By:  Parker                                           S.B. No. 1409
                                 A BILL TO BE ENTITLED
                                        AN ACT
    1-1  relating to medical liability actions and medical liability
    1-2  insurance; providing penalties.
    1-3        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-4        SECTION 1.  Section 41.02, Part 4, Chapter 817, Acts of the
    1-5  65th Legislature, Regular Session, 1977, as it relates to Parts 2
    1-6  and 3 of that chapter, not previously repealed by Section 2,
    1-7  Chapter 608, Acts of the 72nd Legislature, Regular Session, 1991,
    1-8  is hereby repealed.
    1-9        SECTION 2.  Section 41.02, Part 4, Chapter 817, Acts of the
   1-10  65th Legislature, Regular Session, 1977, is amended to read as
   1-11  follows:
   1-12        Sec. 41.02.  Part 1 of this <This> Act expires at midnight on
   1-13  August 31, 2009 <1993>.
   1-14        SECTION 3.  Section 10.02, Medical Liability and Insurance
   1-15  Improvement Act of Texas (Article 4590i, Vernon's Texas Civil
   1-16  Statutes), is amended to read as follows:
   1-17        Sec. 10.02.  ACTIONS AGAINST HEALTH CARE PROVIDERS WHOSE
   1-18  IDENTITY OR ROLE IS UNKNOWN.  (a)  For the purposes of tolling the
   1-19  statute of limitations in a health care liability claim, any person
   1-20  may file a petition stating a health care liability claim in the
   1-21  appropriate court of this state, whenever the identity or role of
   1-22  any health care provider is unknown.
   1-23        (b)  The name of any such unknown health care provider shall
    2-1  be designated by the pseudonym John Doe or, if there is more than
    2-2  one tortfeasor, John Doe 1, John Doe 2, John Doe 3, etcetera.
    2-3        (c)  After filing the petition designating a John Doe, the
    2-4  filing party shall proceed with due diligence to discover the
    2-5  identity or role of the health care provider described by the
    2-6  pseudonym and, on determining the identity and role of the health
    2-7  care provider, the petition shall be amended by substituting the
    2-8  real name for the pseudonym, no later than the 120th day after the
    2-9  filing of the petition naming the John Doe.
   2-10        (d)  If the party added by amendment in accordance with this
   2-11  section did not receive notice as provided by Section 4.01 of this
   2-12  Act, that party shall be entitled on request to the court to an
   2-13  abatement of the lawsuit for such time as the court shall determine
   2-14  is appropriate under the circumstances of the case but not to
   2-15  exceed 60 days following the date of service of citation.  <CAUSES
   2-16  OF ACTION COVERED BY OTHER LAW.  Causes of action accruing between
   2-17  the effective date of this Act and the effective date of Article
   2-18  5.82, Insurance Code, shall be filed pursuant to Section 4 of
   2-19  Article 5.82.>
   2-20        SECTION 4.  The Medical Liability and Insurance Improvement
   2-21  Act of Texas (Article 4590i, Vernon's Texas Civil Statutes), is
   2-22  amended by adding Subchapter M to read as follows:
   2-23                 SUBCHAPTER M.  PROCEDURAL PROVISIONS
   2-24        Sec. 13.01.  AFFIDAVIT OR COST BOND.  (a)  In a health care
   2-25  liability claim, the plaintiff's attorney or, if the plaintiff is
    3-1  not represented by an attorney, the plaintiff shall, within 90 days
    3-2  after the date the action was commenced, file an affidavit
    3-3  attesting that the attorney or plaintiff has obtained a written
    3-4  opinion from an expert who has knowledge of accepted standards of
    3-5  care for the diagnosis, care, or treatment of the illness, injury,
    3-6  or condition involved in the claim, that the acts or omissions of
    3-7  the physician or health care provider were negligent and a
    3-8  proximate cause of the injury, harm, or damages claimed.
    3-9        (b)  A plaintiff or plaintiff's attorney shall be deemed to
   3-10  be in compliance with Subsection (a) of this section if, within 90
   3-11  days after the date the action was commenced, the plaintiff posts a
   3-12  bond with surety or any other equivalent security approved by the
   3-13  court, including cash in an escrow account, for costs in an amount
   3-14  of $2,000.
   3-15        (c)  If on the expiration of the 90th day after the date the
   3-16  action was commenced or the expiration of the extension period
   3-17  described in Subsection (d) of this section, whichever is later,
   3-18  the plaintiff has failed to post security as described in
   3-19  Subsection (b) of this section or alternatively has failed to file
   3-20  an affidavit as described in Subsection (a) of this section, then
   3-21  the court on the motion of any party or on the court's own motion
   3-22  shall increase the amount of security required by Subsection (b) of
   3-23  this section to an amount not to exceed $4,000.  If the plaintiff
   3-24  fails to post the increased security within 30 days after being
   3-25  served with a copy of the court's order or fails to provide an
    4-1  affidavit as provided by Subsection (a) of this section, the court
    4-2  shall on motion unless good cause is shown for such failure dismiss
    4-3  the action without prejudice to its refiling and assess costs of
    4-4  court against plaintiff.
    4-5        (d)  The court on motion of any party and for good cause
    4-6  shown may extend the time for the plaintiff to comply with
    4-7  Subsection (a) or (b) of this section for a period not to exceed 90
    4-8  days.  The time for the plaintiff to comply with Subsection (a) or
    4-9  (b) of this section may also be extended by written agreement of
   4-10  the parties filed with the court.
   4-11        (e)  Discovery concerning the affidavit, including the
   4-12  written opinion and the identity of the physician or health care
   4-13  provider who supplied the opinion, shall not be allowed unless the
   4-14  physician or health care provider who supplied the opinion is
   4-15  designated as an expert witness by the plaintiff.
   4-16        Sec. 13.02.  DISCOVERY PROCEDURES.  (a)  In every health care
   4-17  liability claim the plaintiff shall within 45 days after the date
   4-18  of filing of the original petition serve on the defendant's
   4-19  attorney or, if no attorney has appeared for the defendant, on the
   4-20  defendant full and complete answers to the appropriate standard set
   4-21  of interrogatories and full and complete responses to the
   4-22  appropriate  standard set of requests for production of documents
   4-23  and things promulgated in accordance with Subsection (c) of this
   4-24  section.
   4-25        (b)  Every physician or health care provider who is a
    5-1  defendant in a health care liability claim shall within 45 days
    5-2  after the date on which an answer to the petition was due serve on
    5-3  the plaintiff's attorney or, if the plaintiff is not represented by
    5-4  an attorney, on the plaintiff full and complete answers to the
    5-5  appropriate standard set of interrogatories and complete responses
    5-6  to the standard set of requests for production of documents and
    5-7  things promulgated pursuant to Subsection (c) of this section.
    5-8        (c)  The chief justice of the Supreme Court of Texas shall
    5-9  within 30 days after the effective date of this Act appoint as
   5-10  members of the Health Care Liability Discovery Panel three persons
   5-11  from a list of attorneys to be submitted by a statewide association
   5-12  of attorneys whose members include persons who customarily
   5-13  represent patients in health care liability actions and three
   5-14  persons from a list of attorneys to be submitted by a statewide
   5-15  association whose members include persons who customarily represent
   5-16  defendants in health care liability actions.  Members of the Health
   5-17  Care Liability Discovery Panel serve without compensation.  On or
   5-18  before the 1st day of November, 1993, the Health Care Liability
   5-19  Discovery Panel shall promulgate standard sets of interrogatories
   5-20  and requests for production of documents and things appropriate for
   5-21  each of the categories of plaintiffs and defendants usually
   5-22  involved in health care liability claims.  In preparing standard
   5-23  sets of interrogatories  the Health Care Liability Discovery Panel
   5-24  shall not be restricted in number by any limit imposed under the
   5-25  Texas Rules of Civil Procedure.
    6-1        (d)  The Supreme Court of Texas shall review the standard
    6-2  sets of interrogatories and requests for production of documents
    6-3  and things promulgated by the Health Care Liability Discovery Panel
    6-4  and shall, no later than January 1, 1994, approve them in their
    6-5  entirety, disapprove them in their entirety, or approve them with
    6-6  modifications.  If the supreme court disapproves such standard sets
    6-7  of interrogatories and requests for production of documents and
    6-8  things in their entirety, then such standard sets shall be null and
    6-9  void and of no effect, and the Health Care Liability Discovery
   6-10  Panel shall be disbanded.  If the supreme court approves such
   6-11  standard sets of interrogatories and requests for production of
   6-12  documents and things with modifications, then the Health Care
   6-13  Liability Discovery Panel shall either approve or disapprove of
   6-14  such standard sets of interrogatories and requests for production
   6-15  of documents and things as modified by the supreme court by a vote
   6-16  of at least five of the six members of the panel.  If the
   6-17  modifications made by the supreme court fail to obtain the
   6-18  necessary vote for approval by the panel, then such standard sets
   6-19  of interrogatories and requests for production of documents and
   6-20  things shall be null and void and of no effect and the panel shall
   6-21  be disbanded.  If the panel approves of the modified standard sets
   6-22  of interrogatories and requests for production of documents and
   6-23  things, then the supreme court shall proceed to publish the
   6-24  standard sets in accordance with Subsection (e) of this section.
   6-25        (e)  As soon as practical after the approval of such standard
    7-1  sets of interrogatories and requests for production of documents
    7-2  and things by the Health Care Liability Discovery Panel and the
    7-3  Supreme Court of Texas, and in any event no later than February 1,
    7-4  1994, the supreme court shall publish such standard sets.
    7-5  Notwithstanding any other law, the supreme court shall not be
    7-6  required to publish such standard sets of interrogatories and
    7-7  requests for production of documents and things for public comment.
    7-8  Beginning on April 1, 1994, all plaintiffs and all physicians or
    7-9  health care providers who are defendants in a health care liability
   7-10  claim in which the plaintiff's original petition is filed on or
   7-11  after that date shall file full and complete answers and responses
   7-12  in accordance with Subsections (a) and (b) of this section.
   7-13        (f)  Nothing in this section shall limit or impede the
   7-14  Supreme Court of Texas in exercising its rulemaking authority
   7-15  pursuant to Sections 22.003 and 22.004, Government Code.
   7-16        (g)  Except on motion and for good cause shown, no objection
   7-17  may be asserted regarding any standard interrogatory or request for
   7-18  production of documents and things, but no response shall be
   7-19  required where a particular interrogatory or request is clearly
   7-20  inapplicable under the circumstances of the case.
   7-21        (h)  Failure to file full and complete answers and responses
   7-22  to standard interrogatories and requests for production of
   7-23  documents and things in accordance with Subsections (a) and (b) of
   7-24  this section or the making of a groundless objection under
   7-25  Subsection (g) of this section shall be grounds for sanctions by
    8-1  the court in accordance with the Texas Rules of Civil Procedure on
    8-2  motion of any party.
    8-3        (i)  The time limits imposed under Subsections (a) and (b) of
    8-4  this section may be extended by the court on the motion of a
    8-5  responding party for good cause shown and shall be extended if
    8-6  agreed in writing between the responding party and all opposing
    8-7  parties.  In no event shall an extension be for a period of more
    8-8  than an additional 30 days.
    8-9        (j)  If a party is added by an amended pleading,
   8-10  intervention, or otherwise, the new party shall file full and
   8-11  complete answers to the appropriate standard set of interrogatories
   8-12  and full and complete responses to the standard set of requests for
   8-13  production of documents and things no later than 45 days after the
   8-14  date of filing of the pleading by which the party first appeared in
   8-15  the action.
   8-16        (k)  If information or documents required to provide full and
   8-17  complete answers and responses as required by this section are not
   8-18  in the possession of the responding party or attorney when the
   8-19  answers or responses are filed, the party shall supplement the
   8-20  answers and responses in accordance with the Texas Rules of Civil
   8-21  Procedure.
   8-22        (l)  Nothing in this section shall preclude any party from
   8-23  taking additional non-duplicative discovery of any other party.
   8-24  The standard sets of interrogatories provided for in this section
   8-25  shall not constitute, as to each plaintiff and each physician or
    9-1  health care provider who is a defendant, the first of the two sets
    9-2  of interrogatories permitted under the Texas Rules of Civil
    9-3  Procedure.
    9-4        (m)  Notwithstanding any other provisions of this section, if
    9-5  a court of this state has, prior to the effective date of this
    9-6  section, signed an order in tort litigation in which cases have
    9-7  been consolidated for discovery, providing for standard sets of
    9-8  interrogatories and requests for production of documents and
    9-9  things, compliance with such an order shall be deemed to be
   9-10  compliance with the requirements of this section.
   9-11        SECTION 5.  The Medical Liability and Insurance Improvement
   9-12  Act of Texas (Article 4590i, Vernon's Texas Civil Statutes), is
   9-13  amended by adding Subchapter O to read as follows:
   9-14                 SUBCHAPTER O. ARBITRATION AGREEMENTS
   9-15        Sec. 15.01.  ARBITRATION AGREEMENTS.  (a)  No physician,
   9-16  professional association of physicians, or other health care
   9-17  provider shall request or require a patient or prospective patient
   9-18  to execute an agreement to arbitrate a health care liability claim
   9-19  unless the form of agreement delivered to the patient contains a
   9-20  written notice in 10-point boldface type clearly and conspicuously
   9-21  stating:
   9-22              UNDER TEXAS LAW, THIS AGREEMENT IS INVALID
   9-23              AND OF NO LEGAL EFFECT UNLESS IT IS ALSO
   9-24              SIGNED BY AN ATTORNEY OF YOUR OWN CHOOSING.
   9-25              THIS AGREEMENT CONTAINS A WAIVER OF
   10-1              IMPORTANT LEGAL RIGHTS, INCLUDING YOUR
   10-2              RIGHT TO A JURY TRIAL IN THE EVENT YOU FIND
   10-3              IT NECESSARY TO BRING A MALPRACTICE CASE
   10-4              AGAINST YOUR PHYSICIAN OR OTHER HEALTH CARE
   10-5              PROVIDER AS A RESULT OF MEDICAL NEGLIGENCE.
   10-6              YOU SHOULD NOT SIGN THIS AGREEMENT WITHOUT
   10-7              FIRST CONSULTING WITH AN ATTORNEY.
   10-8        (b)  A violation of this section by a physician or
   10-9  professional association of physicians constitutes a violation of
  10-10  the Medical Practice Act (Article 4495b, Vernon's Texas Civil
  10-11  Statutes), and shall be subject to the enforcement provisions and
  10-12  sanctions contained in Subchapter D of that Act.
  10-13        (c)  A violation of this section by a health care provider
  10-14  other than a physician shall constitute a false, misleading, or
  10-15  deceptive act or practice in the conduct of trade or commerce
  10-16  within the meaning of Section 17.46 of the Deceptive Trade
  10-17  Practices-Consumer Protection Act (Subchapter E, Chapter 17,
  10-18  Business & Commerce Code), and shall be subject to an enforcement
  10-19  action by the consumer protection division pursuant to said Act and
  10-20  subject to the penalties and remedies contained in Section 17.47 of
  10-21  that Act, notwithstanding Section 12.01 of this Act or any other
  10-22  law.
  10-23        (d)  Notwithstanding any other provision of this section, a
  10-24  person who is found to be in violation of this section for the
  10-25  first time shall be subject only to injunctive relief or other
   11-1  appropriate order requiring the person to cease and desist from
   11-2  such violation, and not to any other penalty or sanction.
   11-3        SECTION 6.  Section 4.01, Medical Liability and Insurance
   11-4  Improvement Act of Texas (Article 4590i, Vernon's Texas Civil
   11-5  Statutes), is amended by amending Subsection (d) and adding
   11-6  Subsections (e), (f), and (g) to read as follows:
   11-7        (d)  All parties shall be entitled to obtain complete and
   11-8  unaltered copies of the claimant's medical records from any other
   11-9  party within 21 <10> days from the date of receipt of a written
  11-10  request for such records; provided, however, that the receipt of a
  11-11  medical authorization executed by the claimant herein shall be
  11-12  considered compliance by the claimant with this section.  If a
  11-13  claimant on request refuses to provide complete and unaltered
  11-14  copies of the claimant's medical records and further refuses to
  11-15  provide a medical authorization executed by the claimant, then any
  11-16  party who thereafter shall obtain copies by other procedures
  11-17  available through the Texas Rules of Civil Procedure, including by
  11-18  subpoena, shall not be obligated to furnish copies of such medical
  11-19  records to claimant except on payment of a proportionate share of
  11-20  the reasonable court reporter and or records service fees and other
  11-21  reasonable expenses actually incurred by such other party, except
  11-22  on order of the court presiding over the action for good cause
  11-23  shown.
  11-24        (e)  If a claimant, physician, or health care provider
  11-25  receiving a properly executed request for medical records pursuant
   12-1  to this section fails to deliver all requested records actually in
   12-2  such person's possession to the requesting party within the time
   12-3  required in Subsection (d) of this section, then in any action to
   12-4  which the requesting person and the person who received the request
   12-5  are parties, the person who failed to timely deliver such records
   12-6  shall be responsible for paying court costs of the requesting
   12-7  person in an amount not to exceed $250 regardless of whether the
   12-8  requesting person prevails in the action, unless on motion and for
   12-9  good cause shown the court presiding over the action rules
  12-10  otherwise.
  12-11        (f)  For the purposes of this section, and notwithstanding
  12-12  Section 5.08, Medical Practices Act (Article 4495b, Vernon's Texas
  12-13  Civil Statutes), or any other law, a request for the medical
  12-14  records of a deceased person or a person who is incompetent shall
  12-15  be deemed to be valid if accompanied by an authorization signed by
  12-16  a parent, spouse, or adult child of the deceased or incompetent
  12-17  person.
  12-18        (g)  A physician or health care provider or an insurer or
  12-19  other representative of a physician or health care provider who
  12-20  receives medical records or a medical authorization of a patient as
  12-21  a result of a request pursuant to this section made prior to the
  12-22  filing of any action against the physician or other health care
  12-23  provider shall not seek or acquire any confidential information
  12-24  regarding such patient from other physicians or health care
  12-25  providers who have treated the patient without written
   13-1  authorization from the patient or the patient's representative
   13-2  expressly authorizing the other physician or health care provider
   13-3  to discuss the confidential information with the physician, health
   13-4  care provider, insurer, or other representative making the request
   13-5  for the confidential information.  In any action involving the
   13-6  health care liability claim in question, on a showing that a
   13-7  violation of this section has occurred, the court presiding over
   13-8  the action shall impose a sanction on the violating party in
   13-9  accordance with any rule of the Texas Rules of Civil Procedure
  13-10  relating to sanctions for violating discovery orders, including, at
  13-11  a minimum, taxing the violating party court costs incurred by the
  13-12  claimant, not to exceed $2,500, regardless of whether the claimant
  13-13  prevails in the action.
  13-14        SECTION 7.  Section 14.01, Medical Liability and Insurance
  13-15  Improvement Act of Texas (Article 4590i, Vernon's Texas Civil
  13-16  Statutes), is amended to read as follows:
  13-17        Sec. 14.01.  QUALIFICATION OF EXPERT WITNESS IN SUIT AGAINST
  13-18  PHYSICIAN.  (a)  In a suit involving a health care liability claim
  13-19  against a physician or health care provider for injury to or death
  13-20  of a patient, a person may qualify as an expert witness on the
  13-21  issue of whether the physician or health care provider departed
  13-22  from accepted standards of <medical> care only if:
  13-23              (1)  the person is practicing as a physician or a
  13-24  health care provider at the time such testimony is given or was
  13-25  practicing as a physician or a health care provider at the time the
   14-1  claim arose and has knowledge of accepted standards of <medical>
   14-2  care for the diagnosis, care, or treatment of the illness, injury,
   14-3  or condition involved in the claim; <or>
   14-4              (2)  the court, after a hearing conducted outside the
   14-5  presence of the jury, determines that the person is otherwise
   14-6  qualified to give expert testimony on said issue; or
   14-7              (3)  the issue about which the witness will give
   14-8  testimony involves administrative functions and the witness has
   14-9  knowledge of accepted standards of care even though the witness may
  14-10  not be a physician or health care provider.
  14-11        (b)  For the purpose of this section, "practicing" for
  14-12  physicians includes, but is not limited to, training residents or
  14-13  students at an accredited school of medicine or osteopathy or
  14-14  serving as a consulting physician to other physicians who provide
  14-15  direct patient care, upon the request of such other physicians,
  14-16  and, for other health care providers, "practicing" includes, but is
  14-17  not limited to, training students at an accredited school of health
  14-18  care through which the health care provider receives training or
  14-19  serving as a consulting health care provider to other similar
  14-20  health care providers who provide direct patient care, on the
  14-21  request of such other health care providers.
  14-22        SECTION 8.  Section 161.032, Health and Safety Code, is
  14-23  amended to read as follows:
  14-24        Sec. 161.032.  RECORDS AND PROCEEDINGS CONFIDENTIAL.
  14-25  (a)  The records and proceedings of a medical committee are
   15-1  confidential and are not subject to court subpoena.
   15-2        (b)  The records and proceedings may be used by the committee
   15-3  and the committee members only in the exercise of proper committee
   15-4  functions.
   15-5        (c)  This section and Section 5.06, Medical Practices Act
   15-6  (Article 4495b, Vernon's Texas Civil Statutes), do <does> not apply
   15-7  to:
   15-8              (1)  records made or maintained in the regular course
   15-9  of business by a hospital, health maintenance organization, medical
  15-10  organization, university medical center or health science center,
  15-11  or extended care facility;
  15-12              (2)  incident reports, accident reports,
  15-13  mortality/morbidity reports, witness statements, and other
  15-14  investigative records relating to the incident made the basis of
  15-15  the health care liability claim in question, unless prepared in
  15-16  anticipation of litigation after good cause exists to believe a
  15-17  suit will be filed;
  15-18              (3)  records regarding the granting, renewal,
  15-19  restriction, suspension, or termination of privileges of medical
  15-20  staff members; and
  15-21              (4)  any document reflecting the final decision or
  15-22  statement of basis of the decision, by agreement or otherwise, of
  15-23  any medical or nursing peer review committee involving a physician
  15-24  or health care provider who is a defendant in a health care
  15-25  liability claim.  The records enumerated in this subsection shall
   16-1  be discoverable and, to the extent permitted by the Texas Rules of
   16-2  Evidence, admissible in evidence in any health care liability
   16-3  claim, notwithstanding any other law, provided that nothing in this
   16-4  subsection requires the release of peer review committee minutes,
   16-5  hearing transcripts, or other records of the deliberative process
   16-6  of a medical or nursing peer review committee.
   16-7        SECTION 9.  Subsection (g), Section 5.08, (Article 4495b,
   16-8  Vernon's Texas Civil Statutes), is amended to read as follows:
   16-9        (g)  Exceptions to confidentiality or privilege in court or
  16-10  administrative proceedings exist:
  16-11              (1)  when the proceedings are brought by the patient
  16-12  against a physician, including but not limited to malpractice
  16-13  proceedings, and any criminal or license revocation proceeding in
  16-14  which the patient is a complaining witness and in which disclosure
  16-15  is relevant to the claims or defense of a physician;
  16-16              (2)  when the patient or someone authorized to act on
  16-17  his behalf submits a written consent to the release of any
  16-18  confidential information, as provided in Subsection (j) of this
  16-19  section;
  16-20              (3)  when the purpose of the proceedings is to
  16-21  substantiate and collect on a claim for medical services rendered
  16-22  to the patient;
  16-23              (4)  in any civil litigation or administrative
  16-24  proceeding, if relevant, brought by the patient or someone on the
  16-25  patient's <his> behalf, if the patient is attempting to recover
   17-1  monetary damages for any physical or mental condition, including
   17-2  the death of the patient, or, with the deletion of the patient's
   17-3  name and other identifying information, in any civil litigation or
   17-4  administrative proceeding, if relevant, brought by another person
   17-5  to recover monetary damages for any physical or mental injury or
   17-6  death.   Any information is discoverable in any court or
   17-7  administrative proceeding in this state if the court or
   17-8  administrative body has jurisdiction over the subject matter,
   17-9  pursuant to rules of procedure specified for the matters.  Nothing
  17-10  in this subsection shall prejudice the right of a health care
  17-11  provider or physician to request an appropriate protective order
  17-12  pursuant to the Texas Rules of Civil Procedure;
  17-13              (5)  in any disciplinary investigation or proceeding of
  17-14  a physician conducted under or pursuant to this Act, provided that
  17-15  the board shall protect the identity of any patient whose medical
  17-16  records are examined, except for those patients covered under
  17-17  Subdivision (1) of Subsection (g) of this section or those patients
  17-18  who have submitted written consent to the release of their medical
  17-19  records as provided by Subsection (j) of this section;
  17-20              (6)  in any criminal investigation of a physician in
  17-21  which the board is participating or assisting in the investigation
  17-22  or proceeding by providing certain medical records obtained from
  17-23  the physician, provided that the board shall protect the identity
  17-24  of any patient whose medical records are provided in the
  17-25  investigation or proceeding, except for those patients covered
   18-1  under Subdivision (1) of Subsection (g) of this section or those
   18-2  patients who have submitted written consent to the release of their
   18-3  medical records as provided by Subsection (j) of this section.
   18-4  This subsection does not authorize the release of any confidential
   18-5  information for the purpose of instigating or substantiating
   18-6  criminal charges against a patient;
   18-7              (7)  in an involuntary civil commitment proceeding,
   18-8  proceeding for court-ordered treatment, or probable cause hearing
   18-9  under:
  18-10                    (A)  the Texas Mental Health Code (Article 5547-1
  18-11  et seq., Vernon's Texas Civil Statutes);
  18-12                    (B)  the Mentally Retarded Persons Act of 1977
  18-13  (Article 5547-300, Vernon's Texas Civil Statutes);
  18-14                    (C)  Section 9, Chapter 411, Acts of the 53rd
  18-15  Legislature, Regular Session, 1953 (Article 5561c, Vernon's Texas
  18-16  Civil Statutes);
  18-17                    (D)  Section 2, Chapter 543, Acts of the 61st
  18-18  Legislature, Regular Session, 1969 (Article 5561c-1, Vernon's Texas
  18-19  Civil Statutes); or
  18-20              (8)  in any criminal prosecution where the patient is a
  18-21  victim, witness, or defendant.  Records are not discoverable until
  18-22  the court in which the prosecution is pending makes an in camera
  18-23  determination as to the relevancy of the records or communications
  18-24  or any portion thereof.  Such determination shall not constitute a
  18-25  determination as to the admissibility of such records or
   19-1  communications or any portion thereof.
   19-2        SECTION 10.  This Act takes effect immediately except that
   19-3  Sections 3, 4, 5, 6, 7, 8, and 9 take effect on September 1, 1993.
   19-4        SECTION 11.  The importance of this legislation and the
   19-5  crowded condition of the calendars in both houses create an
   19-6  emergency and an imperative public necessity that the
   19-7  constitutional rule requiring bills to be read on three several
   19-8  days in each house be suspended, and this rule is hereby suspended,
   19-9  and that this Act take effect and be in force according to its
  19-10  terms, and it is so enacted.