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OHCA Policies and Rules

317:30-3-35.  Oklahoma Statewide Health Information Exchange

[Revised 08-03-23]

(a) Authority.  This rule is promulgated under the authority granted in Title 63 of the Oklahoma Statutes Section 1-133 (63 O.S. § 1-133).  This Section is intended to be read in conjunction with applicable Oklahoma statutes and federal law.

(b) Applicability and purpose.

(1) Applicability.  This section shall apply to and govern the establishment and operation of the statewide health information exchange (HIE)

(2) Purpose.  The Office of the State Coordinator for HIE is the office within the Oklahoma Health Care Authority (OHCA) that holds the power and duty to oversee the state-designated entity (SDE) for HIE.

(c) Definitions.  The following words and terms, when used in this Section, shall have the following meaning, unless the context clearly indicates otherwise:

(1) "Health care provider" means any public or private organization, corporation, authority, partnership, sole proprietorship, association, agency, network, joint venture, or other entity that is established and licensed, certified, or otherwise authorized by the laws of this state to administer health care in the ordinary course of business or practice of a profession and/or employs licensed health care workers in the State of Oklahoma.  Health care provider includes but is not limited to facilities such as:  ambulatory surgery centers, clinics, home care agencies, hospices, hospitals, intermediate care facilities, laboratories, long-term care agencies, medical centers, mental health and substance use disorder treatment centers, nursing homes, PACE centers, pharmacies, physicians' offices, psychiatric hospitals, public health clinics, and rehabilitation centers.

(2) "Health Information Exchange (HIE)" means the electronic movement of health-related information among organizations according to nationally recognized standards for purposes including, but not limited to payment, treatment, and administration.

(3) "Health information exchange organization" means an entity whose primary business activity is health information exchange and which is governed by its stakeholders.

(4) "OKSHINE" means the Oklahoma Statewide Health Information Network and Exchange, a collective effort of the Office of the State Coordinator and SDE in support of statewide health information exchange.

(5) "Report data to" means that health care providers shall establish a direct, secure connection to the state designated entity for HIE and submit data according to the United States Core Date for Interoperability (USCDI) standard.  The form and format are further defined in the specifications on the OKSHINE website.  Providers shall transmit data types they collect within their Electronic Health Record, with the exception of any data that:  1) the provider determines to be sensitive patient information that is to be suppressed from transmission to the SDE; 2) is subject to a patients' request for exclusion, consistent with a provider-implemented policy; or 3) such transmission would violate state or federal law or regulation.

(6) "State designated entity (SDE)" means the health information exchange organization designated by the State of Oklahoma.  The name and contact information for the state designated entity for HIE is found on the OKSHINE website.

(7) "Utilize" means to actively use the HIE services to securely access records during and/or in support of patient treatment or health care operations.

(d) Required participation.

(1) All health care providers as defined above and who are licensed by and located in the state of Oklahoma and are not otherwise exempted, shall submit an application to report data to and utilize the SDE.  Providers may register for an exemption from required participation as specified in paragraph (f) of this Section.

(2) Paragraph (d) of this Section shall not apply to:

(A) A health care provider that does not currently own or subscribe to an electronic health records technology system or service.

(B) Health care providers classified as substance abuse treatment facilities covered by 42 Code of Federal Regulations (CFR) Part 2.

(3) Patient-specific protected health information requiring patient consent prior to disclosure, shall only be disclosed in compliance with relevant state or federal privacy laws, rules, regulations, or policies including, but not limited to, the Health Insurance Portability and Accountability Act of 1996, and any laws that require patient consent prior to sharing health information.

(4) The state acknowledges that establishing the connection to the HIE can take substantial time to complete.  A health care provider will be considered to have met the requirement to report data to the SDE as long as the provider is actively engaged with the HIE in the onboarding process of connecting to the HIE, and as reported by the SDE.

(5) In order to meet the requirement to utilize the SDE, each health care provider shall secure access to HIE services by the following:

(A) Completing and maintaining an active participation agreement with the SDE for HIE;

(B) Executing annually an order form electing at a minimum the set of core services relevant to the provider practice or organization; and

(C) Maintaining good standing as a participating organization in the SDE for HIE by remaining compliant with the terms and conditions, network policies and procedures, and paying all fees associated with the services elected on the order form.

(e) Fees.

(1) Subscription fees.  Health care providers as defined in this section are required to subscribe and to pay a subscription fee directly to the SDE on a monthly or annual basis.  Subscription fees are determined based on the organization type and size.  Subscription fee schedule is established by the SDE based on network operating costs as approved by the SDE board and can be obtained upon request to the SDE.  The Office of the State Coordinator for HIE shall receive notice from the SDE of the established subscription fee schedule or changes to the fee schedule no later than ninety (90) days prior to the effective date.

(2) Connection fees.  Health care providers as defined in this section are required to connect their electronic health record to the SDE to securely report data to the HIE.  This is a variable one-time fee paid to the SDE.  The Office of the State Coordinator for HIE shall receive notice of connection fees established by the SDE no later than thirty (30) days of being established.

(3) Grant funds.  Health care providers may apply for a grant to cover connection fees subject to the availability of funds.  Grant fees for connection will be paid directly to the SDE on behalf of the provider.  Information on grant eligibility can be found on OKSHINE website.

(f) Exemptions.

(1) Any health care provider as defined in paragraph (c) of this section may register an exemption from reporting data to the SDE and/or utilizing the HIE on the OKSHINE website by registering an exemption with the Office of the State Coordinator for HIE.

(2) All providers that register an exemption shall be granted such exemption and shall not be subject to pay subscription fees and/or connection fees.

(3) The exemption will automatically renew annually unless the provider withdraws their exemption and elects to participate.

Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.