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Health Information Technology in Tennessee

        Tennessee has taken steps to utilize information technology in the disclosure, use and collection of health information.  One way in which the state has done so is through the all-payer claims database, established by the commissioner of commerce and insurance.  The database is comprised of health insurance issuer and group health plans information, and enables the commissioner of finance and administration to, among other things, determine resource allocation, evaluate the effectiveness of intervention programs on improving patient outcomes, and provide publicly available information on health care providers’ quality of care.  In conjunction with the all-payer claims database, the state established a health information committee, which forms recommendations and policies regarding the database for consideration by the commissioner of finance and administration.  All group health plans and health insurance issuers must provide electronic health insurance claims data for state residents to the commissioner of commerce and insurance; all plans and issuers that collect the health employer data and information set (HEDIS) must also annually submit such information to the commissioner.1

        Another method by which Tennessee encourages the use of information technology is its authorization for establishment of electronic reporting systems by the inspector general and the Medicaid Fraud Control Unit (MCFU) for use by physicians in reporting TennCare-related fraud.2

 

Footnotes

  • 1. Tenn. Code Ann. § 56-2-125 (2012)
  • 2. Tenn. Code Ann. § 71-5-2603 (2012)

 

Health Information Technology in Tennessee

Subtopic Statute/Regulation Description
Health Information Technology Tenn. Code Ann. § 56-2-125 - Establishment and Maintenance of an All-Payer Claims Database and Establishment of a Tennessee Health Information Committee The commissioner of commerce and insurance must establish and maintain an all-payer claims database (comprised of insurer data) to enable the...
Tenn. Code Ann. § 71-5-2603 - TennCare Fraud Reporting Requirements and Immunity From Liability All managed care organizations, contractors, providers or other person or entity must advise the Tenn Care office if there is actual knowledge that a...