| (a) Within five months after the end of each reporting
quarter, DSHS shall compile one or more electronic data files for
each reporting hospital using all discharge claims received from each
hospital. The file shall have one record for each patient discharged
during the reporting quarter and one record for any patient discharged
during one prior reporting quarter for whom additional discharge claims
have been received. This file will include all data submitted by the
hospital, which DSHS intends to use in the creation of the public
use data file. The data files, including reports and any additional
information returned to the hospital, allows the hospital to provide
physicians and other health professionals the opportunity to review,
request correction of, and comment on records of discharged patients
for whom they are shown as "attending" or "operating or other." DSHS
shall determine the format and medium in which the quarterly file
will be delivered to hospitals.
(b) The chief executive officer or chief executive
officer's designated agent of each hospital shall indicate whether
the hospital is certifying or not certifying the discharge encounter
data specified in subsection (a) of this section, sign and return
the form corresponding to the discharge report for each quarter using
forms supplied by DSHS. The certification form may be signed by a
person designated by the chief executive officer and acting as the
officer's agent. Designation of an agent does not relieve the chief
executive officer of personal responsibility for the certification.
If the chief executive officer or chief executive officer's designated
agent does not believe the quarterly file is accurate, the officer
shall provide DSHS with detailed comments regarding the errors or
submit a written request (on a form supplied by DSHS) and provide
the data necessary to correct any inaccuracy and certify the file
subject to those corrections being made prior to the deadlines specified
in this subsection. Corrections to certification discharge data shall
be submitted on or prior to the following schedule: Quarter 1- October
1; Quarter 2- January 1; Quarter 3- April 1; and Quarter 4- July 1.
Chief Executive Officers or designees that elect not to certify shall
submit a reasoned justification explaining their decision to not certify
their discharge encounter data and attach the justification to the
certification form. Election to not certify data does not prevent
data from appearing in the public use data file. Data that is not
corrected and submitted by the deadline may appear in the public use
data file.
(c) The signed certification form shall represent that:
(1) policies and procedures are in place within the
hospital's processes to validate and assure the accuracy of the discharge
encounter data and any corrections submitted; and
(2) all errors and omissions known to the hospital
have been corrected or the hospital has submitted comments describing
the errors and the reasons why they could not be corrected; and
(3) to the best of their knowledge and belief, the
data submitted accurately represents the hospital's administrative
status of discharged inpatients for the reporting quarter; and
(4) the hospital has provided physicians and other
health professionals a reasonable opportunity to review and comment
on the discharge data of patients for which they were reported in
one of the available physician number and name fields provided on
the acceptable formats specified in §421.9 of this title (relating
to Discharge Reports--Records, Data Fields and Codes) (for example,
"attending physician" or "operating or other physician" as applicable).
The physicians or other health professionals may write comments and
have errors brought to the attention of the chief executive officer
or the chief executive officer's designated agent and the chief executive
officer or the chief executive officer's designated agent, shall address
any comments by the physicians or other health professionals.
(5) if the chief executive officer or the officer's
designee elects not to certify the discharge encounter data for a
specific quarter, a written justification of any unresolved data issues
concerning the accuracy and completeness of the data at the time of
the certification shall be included on the certification form. Discharge
data that has been edited, returned to hospital and is not certified
may be released and published in the public use data file.
(d) Each hospital shall submit its certification form
for each quarter's data to DSHS by the fifteenth day of the seventh
month (Quarter 1- October 15; Quarter 2- January 15; Quarter 3- April
15; and Quarter 4- July 15) following the last day of the reporting
quarter as specified in §421.3(a)(1) - (4) of this title (relating
to Schedule for Filing Discharge Reports). Individual hospital requests
for an extension to these deadlines will not be granted. DSHS may
extend the deadline for all hospitals when deemed necessary.
(e) Hospitals, physicians or other health professionals
may submit concise written comments regarding any data submitted by
them or relating to services, they have delivered which may be released
as public use data. Comments shall be submitted to DSHS on or before
the dates specified in subsection (d) of this section, regarding the
submission of the certification form. Commenters are responsible for
assuring that the comments contain no patient or physician identifying
information. Comments shall be submitted electronically using the
method described in §421.4(a) and (b) of this title (relating
to Instructions for Filing Discharge Reports).
(f) Failure to either correct a discharge report which
has been submitted and contains errors or omissions known to the hospital
on or prior to the dates specified in subsection (b) of this section
or to address in the comments the errors known to the hospital contained
in the data and return the comments on or prior to the dates specified
in subsection (d) of this section is punishable by a civil penalty
pursuant to Health and Safety Code, §108.014(b).
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| Source Note: The provisions of this §421.7 adopted to be effective August 19, 1997, 22 TexReg 7490; amended to be effective December 29, 1997, 22 TexReg 12494; amended to be effective July 26, 1998, 23 TexReg 7365; amended to be effective July 29, 2001, 26 TexReg 5408; amended to be effective April 21, 2002, 27 TexReg 3183; amended to be effective July 6, 2003, 28 TexReg 4915; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8842; amended to be effective December 27, 2007, 32 TexReg 9683; amended to be effective July 5, 2017, 42 TexReg 3373; amended to be effectiveJanuary 30, 2019, 44 TexReg 429 |
