N.Y. Comp. Codes R. & Regs. Tit. 10 § 400.18 - Statewide Planning and Research Cooperative System (SPARCS)
(a)
Definitions.
For the purposes of this section, these terms shall have the following meanings:
(1)
Health care facilities shall mean facilities licensed under
article 28 of the Public Health Law.
(2)
Identifying data elements
shall mean those SPARCS data elements that, if disclosed without any restrictions
on use or re-disclosure would constitute an unwarranted invasion of personal
privacy. A list of identifying data elements shall be specified by the
commissioner and will be made available publicly.
(3)
Inpatient hospitalization
data shall mean SPARCS data submitted by hospitals for patients
receiving inpatient services at a general hospital that is licensed under article
28 of the Public Health Law and that provides inpatient medical
services.
(4)
Outpatient
data shall mean emergency department data, ambulatory surgery data, and
outpatient services data.
(i)
Emergency
department data shall mean SPARCS data submitted by a facility licensed
to provide emergency department services under article 28 of the Public Health
Law.
(ii)
Ambulatory surgery
data shall mean SPARCS data submitted by a facility licensed to provide
ambulatory surgery services under article 28 of the Public Health Law.
(iii)
Outpatient services data
shall mean all data submitted by licensed article 28 facilities excluding
inpatient hospitalization data, emergency department data, and ambulatory surgery
data.
(5)
SPARCS
Administrator shall mean a person in the SPARCS program designated by
the commissioner to act as administrator for all SPARCS activities.
(6)
SPARCS data shall mean the
data collected by the commissioner under section
2816 of the Public Health Law and this
section, including inpatient hospitalization data and outpatient data.
(7)
SPARCS program shall mean
the program in the New York State Department of Health (NYSDOH) that collects and
maintains SPARCS data and discloses SPARCS data.
(b)
Reporting SPARCS data.
(1) Health care facilities shall report data as
follows:
(i) Health care facilities shall
submit, or cause to have submitted, SPARCS data in an electronic,
computer-readable format through a secure electronic network designated by the
department according to specifications provided by the commissioner.
(ii) All SPARCS data must be supported by
documentation in the patient's medical and billing records.
(iii) Health care facilities must submit on a
monthly basis to the SPARCS program, or cause to have submitted on a monthly
basis to the SPARCS program, data for all inpatient discharges and outpatient
visits. Health care facilities must submit, or cause to have submitted, at least
95 percent of data for all inpatient discharges and outpatient visits within 60
days from the end of the month of a patient's discharge or visit. Health care
facilities must submit, or cause to have submitted, 100 percent of data for all
inpatient discharges and outpatient visits within 180 days from the end of the
month of a patient's discharge or visit.
(iv) The SPARCS program may conduct an audit
evaluating the quality of submitted SPARCS data and issue an audit report to a
health care facility listing any inadequacies or inconsistencies in the data. Any
health care facility so audited must submit corrected data to the SPARCS program
within 90 days of the receipt of the audit report.
(2) Content of the SPARCS data.
(i) Health care facilities shall submit, or
cause to have submitted, uniform bill data elements as required by the
commissioner. The data elements required by the commissioner shall be based on
those approved by the National Uniform Billing Committee (NUBC) or required under
national electronic data interchange (EDI) standards for health care transactions
and shall be published on the NYSDOH website to the extent allowed by copyright
law.
(ii) Health care facilities
shall submit, or cause to have submitted, additional data elements as required by
the commissioner. Such additional data elements shall be from medical records or
demographic information maintained by the health care facilities.
(iii) The list of specific SPARCS data elements
and their definitions shall be maintained by the commissioner, will be made
available publicly, and may be modified by the commissioner.
(c)
Maintenance of SPARCS
data.
The commissioner shall be responsible for protecting the privacy and security of the health care information reported to the SPARCS program.
(d)
Requests
for SPARCS data.
(1) SPARCS data may be
used for medical or scientific research or statistical or epidemiological
purposes approved by the commissioner.
(2) The commissioner may determine that
additional purposes are proper uses of SPARCS data.
(3) In determining the purpose of a request for
SPARCS data, the SPARCS program shall not be limited to information contained in
the data request form and may request supplemental information from the
applicant.
(4) The commissioner shall
charge a reasonable fee to all persons and organizations receiving SPARCS data
based upon costs incurred and recurring for data processing, platform/data center
and software. The commissioner may discount the base fee or waive the fee upon
request to the SPARCS program. The fee may be waived in the following
circumstances:
(i) Use by a health care
facility of the data it submitted to the SPARCS program.
(ii) Use by a health care facility that is
licensed under article 28 of the Public Health Law for the purpose of rate
determinations or rate appeals and for health care-related research.
(iii) Use by a Federal, New York State, county
or local government agency for health care-related purposes.
(5) The SPARCS program shall follow applicable
Federal and State laws when determining whether SPARCS data contain identifying
data elements may be shared and whether a disclosure of SPARCS data constitutes
an unwarranted invasion of personal privacy.
(6) All entities seeking SPARCS data must
submit a request to the SPARCS program using standard data request forms
specified by the SPARCS program. Data users shall take all necessary precautions
to prevent unwarranted invasions of personal privacy resulting from any data
analysis or release. Data users may not release any information that could be
used, alone or in combination with other reasonably available information, to
identify an individual who is a subject of the information. Data users bear full
responsibility for breaches or unauthorized disclosures of personal information
resulting from use of SPARCS data. Applications for SPARCS data must provide an
explicit plan for preventing breaches or unauthorized disclosures of personal
information of any individual who is a subject of the information.
(7) Each data request form must include an
executed data use agreement in a form prescribed by the SPARCS program. Data use
agreements are required of: a representative of the requesting organization; a
representative of each other organization associated with the project; and all
individuals who will have access to any data including identifying data
elements.
(8) The SPARCS program
shall publish and make publicly available the name of the project director, the
organization, and the title of approved projects.
(9) The SPARCS administrator shall review and
make recommendations on requests for SPARCS data containing identifying data
elements to a data release committee established by the commissioner. The data
release committee shall have at least three members, including at least one
member not otherwise affiliated with NYSDOH. The members of the data release
committee shall be posted on the NYSDOH website. Requests will be granted only
upon formal, written approval for access by a majority of the members of the data
release committee. The commissioner has the final authority over the approval, or
disapproval, of all requests. Requests for identifying data elements shall be
approved only if:
(i) the purpose of the
request is consistent with the purposes for which SPARCS data may be
used;
(ii) the applicant is qualified
to undertake the project; and
(iii)
the applicant requires such identifying data elements for the intended project
and is able to ensure that patient privacy will be protected.
(10) The SPARCS administrator may
recommend approval of a request in which future SPARCS data is to be supplied on
a periodic basis under the following conditions:
(i) SPARCS data may be requested for a
predetermined time not to exceed three years beyond the current year provided
that the organization and uses of the data remain as indicated in the data
request form submitted to the SPARCS program.
(ii) During the period of retention of SPARCS
data, no additional individuals may access SPARCS data without an executed data
use agreement on file with the SPARCS program.
(11) The commissioner may rescind for cause, at
any time, approval of a data request.
(e)
Penalties.
(1) Any person or entity that violates the
provisions of this section or any data use agreement may be liable pursuant to
the provisions of the Public Health Law, including, but not limited to, sections
12 and
12-d of the Public Health Law.
(2) Any person or entity that violates the
provisions of this section or any data use agreement may be denied access to
SPARCS data.
Notes
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