1. A community health management information system governing board is established and shall consist of twelve members, including the following:
a. Four individuals representing providers including two individuals representing hospitals as defined in chapter 135B, and two individuals representing physicians as defined in chapters 148 and 150A.
b. Six individuals representing consumers of which at least two individuals shall represent employment-based purchasers representing nongovernmental entities purchasing group health plans on behalf of other individuals. Additionally, at least one of the individuals representing employment-based purchasers shall represent self-insured plans.
c. Two individuals representing payors other than a self- insured plan.
2. The commissioner or the commissioner's designee shall serve as an ex officio, nonvoting member of the board.
3. The members of the board shall be appointed by the governor, subject to senate confirmation. Members shall serve three-year staggered terms beginning and ending as provided in section 69.19. Appointments to the board are subject to sections 69.16 and 69.16A. Removal of a member of the board and the filling of a vacancy on the board are governed by chapter 69. The members of the board shall be reimbursed from funds collected by the system for actual and necessary travel and related expenses incurred in the discharge of official duties.
4. The commissioner shall cooperate with the board in the implementation of this chapter and shall review the procedures and operation of the system as provided in section 144C.5.
5. The board shall develop all public policy positions and operational policies and procedures related to the system. The board shall adopt written policies and procedures necessary to implement and administer this chapter. Policies and procedures adopted by the board are subject to the review and approval of the insurance division.
6. The board shall do all of the following:
a. Define a reporting methodology for the types of information, including severity of illness and outcomes, gathered by the community health management information system, applicable to all Iowa hospitals and hospital discharges, and outpatient and ambulatory care. For purposes of this chapter, data related to severity of illness shall include a severity of illness risk adjustment, patient average length of stay, patient mortality, and average total patient charges. Upon implementation of the severity of illness and outcomes reporting methodology as authorized in this section, the board, through its data advisory committee, may continue to review alternative severity of illness and outcomes measures which may be recommended to the board for use in the data plan.
b. Establish and implement functions as appropriate for the operation of the system consistent with the implementation of the system as provided in section 144C.8.
c. Appoint appropriate advisory committees as necessary including, but not limited to, an ethics and confidentiality review committee, a data advisory committee, a technical advisory committee, and a communications and education committee to provide technical assistance regarding the operation of the system, policies and contractual agreements, and other functions within the authority of the system.
d. Establish a certification process for transaction networks. The board shall only contract with certified transaction networks for purposes of this chapter.
e. Establish an appropriate network certification fee and any other fees as necessary to maintain the efficient administration of the system and for the repayment of any indebtedness incurred by the board pursuant to this chapter.
f. Establish standards for the electronic transaction submission format, transaction networks, supplemental information requirement transaction forms, computer software, and any other information or procedures necessary to effect the purposes of this chapter.
7. The board may do any of the following:
a. Enter into contracts as necessary to administer the provisions of this chapter.
b. Borrow money to effect the purposes of the system, except that the board shall not have the authority to directly issue any notes or bonds for indebtedness and shall not have the authority to pledge the credit or taxing power of this state.
c. Employ legal counsel and other staff as necessary to effect the purposes of this chapter.
d. Assist health care providers and payors as needed in obtaining necessary equipment and skills to access the system and in implementing the necessary procedures to effect the purposes of this chapter.
e. Enter into agreements consistent with and furthering the intent and purposes of this chapter with similar entities created in other states.
8. The board shall file a written report with the general assembly on or before January 15 of each year concerning the operation of the system. In addition to any other information contained in the report, the board shall include the system's annual operating budget for the coming year and any legislative recommendations which the board believes are necessary and which further the purposes of this chapter.
94 Acts, ch 1033, §5; 95 Acts, ch 185, §2
Referred to in § 144C.2
Confirmation, see § 2.32
Iowa General Assembly
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