Mandatory participation in the Wisconsin Health Information Organization. (FE)

The bill provides that, beginning on the date on which the bill becomes law, WHIO, as the data organization under contract, has the exclusive right to use and to provide for a fee a data compilation, data service, or special report based on information collected by WHIO or provided to WHIO by DHS. WHIO, as the data organization under contract, must establish reasonable and necessary user fees for the provision of a compilation, service, or report, subject to approval by the secretary of health services. WHIO may additionally establish, subject to approval by the secretary of health services, reasonable and necessary fees to be paid by insurers, administrators, and any other data contributors for any services provided by WHIO. Further, the bill provides that WHIO, as the data organization under contract, may share data for health care operations, research, public health, or publication purposes if it determines 1) that the data request is consistent with program goals; 2) that the use of data provides greater transparency in health care costs, utilization, quality, or safety; and 3) that the information will be used to inform policy decisions.

The bill repeals certain requirements under current law that are applicable to WHIO, as the data organization under contract, with respect to the management of patient-identifiable data and instead imposes general requirements on WHIO, as the data organization under contract, to manage the data collected. Under the bill, WHIO must ensure the security of the data collected, protect the privacy of the data in compliance with state and federal law, and incorporate and utilize publicly available data other than administrative claims if necessary to measure and analyze a significant health care cost, utilization, quality, or safety issue that cannot be adequately measured with administrative claims data on its own. Subject to limitations, the bill also requires WHIO, as the data organization under contract, to take certain actions, including auditing the accuracy of all data collected and, under certain circumstances, sharing data. The bill provides that the board of directors of the data organization under contract may make recommendations regarding the database, if the recommendations meet certain standards.

The bill repeals certain conditions of contract imposed on the data organization under contract under current law, including an obligation to provide matching funds and an obligation to conduct statewide consumer information campaigns to improve health literacy.

The bill allows the secretary of health services to appoint an advisory committee to advise DHS and ETF on the establishment of an all-payer claims database dashboard.