A-1.8

Current through Register Vol. 57, No. 1, January 6, 2025

Section 10:79A-1.8 - Data analyses and annual project evaluation

(a) Pursuant to the Act, the Rutgers Center for State Health Policy (the Center) shall make HIPAA-compliant data requests to the Department and the Department of Health to support the Demonstration Project.

(b) The Department, in consultation with the Department of Health, shall review the Centers assessment of the gainsharing plans in accordance with the Act.

(c) Certified ACOs shall execute a HIPAA-required business associate agreement between the ACO and its participating hospitals, primary care offices, and other members, as needed, to permit sharing of protected health information. Certified ACOs shall perform data analyses of patient utilization of local hospitals to improve care coordination and monitor program performance. All such agreements shall require that beneficiaries are to be notified by all such members or providers that the ACO will obtain beneficiary-identifiable data, and that beneficiaries shall be given the opportunity to decline such data sharing, in which case no such data sharing shall occur.

(d) Certified ACOs shall, upon direction from the Department, execute HIPAA-compliant data use agreements for sharing of protected health information with the Rutgers Center for State Health Policy, for use in the annual evaluation of the Demonstration Project. The protected health information shall enable an evaluation of patient care utilization over time without providing direct patient identifiers.

N.J. Admin. Code § 10:79A-1.8

Amended by 46 N.J.R. 791(a), effective 5/5/2014.