Chapter 126: Health Statistics

In this chapter:

I. "Board" means the vital records privacy board for health-related research, established in RSA 126:24-e.

II. "Commissioner" means the commissioner of the department of health and human services.

III. "Department" means the department of health and human services.

The bureau of health statistics and data management within the department is designated the health statistics center of New Hampshire in accordance with Public Law 95-623 section V(c)(1). The bureau is authorized to coordinate and disseminate health-related information for the purposes of protecting public health while adhering to privacy requirements. In carrying out its duties, the department shall use the minimum amount of information that is reasonably necessary to protect the health of the public.

The department shall have a direct and tangible interest in vital records data including personal identifiers. The secretary of state shall provide continuous electronic access to the department of the entire contents of the data files on a 24-hour, 7-day per week basis. If a means of electronic access becomes possible that will allow access at a faster rate, the department may utilize such new means of access, provided that it assumes the full cost of implementing the new means of access. Such access shall be provided in standard database format that establishes a remote electronic link from the secretary of state's office to the department that would not restrict the ability of the department to transfer data. However, under no circumstance shall any information relative to any adoption or any restricted record as determined by a court of law be provided to the department.

The commissioner and secretary of state shall enter into a memorandum of understanding to address the role of each agency in maintaining the state's vital records system. The memorandum shall facilitate a working relationship between the 2 agencies in meeting their respective responsibilities under this chapter and RSA 5-C. The memorandum shall be reviewed annually and may be modified at the request of either agency.

All protected health information possessed by the department shall be considered confidential, except that the commissioner shall be authorized to provide vital record information to institutions and individuals both within and outside of the department who demonstrate a need for such information for the purpose of conducting health-related research. Any such release shall be conditioned upon the understanding that once the health-related research is complete that all information provided will be returned to the department or destroyed. All releases of information shall be consistent with the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (HIPAA) and regulations promulgated thereunder by the United States Department of Health and Human Services (45 C.F.R. Part 160 and Part 164). This shall include the requirement that all proposed releases of vital records information to institutions and individuals both within and outside the department for the purposes of health-related research be reviewed and approved by the board, under RSA 126:24-e, before the requested information is released.

I. There is hereby established an independent board administratively attached, pursuant to RSA 21-G:10, to the department to review requests for vital records information for the purposes of conducting health-related research. No vital records information requested for the purposes of conducting health-related research shall be released until the request has first been reviewed and approved by the board.

II. The board shall have 6 members, with varying backgrounds to promote complete and adequate review of health-related research activities. The commissioner shall appoint 3 of the members and the secretary of state shall appoint 3 members. The board shall be sufficiently qualified through the experience and expertise of its members, and the diversity of the members to promote respect for its advice and counsel in safeguarding the privacy and confidentiality of vital records information that is used for the purposes of health-related research. In addition to possessing the professional competence necessary to review specific health-related research activities, the board shall be able to ascertain the acceptability of proposed research in terms of applicable law, regulations, and standards of professional conduct and practice. The board shall therefore include persons knowledgeable in these areas.

III. The board shall include at least one member whose primary concerns are in the area of public health research activities and at least one member whose primary concerns are in nonpublic health areas.

IV. The board shall include at least 2 members who are not otherwise affiliated with either the department or the department of state and who are not part of the immediate family of a person who is affiliated with either the department or the department of state.

V. No member of the board shall participate in initial or continuing review of any health-related research project in which the member has a conflicting interest, except to provide information requested by the board.

VI. The board may, in its discretion, invite individuals with competence in special areas to assist in the review of issues which require expertise beyond or in addition to that possessed by the members of the board. These individuals may only offer advice and guidance and shall not participate in the decision as to whether or not to approve the release of vital records information for the purposes of health-related research.

VII. The board shall have 2 part-time staff persons to conduct the duties associated with the work of the board. The board shall reimburse members for travel expenses associated with board activities.

The commissioner may adopt rules, pursuant to RSA 541-A, relative to:

I. With the exception of vital records, guidance and direction in the collection and accuracy of statistical and medical information by data collectors.

II. Procedures, conditions, and criteria for release of information, under RSA 126:24-d.

Any person shall be guilty of a class B felony if he or she willfully and knowingly furnishes or disseminates vital records information in a manner inconsistent with the purposes for which it was released.

I. This subdivision establishes a system for the collection of health care data and for the disclosure of data consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45 C.F.R. sections 160, 162, and 164, limited to public health activities, health care oversight, research, health care operations, the administration of anti-fraud, waste, and abuse activities, and the prevention of anti-competition practices in the health care system. For the purposes of this section, health care operations shall not include marketing or fundraising except such use or disclosure shall be permissible for market analysis.

II. All health care facilities under RSA 151:2 shall file health care data as required by the commissioner of health and human services, pursuant to RSA 126:27. This data shall include, but not be limited to:

(a) For hospitals, the data now collected through the uniform health care facility discharge data set as amended by rule pursuant to RSA 541-A; and

(b) For all facilities, disposition destination of each patient or resident admitted, payer information, charge by discharge, and any demographic or diagnostic information necessary for the administration of this subdivision.

The commissioner of health and human services shall adopt rules, pursuant to RSA 541-A, relative to:

I. The types of data which each facility shall be required to file under RSA 126:25.

II. The form in which data shall be filed under RSA 126:25.

III. The times at which data shall be filed under RSA 126:25.

IV. User fees which shall be assessed persons requesting data under RSA 126:28, 126:30, and 141-B:9.

V. Confidentiality of data collected and disclosed under this subdivision subject to the provisions of RSA 126:28.

VI. Procedures and written requirements for obtaining, using, and protecting data provided by the department of health and human services under RSA 126:28.

Notwithstanding any other provision of law, data collected under RSA 126:25 shall be made available:

I. To the public upon request, provided that individual patients or health care practitioners shall not be directly or indirectly identifiable.

II. To individuals or entities for research, public health, or health care operations as defined by HIPAA, or any other individual or entity as allowable by law, demonstrating a legitimate need for such information, if such disclosure is consistent with all applicable HIPAA standards and approved by the commissioner, or designee, in accordance with rules adopted under RSA 126:27. Use of data disclosed shall not be for marketing or fundraising targeted to individuals except such use or disclosure shall be permissible for market analysis.

III. To the insurance department, the department of justice, or any other state or federal agency, and any agency's contractors, for review of health care matters within the agency's respective jurisdictional authority. An agency or contractor receiving health care data under this section shall comply with all state and federal confidentiality, privacy, and security protections.

In addition to any other penalties provided by law, any health care facility which willfully fails to comply with the provisions of this subdivision shall be subject to a civil penalty of $100 for each day of noncompliance, which shall not be reimbursable by a commercial insurer, nonprofit health services corporation, health maintenance organization, or multiple employer welfare arrangement as provided in RSA 415, 420-A, 420-B, and 415-E.

Any person requesting copies of data or statistical information filed with the department of health and human services under RSA 126 or RSA 141-B shall pay to the department a fee established by the commissioner of health and human services pursuant to RSA 126:27, IV. The fee shall reflect the full costs of preparing the data for release, including the cost of personnel time, computer and any related expenses associated with fulfilling the request.