Hawaii Administrative Code

The rules in this chapter govern the submission of information by health care providers doing business in the State to the state health pluming and development agency. The rules in this chapter are adopted by the State pursuant to chapter 3230, Hawaii. Revised Statutes, to carry …

The rules in this chapter shall be Liberally Construed to promote the submission of information by health care provider doing business in the State to the state health planning and development agency, in order to facilitate informed health planning and resources development in th…

Any inpatient health care facility in case facility in the State shall file with the agency; (1) Five year plans and one year plans in the format prescribed by the agency; (2) Quarterly inpatient utlilization reports in the format prescribed by the agency. Each report shall be fi…

If any provision of this chapter, or the application thereof to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of the chapter which can be given effect without the invalid provisions of this chapter are severable. Notes…

The rules in this chapter govern the submission of administrative data by providers of health insurance that provide health benefit plans funded by the Hawaii employer-union health benefits trust fund and the state medicaid agency, to the state health planning and development age…

To minimize the risk of data breaches and re-identification of data, the data and information submitted to the agency shall include only the minimum protected health information identifiers according to the data submission guide necessary to link the public and private data sourc…

Mandatory and voluntary reporters shall comply with the data submission guide. The data submission guide may be -amended annually. Notes Haw. Code R. § 11-188-11 [Eff 3/17/2018] (Auth: HRS §§ 323D-12, 323D-18.5, 323D-62) (Imp: HRS §§ 323D-12, 323D-18.5)

All data shall be submitted through secure file transfer protocol or media that is properly encrypted in accordance with the data submission guide. No data shall be sent to the agency or any of the agency's designees without proper encryption. Notes Haw. Code R. § 11-188-12 [Eff …

(a) All data shall be submitted to the agency or the agency's designee, as separate files in the format described in the data submission guide. (b) Files shall be encrypted and submitted in the method specified by the data submission guide. (c) All submissions shall include the f…

Mandatory and voluntary reporters shall submit test data as specified in the data submission guide to the agency or the agency's designee. The agency may request additional submissions of test data as needed. Notes Haw. Code R. § 11-188-14 [Eff 3/17/2018] (Auth: HRS §§ 323D-12, 3…

Upon submission, the agency or the agency's designee shall evaluate each submitted file against thresholds and standards pursuant to the data submission guide. Reporters with nonconforming files shall be notified of the noncompliance. Reporters shall correct and resubmit nonconfo…

Voluntary reporters, with approval of the administrator, may submit health care claims data to the agency or the agency's designee. Voluntary reporters -shall enter into an agreement with the agency or the agency's designee prior to submitting health care claims data, in a format…

(a) Reporters who temporarily cannot meet the terms and conditions of this chapter shall submit a written request to the administrator as soon as the reporter has determined that an extension or waiver is required. Reporters shall follow procedures identified in the data submissi…

It is the policy of the agency to hold itself accountable for the privacy and security of the data entrusted to it while keeping that data accessible for appropriate use. Notes Haw. Code R. § 11-188-18 [Eff 3/17/2018] (Auth: HRS §§ 323D-12, 323D-18.5, 323D-62) (Imp: HRS §§ 323D-1…

The agency shall develop an annual plan for the protection, collection per the parameters specified in the data submission guide, analysis, maintenance, and publication of data collected The agency shall seek approval for the annual plan from the director of health, administrator…

As used in this chapter, unless a different meaning clearly appears in the context: "Administrative data" or "data" means: (1) Statistical and financial reports of information; (2) Provider invoices or similar patient encounter data; (3) Records of services used for or resulting …

The agency and the agency's designees shall use the data for studies on the cost and quality of care, population health, health disparities, consumer transparency in the cost and quality of health care, health care planning, and to inform public policy. Initial studies will be co…

(a) The agency shall, at a minimum, issue reports from the health care claims data at an aggregate level to describe patterns of incidence and variation of targeted medical conditions, state and regional cost patterns, and utilization of services. (b) The health care claims data …

A government agency engaged in efforts to improve health care or public health outcomes for members under health benefits plans funded by the EUTF or the state medicaid agency may request a specialized report, excluding personally identifiable information, from the agency by subm…

This subchapter addresses the information security, data privacy, and confidentiality concerns for health care claims data. Notes Haw. Code R. § 11-188-23 [Eff 3/17/2018] (Auth: HRS §§ 323D-12, 323D-18.5, 323D-62, 487N-1; 45 C.F.R. part 164 ) (Imp: HRS §§ 323D-12, 323D-18.5)…

The agency, the agency's designees, and any recipient of data, such as subcontractors and business associates, shall comply with the applicable Health Insurance Portability and Accountability Act's security, privacy, and confidentiality rules, including uses and disclosures requi…

The agency, the agency's designees, such as subcontractors and business associates of the agency or the agency's designee, shall maintain the original direct personal identifiers in a separate database that is not linked with any other data and shall use a proxy or encrypted reco…

The agency and the agency's designees, shall not attempt to re-identify subjects of protected health information submitted to the agency or its designee. Notes Haw. Code R. § 11-188-26 [Eff 3/17/2018] (Auth: HRS §§ 323D-12, 323D-18.5, 323D-62) (Imp: HRS §§ 323D-12, 323D-18.5)…

No person or entity shall disclose data that contain direct personal identifiers. No report shall include a cell size of ten or less to prevent the re-identification of individuals. Notes Haw. Code R. § 11-188-27 [Eff 3/17/2018] (Auth: HRS §§ 323D-12, 323D-18.5, 323D-62) (Imp: HR…

If any provision of this chapter, or the application thereof to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of the chapter which can be given effect without the invalid provision or application, and to this end the p…

Data governance is the exercise of authority and management planning, oversight, monitoring, and securing the health care claims data entrusted to the agency and its designee(s). Data governance at the agency fosters a culture of shared responsibility, accountability and active p…

The goals of data governance at the agency are to: (1) Promote the use of claims data to enable studies on the cost and quality of care, population health, health disparities, consumer transparency in the cost and quality of health care, health care planning, and to inform public…

Data governance applies to the following: (1) State employees, contractors, or any of the agency's designees including their employees, and agents (including out of state governmental entities or nonprofits and private firms or entities and individuals, third party administrators…

(a) The steering committee's responsibilities include:(1) Providing project direction and executive leadership; (2) Reviewing, requiring changes, and approving the annual plan developed by the agency; (3) Defining clear and consistent structures, models, and processes that promot…

All members of the steering committee shall meet the conflicts of interest requirements of title 42 U.S.C. section 300gg-94(d)(2). Members of the steering committee shall not be controlled or influenced by, and may not have any corporate relation to, any individual or entity that…

All data shall be submitted in the form and manner compliant with the data submission guide. Notes Haw. Code R. § 11-188-8 [Eff 3/17/2018] (Auth: HRS §§ 323D-12, 323D-18.5, 323D-62) (Imp: HRS §§ 323D-12, 323D-18.5)

Mandatory reporters or their designees shall regularly submit health care claims data to the agency or the agency's designee, for each applicable health line of business, including but not limited to, comprehensive major medical plans, third party administrator plans, administrat…

To prescribe procedures to be utilized by the department of health (DOH) to provide safe drinking water during emergency situations. Notes Haw. Code R. § 11-19-1 [Eff. 11/27/81] (Auth: HRS §§ 340E-5, 340E-9) (Imp: HRS §§ 340E-5, 340E-9, 42 U.S.C. §300 g - 2(a)(5) )

As used in this chapter: "CDA" means Civil Defense Agency. "Corps" means United States Army Corps of Engineers. "DHO" means the state department of health district health officer or district health office, as appropriate. "DOH" means the state department of health. "DWS" means th…

(a) "Type A" emergencies are major state or county disasters and include: nuclear disasters, tsunamis, earthquakes, volcano eruptions, floods, hurricanes and tornadoes. Type A disasters will most likely be characterized by: (1) Relatively widespread disruption of many basic publi…

The primary responsibilities of DOH on all emergency circumstances involving drinking water shall be: (1) To coordinate with other governmental agencies and the private sector to provide drinking water supplies to areas deprived of such supplies as a result of the emergency. (2) …

(a) "Type A" and "Type B" emergencies county water systems. (1) The state and all county government agencies in Hawaii shall have emergency response plans, to deal with drinking water problems. (2) Each county department of water supply shall have a plan, updated at least yearly,…

(a) The DOH has neither the equipment nor the expertise to actually "provide" water in an emergency nor does it have generally-recognized authority to mobilize such equipment, expertise, or other resources from a wide range of public and private agencies. (b) Primary responsibili…

(a) "Type A" emergencies. (1) The state CDA shall notify DOH emergency health mobilization coordinator who shall notify the chief, EPHSD. The chief, EPHSD, shall notify the drinking water supervisor, EPHSD; chief, laboratories branch, MHSD; and DHO. (2) The county CDA shall notif…

(a) "Type A" emergencies. (1) The DOH and CDA shall determine response priorities, resource allocation, and activities in consultation with appropriate DOH personnel. (2) Within the DOH as relating to drinking water, the DHO in consultation with the chief, EPHSD, shall determine …

The list located at the end of this chapter entitled "Contact List" dated September 1981 provides addresses and telephone numbers of certain agencies and officials relevant to this emergency plan, accurate as to the effective date of this rule. The DOH shall receive, keep, and ma…

(a) General requirements The requirements of this section constitute national primary drinking water regulations This section establishes requirements for filtration and disinfection that are in addition to criteria under which filtration and disinfection are required under secti…

(a) Samples shall be taken by suppliers of water for public water systems using surface water sources in whole or in part. Turbidity measurements shall be made by the Nephelometric Method 2130B cited in the 18th edition of Standard Methods for the Examination of Water and Wastewa…

If any provision of this chapter, or the application thereof to any person or circumstance, is held invalid, the invalidity does not affect other provisions of applications of this chapter which can be given effect without the invalid provision or application, and to this end the…

(a) Community water systems shall conduct monitoring to determine compliance with the MCLs specified in section 11-20-3 in accordance with this section. Non-transient, non-community water systems shall conduct monitoring to determine compliance with the MCLs specified in section …

(a) (Reserved) (b) (Reserved) (c) (Reserved) (d) (Reserved) (e) Analysis for the contaminants in section 11-20-4(d) and (e) shall be conducted using the EPA methods cited in 40 C.F.R. § 141.24(e), or alternative methods listed in Appendix A to Title 40 Code of Federal Regulations…