Utah Code § 26B-8-513

Current through the 2024 Third Special Session
Section 26B-8-513 - Identifying potential overuse of non-evidence-based health care
(1) The department shall, in accordance with Title 63G, Chapter 6a, Utah Procurement Code, contract with an entity to provide a nationally-recognized health waste calculator that:
(a) uses principles such as the principles of the Choosing Wisely initiative of the American Board of Internal Medicine Foundation; and
(b) is approved by the committee.
(2) The department shall use the calculator described in Subsection (1) to:
(a) analyze the data in the state's All Payer Claims Database; and
(b) flag data entries that the calculator identifies as potential overuse of non- evidence-based health care.
(3) The department, or a third party organization that the department contracts with in accordance with Title 63G, Chapter 6a, Utah Procurement Code, shall:
(a) analyze the data described in Subsection (2)(b);
(b) review current scientific literature about medical services that are best practice;
(c) review current scientific literature about eliminating duplication in health care;
(d) solicit input from Utah health care providers, health systems, insurers, and other stakeholders regarding duplicative health care quality initiatives and instances of non-alignment in metrics used to measure health care quality that are required by different health systems;
(e) solicit input from Utah health care providers, health systems, insurers, and other stakeholders on methods to avoid overuse of non-evidence-based health care; and
(f) present the results of the analysis, research, and input described in Subsections (3)(a) through (e) to the committee.
(4) The committee shall:
(a) make recommendations for action and opportunities for improvement based on the results described in Subsection (3)(f);
(b) make recommendations on methods to bring into alignment the various health care quality metrics different entities in the state use; and
(c) identify priority issues and recommendations to include in an annual report.
(5) The department, or the third party organization described in Subsection (3) shall:
(a) compile the report described in Subsection (4)(c); and
(b) submit the report to the committee for approval.
(6) Beginning in 2021, on or before November 1 each year, the department shall submit the report approved in Subsection (5)(b) to the Health and Human Services Interim Committee.

Utah Code § 26B-8-513

Renumbered from § 26-33a-117 and amended by Chapter 306, 2023 General Session ,§ 289, eff. 5/3/2023.
Added by Chapter 181, 2020 General Session ,§ 1, eff. 5/12/2020.

Affected by 63I-1-226 on 12/31/2023