AB 133(Data exchange framework - DxF)

AB 133(Data exchange framework - DxF)

California has introduced a new law, AB 133 (signed by Governor Gavin Newsom in 2021), which mandates the creation of the nation’s first statewide bidirectional data exchange framework, known as the California Health and Human Services Data Exchange Framework. This initiative, led by a stakeholder advisory group, aims to develop a standardized set of policies and procedures and establish a single data-sharing agreement. This agreement will govern the real-time health information exchange among healthcare entities and government agencies within the state. The law focuses on making healthcare data more accessible to key stakeholders while addressing privacy concerns and patients’ rights to control their data.


Starting in 2024, all health plans, hospitals, physician organizations, and clinical laboratories in California will be required to participate in this new data exchange.

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Entities required to sign the DxF DSA are listed below.

1.

General Acute Care Hospitals, defined by Health and Safety Code Section 1250.

2.

Physician Organizations (e.g., Independent Practice Associations that exchange health information) and Medical Groups.

3.

Skilled Nursing Facilities, as defined in Health and Safety Code Section 1250.

4.

Health Plans

5.

Health Care Service Plans and Disability Insurers provide hospital, medical, or surgical coverage regulated by the California Department of Managed Healthcare or the California Department of Insurance.

6.

Medi-Cal Managed Care Plans that have signed a comprehensive risk contract with the Department of Healthcare Services under the MediCal Act1 or the Waxman-Duffy Prepaid Health Plan Act2 and that is not regulated by the California Department of Managed Healthcare or the California Department of Insurance.

7.

Clinical Laboratories, as defined in Business and Professions Code Section 1265 and, are regulated by the California Department of Public Health.

8.

Acute Psychiatric Hospitals, as defined in Health and Safety Code Section 1250.

Under AB 133, all mandatory signatories must sign the DSA by January 31, 2023. Some of these organizations, such as smaller physician practices and clinics, rehabilitation, long-term acute care, psychiatric, and critical access hospitals, and smaller rural acute care hospitals, will have until January 31, 2026, to fully implement the Data Exchange Framework even though they signed the agreement in January 2023.

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The Data Exchange Framework includes a single data-sharing agreement and a standard set of policies and procedures that will govern and require the exchange of health information among California's healthcare and government entities.

The CalHHS Data Sharing Agreement (DSA) Signing Portal External Link is now open for providers and healthcare entities to take the first step toward better health information exchange. The DSA is a mandated agreement

between hospitals, physician organizations, medical groups, skilled nursing facilities, health plans, disability insurers, clinical laboratories, and acute psychiatric hospitals to share patient information safely.

What are Qualified Health Information Organizations (QHIOs)?

A Qualified Health Information Organization (QHIO) is a DxF-designated intermediary that meets the requirements for secure data exchange and other criteria. These intermediaries offer services and functions to support sharing of health and social services information. DxF Participants may choose to use a QHIO or another intermediary to meet some or all of their Data Sharing Agreement (DSA) requirements for secure data exchange.