R590. Insurance, Administration.R590-271. Data Reporting for Consumer Quality Comparison.
R590-271-1. Authority.
This rule is promulgated by the commissioner pursuant to Sections 31A-2-201 and 31A-2-216.
R590-271-2. Purpose and Scope.
(1) The purpose of this rule is to require an insurer to comply with the HEDIS reporting requirements under the Department of Health and Human Services.
(2)(a) This rule applies to an insurer offering a health benefit plan.
(b) This rule does not apply to an insurer whose health benefit plans cover fewer than 3,000 individual Utah residents in aggregate.
R590-271-3. Definitions.
Terms used in this rule are defined in Section 31A-1-301. Additional terms are defined as follows:
(1) "HEDIS" means the Healthcare Effectiveness Data and Information Set.
R590-271-4. Reporting Requirements.
An insurer shall comply with the reporting guidelines, procedures, and format of Rule R428-13 and submit HEDIS data for the preceding calendar year to the Utah Department of Health and Human Services Office of Health Care Statistics.
R590-271-5. Severability.
If any provision of this rule, Rule R590-271, or its application to any person or situation is held invalid, such invalidity does not affect any other provision or application of this rule that can be given effect without the invalid provision or application. The remainder of this rule shall be given effect without the invalid provision or application.
KEY: data, data reporting, insurance
Date of Last Change: July 23, 2024
Notice of Continuation: June 2, 2025
Authorizing, and Implemented or Interpreted Law: 31A-2-216
