BILL ANALYSIS S.B. 548 By: Madla (S. Turner) 04-25-95 Committee Report (Unamended) BACKGROUND Persons who practice podiatry in Texas are required to be licensed by the Texas State Board of Podiatry Examiners. However, the laws regulating the practice of podiatry do not provide for the confidentiality of podiatric patient records or communications between podiatrist and patient. In addition, Section 5.01, Medical Practice Act (Article 4495b, Vernon's Texas Civil Statutes), allows the approval of health organizations formed solely by persons licensed by the Texas State Board of Medical Examiners; however, current law does not authorize podiatrists to provide podiatry services on behalf of such health organizations. PURPOSE S.B. 548 provides that podiatric patient records and communications between a podiatrist and a patient are confidential and privileged unless otherwise specified in this Act, and that podiatrists may provide podiatry services on behalf of a health organization approved by the Texas State Board of Medical Examiners. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. Adds Article 4575d, "CONFIDENTIALITY AND PRIVILEGE REQUIREMENTS," to Chapter 11, Title 71 of the Revised Statutes as follows: Sec. 1. Defines patient and podiatric record. Sec. 2. Provides that (a) communication between a podiatrist and a patient and (b) the patient's records are confidential and privileged except as provided by this Article. Subsection (c) sets conditions on the authorized disclosure of patient information, and (d) establishes that the prohibitions of this Section apply regardless of when the patient received the services. Sec. 3. Allows a patient or a podiatrist acting on behalf of a patient to claim the privilege of confidentiality, and this authority is presumed in absence of evidence to the contrary. Sec. 4. Provides exceptions to the confidentiality and privilege requirements as follows: (a) An exemption exists in a court or administrative proceeding if the action is brought by the patient against the podiatrist, the patient or another authorized person submits written consent on behalf of the patient, or if the action is brought to collect on a claim for podiatric services. (b) An exemption is granted in a civil litigation or administrative proceeding brought on behalf of a patient if the plaintiff is attempting to recover monetary damages. States that the information is discoverable if relevant to the proceeding and if under the applicable state rules of procedure. (c) In a disciplinary investigation or proceeding against a podiatrist, during which the identity of the patient will be protected by the Texas State Board of Podiatry Examiners, unless otherwise specified in this subsection. (d) In a criminal proceeding against or criminal investigation of a podiatrist in which the Texas State Board of Podiatry Examiners is participating by providing the records of the patient. The Board is required to protect the identity of the patient unless otherwise specified in Subsection (a)(1) of this section, and this subsection does not authorize the release of confidential information for criminal charges against a patient. (e) In a criminal prosecution in which the patient is a victim, witness or defendant. The relevancy of the records or communications must be determined by an in camera determination. The ruling on relevancy does not constitute a determination of admissibility. Sec. 5. Specifies that other than Section 4 of this Article, an exception to the confidentiality or privilege requirements exists only for certain persons under specified conditions listed in this section, and a person receiving information for audit or research purposes may not disclose the patient's identity in any way. Records reflecting charges and services rendered may only be disclosed for the collection of fees for services provided. Confidential information other than the identity of the patient, unless consented to by the patient, may not be disclosed in an official legislative inquiry regarding a state school or state hospital. Sec. 6. Requires the consent for the release of the confidential information to be made in writing and signed by the persons listed in this section, and the written consent must specify the information and records to be released, the reasons for and the person to whom the information will be released. The patient or other authorized person can withdraw the consent, but this does not affect the information disclosed before the withdrawal. Sec. 7. Allows a person who receives confidential information to disclose this to others only for the authorized purposes under which the consent was obtained. Sec. 8. Requires a podiatrist to release records or summaries of records when written consent is made, in accordance with Sec. 6, unless the podiatrist determines that access as harmful to the patient. Allows the podiatrist to delete confidential information about another person who has not consented to the release. Requires the information to be released within a reasonable period of time, and requires the patient or person on the patient's behalf to pay reasonable fees for the information. SECTION 2. Adds Article 4576, "PODIATRY SERVICES FOR CERTAIN HEALTH ORGANIZATIONS," to Chapter 11, Title 71 of the Revised Statutes, allowing a licensed podiatrist to contract with a health organization approved by the Texas State Board of Medical Examiners under Section 5.01 of the Medical Practices Act (Article 4495b of Vernon's Texas Civil Statutes) to provide podiatry services on its behalf. SECTION 3. Establishes that this Act applies only to those podiatric records and information released after the effective date. SECTION 4. Effective date: September 1, 1995. SECTION 5. Emergency clause. SUMMARY OF COMMITTEE ACTION S.B. 548 was considered by the Public Health Committee in a public hearing on April 25, 1995. The bill was reported favorably without amendment, with the recommendation that it do pass and be printed, by a record vote of 6 AYES, 0 NAYS, 0 PNV, and 3 ABSENT.