BILL ANALYSIS
S.B. 548
By: Madla
Health and Human Services
03-15-95
Committee Report (Amended)
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,
V.T.C.S.), authorizes 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
As proposed, S.B. 548 sets forth confidentiality and privilege
requirements relating to the regulation of podiatry and authorizes
a podiatrist to provide services for certain health organizations
authorized under Section 5.01, Medical Practice Act.
RULEMAKING AUTHORITY
It is the committee's opinion that this bill does not grant any
additional rulemaking authority to a state officer, institution, or
agency.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Chapter 11, Title 71, V.T.C.S., by adding
Article 4575d, as follows:
Art. 4575d. CONFIDENTIALITY AND PRIVILEGE REQUIREMENTS
Sec. 1. Defines "patient" and "podiatric record."
Sec. 2. (a) Makes confidential, privileged, and not to be
disclosed except as provided by this article a communication,
relating to podiatric services, between a podiatrist and a
patient.
(b) Makes confidential, privileged, and not to be disclosed
except as provided by this article records of a podiatrist
concerning the identity, diagnosis, evaluation, or treatment
of a patient.
(c) Prohibits a person, other than one listed under Section
5 or 6 of this Article, from disclosing confidential
information beyond the extent to which disclosure is
consistent with the authorized purposes of its obtainment.
(d) Makes the prohibitions of this section continually
applicable irrespective of when the patient received the
services.
Sec. 3. (a) Authorizes the privilege of confidentiality to be
claimed by the patient or a podiatrist acting on the patient's
behalf.
(b) Authorizes the podiatrist to claim the privilege of
confidentiality only on behalf of the patient. Provides
that the authority to claim the privilege is presumed in the
absence of contrary evidence.
Sec. 4. (a) Provides that an exception to the confidentiality
and privilege requirements exists in a court or administrative
proceeding if the proceeding is brought by the patient against
a podiatrist, the patient or person authorized to act on the
patient's behalf submits a written consent to the release of
confidential information, or the purpose of the proceeding is
to substantiate and collect on a claim for services.
(b) Provides that an exception to the confidentiality and
privilege requirements exists in a civil litigation or
administrative proceeding brought on the patient's behalf if
the plaintiff is attempting to recover monetary damages for
any physical or mental condition, including the patient's
death. Makes information discoverable in a court or
administrative proceeding if the information is relevant to
the proceeding and the court or administrative body has
jurisdiction over the subject matter.
(c) Provides that an exception to the confidentiality and
privilege requirements exists in a disciplinary
investigation or proceeding conducted against a podiatrist
under this chapter. Requires the Texas State Board of
Podiatry Examiners (board) to protect the identity of any
patient except those covered under Subsection (a)(1) or
those who have submitted written consent to the release of
their records.
(d) Provides that an exception to the confidentiality and
privilege requirements exists in a criminal investigation
of, or criminal proceeding against, a podiatrist in which
the board is providing records obtained from the podiatrist.
Requires the board to protect the identity of any patient,
except those covered under Subsection (a)(1) or those who
have submitted written consent to the release of their
records.
(e) Provides that an exception to the confidentiality or
privilege requirements exists in a criminal prosecution in
which the patient is a victim, witness, or defendant.
Provides that records or communications are not discoverable
until the court makes an in camera determination as to their
relevancy.
Sec. 5. (a) Provides that an exception to the confidentiality
or privilege requirements exists only for, and authorizes
disclosure of confidential information by a podiatrist only to
a governmental agency or to medical or law enforcement
personnel under specific circumstances.
(b) Prohibits a person who receives information under
Subsection (a)(3) from disclosing a patient's identity
directly or indirectly.
(c) Authorizes records reflecting charges and services
rendered to be disclosed only when necessary in the
collection of fees for services.
(d) Authorizes confidential information other than that
which identifies a patient or client, unless the patient
gives consent to release the information, to be disclosed in
an official legislative inquiry regarding a state hospital
or state school.
Sec. 6. (a) Sets forth the parties required to grant consent
for the release of confidential information.
(b) Sets forth the required specifications of the written
consent.
(c) Gives the patient or other person authorized to consent
the right to withdraw the consent. Provides that the
withdrawal of consent does not affect information disclosed
before the written notice of withdrawal.
Sec. 7. Authorizes the person who receives confidential
information to disclose the information only to the extent
consistent with the authorized purposes for which consent was
obtained.
Sec. 8. (a) Requires the podiatrist to furnish copies,
summaries, or narratives of records requested under a written
consent unless the podiatrist determines that access to the
information would be harmful to the physical, mental, or
emotional health of the patient. Authorizes the podiatrist to
delete confidential information about another person who has
not consented to the release.
(b) Requires the podiatrist to furnish the information
within a reasonable period of time and requires the patient
or another person acting on the patient's behalf to pay
reasonable fees for furnishing the information.
SECTION 2. Amends Chapter 11, Title 71, V.T.C.S., by adding Article
4576, as follows:
Art. 4576. PODIATRY SERVICES FOR CERTAIN HEALTH
ORGANIZATIONS. Authorizes a licensed podiatrist to contract
with a health organization approved by the Texas State Board
of Medical Examiners under Section 5.01, Medical Practice Act
(Article 4495b, V.T.C.S.), to provide podiatry services on its
behalf.
SECTION 3. Makes application of this Act prospective.
SECTION 4. Effective date: September 1, 1995.
SECTION 5. Emergency clause.