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Current as of January 02, 2024 | Updated by FindLaw Staff
(a) Each licensed ambulatory surgical treatment center (ASTC) and each licensed outpatient diagnostic center (ODC) shall report all claims data found on the appropriate form on every discharge to the executive director of the health facilities commission. ASTCs and ODCs shall file joint annual reports as required by the health facilities commission. ASTCs and ODCs shall submit the data through third party entities approved by the health facilities commission for the purpose of editing the data according to rules and regulations established by the executive director. The ASTCs and ODCs shall be responsible for the costs associated with processing of the data by the approved vendors. An ASTC and an ODC shall report the claims data at least quarterly to the executive director. No information shall be made available to the public by the executive director that reasonably could be expected to reveal the identity of any patient. The claims data reported to the executive director under this section are confidential and not available to the public until the executive director processes and verifies the data. The executive director shall prescribe conditions under which the processed and verified data are available to the public and shall establish policies for the release of HIPAA compliant limited use data sets.
(b) A licensed ASTC and ODC shall pay to the executive director a civil penalty of five cents (5¢) for each day the claims data discharge report is delinquent. A claims data report is delinquent if the executive director does not receive it before sixty (60) days after the end of the quarter. If the executive director receives the report in incomplete form, the executive director shall notify the ASTC and ODC and provide fifteen (15) additional days to correct the error. The notice shall provide the ASTC and ODC an additional fifteen (15) days to complete the form and return it to the executive director prior to the imposition of any civil penalty. The maximum civil penalty for a delinquent report is ten dollars ($10.00) for each discharge record. The executive director shall issue an assessment of the civil penalty to the ASTC and ODC. The ASTC and ODC has a right to an informal conference with the executive director, if the ASTC and ODC requests the conference within thirty (30) days of receipt of the assessment. After the informal conference or, if no conference is requested, after the time for requesting the informal conference has expired, the executive director may proceed to collect the penalty by setting the penalty off against funds owed to the ASTC and ODC or by instituting litigation.
(c) In its request for an informal conference, the ASTC and ODC may request the executive director to waive the penalty. The executive director may waive the penalty in cases of an act of God or other acts beyond the control of the ASTC and ODC. Waiver of the penalty is in the sole discretion of the executive director. None of these proceedings are subject to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
(d) No person or entity may be held liable in any civil action with respect to any report or disclosure of information made under this section, unless the person or entity has knowledge of any falsity of the information reported or disclosed.
(e) This section shall not affect or replace any other reporting responsibility placed upon ASTCs. The report filed pursuant to this section shall not be required for discharges reported by ASTCs under § 68-3-505.
(f) The claims data required to be reported by this section shall be collected and reported only to the extent it is collected and reported in the normal billing process, unless other claims data is deemed by the executive director to be essential to the development or use of the ASTC claims data reporting system, in which case the identified data that is outside the normal billing process must be collected and reported; provided, however, that other claims data that may be required to be collected and reported shall be consistent with data required to be collected and reported by other healthcare providers. Any data that is submitted to the executive director pursuant to this section shall be made available to the public no more frequently and no sooner after the data is submitted than the data collected and reported by licensed hospitals pursuant to § 68-1-108.
Cite this article: FindLaw.com - Tennessee Code Title 68. Health, Safety and Environmental Protection § 68-1-119 - last updated January 02, 2024 | https://codes.findlaw.com/tn/title-68-health-safety-and-environmental-protection/tn-code-sect-68-1-119/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
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