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Tenn. Code Ann. § 56-2-125 - Establishment and Maintenance of an All-Payer Claims Database and Establishment of a Tennessee Health Information Committee

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The commissioner of commerce and insurance must establish and maintain an all-payer claims database (comprised of insurer data) to enable the commissioner of finance and administration to do the following:

  1. Improve the accessibility and affordability of patient health care and coverage;
  2. Identify health care needs;
  3. Determine resource allocation;
  4. Evaluate the effectiveness of treatment programs;
  5. Review costs among treatment settings and across providers;
  6. Provide the public with information regarding providers’ quality of care.

The all-payer claims database must be HIPAA compliant, and not release any individually identifiable data.  The database must use unique patient identifiers, and cannot include identifying information, such as patient name, address, phone numbers, social security numbers, or other such information.  All group health plans and health insurance issuers must submit claims data to the Commissioner electronically. 

The law also calls for the establishment of a health information committee, which is to make recommendations.  The Committee has the authority to publicly release information from the all-payer claims database.  The source data, reports, and other information pertaining to the database must remain confidential and is not subject to public inspection unless released by the health information committee.

Current as of June 2015