Delaware § 2004 - Reporting requirements.

§ 2004. Reporting requirements.

(a) The Delaware uniform claims and billing data set (UB-04 or successor form) shall be completed for all hospital inpatient discharges and emergency department visits.

(b) All hospitals must submit data electronically to the state agency according to a schedule established pursuant to subsection (e) of this section, through the state agency’s Secure File Transfer Protocol (SFTP), in the format agreed upon by the state agency and the Delaware Healthcare Association. All third-party payers shall be required to accept this uniform claims and billing form.

(c) The Delaware uniform claims and billing data set (UB-04 or successor form) shall be completed for all nursing home inpatient discharges beginning not sooner than June 30, 1995, and shall be submitted by all nursing homes to the state agency according to a schedule established pursuant to subsection (e) of this section. All third-party payers shall be required to accept the Delaware uniform claims and billing form. Nursing homes shall submit data electronically through the State agency’s SFTP and in a format agreed upon by the state agency and the Delaware Health Care Facilities Association.

(d) The state agency shall assure that any report of data specific to hospitals or nursing homes presents data that are reliable, valid and informative. Such data shall reflect, as appropriate, factors including, but not limited to, the number of patients, patient severity at admission, age of patients, the actual versus expected number of deaths, average length of stay and case mix. The report shall explain each of these adjustments. The report also shall include information necessary to adequately represent the operations of the individual hospital or nursing home such as whether physician charges are included in the hospital charges, whether the hospital maintains medical education programs and the hospital’s payer mix. The state agency shall consult with the Delaware Healthcare Association and the Delaware Health Care Facilities Association in identifying the various adjustment factors and information to be included.

(e) The state agency shall establish schedules for the timely submission of data and information collected pursuant to this section. The state agency may grant waivers from such schedules for good cause shown.

67 Del. Laws, c. 143, §  1;  69 Del. Laws, c. 347, §  1;  85 Del. Laws, c. 242, § 1;