ASSEMBLY HEALTH COMMITTEE

STATEMENT TO

[Second Reprint]

SENATE, No. 50

with committee amendments

STATE OF NEW JERSEY

DATED: MAY 1, 1997

      The Assembly Health Committee reports favorably and with committee amendments Senate Bill No. 50 (2R).

      As amended by the committee, this bill establishes the Health Information Electronic Data Interchange Policy Advisory Council in the Department of Health and Senior Services.

      The council will be comprised of 31 members, representing the various participants in the health care services delivery process, including health care providers, insurers, employers and consumers of health care services. The council will be primarily responsible for developing standards for an effective electronic data interchange (EDI) network for use in the health care services delivery process.

      Specifically, the council's responsibilities will include:

      (1) Developing standards for interorganizational communication among the participants in the health care services delivery process.

      (2) Developing standards for the transmission of forms and information among the various sectors of the health care services delivery process.

      (3) Encouraging health insurers and other benefit providers to issue patient identification cards or equipment that provide rapid, efficient electronic access to health care services, to covered individuals.

      (4) Encouraging and facilitating the development of secure networks that would be interconnected and available to all participants of the health care services delivery process.

      In developing the standards for the EDI network, the council is to consider the following guidelines:

      (1) National standards, such as those developed by the American National Standards Institute (ANSI) and the Health Care Financing Administration (HCFA) will be evaluated and adopted wherever possible.

      (2) To the greatest extent possible, all participants will be provided with equal functionality in their access to the network. Interconnection speeds and types of connections may vary, but the services offered will be available to all participants.

      (4) The State's EDI network will encourage direct connections to the Internet or similar networks for communication and research purposes.

      (5) The network's design will be flexible and allow for new services to be offered without impacting existing services.

      (6) Wherever possible, the network will utilize existing networks that are available for other applications and will take into consideration existing proprietary networks which can connect to and transmit specified health care enrollment, claim and medical information to the open networks in the State.

      (7) Whenever possible, all participants in the network will establish a single connection to the network and this single connection should support all functions of the network.

      (8) All providers of network services will agree to work in an ethical manner so as not to achieve a competitive advantage when collecting or accumulating content information from the transmissions carried on their network.

      To the maximum extent possible and practicable the council shall coordinate its responsibilities and functions with other health information initiatives undertaken by the Department of Health and Senior Services and other State agencies.

      In addition, the council will advise the Commissioner of Banking and Insurance in the development of recommended standards for the electronic processing of health care coverage claim information by health insurers pursuant to Senate Bill No. 48 or Assembly Bill No. 1481 of 1996; and will advise the commissioner in the development of standard health care enrollment and claim forms pursuant to Senate Bill No.49 or Assembly Bill No.1473 of 1996, as well as with the Commissioner of Health and Senior Services in his preparation of the annual report on health care expenditures required by Senate Bill No. 43 or Assembly Bill No.1479 of 1996.

      This bill is part of a legislative package designed to effectuate the recommendations of the Healthcare Information Networks and Technologies (HINT) report to the Legislature under the joint auspices of Thomas Edison State College and the New Jersey Institute of Technology.

      The committee amendments:

∙    change the Health Information Electronic Data Interchange Policy Council to an advisory council and rename it accordingly;

∙    expand the council from 29 to 31 members by adding a representative of the osteopathic profession and the mental health professions, respectively, who shall be appointed by the Governor;

∙    delete the requirement that the gubernatorial appointments to the council be made with the advice and consent of the Senate;

∙    delete the provisions for appointment by the council of staff other than an executive director and provide, instead, that the Department of Health and Senior Services shall provide staff support for the council;

∙    delete the provisions for certification by the council of electronic data interchange networks based upon compliance with standards developed by the council;

∙    delete the reference to the Electronic Data Interchange Technology Fund (which would be established by Senate Bill No. 45 or Assembly Bill No. 1480 of 1996 and supported by a processing surcharge on payment transactions of health care facilities and providers) as a funding source for the council;

∙    delete the $250,000 appropriation provided in the bill;

∙    delete the authority of the council to adopt administrative regulations and provide, instead, that: (1) the council shall make recommendations to the Commissioner of Health and Senior Services through resolutions adopted by a recorded majority vote of the council regarding the development of standards for the State's EDI network; and (2) if the commissioner disagrees with the recommendations of the council, the commissioner shall present the reasons therefor to the council; and

∙    change the references in the bill to the "Commissioner of Health" and the "Commissioner of Insurance" to the "Commissioner of Health and Senior Services" and the "Commissioner of Banking and Insurance," respectively.

      As reported by the committee, this bill is identical to Assembly Bill No. 1476 Aca (Felice/Kavanaugh), which the committee also reported on this date.