153.50 Protection of patient confidentiality.

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153.50 Protection of patient confidentiality. Subject to s. 153.455 :

(1)Definitions. In this section:

1. “Patient-identifiable data”, for information submitted by hospitals and ambulatory surgery centers, means all of the following data elements:

a. Patient medical record or chart number.

b. Patient control number.

c. Patient date of birth.

d. Date of patient admission.

e. Date of patient discharge.

f. Date of patient’s principal procedure.

g. Encrypted case identifier.

h. Insured’s policy number.

i. Patient’s employer’s name.

j. Insured’s date of birth.

k. Insured’s identification number.

L. Medicaid resubmission code.

m. Medicaid prior authorization number.

1m. “Patient-identifiable data” does not include calculated variables that are derived from patient-identifiable data and the dissemination of which does not permit patient identification.

1r. “Patient-identifiable data” does not include data elements that identify a patient’s race or ethnicity.

2. “Patient-identifiable data”, for information submitted by health care providers who are not hospitals or ambulatory surgery centers and by insurers and administrators, means all of the following data elements:

a. Data elements specified in subd. 1. a. to g. , L. and m.

b. Whether the patient’s condition is related to employment, and occurrence and place of an auto accident or other accident.

c. Date of first symptom of current illness, of current injury or of current pregnancy.

d. First date of the patient’s same or similar illness, if any.

e. Dates that the patient has been unable to work in his or her current occupation.

f. Dates of receipt by the patient of medical service.

g. The patient’s city, town or village.

(c)“Small number” means a number that is insufficiently large to be statistically significant, as determined by the department.

(3)Measures to ensure protection of patient identity. To ensure that the identity of patients is protected when information obtained by the department, by the entity under contract under s. 153.05

(a), or by the data organization under contract under s. 153.05

(2r)is disseminated, the department, the entity, and the data organization shall do all of the following:

(a)Aggregate any data element category containing small numbers. The department, in so doing, shall use procedures that are developed by the department and that follow commonly accepted statistical methodology.

(b)Remove and destroy all of the following data elements on the uniform patient billing forms that are received by the department, the entity, or the data organization under the requirements of this subchapter:

1. The patient’s name and street address, except as provided under sub.

(am).

2. The insured’s name, address and telephone number.

3. Any other insured’s name, employer name and date of birth.

4. The signature of the patient or other authorized signature.

5. The signature of the insured or other authorized signature.

6. The signature of the physician.

7. The patient’s account number, after use only as verification of data by the department or by the entity.

(c)Develop, for use by purchasers of data under this subchapter, a data use agreement that specifies data use restrictions, appropriate uses of data and penalties for misuse of data, and notify prospective and current purchasers of data of the appropriate uses.

(d)Require that a purchaser of data under this subchapter sign and have notarized the data use agreement of the department, the entity, or the data organization, as applicable.

(3m)Provider, administrator, or insurer measures to ensure patient identity protection. A health care provider that is not a hospital or ambulatory surgery center or an insurer or an administrator shall, before submitting information required by the department, or by the data organization under contract under s. 153.05

(2r), under this subchapter, convert to a payer category code as specified by the department or the data organization, as applicable, any names of an insured’s payer or other insured’s payer.

(4)Release of patient-identifiable data.