RELATING TO HOSPITAL DISCHARGE DATA.

HB1869

HOUSE OF REPRESENTATIVES

H.B. NO.

1869

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

relating
to hospital discharge data
.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

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SECTION
1.
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The legislature finds that heath care
data can be a valuable tool to create and implement evidence-based health care
policies, which may result in better coordination and decision-making across
all participants in the health care landscape, from patients, to providers,
payors, and the State.

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The
legislature further finds that forty-eight states collect statewide inpatient hospital
discharge data and that more than thirty make a public-use file available for
research and public health.
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Some states
with similar population data or geographic isolation like Alaska, Delaware, Maine,
New Hampshire, and Rhode Island release or support the public use of hospital discharge
data through state agencies.

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The
legislature additionally finds that Hawaii has all-payer hospital discharge data,
historically via the Hawaii Health Information Corporation and now the Laulima Data
Alliance, but access for external users and consumers is limited.

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The
purpose of this Act is to:

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(1)
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Establish a statewide system for the collection,
audit, and public release of de‑identified hospital discharge data; and

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(2)
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Require the state health planning and development
agency to convene a working group to establish hospital discharge data
procedures.

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SECTION
2.
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Chapter 323D, Hawaii Revised
Statutes, is amended by adding a new subpart to part II to be appropriately
designated and to read as follows:

" .
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Hospital Discharge Data

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�323D-A
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Definitions
.
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As used in this subpart:

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"Acute
care" means inpatient general routine care provided to patients who are in
an acute phase of illness, which includes the concentrated and continuous
observation and care provided in the intensive care units of an institution.

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"Discharge"
means a patient's exit or release from a hospital to the patient's residence
following any medical care or treatment rendered to the patient following an
inpatient admission.

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"Emergency
department" means any department of any general hospital when a request is
made for emergency services and care for any emergency medical condition, which
is within the service capability of the hospital.

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"Entry"
means a patient's entrance into a hospital for the purpose of receiving
inpatient medical care.

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"Executive
officer" means a reporting facility's chief executive officer, chief
financial officer, chief operating officer, president, or any vice president of
the hospital in charge of a principal business unit, division, or function,
including administration or finance.

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"Hospital"
means an institution with an organized medical staff, regulated under section
321-11(10) that admits patients for inpatient care, diagnosis, observation, and
treatment, or is a facility licensed under section 321-14.5.

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"Hospital
discharge data" means the information required to be submitted under this subpart,
as developed and administered by the state agency.

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"Inpatient"
means a patient who has an admission order given by a licensed physician or
other individual who has been granted admitting privileges by the hospital.
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"Inpatient" does not include observation
patients.

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"Outpatient"
means a patient who has a surgical procedure that may be performed at an
organized ambulatory health care facility or emergency department and who does
not require overnight hospital care.

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"Patient"
means an individual admitted to a hospital, an organized ambulatory health care
facility or emergency department for inpatient or outpatient treatment or a
visit.

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"Reporting
facility" means a hospital, licensed short-term acute care hospital; licensed
organized ambulatory health care facility, emergency department, lithotripsy
center, or cardiac catheterization laboratory required to submit hospital
discharge data under this subpart.

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"Visit"
means a face-to-face encounter between a health care provider and a patient who
is not formally admitted as an inpatient in an acute care hospital setting at
the time of the encounter or who is not admitted to the same facility's acute
care hospital setting immediately following the encounter.

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�323D-B
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Hospital discharge data; inpatient reporting;
audit procedures.
�
(a)
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Beginning July 1, 2027, all hospitals shall submit,
at least quarterly, inpatient hospital discharge data reports to the state agency
according to the provisions and procedures established by the hospital discharge
data working group established pursuant to section 4 of Act ,
Session Laws of Hawaii 2026.

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(b)
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Each hospital shall submit a separate
inpatient hospital discharge data report for each location, or a combined
report with multiple locations; provided that each location and its hospital
discharge data shall be clearly identified in the report.

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(c)
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All live discharges and deaths, including
newborn live discharges and deaths, from the following settings shall be
reported:

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(1)
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Acute care;

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(2)
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Intensive care;

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(3)
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Long-term acute care;

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(4)
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Short-term and long-term psychiatric; and

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(5)
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Substance abuse and comprehensive
rehabilitation.

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(d)
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Upon notification by state agency staff,
hospitals shall provide access to all required information from the medical
records and billing documents underlying and documenting the inpatient hospital
discharge data reports submitted, as well as other inpatient related
documentation deemed necessary to conduct complete inpatient hospital discharge
data audits.

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(e)
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The following provisions shall apply for
inpatient hospital discharge data reports submitted pursuant to this section:

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(1)
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Any inpatient who is transferred or discharged
from the acute care setting into a rehabilitative care distinct part unit or
free-standing hospital shall be reported as a separate record from the
patient's acute care record; provided that the report shall distinguish the
discharge records as either :

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(A)
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Data type one, for an acute care discharge
record; or

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(B)
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Data type two, for a comprehensive
rehabilitative therapy discharge record;

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(2)
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If an inpatient is administratively
transferred or formally discharged from the acute care setting into a distinct part
of a medicare-certified skilled nursing unit or to hospice care, reporting
accountability shall cease at the time of discharge or transfer.
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Patients receiving sub-acute care in these
settings shall be excluded from the reporting requirements under this section;

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(3)
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Observation patients shall not be included in
the inpatient hospital discharge data reports unless admitted to the hospital
as an inpatient; and

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(4)
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When reporting visits, the hospital shall
record each instance that requires the patient to appear in an ambulatory
setting before the actual procedure; provided that a visit that occurs one or
more days before the procedure shall be considered as one visit; provided
further that the admit date in this instance shall be the day of the procedure.

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�323D-C
�
Hospital discharge data; organized ambulatory
health care facility and emergency department reporting; audit procedures.
�
(a) Beginning July 1, 2027, the following
entities shall submit, at least quarterly, hospital discharge data reports, to
the state agency according to the provisions and procedures established by the hospital
discharge data working group established pursuant to section 4 of Act
, Session Laws of Hawaii 2026.:

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(1)
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Licensed short-term acute care hospitals;

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(2)
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Licensed organized ambulatory health care
facilities;

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(3)
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Emergency departments;

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(4)
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Lithotripsy centers; and

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(5)
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Cardiac catheterization laboratories.

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(b)
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Each entity shall submit a separate hospital
discharge data report for each location.

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(c)
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All services for non-emergency visits for
surgical procedures or services performed in the operating room; ambulatory
surgical care; cardiology, including
cardiac catheterization and
percutaneous
transluminal coronary angioplasty; gastrointestinal; extra-corporeal shock wave
treatment or lithotripsy
surgery; and endoscopy shall be included in the reports required under
this section.

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�323D-D
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Certification; resubmission of reports;
change in personnel.
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(a)
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The executive officer, administrator, or
authorized designee of every reporting facility required to submit hospital
discharge data reports to the state agency under this subpart shall certify
that the reports are accurate, complete, and verifiable.

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(b)
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The executive officer, administrator, or
authorized designee of a reporting facility may submit a written request to the
state agency to amend certified hospital discharge data reports submitted under
sections 323D-B or 323D-C.
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Requests to
resubmit a report shall be made within twelve months following the initial
submission due date.
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The written request
shall specify the reason for the corrections or changes; explain the cause
contributing to the inaccurate reporting; describe a corrective action plan to
prevent future errors; and indicate the total number of records affected by
quarters and years, the data type, and the date the amended hospital discharge
data report is to be submitted to the state agency.
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The state agency may grant approval for
resubmission if the state agency determines that the amended report will
significantly impact data quality.

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(c)
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A reporting facility shall notify the state
agency when a change in certain personnel occurs, including the reporting facility
contact who is responsible for handling the hospital discharge data submission,
the facility chief executive officer, or administrator.
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The notification shall include full names,
titles, applicable telephone and fax numbers, and electronic mail addresses of
the new personnel.

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�323D-E
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Data elements and codes; standards.
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All hospitals, organized ambulatory health care
facilities, and emergency departments submitting hospital discharge data
pursuant to this subpart shall report the

required data elements and
data element codes as required by the state agency, including but not be
limited to information on a standard claim form for institutional health care
providers used to bill for services to payers, including medicare, medicaid,
and private insurers, which captures patient info, diagnoses (ICD codes),
procedures, dates, charges, and provider details for inpatient or outpatient
care as designed by the National Uniform Billing Committee.

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�323D-F
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Hospital discharge data reports; public
inspection.
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(a)
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The state agency shall make hospital
discharge data reports available for public inspection during normal business
hours.
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The state agency may charge a
reasonable fee for the cost of copying a report under this section.

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(b)
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Patient-specific records collected by the
state agency shall be exempt from disclosure and shall not be released unless the
following patient information has been de-identified:

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(1)
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Name and any other assigned name or number by
the hospital;

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(2)
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Social security number;

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(3)
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Birth date; provided that age in years may be
disclosed;

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(4)
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Entry date;

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(5)
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Discharge date;

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(6)
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Procedure date; provided that the number of
days from admission to the procedure may be substituted;

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(7)
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Other procedure date; provided that the number
of days from admission to other procedure may be substituted; and

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(8)
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Medical or health record number."

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SECTION
3
.
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Chapter 323D, Hawaii Revised Statutes, is
amended by designating sections 323D-11 through 323D-18.6 as subpart A and
inserting a title before section 323D-11 to read as follows:

"
A.
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State Health Planning and Development Agency;
Council; Functions
"

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SECTION 4.
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(a)
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The
state health planning and development agency shall convene a hospital discharge
data working group no later than September 1, 2026, to develop the nature, scope,
and procedures for submission of the hospital discharge data required by this
Act.

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(b)
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The working group shall consist of the
following members, or their designee:

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(1)
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The director of health;

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(2)
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The administrator of the state health planning
and development agency;

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(3)
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The administrator of med-QUEST division of the
department of human services;

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(4)
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The insurance commissioner; and

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(5)
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A representative of the Hawaii health systems corporation.

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(c)
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The members of the working group shall invite
a representative from each of the following entities to be a member of the
working group:

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(1)
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Hawaii Health Information Exchange;

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(2)
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Healthcare Association of Hawaii;

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(3)
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The Queen's Health Systems;

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(4)
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Hawaii Pacific Health;

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(5)
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Hawaii Primary Care Association;

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(6)
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Hawaii Medical Association;

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(7)
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Pacific Medical Administrative Group; and

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(8)
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A company with experience in comprehensive
health care data analytic solutions.

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(d)
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The majority of working group members may
invite any other person deemed necessary to be a member of the working group.

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(e)
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The working group shall select a chairperson
from among its members.

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(f)
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The working group shall hold public meetings
with stakeholders, solicit input, and set its own meeting agendas.

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(g)
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The members of the working group shall serve
without compensation but shall be reimbursed for any actual and necessary
expenses, including travel expenses, necessary for the performance of their
duties.

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(h)
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The working group shall submit a report of
its findings and recommendations, including any proposed legislation, to the
legislature no later than twenty days prior to the convening of the regular
session of
2027.

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(i)
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The working group shall cease to exist on June 30, 2027.

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SECTION 5.
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There is appropriated out of the general
revenues of the State of Hawaii the sum of $200,000 or so much thereof as may
be necessary for fiscal year 2026-2027 for the purposes of this Act.

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The sum
appropriated shall be expended by the department of health for the purposes of
this Act.

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SECTION 6.
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In codifying the new sections added by
section 2 of this Act, the revisor of statutes shall substitute appropriate
section numbers for the letters used in designating the new sections in this
Act.

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SECTION 7.
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New statutory material is underscored.

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SECTION 8.
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This Act shall take effect on July 1, 2026.

INTRODUCED BY:

_____________________________

Report Title:

DOH; State
Health Planning and Development Agency; Hospital Discharge Data; Working Group;
Appropriation

Description:

Establishes
a statewide system for collecting, auditing, and publicly releasing of de‑identified
hospital discharge data.
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Requires the
State
Health Planning and Development Agency to convene a working group. Appropriates
funds.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.