House Bill 102
By: Representatives Cooper of the 45th, Newton of the 127th, Silcox of the 53rd, Hawkins of
the 27th, and Au of the 50th
A BILL TO BE ENTITLED
AN ACT
To amend Chapter 2 of Title 31 of the Official Code of Georgia Annotated, relating to the
Department of Community Health, so as to provide for the establishment of the Georgia
Quality Reporting Project; to provide for definitions; to provide for the purposes of the
project; to provide for a working group; to provide for submission of clinical data; to provide
for processing of clinical data with claims data; to provide for penalties; to amend Code
Section 33-6-4 of the Official Code of Georgia Annotated, relating to enumeration of unfair
methods of competition and unfair or deceptive acts or practices and penalty, so as to provide
for conforming changes; to provide for related matters; to repeal conflicting laws; and for
other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
Chapter 2 of Title 31 of the Official Code of Georgia Annotated, relating to the Department
of Community Health, is amended by adding a new Code section to read as follows:
<ins>"31-2-20.
(a) As used in this Code section, the term:
</ins>
<ins>(1) 'Direct personal identifiers' means information relating to a covered individual that
contains primary or obvious identifiers, such as the individual's name, street address,
email address, telephone number, and social security number, but shall not include
geographic or demographic information that would prohibit the identification of a
covered individual.
(2) 'GQRP' means the Georgia Quality Reporting Project established pursuant to this
Code section.
(3) 'HEDIS' means the Healthcare Effectiveness Data and Information Set.
(4) 'Qualified Health Information Network' or 'QHIN' means a network certified by the
secretary of the United States Department of Health and Human Services and the
assistant secretary for technology policy/office of the National Coordinator for Health
Information Technology that meets all of the Trusted Exchange Framework and Common
Agreement requirements established by the federal 21st Century Cures Act, P.L. 114-255,
and utilizes a quality measure calculation product certified by the National Committee
for Quality Assurance for HEDIS reporting.
(5) 'Submitting entity' means a Medicaid care management organization that contracts
with the department to arrange healthcare services for Medicaid recipients.
(b)(1) The department shall facilitate the establishment of the Georgia Quality Reporting
Project. The purpose of the GQRP shall be to:
(A) Gauge the quality of treatment for opioid use disorder and healthcare overall;
(B) Improve the quality of care to Georgia residents;
(C) Reduce the overall cost of medical treatment and care in this state; and
(D) Foster clinical research in this state.
(2) The department may enter into agreements with the administrator of the Georgia
All-Payer Claims Database established pursuant to Article 3 of Chapter 53 of this title
and the Georgia Data Analytic Center established pursuant to Part 3 of Article 4 of
</ins>
<ins>Chapter 12 of Title 45 for purposes of establishing the GQRP and accomplishing its
purposes.
(c) The department shall facilitate the establishment of a GQRP use case working group
for the purpose of creating a framework and implementation plan for the GQRP.
(d) Beginning January 1, 2028, and every month thereafter, all submitting entities shall be
required to transmit clinical data collected through the methods and formats established by
the federal Department of Health and Human Services' Electronic Clinical Quality
Measures Fast Health Information Resources standards to the department. Such data shall
be transmitted either directly or through QHIN connections implemented by such
submitting entities. Such data shall include:
(1) Clinical data from electronic health records for all Georgia healthcare organizations
who provide substance use disorder care to Medicaid patients to evaluate opioid care in
this state; and
(2) Clinical data from electronic health records to report relevant state level quality
measures to evaluate the quality of care and improve clinical outcomes for in-state
patients.
(e) Beginning January 1, 2029, and every month thereafter, the clinical data collected
pursuant to subsection (d) of this Code section shall be converted and combined with all
claims data to calculate state level opioid statistics and relevant state level quality measures
available in the HEDIS data sets. A nationally recognized and standardized National
Committee for Quality Assurance accredited process shall be used for the calculation of
relevant HEDIS quality measures.
(f) Direct personal identifiers contained in clinical data transmitted pursuant to this Code
section shall not be considered a public record and shall not be subject to Article 4 of
Chapter 18 of Title 50, relating to open records.
</ins>
<ins>(g) The collection, storage, and release of healthcare data and other information pursuant
to this Code section shall be subject to the federal Health Insurance Portability and
Accountability Act (HIPAA) of 1996, P.L. 104-191.
(h) Except as otherwise provided in this Code section, any submitting entity that fails to
submit clinical data in accordance with this Code section shall be subject to penalty. The
department shall adopt a schedule of penalties not to exceed $1,000.00 per day of violation,
determined by the severity of the violation. A penalty imposed under this subsection may
be remitted or mitigated upon such terms and conditions as the department considers proper
and consistent with the public health and safety. Any fines collected pursuant to this
subsection shall be deposited into the state treasury.
(i) Any submitting entity that is subject to the jurisdiction of the Commissioner of
Insurance that fails to submit clinical data in accordance with this Code section shall be
subject to violation of paragraph (14.2) of subsection (b) of Code Section 33-6-4, and any
other penalties that may be imposed by the Commissioner of Insurance. The department
may refer violations by such submitting entities to the Commissioner of Insurance for
enforcement action for each instance in which such submitting entity fails to submit clinical
data to the department in accordance with this Code section and in accordance with any
rules and regulations established for such purpose.
(j) No healthcare provider contracting with a submitting entity to provide healthcare
services to Medicaid recipients shall be required to incur any direct or indirect expense
related to the compliance by a submitting entity with the requirements of this Code section."
</ins> SECTION 2.
Code Section 33-6-4 of the Official Code of Georgia Annotated, relating to enumeration of
unfair methods of competition and unfair or deceptive acts or practices and penalty, is
amended by revising paragraph (14.2) of subsection (b) as follows:
"(14.2) Failing to submit all claims data to the Georgia All-Payer Claims Database as
required in Article 3 of Chapter 53 of Title 31 <ins>or failing to submit all clinical data to the
department as required in Code Section 31-2-20;"
</ins> SECTION 3.
All laws and parts of laws in conflict with this Act are repealed.