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To: Public Health and Human
Services
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026
By: Representative Creekmore IV
COMMITTEE SUBSTITUTE
FOR
HOUSE BILL NO. 534
AN ACT TO ESTABLISH THE MISSISSIPPI HEALTH INFORMATION 1
EXCHANGE FOR THE PURPOSE OF ESTABLISHING A STATEWIDE HEALTH 2
INFORMATION EXCHANGE THAT PROVIDES REAL-TIME BIDIRECTIONAL PATIENT 3
ADMISSION, DISCHARGE AND TRANSFER DATA, AND OTHERWISE FACILITATES 4
THE SECURE ELECTRONIC SHARING OF HEALTH INFORMATION BETWEEN 5
LICENSED HOSPITALS AND PRACTITIONERS, PAYERS, PUBLIC HEALTH 6
ENTITIES AND OTHERS; TO PROVIDE THAT THE EXCHANGE SHALL BE 7
DEVELOPED AND ADMINISTERED BY A DESIGNATED ENTITY SELECTED BY THE 8
STATE DEPARTMENT OF HEALTH THROUGH A COMPETITIVE BID PROCESS; TO 9
SPECIFY THE AUTHORIZED AND REQUIRED PARTICIPANTS IN THE EXCHANGE; 10
TO PROVIDE THAT PARTICIPANTS IN THE EXCHANGE ARE PERMITTED TO 11
RETRIEVE OR ACCESS IDENTIFIED DATA ONLY FOR PATIENTS OR INSUREDS 12
WITH WHOM THE PARTICIPANT HAS A TREATMENT, PAYMENT OR HEALTH CARE 13
OPERATIONS RELATIONSHIP; TO PROVIDE THAT PARTICIPANTS SHALL GRANT 14
TO OTHER PARTICIPANTS A NONEXCLUSIVE LICENSE TO RETRIEVE AND USE 15
IDENTIFIED DATA RELATED TO THEIR OWN PATIENTS OR INSUREDS; TO 16
SPECIFY CERTAIN CRITERIA THAT MUST BE MET BY THE DESIGNATED ENTITY 17
SELECTED TO DEVELOP AND ADMINISTER THE EXCHANGE; TO PROVIDE THAT 18
RECORDS TRANSMITTED TO OR FROM THE EXCHANGE SHALL BE EXEMPT FROM 19
THE PROVISIONS OF THE MISSISSIPPI PUBLIC RECORDS ACT; TO CREATE 20
THE MISSISSIPPI HEALTH INFORMATION EXCHANGE FUND AS A SPECIAL FUND 21
IN THE STATE TREASURY FOR THE PURPOSE OF SUPPORTING PARTICIPANT 22
CONNECTION TO, SUBSCRIPTION FOR, AND ONGOING PARTICIPATION IN THE 23
EXCHANGE; AND FOR RELATED PURPOSES. 24
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 25
SECTION 1. (1) There is established the Mississippi Health 26
Information Exchange for the purpose of establishing a statewide 27
health information exchange that provides, at a minimum, real-time 28
bidirectional patient admission, discharge and transfer data, and 29
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otherwise facilitates the secure electronic sharing of health 30
information, as defined in 45 CFR Section 160.103, between 31
licensed hospitals and practitioners, payers, public health 32
entities and others; helps provide access to health care for 33
Mississippi citizens; improves health care quality and the overall 34
health of the population; increases efficiencies in the 35
administration of health care; and reduces unnecessary health care 36
costs. 37
(2) The Mississippi Health Information Exchange shall be the 38
state-recognized health information exchange operating in the 39
state and shall be developed and administered by a designated 40
entity selected by the State Department of Health (the 41
"department") through a competitive bid process pursuant to 42
Section 31-7-13(c) and (d). The designated entity shall not be 43
selected through the emergency purchase procedure provided in 44
Section 31-7-13(j) or through any of the exceptions from bidding 45
requirements as provided for in Section 31-7-13(m). The initial 46
designation agreement shall be for a term of not less than five 47
(5) years, subject to satisfactory performance. 48
(3) The designated entity shall be a nonprofit corporation, 49
which shall collaborate with the department, but shall not be 50
considered, in whole or in part, an agency, department or 51
administrative unit of the state. 52
(4) (a) Participants in the exchange may include health 53
care providers licensed or certified by the state, including, but 54
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not limited to, federally qualified health centers, ambulatory 55
surgical facilities, or other health care clinics; managed care 56
entities as defined in Section 83-41-403; health insurance issuers 57
as defined in Section 41-149-3; health insurance plans as defined 58
in Section 73-21-153; public health agencies, or any other entity 59
or individual that the department has authorized to subscribe and 60
submit, retrieve, access, or disclose health information 61
transmitted through the exchange in accordance with applicable 62
state and federal laws, including the federal Health Insurance 63
Portability and Accountability Act of 1996 (HIPAA), and the 64
policies and standards established by the designated entity and 65
the department. 66
(b) Participants in the exchange shall include licensed 67
hospitals as defined in Section 41-9-3, including, but not limited 68
to, rural emergency hospitals as defined in 42 USC Section 69
1395x(kkk), and community mental health centers operated by a 70
regional commission established under 41-19-33. As a condition 71
for licensure in the State of Mississippi, hospitals and community 72
mental health centers shall be required to connect to the 73
exchange, transmit data, and participate in any bed availability 74
program available through the exchange. 75
(c) Participants in the exchange shall be permitted to 76
retrieve or access identified data only for patients or insureds 77
with whom the participant has a treatment, payment, or health care 78
operations relationship, or for whom the participant reasonably 79
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anticipates such a relationship, including, but not limited to, 80
circumstances involving referrals, transfers, emergency treatment, 81
or care coordination, in accordance with applicable state and 82
federal laws, including HIPAA, and the policies and standards 83
established by the designated entity and the department. 84
(d) Participants in the exchange shall grant to other 85
participants a nonexclusive license to retrieve and use identified 86
data related to their own patients or insureds, in accordance with 87
applicable state and federal laws, including HIPAA, and the 88
policies and standards established by the designated entity and 89
the department. 90
(e) The department may access all exchange data for 91
public health purposes only, but shall not disclose such data to 92
any other participant, entity, or individual. The department may 93
use de-identified data within the exchange for research and 94
broader public health purposes, and may disclose such data to the 95
public in furtherance of broader public health purposes, in 96
accordance with applicable state and federal laws, including 97
HIPAA, and the policies and standards established by the 98
designated entity and the department. 99
(5) The designated entity selected to develop and administer 100
the exchange shall demonstrate, at a minimum, the following 101
principles and capabilities: 102
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(a) A patient-centered mission driven primarily to 103
increase access to and ensure the efficient administration of 104
health care in Mississippi; 105
(b) Compliance with established national standards and 106
applicable state and federal laws, including HIPAA; and 107
(c) In terms of the exchange software, hardware, and 108
platform provided by the designated entity, minimum requirements 109
shall include: 110
(i) Interoperability between electronic health 111
record systems; 112
(ii) Deliverance of real-time bidirectional 113
admission, transfer, and discharge data across all connected 114
participants; 115
(iii) Ability to create and implement a real-time 116
bed availability system to ease essential transfers between 117
licensed hospitals and mental health providers; and 118
(iv) Deliverance of de-identified data to 119
participants, the Legislature, public health agencies, and others 120
on focus areas for the state, including, but not limited to, 121
maternal and infant morbidity and mortality, behavioral and mental 122
health conditions, substance use disorders, and other priority 123
health outcomes identified by the department and other agencies, 124
for the purpose of improving public health across the state. 125
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(6) In order to minimize implementation time and cost to the 126
state, preference in the selection of a designated entity shall be 127
provided to entities that can demonstrate: 128
(a) At least two (2) years of continuous operational 129
experience providing health information exchange services offering 130
real-time bidirectional admission, discharge, and transfer data to 131
Mississippi health care providers; 132
(b) Established, operational data interfaces with major 133
electronic health record systems utilized by Mississippi 134
providers; 135
(c) Current certification under nationally-recognized 136
security and privacy certification frameworks; 137
(d) Ability to expand current services to meet the 138
requirements of this section within six (6) months of designation; 139
and 140
(e) Ability to expand the capabilities of the exchange 141
over time into patient navigation and care coordination, or other 142
similar programs aimed at connecting participants to improve 143
health care quality, access, and efficiency. 144
(7) The designated entity selected to administer the 145
exchange shall, at a minimum, develop and implement: 146
(a) A standard participation agreement that defines the 147
minimum privacy and security obligations of all participants using 148
the exchange and services available through the exchange; 149
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(b) A process by which patients may opt out of 150
participating, in whole or in part, in the health information 151
exchange. A patient shall not be denied health care or treatment 152
for declining to participate in the health information exchange; 153
and 154
(c) Industry accepted security standards, policies, and 155
procedures to protect the transmission and receipt of protected 156
health information exchanged through the exchange, which shall, at 157
a minimum, comply with all applicable state and federal laws, 158
including HIPAA, and the policies and standards established by the 159
designated entity and the department. 160
(8) A participant shall not be compelled by subpoena, court 161
order, or other process of law to access health information 162
through the exchange to gather records or information not created 163
by the participant. 164
(9) Records transmitted to or from the exchange shall be 165
exempt from the provisions of the Mississippi Public Records Act 166
of 1983. 167
(10) Nothing in this section shall be interpreted to impede 168
or preclude the formation and operation of regional, 169
population-specific, or local health information networks or the 170
participation of such networks in the exchange. 171
(11) The State Board of Health shall promulgate rules and 172
regulations necessary for the proper administration of the 173
exchange. 174
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ST: Mississippi Health Information Exchange;
create.
(12) There is created the Mississippi Health Information 175
Exchange Fund as a special fund in the State Treasury, into which 176
are deposited those funds appropriated by the Legislature and any 177
other funds, including, but not limited to, funds from the Rural 178
Health Transformation Fund, Public Law No. 119-21, that may be 179
made available for the purpose of supporting participant 180
connection to, subscription for, and ongoing participation in the 181
Mississippi Health Information Exchange, including costs 182
associated with initial connectivity, interface development, 183
cybersecurity, required system upgrades, and annual or multi-year 184
subscription fees. Monies in the fund at the end of a fiscal year 185
shall not lapse into the General Fund, and interest earned on any 186
amounts deposited into the fund must be credited to the special 187
fund. All monies shall be disbursed in compliance with applicable 188
state and federal law and guidelines, guidance, rules, regulations 189
and/or other criteria, as may be amended from time to time. 190
SECTION 2. This act shall take effect and be in force from 191
and after its passage. 192