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Arkansas Central Cancer Registry

Laws and Regulations


ACCR Rules and Regulations | State Law
Cancer Registries Amendment Act | HIPPA



ACCR Rules and Regulations

SECTION I. AUTHORITY. The following Rules and Regulations Pertaining to Arkansas Cancer Registry are duly adopted and promulgated by the Arkansas State Board of Health pursuant to the authority expressly conferred by the laws of the State of Arkansas, A.C.A. 20-15-201, et seq.

SECTION II. PURPOSE. Since cancer is one of the leading causes of death in Arkansas it is essential that specific information concerning this group of diseases be collected, analyzed and reported. All Arkansans will benefit from the epidemiological surveillance of this group of diseases.

SECTION III. DEFINITIONS.

  1. Registry. Means the system for the reporting, collection, and analysis of cancer cases by the Arkansas Department of Health.


  2. Reporting. Means the notification furnished to the Arkansas Department of Health of cases of in situ or invasive neoplasms of the human body, not including squamous cell and basal cell carcinoma of the skin.
SECTION IV. GENERAL REQUIREMENTS.

  1. Each hospital or other medical facility providing screening, diagnostic or therapeutic service, physicians, including surgeons, and all other health care practitioners or their designees shall report the following information concerning each case.


    1. Personal information.


      1. Name.


      2. Address.


      3. Date of birth.


      4. Place of birth.


      5. Race and Spanish/Hispanic origin.


      6. Sex.


      7. Social security number.


      8. County of residence.


      9. Marital status.


      10. Maiden name, if applicable.


      11. Alias.


      12. Occupational history, if available.


    2. Diagnosis.


      1. Class of case.


      2. Date of diagnosis.


      3. Primary site.


      4. Laterality.


      5. Histology.


    3. Treatment.


      1. Grade.


      2. Diagnostic confirmation.


      3. Staging (American Joint Committee for Cancer - AJCC).


      4. Reporting identification of the facility or person reporting.


    4. Summary of Treatment.


      1. Date first course started.


      2. Name of physician.


      3. First course of treatment, i.e., surgery, radiation, chemotherapy, hormone therapy.


    5. Follow-up.


    6. Recurrence.


  2. In order to insure the accuracy and completeness of the cancer registry within the Department of Health, staff and agents shall be permitted access to records of hospitals, other medical facilities, physicians (including surgeons), nursing homes and other individuals or agencies providing services wherein records concerning patients in which cases of cancer are identified are located.


  3. All reportig shall be made on forms or in an acceptable manner in accordance with directives of the Department of Health. All cancer cases shall be reported within six months after the date of discharge or diagnosis is made or within six months after a cancer case is known, even if diagnosed elsewhere. Where appropriate cancer data will be in the format recognized by the American Association of Central Cancer Registries.


  4. Each hospital licensed by the Department of Health shall designate a person who shall be responsible for accurate and timely reporting pursuant to this rule. Such hospital shall also adopt a policy which ensures the designation of such person and the hospital's reporting to the Registry.
SECTION V. CONFIDENTIALITY. All information reported to the Deprtment of Health shall be confidential and shall not be disclosed under any circumstances except (1) to other state cancer registries with which the Department of Health has agreements that insure confidentiality; (2) to other state health officials who are obligated to keep such information confidential; and (3) to approved cancer research centers under specific conditions where the names and identities of the individuals are appropriatly protected, and when such research is conducted for the purpose of cancer prevention, control and treatment. (Click here for more on confidentiality)

SECTION VI. SEVERABILITY. If any provision of these Rules and Regulations or the application thereof to any person or circumstances is held invalid such invalidity shall not affect other provisions or applications of these Rules and Regulations which can give effect without the invalid provisions or applications, and to this end the provisions hereto are declared to be severable.

SECTION VII. REPEAL. All Regulations and parts of Regulations in conflict herewith are hereby repealed.

 Click here to view a copy of the original signed document (pdf).

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State Law

Subchapter 2 - Cancer

20-15-201. Reporting requirements.
The Arkansas Department of Health shall accumulate such data concerning cancer in Arkansas and its residents as is deemed appropriate for the purpose of describing the frequency of cancer, furnishing reports to health professionals and the public, and for planning and evaluating cancer prevention and control programs. Such data shall be collected under the authority of regulations promulgated by the Arkansas State Board of Health.

20-15-202. State Cancer Plan.
A task force consisting of public and private entities will be established by the Director of the Department of Health to assist the department to develop a strategic plan for a coordinated, comprehensive, statewide network of cancer resources, services, and programs.

20-15-203. Confidentiality.
Information accumulated and maintained in the Cancer Registry of Arkansas shall not be divulged except as statistical information which does not identify individuals and for purposes of such research as approved by the Arkansas State Board of Health. (Click here for more on confidentiality)

20-15-204. Agreements with other states.
The Arkansas Department of Health is hereby authorized to enter into agreement with other states and federal organizations authorized to exchange registry data. Such agreements shall prohibit divulging information to entities without prior approval of the Arkansas State Department of Health.

20-15-205. Gifts, grants, and donations.
The Department of Health is authorized to receive gifts, grants, and donations for the purpose of this subchapter.

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Cancer Registries Amendment Act

Public Law 102-515
102d Congress

An Act
Entitled the "Cancer Registries Amendment Act".

 Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled.

SECTION 1. SHORT TITLE.

This act may be cited as the "Cancer Registries Amendment Act".

SEC. 2. FINDINGS AND PURPOSE.
  1. Findings.-Congress finds that-
    1. cancer control efforts, including prevention and early detection, are best addressed locally by State health departments that can identify unique needs;
    2. cancer control programs and existing statewide population-based cancer registries have identified cancer incidence and cancer mortality rates that indicate the burden of cancer for Americans is substantial and varies widely by geographic location and by ethnicity;
    3. statewide cancer incidence and cancer mortality data, can be used to identify cancer trends, patterns, and variation for directing cancer control intervention;
    4. the American Association of Central Cancer Registries (AACCR) cites that of the 50 States, approximately 38 have established cancer registries, many are not statewide and 10 have no cancer registry; and
    5. AACCR also cites that of the 50 States, 39 collect data on less than 100 percent of their population, and less than half have adequate resources for insuring minimum standards for quality and for completeness of case information.
  2. Purpose.-It is the purpose of this Act to establish a national program of cancer registries.
SEC. 3. NATIONAL PROGRAM OF CANCER REGISTRIES.

Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by adding at the end the following new part:
"Part M-National Program of Cancer Registries

"SEC. 399H. NATIONAL PROGRAM OF CANCER REGISTRIES.
  1. "In general.-The Secretary, acting through the Director of the Centers for Disease Control, may make grants to States, or may make grants or enter into contracts with academic or nonprofit organizations designated by the State to operate the State's cancer registry in lieu of making a grant directly to the State, to support the operation of population-based, statewide cancer registries in order to collect, for each form of in-situ and invasive cancer (with the exception of basal cell and squamous cell carcinoma of the skin), data concerning-
    1. "demographic information about each case of cancer;
    2. "information on the industrial or occupational history of the individuals with the cancers, to the extent such information is available from the same record;
    3. "administrative information, including date of diagnosis and source of information;
    4. "pathological data characterizing the cancer, including the cancer site, stage of disease (pursuant to Staging Guide), incidence, and type of treatment; and
    5. "other elements determined appropriate by the Secretary.
  2. "Matching Funds.-
    1. "In General.-The Secretary may make a grant under subsection (a) only if the State, or the academic or nonprofit private organization designated by the State to operate the cancer registry of the State, involving agrees, with respect to the costs of the program, to make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that is not less than 25 percent of such costs or $1 for every $3 of Federal funds provided in the grant.
    2. "Determination Of Amount of Non-Federal Contribution; Maintenance of Effort.-
      1. "Non-Federal contributions required in paragraph (1) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, may not be included in determining the amount of such non-Federal contributions.
      2. "With respect to a State in which the purpose described in subsection (a) is to be carried out, the Secretary, in making a determination of the amount of non-Federal contributions provided under paragraph (1), may include only such contributions as are in excess of the amount of such contributions made by the State toward the collection of data on cancer for the fiscal year preceding the first year for which a grant under subsection (a) is made with respect to the State. The Secretary may decrease the amount of non-Federal contributions that otherwise would have been required by this subsection in those cases in which the State can demonstrate that decreasing such amount is appropriate because of finanial hardship.
  3. "Eligibility for Grants.-
    1. "In General.-No grant shall be made by the Secretary under subsection (a) unless an application has been submitted to, and approved by, the Secretary. Such application shall be in such form, submitted in such a manner, and be accompanied by such information, as the Secretary may specify. No such application may be approved unless it contains assurances that the applicant will use the funds provided only for the purposes specified in the approved application and in accordance with the requirements of this section, that the application will establish such fiscal control and fund accounting procedures as may be necessary to assure proper disbursement and accounting of Federal funds paid to the applicant under subsection (a) of this section, and that the applicant will comply with the peer review requirements under sections 491 and 492.
    2. "Assurances.-Each applicant, prior to receiving Federal funds under subsection (a), shall provide assurances satisfactory to the Secretary that the applicant will-
      1. "provide for the establishment of a registry in accordance with subsection (a);
      2. "comply with appropriate standards of completeness, timeliness, and quality of population-based cancer registry data;
      3. "provide for the annual publication of reports of cancer data under subsection (a); and
      4. "provide for the authorization under State law of the statewide cancer registry, including promulgation of regulations providing-
        1. "a means to assure the complete reporting of cancer cases (as defined in subsection (a)) to the statewide cancer registry by hospitals or other facilities or other facilities providing screening, diagnostic or therapeutic services to patients with respect to cancer;
        2. "a means to assure the complete reporting of cancer cases (as defined in subsection (a)) to the statewide cancer registry by physicians, surgeons, and all other health care practitioners diagnosing or providing treatment for cancer patients, except for cases directly referred to or previously admitted to a hospital or other facility providing screening, diagnostic or therapeutic services to patients in that State and reported by those facilities;
        3. "a means for the statewide cancer registry to access all records of physicians and surgeons, hospitals, individuals, or agencies providing such services to patients which would identify cases of cancer or would establish characteristics of the cancer, treatment of the cancer, or medical status of any identified patient;
        4. "for the reporting of cancer case data to the statewide cancer registry in such a format, with such data elements, and in accordance with such standards of quality timeliness and completeness, as may be established by the Secretary;
        5. "for the protection of the confidentiality of all cancer case data reported to the statewide cancer registry, including a prohibition on disclosure to any person of information reported to the statewide cancer registry that identifies, or could lead to the identification of, an individual cancer patient, except for disclosure to other State cancer registries and local and State health officers;
        6. "for a means by which confidential case data may in accordance with State law be disclosed to cancer researchers for the purposes of cancer prevention, control and research;
        7. "for the authorization or the conduct, by the statewide cancer registry or other persons and organizations, of studies utilizing statewide cancer registry data, including studies of the sources and causes of cancer, evaluations of the cost, quality, efficacy, and appropriateness of diagnostic, therapeutic, rehabilitative, and preventative services and programs relating to cancer, and any other clinical, epidemiological, or other cancer research; and
        8. "for protection for individuals complying with the law, including provisions specifying that no person shall be held liable in any civil action with respect to a cancer case report provided to the statewide cancer registry, or with respect to access to cancer case information provided to the statewide cancer registry.
  4. "Relationship to Certain Programs.-
    1. "In General.-This section may not be construed to act as a replacement for or diminishment of the program carried out by the Director of the National Cancer Institute and designated by such Director as the Surveillance, Epidemiology, and End Results Program (SEER).
    2. "Supplanting of Activities.-In area where both such programs exist, the Secretary shall ensure that SEER support is not supplanted and that any additional activities are consistent with the guidelines provided for in subsection (c)(2) (C) and (D) and are appropriately coordinated with the existing SEER program.
    3. "Transfer of Responsibility.-The Secretary may not transfer administration responsibility for such SEER program from such Director.
    4. "Coordination.-To encourage the greatest possible efficiency and effectiveness of Federally supported efforts with respect to the activities described in this subsection, the Secretary shall take steps to assure the appropriate coordination of programs supported under this part with existing Federally supported cancer registry programs.
  5. "Requirement Regarding Certain Study on Breast Cancer.-In the case of a grant under subsection (a) to any State specified in section 399K(b), the Secretary may establish such conditions regarding the receipt of the grant as the Secretary determines are necessary to facilitate the collection of data for the study carried out under section 399C.
"SEC. 399I. PLANNING GRANTS REGARDING REGISTRIES.
  1. In General.-
    1. "States.-The Secretary, acting through the Director of the Centers for Disease Control, may make grants to States for the purpose of developing plans that meet the assurances required by the Secretary under section 399B(c)(2).
    2. "Other Entities.-For the purpose described in paragraph (1), the Secretary may make grants to public entities other than States and to nonprofit private entities. Such a grant may be made to an entity only if the State in which the purpose is to be carried out has certified that the State approves the entity as qualified to carry out the purpose.
  2. "Application.-The Secretary may make a grant under subsection (a) only if an application for the grant is submitted to the Secretary, the application contains the certification required in subsection (a)(2) (if the application is for a grant under such subsection), and the application is in such form, is made in such a manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this section.
"SEC. 399J. TECHNICAL ASSISTANCE IN OPERATIONS OF STATEWIDE CANCER REGISTRIES.

"The Secretary, acting through the Director of the Centers for Disease Control, may, directly or through grants and contracts, or both, provide technical assistance to the States in the establishment and operation of statewide registries, including assistance in the development of model legislation for statewide cancer registries and assistance in establishing a computerized reporting and data processing system.

"SEC. 399K. STUDY IN CERTAIN STATES TO DETERMINE THE FACTORS CONTRIBUTING TO THE ELEVATED BREAST CANCER MORTALITY RATES.
  1. "In General.-Subject to subsections (c) and (d), the Secretary, acting through the Director of the National Cancer Institute, shall conduct a study for the purpose of determining the factors contributing to the fact that the breast cancer mortality rates in other States.
  2. "Relevant States.-The States referred to in subsection (a) are Connecticut, Deleware, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, Vermont, and the District of Columbia.
  3. "Cooperation of State.-The Secretary may conduct the study required in subsection (a) in a State only if the State agrees to cooperate with the Secretary in the conduct of the study, including providing information from any registry operated by the State pursuant to section 399H(a).
  4. "Planning, Commencement, and Duration.-The Secretary shall, during each of the fiscal years 1993 and 1994, develop a plan for conducting the study required in subsection (a). The study shall be initiated by the Secretary not later than fiscal year 1994, and the collection of data under the study may continue through fiscal year 1998.
  5. "Report.-Not later than September 30, 1999, the Secretary shall complete the study required in subsection (a) and submit to the Comittee on Energy and Commerce of the House of Representatives, and to the Committee on Labor and Human Resources of the Senate, a report describing the findings and recommendations made as a result of the study.
"SEC. 399L. AUTHORIZATION OF APPROPRIATIONS.
  1. "Registries.-For the purpose of carrying out this part, the Secretary may use $30,000,000 for each of the fiscal years 1993 through 1997. Out of any amounts used for any such fiscal year, the Secretary may obligate not more than 25 percent for carrying out section 399I, and not more than 10 percent may be expended for assessing the accuracy, completenesss and quality of data collected, and not more than 10 percent of which is to be expended under subsection 399J.
  2. "Breast Cancer Study.-Of the amounts appropriated for the National Cancer Institute under subpart 1 of part C of title IV for any fiscal year in which the study required in section 399K is being carried out, the Secretary shall expend not less than $1,000,000 for the study.".

Approved October 24, 1992.

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HIPPA - Health Insurance Portability and Accountability Act

PUBLIC LAW 104-191
104th Congress
AUG. 21, 1996

EFFECT ON STATE LAW

"SEC. 1178. (a) GENERAL EFFECT.--

 (1) GENERAL RULE.--Except as provided in paragraph (2), a provision or requirement under this part, or a standard or implementation specification adopted or established under sections 1172 through 1174, shall supersede any contrary provision of State law, including a provision of State law that requires medical or health plan records (including billing information) to be maintained or transmitted in written rather than electronic form.

(2) EXCEPTIONS.--A provision or requirement under this part, or a standard or implementation specification adopted or established under sections 1172 through 1174, shall not supersede a contrary provision of State law, if the provision of State law--

(A) is a provision the Secretary determines--

(i) is necessary--

(I) to prevent fraud and abuse;

(II) to ensure appropriate State regulation of insurance and health plans;

(III) for State reporting on health care delivery or costs; or

(IV) for other purposes; or

(ii) addresses controlled substances; or

(B) subject to section 264(c)(2) of the Health Insurance Portability and Accountability Act of 1996, relates to the privacy of individually identifiable health information.

(b) PUBLIC HEALTH.--Nothing in this part shall be construed to invalidate or limit the authority, power, or procedures established under any law providing for the reporting of disease or injury, child abuse, birth, or death, public health surveillance, or public health investigation or intervention.

(c) STATE REGULATORY REPORTING.--Nothing in this part shall limit the ability of a State to require a health plan to report, or to provide access to, information for management audits, financial audits, program monitoring and evaluation, facility licensure or certification, or individual licensure or certification.

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