N.M. Admin. Code § 7.1.27.13

Current through Register Vol. 35, No. 21, November 5, 2024

Section 7.1.27.13 - GENERAL PROVISIONS ON ACCESS TO THE HEALTH INFORMATION SYSTEM DATA

A.Reporting: In accordance with Subsections 24-14A-3(D) (6), 24-14A-4.3 & 24-14A-6(D) of the HIS Act, data may be reported routinely to authorized federal, state, and local public agencies. Record-level data shall be reported to the agency for healthcare research and quality (AHRQ) for incorporation into the healthcare cost and utilization project (HCUP) databases as part of the federal-state-industry partnership.

B.Access requirements: Data and reports based on the HIS may be obtained only in accordance with the requirements of the HIS Act and this rule. Any request for information that would not be contained in routine reports will require completion of a data request form available on the division's website or by contacting the division.

C.Evaluation of requests: In addition to other requirements stated in this rule, all requests for HIS data and reports, other than routine reports, shall be evaluated by the division and shall satisfy the following criteria for approval.

(1) The specific intended use of the data shall comport with the purposes of the HIS Act, as stated in 24-14A-3 A and rules promulgated pursuant to the act, including use of data to assist in:

(a) the performance of health planning, policy making functions, and research conducted for the benefit of the public;

(b) informed health care decision making by consumers;

(c) surveillance for the control of disease and conditions of public health significance as required by Public Health Act, Subsection 24-1-3(C) NMSA 1978;

(d) administration, monitoring, and evaluation of a statewide health plan.

(2) The request shall be consistent with the responsibilities of the division in accomplishing the priorities of the HIS.

(3) The request is for data that are either:

(a) in a routine report previously published by the division, or

(b) aggregate data in or reports based on a subset or portion of the HIS database that is relevant to the individual's stated purpose upon approval of the request by the division, or

(c) record-level data, such that an individual patient or healthcare professional cannot be identified, pursuant to the HIS Act, to federal, state, and local public agencies, and upon approval of the request by the division.

D.Request procedures: All requests for data shall be made pursuant to the requirements of 7.1.27.14 NMAC.

E.Fees: Fees for access to data and reports shall be paid pursuant to the requirements of 7.1.27.18 NMAC.

F.Restrictions on access to sensitive data: The division shall have the authority to deny access to information from the HIS database where use of the information, as determined by the division, could result in violation of a patient's privacy.

G.Compliance with other laws: The division shall ensure that any access to data that is subject to restrictions on use pursuant to state, federal, or tribal law or regulation, or any other legal agreement, complies with those restrictions.

H.Disclaimer: The division shall include a disclaimer in all HIS data and reports released pursuant to this rule stating that the accuracy of the original data is the responsibility of the submitting data provider and that the division assumes no responsibility for any use made of or conclusions drawn from the data.

I.Agency contractors:

(1) A state or federal agency that receives HIS data or reports under an agreement with the division pursuant to 7.1.27.15 NMAC, 7.1.27.16 NMAC, and 7.1.27.17 NMAC shall be solely responsible for fulfillment of the agreement, including responsibility for the actions of any subcontractor engaged to perform services that require access to HIS data or reports.

(2) No state or federal agency shall subcontract any portion of services to be performed under an agreement with the division without prior written approval of the division.

(3) A state or federal agency subcontractor that is provided access to HIS data or reports shall be subject to the full provisions of the HIS Act, and this rule, including 7.1.27.15 NMAC, 7.1.27.16 NMAC, and 7.1.27.17.

J.Public data: The restrictions that apply to the release of data do not apply when the data provider is a government agency and the data provided to the HIS otherwise would be considered public data in accordance with the Public Records Act, Sections 14-3-1 to 14-3-23, NMSA 1978, and the Open Meetings Act, Sections 10-15-1 to 10-15-4, NMSA 1978.

K.Proprietary and confidential information:

(1) Proprietary information and patient confidential information shall not be routinely disclosed in or as part of a public health information report by the division.

(2) A data provider that objects on proprietary grounds to the potential release in a public health information report, or a record level data disclosure, of its reported data or information derived from its reported data shall submit to the division a written request to exempt its data from such disclosures. By the end of each fiscal year (June 30^th) data providers must notify, in writing, the division regarding data items that they deem proprietary. Application for an exemption must be addressed by a representative of the data provider to the division.

L. Final determination:

(1) The division shall prepare a recommended written decision in the format required by Subsection 39-3-1.1 NMSA 1978. The recommended written decision shall be approved or disapproved by the department division director or designee within 10 days or as expeditiously as possible after the issuance of the division's written recommendation.

(2) The decision by the department division director or designee is subject to review by the secretary at the secretary's discretion and is the final determination for purpose of judicial review.

(3) The department shall issue a final decision that includes an order granting or denying relief. The final decision may incorporate the division's recommended decision or the department may render any other final decision supported by law. The final decision shall include a statement of the factual and legal basis for the decision.

N.M. Admin. Code § 7.1.27.13

7.1.27.13 NMAC - N, 12/31/2012