SB3246

SECTION 1. 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.

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. 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.

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.

The purpose of this Act is to:

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

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

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

" . Hospital Discharge Data

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

"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.

"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.

"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.

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

"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.

"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.

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

"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. "Inpatient" does not include observation patients.

"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.

"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.

"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.

"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.

§323D-B Hospital discharge data; inpatient reporting; audit procedures. (a) 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.

(b) 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.

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

(1) Acute care;

(2) Intensive care;

(3) Long-term acute care;

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

(5) Substance abuse and comprehensive rehabilitation.

(d) 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.

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

(1) 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 :

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

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

(2) 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. Patients receiving sub-acute care in these settings shall be excluded from the reporting requirements under this section;

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

(4) 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.

§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.:

(1) Licensed short-term acute care hospitals;

(2) Licensed organized ambulatory health care facilities;

(3) Emergency departments;

(4) Lithotripsy centers; and

(5) Cardiac catheterization laboratories.

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

(c) 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.

§323D-D Certification; resubmission of reports; change in personnel. (a) 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.

(b) 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. Requests to resubmit a report shall be made within twelve months following the initial submission due date. 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. The state agency may grant approval for resubmission if the state agency determines that the amended report will significantly impact data quality.

(c) 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. The notification shall include full names, titles, applicable telephone and fax numbers, and electronic mail addresses of the new personnel.

§323D-E Data elements and codes; standards. 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.

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

(b) 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:

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

(2) Social security number;

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

(4) Entry date;

(5) Discharge date;

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

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

(8) Medical or health record number."

SECTION 3. 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. State Health Planning and Development Agency; Council; Functions"

SECTION 4. (a) 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.

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

(1) The director of health;

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

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

(4) The insurance commissioner; and

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

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

(1) Hawaii Health Information Exchange;

(2) Healthcare Association of Hawaii;

(3) The Queen's Health Systems;

(4) Hawaii Pacific Health;

(5) Hawaii Primary Care Association;

(6) Hawaii Medical Association;

(7) Pacific Medical Administrative Group; and

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

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

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

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

(g) 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.

(h) 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.

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

SECTION 5. 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.

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

SECTION 6. 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.

SECTION 7. New statutory material is underscored.

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

INTRODUCED BY:	_____________________________

THE SENATE	S.B. NO.	3246
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII